Type 2 Diabetes

An Overview of Type 2 Diabetes

Diabetes is a progressive, chronic disease related to your body's challenges with regulating blood sugar. It is often associated with generalized inflammation. Your pancreas produces the hormone insulin to convert sugar (glucose) to energy that you either use immediately or store. With type 2 diabetes, you are unable to use that insulin efficiently. Although your body produces the hormone, either there isn't enough of it to keep up with the amount of glucose in your system, or the insulin being produced isn't being used as well as it should be, both of which result in high blood sugar levels.

While this can produce different types of complications, good blood sugar control efforts can help to prevent them. This relies heavily on lifestyle modifications such as weight loss, dietary changes, exercise and, in some cases, medication. But, depending on your age, weight, blood sugar level, and how long you've had diabetes, you may not need a prescription right away. Treatment must be tailored to you and, though finding the perfect combination may take a little time, it can help you live a healthy, normal life with diabetes.

What Causes of Type 2 Diabetes?

Type 2 diabetes is most common is those who are genetically predisposed and who are overweight, lead a sedentary lifestyle, have high blood pressure, and/or have insulin resistance due to excess weight. People of certain ethnicities are more likely to develop diabetes, too. These include: African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders, and Asian Americans. These populations are more likely to be overweight and have high blood pressure, which increases the risk of developing diabetes.

As you age, you are also at increased risk of developing diabetes.

A poor diet and smoking can also affect your risk.

What Are the Complications of Type 2 Diabetes? 

There are many complications of diabetes. Knowing and understanding the signs of these complications is important. If caught early, some of these complications can be treated and prevented from getting worse. The best way to prevent complications of diabetes is to keep your blood sugars in good control. High glucose levels produce changes in the blood vessels themselves, as well as in blood cells (primarily erythrocytes) that impair blood flow to various organs.

Complications of diabetes are broken into two categories: microvascular (damage to the small blood vessels) and macrovascular (damage to the large blood vessels). They can include:

  • Kidney disease (nephropathy)
  • Nerve damage (neuropathy), which is most common in the feet and hands, but can also cause erectile dysfunction
  • Eye disease (retinopathy)
  • Peripheral arterial disease (a disease that affects the vessels in the lower and upper extremities)

What Are the Symptoms of Type 2 Diabetes?

Often people don't experience symptoms of diabetes until their blood sugars are very high. Symptoms of diabetes include: increased thirst, increased urination, increased hunger, extreme fatigues, numbness and tingling in the extremities (hands and feet), cuts and wounds that are slow to heal, and blurred vision. Some people also experience other less common symptoms including weight loss, dry itchy skin, increased yeast infections, erectile dysfunction, and acanthosis nigricans (thick, "velvety" patches found in the folds or creases of skin, such as the neck, that is indicative of insulin resistance). 

If you are experiencing any of these symptoms, don't ignore them. Make an appointment to see your doctor. The earlier diabetes is caught, the more likely you can prevent complications. 

How Is Type 2 Diabetes Diagnosed? 

A diagnosis of diabetes can be done using a variety of blood tests.

If you are at increased risk of diabetes, have symptoms of diabetes, or have pre-diabetes (a major warning sign for diabetes), your doctor will check to see if you have diabetes. Your doctor may also check to see if you have diabetes if you are over the age of 45, have a family history of the disease, are overweight, or if you are at increased risk for another reason. The tests used to check for diabetes are the same tests used to check for pre-diabetes.

Fasting blood sugar test: This test checks your blood sugar when you haven't eaten for at least eight hours. A fasting blood sugar above 126 could be indicative of diabetes. Your doctor will re-check this to determine if you have diabetes. 

Glucose tolerance test: This is a test that checks how you respond to sugar. You will be given a sample of sugar (75 grams over the course of two hours). If your blood sugar is above target after that time, you may be diagnosed with diabetes.

Hemoglobin A1c: This test checks your blood sugar over the course of three months.

If your blood sugar is above 6.5 percent, you may be considered to have diabetes.

Random blood sugar test: Your doctor can do this test if you are experiencing symptoms of diabetes—increase thirst, fatigue, increased urination. If your blood sugar is above 200mg/dL, you may be considered to have diabetes.

If you have no symptoms and any of these tests are positive, the American Diabetes Association recommends that a new blood sample be drawn to confirm a diagnosis. 

How Can I Avoid Type 2 Diabetes?

While you can't change getting older, your family history, or ethnicity, you can work on ways to reduce your weight and waist circumference, increase your activity, and lower your blood pressure.

Eating a balanced diet that is rich in fiber, non-starchy vegetables, lean protein, and healthy fat can help get you to your goal weight and reduce your waist size and body mass index (BMI). Reducing your intake of sweetened beverages (juices, sodas) is the easiest way to lose weight and reduce blood sugars. ​If you are someone who has high blood pressure and are salt sensitive, aim to reduce your intake of sodium; do not add salt to your food, read package labels for added sodium, and reduce your intake of fast food and take out. Don't go on a diet. Instead, adapt a healthier way of eating, one that you'll enjoy for a long time. 

