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Type 2 Diabetes – Causes, Symptoms and Treatment
Type 2 diabetes is a chronic metabolic disease in which the body can no longer use insulin effectively, leading to persistently elevated blood sugar levels.
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Type 2 diabetes is a chronic metabolic disease in which the body can no longer use insulin effectively, leading to persistently elevated blood sugar levels.
What Is Type 2 Diabetes?
Type 2 diabetes mellitus is a chronic metabolic condition in which the body's cells no longer respond adequately to the hormone insulin – a state known as insulin resistance. Insulin is produced by the pancreas and enables glucose (sugar) to move from the bloodstream into cells, where it is used for energy. In type 2 diabetes, this process is impaired, causing blood glucose levels to remain persistently elevated, a condition known as hyperglycemia. Type 2 diabetes is the most common form of diabetes and affects hundreds of millions of people worldwide.
Causes and Risk Factors
The development of type 2 diabetes is multifactorial, meaning that several factors contribute to its onset:
- Overweight and obesity: Excess body fat, especially around the abdomen, significantly promotes insulin resistance.
- Physical inactivity: A sedentary lifestyle reduces the sensitivity of muscle cells to insulin.
- Unhealthy diet: A diet high in sugar, saturated fats, and low in fiber increases the risk of developing the disease.
- Genetic predisposition: A family history of diabetes considerably raises an individual's risk.
- Age: Risk increases after the age of 45, although the disease is increasingly observed in younger people as well.
- High blood pressure and lipid disorders: These conditions frequently co-occur with type 2 diabetes.
- Sleep deprivation and chronic stress: Both can negatively affect blood glucose regulation.
Symptoms
Type 2 diabetes often develops gradually over many years and may go unnoticed for a long time. Common symptoms include:
- Frequent urination (polyuria)
- Excessive thirst (polydipsia)
- Persistent fatigue and lack of energy
- Blurred vision
- Slow wound healing
- Frequent infections (e.g., urinary tract or skin infections)
- Tingling or numbness in the hands and feet (peripheral neuropathy)
Many people are unaware they have the condition, which makes regular screening examinations particularly important.
Diagnosis
Type 2 diabetes is diagnosed through blood tests. The following tests are commonly used:
- Fasting blood glucose: A level of 126 mg/dL (7.0 mmol/L) or higher after at least 8 hours of fasting is considered diagnostic.
- HbA1c (glycated hemoglobin): A value of 6.5% or higher indicates diabetes. It reflects average blood glucose levels over the previous 2–3 months.
- Oral glucose tolerance test (OGTT): Blood glucose is measured 2 hours after drinking a glucose solution. A result of 200 mg/dL or above is diagnostic.
Treatment
Lifestyle Modifications
Lifestyle changes form the cornerstone of type 2 diabetes management:
- Weight loss: Even modest weight reduction can significantly improve insulin sensitivity.
- Regular physical activity: At least 150 minutes of moderate-intensity exercise per week (e.g., walking, cycling, swimming) is recommended.
- Balanced diet: Emphasis on whole grains, vegetables, legumes, and healthy fats, with reduced intake of sugar and processed foods.
Medication
When lifestyle changes alone are insufficient, medications are prescribed:
- Metformin: The first-line medication that improves insulin action in the liver.
- SGLT-2 inhibitors (e.g., empagliflozin): Lower blood glucose through the kidneys and have proven cardiovascular protective effects.
- GLP-1 receptor agonists (e.g., semaglutide): Stimulate insulin secretion and support weight loss.
- Sulfonylureas, DPP-4 inhibitors, and other drug classes may also be used depending on individual needs.
- Insulin therapy: Required in advanced stages or when other medications are no longer sufficient.
Long-Term Complications
Inadequately controlled diabetes can lead to serious complications, including:
- Heart disease and stroke (cardiovascular disease)
- Kidney damage (diabetic nephropathy)
- Nerve damage (diabetic neuropathy)
- Eye damage and potential blindness (diabetic retinopathy)
- Diabetic foot syndrome and amputations
Prevention
In many cases, type 2 diabetes can be prevented or significantly delayed through a healthy lifestyle. Maintaining a balanced diet, engaging in regular physical activity, and avoiding excess weight are the most effective preventive measures.
References
- World Health Organization (WHO) – Diabetes Fact Sheet (2023). Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes
- American Diabetes Association – Standards of Medical Care in Diabetes 2024. Diabetes Care, 47(Suppl 1), S1–S321.
- International Diabetes Federation (IDF) – IDF Diabetes Atlas, 10th Edition (2021). Available at: https://www.diabetesatlas.org
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