Type 2 diabetes: What you should know

Learn about diabetes and how you can avoid getting it by HealthTap Chief Medical Officer, Geoffrey Rutledge, MD.

The bad news first: Diabetes is one of the leading causes of death in the United States.

Now, the good news: It’s also one of the most preventable, and can be managed effectively with the right care.

Diabetes affects more than 34 million Americans — about 10 percent of the population. Most of those cases are type 2, and it’s a condition that usually affects older people.

But not always. More and more young people, teenagers, and even children in the United States are being diagnosed as prediabetic or type 2 diabetic.

We’ve put together this helpful guide to answer some of the most common questions about type 2 diabetes.

What is type 2 diabetes?

To understand type 2 diabetes, it’s helpful to understand how your body creates energy.

Most of the food you eat contains some sort of sugar (natural or added sugar), also called glucose. Once it’s absorbed into your body, your pancreas secretes a hormone called insulin. Insulin essentially acts like a doorman for your blood cells: it “unlocks” the cells so the glucose can get in, at which point your body converts it into energy. When you add more sugar to your diet, your pancreas secretes more insulin. 

Sometimes, people who consume high levels of sugar — consistently, over time — develop insulin resistance. The amount of sugar in their bodies becomes greater than their pancreas’ ability to produce insulin, and their blood sugar rises as a result.

This is what can lead to prediabetes and type 2 diabetes.

What is prediabetes?

If your blood sugar is higher than what’s considered normal but not yet high enough to be type 2 diabetes, it’s defined as prediabetes. 

How is type 2 diabetes different from type 1 diabetes?

Most people who have type 1 diabetes are born with it but it may develop later in life. Type 1 diabetes is an autoimmune condition that causes people’s bodies to stop making insulin entirely.

It’s not entirely clear why type 1 diabetes happens, and unlike type 2, it’s not preventable.

What about gestational diabetes?

Pregnant women sometimes develop gestational diabetes. This happens when the placenta secretes a hormone that makes insulin less effective. Blood sugar builds up in the bloodstream as a result.

It’s not clear why gestational diabetes happens. Less than 10 percent of pregnant women in the U.S. experience it, and it usually goes away after birth.  

Side effects of diabetes

When blood glucose levels are above normal levels over a long period of time, as they are in people with diabetes, serious and life-threatening complications can occur:

• Nerve damage.
• Eye damage.
• Kidney damage.
• Heart disease.
• Loss of vision.

These are just a few of the possible complications, and they can lead to other related problems. Studies have found that people with diabetes may be more likely to develop other medical conditions such as depression or Alzheimer’s disease.   

What causes type 2 diabetes?

As we outlined above, type 2 diabetes happens when the amount of sugar in someone’s body is greater than the amount of insulin they can produce.

Exactly how that happens can depend on several things. Some of the risk factors associated with type 2 diabetes include:

• Having prediabetes.
• Being overweight.
• Having an immediate family member (parent or sibling) with type 2 diabetes.
• Being 45 years old or older (type 2 diabetes tends to affect older people, but not exclusively).
• Having had gestational diabetes or a baby who weighed more than nine pounds. 

Certain ethnic groups are also at greater risk to develop type 2 diabetes, including Black  Americans, Latina/o Americans, Native Americans, and Alaska Natives, as well as some Pacific Islanders and Asian Americans.

Type 2 diabetes symptoms

A lot of people don’t experience any symptoms of diabetes. That’s one reason why it’s important to have regular check-ups with your doctor.

That said, there are some symptoms that may lead a doctor to want to investigate further:

• Frequent urination.
• Feeling thirsty and/or hungry.
• Unexplained weight loss.
• Blurry vision.
• Numb or tingly hands and feet.
• Feeling tired.
• Dry skin.
• Sores that heal slowly.
• More infections than usual.

Getting tested

The only way to confirm type 2 diabetes is with a blood test.

There are a few different tests that a doctor may use:

• Fasting plasma glucose test — Taken after an eight-hour fast.

• Random plasma glucose test — Taken any time.

• A1c test — Taken any time; it shows your blood-glucose levels over several months.

• Oral glucose test — A multi-step test taken first after an eight-hour fast, then in three one-hour intervals after you’ve had a sugary drink in the lab.

If a HealthTap doctor determines that it’s medically necessary, they can order any of these tests. Taking one would require traveling to an in-person lab or clinic. Schedule an appointment with your doctor if you have questions about being tested.

Prevention

Even for groups who are genetically more likely to develop type 2 diabetes, there are many lifestyle choices that can be made to help prevent it from happening.

Maintain a healthy weight

One of the best ways to avoid prediabetes or type 2 diabetes is to keep your weight in check. A “healthy weight” is different for everyone. If you’re not sure if you’re in a healthy range, talk to your doctor.

Also, be aware that weight isn’t everything. Someone who is overweight isn’t necessarily at risk for type 2 diabetes, just as someone who’s at a healthy weight can still be at risk.     

Exercise regularly

Regular aerobic exercise and resistance training (e.g. weight lifting, yoga, bodyweight exercises) may help ward off insulin resistance and therefore reduce the risk of developing diabetes. 

It’s a good idea for most people to aim to exercise most days of the week for at least 30 minutes per day. But for people with mobility issues or a history of injuries, it’s best to consult with a doctor first on what forms of exercise might be safest.

In addition to exercise, it’s helpful to come at this from the opposite angle: Reduce sedentary activity. Many of us work desk jobs that keep us off our feet for large swaths of the day. We could all benefit from more breaks where we’re up and moving around. 

Eat a balanced diet    

Healthy eating is a major factor in the prevention and treatment of type 2 diabetes. 

What to eat (and what not to) is incredibly subjective. What’s right for one person can be completely wrong for another. But as a general starting point, the advice we’ve all heard for years still stands — eat more vegetables and fewer processed and packaged foods.

For people who have been diagnosed as prediabetic or with type 2 diabetes, their doctor may recommend a low-fat, low-glycemic diet.

Managing and treating type 2 diabetes

A type 2 diabetes diagnosis will undoubtedly change a person’s life. But compared to other serious health conditions, it’s incredibly manageable. In fact, most people manage the condition on their own and get support from periodic check-ins with their doctor.

A diabetes management plan will look different for everyone, but could include one or more of the following:

• Weight management, diet, and exercise ⁠
  ⁠Just like we outlined above in the Prevention section. 
• Monitoring blood sugar ⁠
  ⁠This is done with special equipment like a blood sugar meter and testing strips.
• Taking insulin  ⁠
  ⁠This can be done with a syringe, a pen, or a pump.
• Taking other medication ⁠
  ⁠A doctor may recommend other prescription medication to help manage diabetes.

There is no cure for type 2 diabetes.

But the right treatment plan and diligent adherence to that plan can effectively bring the condition under control for many people.

HealthTap can help

Regardless of whether you’re concerned about symptoms, or if you’ve been diagnosed with prediabetes or type 2 diabetes, HealthTap doctors can help. We can:

• Order labs and tests to determine if you have prediabetes or type 2 diabetes.
• Recommend a prevention or management plan that’s right for you.
• Prescribe medication and send it to your nearest pharmacy.
• Check in with you regularly — including free, post-visit follow-up text messages — to make sure your plan is on track.

Talk to your doctor or sign up for HealthTap today to get started.

“Having diabetes 25 years, upon using HealthTap, I was able to get the most help I've ever been able to out of all the doctors I've seen. ... [They were] super nice, actually took the time to listen to my health history and concerns, and [I] still could see them "face to face" over the phone.”

— HealthTap customer testimonial