Exercising regularly, about 30 minutes a day or 150 minutes per week, can also help to reduce your weight and blood pressure. Finally, if you smoke, aim to quit. Smoking can increase your risk of stroke, blood pressure, and heart attack, and quitting can reduce your risk of diabetes. 

How Can I Manage My Diabetes?

The good news is that if you have diabetes, you have a great amount of control in managing your disease. Although it can be difficult to manage a disease on a daily basis, the resources and support for people with diabetes is endless. It's important for you to receive as much education as possible so that you can take advantage of all the good information that is out there (and weed out the bad).

Don't let others let you feel like a diabetes diagnosis means you are doomed.

  • Get Educated: The American Diabetes Association advises that all persons with diabetes receive diabetes self-management education (DSME) at diagnosis and thereafter. A certified diabetes educator or other qualified health professional can give you the tools you need to understand and take care of your diabetes. In addition, these individuals are trained to create a customized plan that works for you. Diabetes self-management education is a patient-centered approach that enables patients to get involved in their care.
  • Assemble a Medical Team: Whether you've had diabetes for a long time or you've just been diagnosed, there are certain doctors that are important to see. It is extremely important to have a good primary care physician. This type of doctor will help coordinate appointments for other physicians if they think that you need it. Some primary physicians treat diabetes themselves, whereas others will recommend that you visit an endocrinologist for diabetes treatment. An endocrinologist is a person who specializes in diseases of the endocrine system, diabetes being one of them. 

    All people with diabetes should also be seen by an ophthalmologist after diagnosis. Diabetes can affect the eyes before it is even diagnosed. After the initial session, people should be seen every two years if there are no issues, or more often if there are. 

    In addition, people with diabetes should have a comprehensive foot exam by a podiatrist once they are diagnosed or if they are experiencing issues, such as tingling of the feet, pain, sores, hammer toes, thick dry skin, or fungal nails. 

    registered dietitian and/or certified diabetes educator will educate you on how to eat for diabetes and provide you the tools you need to self-manage your diabetes. 

    Some other doctors you may want to or have to add to your list as the disease progresses include a cardiologist (to make sure your heart is working efficiently and you have no blockages in your arteries), a vascular doctor (a doctor who specializes in veins and circulatory issues), and a therapist to help you cope with your diagnosis. 
  • Lose Weight: If you are overweight, losing weight can help your body use insulin. In fact, the American Diabetes Association recommends that people with diabetes lose about 7 percent of their body weight, which should improve the way your body uses insulin and reduces insulin resistance. In addition, weight loss can help lower blood pressure, reduce joint pain, increase energy, and reduce sleep apnea and cholesterol. It can also reduce your risk of other diseases, including heart disease.

    What you eat plays a major part in your diabetes control—and your weight. Eating a balanced diet that is rich in non-starchy vegetables, lean protein, and healthy fats can help you improve your nutrition, lose weight, and lower your blood sugars. 
  • Reduce Your Carbohydrate Intake: One of the most important components involved in a diabetes diet is knowing how to eat a modified carbohydrate diet. Carbohydrates are the nutrient that impacts blood sugars the most. Carbohydrates are found in starches, fruit, some vegetables like potatoes, sweets, and grains. Eating the right kinds of carbohydrate in the right quantities can help you manage your weight and your blood sugars. Knowing how to identify and count carbohydrates is very important in managing diabetes. Eating a consistent carbohydrate diet is ideal because it can help you body regulate blood sugars. 

    These dedicated Verywell sections can help you improve your diabetes diet know-how:
    Type 2 Diabetes Diet
    Dietitian Advice and Recipes
  • Exercise: We all know that physical activity is an important part of maintaining a healthy lifestyle, but exercise is also important in managing blood sugars and preventing complications of diabetes. And, of course, it's an important part of your weight loss effort. 

    It isn't always easy to start an exercise regimen, but once you get into a groove, you may be surprised at how much you enjoy it. Find a way to fit activity into your daily routine. Even a few minutes a day goes a long way. The American Diabetes Association recommends that adults with diabetes should perform at least 150 minutes of moderate-intensity aerobic physical activity per week (spread over at least three days with no more than two consecutive days without exercise). You don't have to start with this right away, though. Start with five to 10 minutes per day and go from there. To stay motivated, find a buddy, get a fitness tracker, or use another measurement tool that can help you see your progress.
  • Test Your Blood Sugar: Blood sugar testing is an important part of helping to manage your diabetes. Whether you choose to do selective blood sugar testing or test your blood sugar at the same times daily, blood sugar testing gives you another piece of information and can help you change your diet and adjust your fitness routine or medicines. Keeping your blood sugars at target will help to reduce diabetes complications.

