Type 2 Diabetes - Risks, Signs, and Symptoms
November is National Diabetes Month, in which there is an effort to bring attention to diabetes. In 2021, the focus is on prediabetes and preventing diabetes.
And while increasing awareness of many chronic health issues, including diabetes, is something I do year-round in my work, I want to highlight some of that information here.
World Diabetes Day is held on November 14th each year to commemorate the birthday of Sir Frederick Banting, who co-discovered insulin in 1922.
In my opinion, the discovery of insulin in 1922 to treat people with diabetes is one of the more amazing medical advancements in the past 100 years. The other four include the discovery and development of antibiotics in 1928, organ transplants, the advancement of cancer treatment, and, of course, the development of medications to treat migraines round out my top five.
Diabetes is one of the top ten leading causes of death in the U.S. However, people don’t realize that very often, people with diabetes often have heart disease as well and die not from diabetes but complications from heart disease. Heart disease is the number one cause of death in both men and women in the U.S. and has been for decades.
Insulin is a medication primarily used for type 1 diabetes but sometimes is used for people with type 2 diabetes.
Because the focus in 2021 for National Diabetes Month is on prediabetes and preventing diabetes, this article won’t cover type 1 diabetes because type 1 diabetes is an autoimmune disease, and lifestyle factors do not change the risk of getting it. Type 1 also only makes up about 5% of all cases of diabetes.
Type 2 Diabetes and Prediabetes
Now, type 2 diabetes is the most common form of diabetes, making up 90-95% of all cases. Because of this, this article focuses on type 2 diabetes only.
With type 2 diabetes, the body can still make insulin; it doesn’t use it properly. People may or may not need insulin. People may often manage it with lifestyle or other types of medication (not insulin). A person may have diabetes for years without knowing.
Some may recall type 2 diabetes was called adult-onset diabetes or non-insulin-dependent diabetes (NIDDM). But this is no longer accurate because children can get type 2 diabetes, and some people with type 2 diabetes may need insulin.
Today, we now know about prediabetes. Prediabetes is a serious health condition with higher blood sugar levels than expected, but not high enough to be diagnosed with type 2 diabetes. However, it does increase the risk of developing type 2 diabetes, heart disease, and stroke.
But it is essential to know that prediabetes isn’t diabetes YET. We can reverse it. It can be stopped – or at least delayed.
Approximately 88 million American adults—more than 1 in 3—have prediabetes. Yet, of those with prediabetes, more than 84% don’t know they have it.
Prediabetes can exist for years but have no apparent symptoms and often goes undetected until serious health problems such as type 2 diabetes (and complications) show up.
Then, How Do You Know? Get Tested!
Getting tested requires a blood test. It could be a simple finger stick to test your capillary blood sugar, but that would be a screening and would still need additional blood tests.
The preferred method is a hemoglobin A1C (HgbA1c) or sometimes just referred to as A1c. The results are listed as a percentage and show the average blood sugar for two to three months.
Diabetes is diagnosed with an A1c at >6.5%
Prediabetes is diagnosed at 5.7% to 6.4%.
At 5.6% or below, no issue.
Another testing for diabetes and prediabetes is fasting plasma glucose (FPG), in which there is a blood draw after fasting for at least 8 hours – more often 12 hours.
Diabetes is diagnosed at >126 mg/dl
Prediabetes is diagnosed at 100 mg/dl – 125 mg/dl.
However, because this is just a result at that moment, a single blood draw would not be a diagnosis. It would need confirmation with a second test to be sure. This “snapshot” is partly why the HgbA1c is preferred since it would not need a second test to confirm.
People should get screened regularly (every 1-2 years), especially if there are any risk factors.
What are the risk factors?
Risk factors fall into two major categories: modifiable and non-modifiable, meaning that risk can or cannot be changed.
Non-modifiable risk includes:
Being 45 years or older (the older we get, the higher the risk)
Having a first-degree relative with type 2 diabetes (parent or sibling)
Ever having gestational diabetes or giving birth to a baby who weighed >9 pounds
Having PCOS
Persons of African American, American Indian, some Asian American, Hispanic/Latino American, and Pacific Islander descent
Modifiable risks include:
Being overweight (BMI >25)
Being physically active less than three times a week
Other risks include:
Having high blood pressure or taking medication to treat high blood pressure
Having low HDL cholesterol and/or high triglycerides.
Signs and Symptoms
What makes things challenging with type 2 diabetes is that there are no clear signs or symptoms. However, they exist and can be mild and often be ignored or explained by other things in life.
Symptoms include:
Increased thirst
Frequent urination
Increased hunger
Unintended weight loss
Fatigue
Blurred vision
Slow-healing sores
Frequent infections
Numbness or tingling in the hands or feet
Areas of darkened skin, usually in the armpits and neck (called acanthosis nigricans)
If these are ignored or go too long with about being addressed, there is an increased risk of:
Nerve damage, including in the feet and kidneys
Skin infections
Eye problems including blindness
Heart disease as well as increased risk for high blood pressure and stroke
What Can You Do?
Someone with prediabetes can stop the progression to type 2 with interventions, and moderate lifestyle changes can help return blood sugar levels to a normal range and preventing or delay type 2 diabetes.
The critical part is making and KEEPING healthier lifestyle habits through food choices and physical activity.
Even small changes can have a significant impact on delaying or preventing diabetes altogether.
These include:
Calorie reduction
Increased physical activity to at least 150 minutes per week.
Weight loss of 5 to 7 percent of body weight
Calorie reductio is not just about cutting things OUT. I always encourage people to ADD items – such as vegetables, fruit, plant-based protein food, healthy cuts of animal protein, and appropriate water/fluid intake. They can also reduce overall portion sizes and minimize added sugars, refined grains, and overly processed foods.
Research has shown that weight loss of 5 to 7 percent of body weight reduces the risk of type 2 diabetes by 58% in adults at high risk for the disease. This weight loss is for people with weight in the classification of overweight/obesity. This weight loss represents a drop of 10-14 pounds for 200 pounds and 7-11 pounds for 150 pounds.
There is NOT a specific diet to follow. Patterns and portions are the crucial components for weight loss and balancing the plate/meal with HALF being non-starchy vegetables, a QUARTER with (non-fried) protein foods, and a QUARTER with carbohydrate-rich foods. Choosing water or other no-calorie fluids is best, especially when choosing over sugar-sweetened beverages.
And then eating at regular intervals, approximately every 4 hours, and ensuring there is a protein food with each eating episode.
Are you feeling overwhelmed? If you have newly diagnosed diabetes, find an endocrinologist who has a dietitian and Certified Diabetes Care and Education Specialist (CDCES) on board.
If you are at risk, get tested at your next physical and discuss your risks with your health care provider.
Even if you have low risk, you should get tested as part of your routine blood work.
Note: Discuss your risks, signs, and symptoms, and any testing and results with a qualified health care professional individually, and don’t just go by what you read on the internet. While I am a qualified health care professional, I would want to discuss your specific situation and results individually. You need to ensure you have information that applies to you specifically.
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