Type 2 diabetes: what it is, who gets it and how it is managed

Type 2 diabetes is the most common type of diabetes. It often develops slowly and quietly, which is why many people do not realise they have it. Here is what major health agencies say about how it happens and how it is managed.

What is type 2 diabetes?

The NIDDK explains that in type 2 diabetes, blood sugar becomes too high because the body does not make enough insulin or does not use it well. Insulin helps glucose enter the cells for energy, so when it is not working properly, glucose stays in the blood. The WHO adds that type 2 accounts for more than 95% of diabetes worldwide and is often preventable. It used to be called adult-onset diabetes, but the WHO notes it is increasingly seen in children.

Who is more likely to get it?

The NIDDK says type 2 diabetes can occur at any age but is most common in middle-aged and older adults. It lists these higher-risk factors:

• Being 45 or older
• A family history of diabetes
• Being overweight or having obesity
• Physical inactivity
• High blood pressure
• Prediabetes
• Having had gestational diabetes

The NIDDK also notes it is more common among African American, Hispanic/Latino, American Indian, Asian American and Pacific Islander people. Risk factors also include smoking and a history of gestational diabetes, according to the NIDDK. The NIDDK names overweight, inactivity, insulin resistance and genes as causes, and states that the exact cause is not fully known.

Symptoms

Symptoms can include more thirst, more urination, hunger, tiredness, blurred vision, tingling or numbness in the hands or feet, sores that do not heal, and unexplained weight loss. According to the NIDDK, symptoms often develop over several years and can be mild, and many people have none.

How is it diagnosed?

A health care professional diagnoses type 2 diabetes with blood tests. The NIDDK gives these examples: an A1C result of 6.5% or higher, a fasting glucose of 126 mg/dL or higher, or a 2-hour result of 200 mg/dL or higher on an oral glucose tolerance test. Doctors usually use a second test to confirm. Home glucose meters cannot diagnose diabetes.

How is it managed?

Your doctor decides the plan. The NIDDK describes these general parts of care:

• Keeping blood glucose, blood pressure and cholesterol under control, and quitting smoking
• Healthy meal planning and staying physically active
• Taking prescribed medicines, which may be pills or injections such as insulin
• Working with a health care team to build a care plan

The NIDDK says some people need more than one medicine over time, and that insulin may sometimes be needed for a short period, for example during pregnancy or a hospital stay.

Possible complications

Over time, high blood sugar can affect the heart, nerves, kidneys, eyes, feet and gums, the NIDDK says. Good management can help prevent or delay these problems.

Prevention

The NIDDK says losing 5% to 7% of body weight may prevent or delay type 2 diabetes. It also suggests at least 30 minutes of physical activity on at least 5 days a week, smaller food portions and choosing water over sweetened drinks.

When to see a doctor

Ask a doctor about testing if you have risk factors or symptoms. Seek urgent help for severe symptoms such as trouble breathing, confusion, fainting, or stomach pain with vomiting.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your own doctor.