    The American Diabetes Association recommends that blood sugars be 80mg/dL-130mg/dL before meals and less than or equal to 180mg/dL two hours after meals. Blood sugar targets are individualized based on a variety of factors such as age, length of diagnosis, if you have other health issues, etc. For example, if you are an elderly person, your targets maybe a bit higher than someone else. Ask your physician what targets are right for you. 
  • Know Your Numbers: Knowing your ABCs—A1c, blood pressure, and cholesterol—are important in reducing your risk for diabetes and keeping your diabetes in good control. If you are someone with diabetes who has elevated blood pressure or cholesterol, you are increasing your risk of heart attack and stroke. Your physician will give you your A1c, blood pressure, and cholesterol targets. Make sure you pay attention to them and understand what they mean and why they are important. 
  • Get to Know Your Medications: If you have diabetes, it is important to know and understand what your medications do. This can help to keep blood sugars controlled and prevent low and high blood sugars. Certain medicines need to be taken with food, or they will cause your blood sugar will drop. There are so many diabetes medications out there. Being your own advocate can help you. Make sure to tell your doctor if your medications are too expensive or if they are causing any side effects. If your medication regimen is not working for you, odds are your doctor can find a new medicine that might work better. 
  • Recognize Signs and Symptoms of Low and High Blood Sugars: Neither high nor low blood sugars are good for diabetes. In some instances, very high or very low blood sugars can result in an emergency situation. It is very important that you understand the signs, symptoms, and treatment of both high and low blood sugars. 

    Read: High and Low Blood Sugar: Managing the Ups and Downs

For Those Newly Diagnosed With Diabetes

The above tips are important for you. But it's also crucial to allow yourself time to cope with the diagnosis and commit to making lifestyle changes that will benefit you forever. The good news is the diabetes is a manageable disease; the tough part is that you must think about it daily. Consider finding support—someone that you can talk to about your struggles—be that a friend, another person with diabetes, or a loved one. This may seem trivial, but it truly can help you take control of diabetes so that it doesn't control you. Some next steps that may help you to get on the right track at this early stage in your journey:

  • Make Lifestyle Changes for Yourself and the Entire Family 
    It will surely be tough eating salads and vegetables when everyone else at your dinner table is eating pizza. Decide that this diagnosis can benefit the health of the entire family. Educate your family about the benefits of eating a healthy diet. Take your children grocery shopping with you. Practice the plate method: Aim to make half your plate non-starchy vegetables; a quarter lean protein; and a quarter whole grains or starchy vegetables, like sweet potatoes. Make exercise part of your daily routine and include your family. Go for walks after dinner. Head to the pool on the weekends, or enroll in an exercise class. If you don't have children, aim to find others with diabetes or friends that can act as your workout partners.
  • If You Haven't Already, Meet With a Certified Diabetes Educator
    Knowledge is power. A certified diabetes educator can provide you with diabetes self-management education. They specialize in diabetes and can help you learn about complicated or easier things. For example, they can help you set up your glucose meter, teach you about how your medicines work, or help you put together a meal plan. You can meet with them one on one or in group setting
  • Make Life Easy 
    Diabetes can be hard enough as it is, so do what you can to make life with it less complicated. For example, you don't have to be a master chef to put together a healthy meal. You can use ingredients that are right in your home. If you find your medication regimen to be too complex or too expensive, request that your physician change it. If you continue to forget to take your medicines, find simple ways to help you take them, like setting a reminder on your cell phone.

A Word From Verywell

Diabetes is a chronic condition that must be managed daily, but it is manageable. You can live a long, healthy life with diabetes if you adapt a healthy lifestyle. By choosing to eat a healthy diet, exercise regularly, and quit smoking, and seeing your doctors regularly, you will increase your energy, feel better, and maybe even feel great.

Many people with diabetes also have other conditions such as sleep apnea, high cholesterol, and high blood pressure. Once they change their lifestyle, many of these other symptoms improve or go away. You are in the driver's seat. You have the ability to control diabetes.

And go easy on yourself: Sometimes you can be doing everything perfectly and your blood sugars start to creep up. Because diabetes is a progressive disease, your body slowly stops making insulin over time. If you've had diabetes for a very long time, try not to be discouraged if your doctor has to increase your medication or discusses insulin with you. Continue to do what you can to improve your health.


American Diabetes Association, American Association of Diabetes Educators, and the American Academy of Nutrition and Dietetics. Diabetes Self-management Education and Support in Type 2 Diabetes 2015. https://www.diabeteseducator.org/docs/default-source/practice/practice-resources/position-statements/dsme_joint_position_statement_2015.pdf?sfvrsn=0

American Diabetes Association. Standards of Medical Care 2016. http://care.diabetesjournals.org/content/39/Supplement_1

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