Type 2 Diabetes
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Finding out you have type 2 diabetes means facing a lot of changes in your daily life.
You have options. With a little support and guidance, adjustments to your diet and exercise can help you manage your condition and avoid insulin shots. That's because, in type 2 diabetes, your body still makes the insulin you need to process sugar, or glucose. You've just developed a resistance to insulin, or you're making less of it. In both cases, nutrition and exercise can help control your blood sugar levels. We're here to help.
Learn more about your risk for type 2 and how it differs from type 1.
Understanding Type 2 Diabetes
Type 2 diabetes is often caused by a combination of factors- your body begins to make less insulin and becomes resistant to insulin.
Type 2 diabetes is often associated with what we call insulin resistance, meaning that your body makes insulin, but it doesn't work as well. Risk factors for type 2 diabetes include family history. So we think about a first degree relative-- mom, dad, brothers, sisters-- giving a patient about a 50% risk, a 50% risk for getting type 2 diabetes during their lifetime. We also know that type 2 diabetes is associated with weight. So for our larger patients, they're at increased risk.
Most commonly, patients with type 2 diabetes will be diagnosed with symptoms of high blood sugar. So they may be feeling thirsty, drinking lots of fluids, urinating a lot. They're often having blurry vision when the blood sugars get high. They also may be feeling fatigued. It can cause weight loss.
In a lot of cases, patients are now being diagnosed by a blood test called a hemoglobin A1C. I think we're as physicians getting much better at screening patients who are at risk for diabetes. So this is being caught earlier. And I think that's incredibly important, because the earlier we can catch this, the better we can move forward with treatment and help prevent the complications of diabetes.
At UVA, we have many providers that treat patients for type 2 diabetes. We have a shared program with the diabetes education and management program, where we have certified diabetes educators, as well as dietitians to help patients learn about their disease and management. It can be a really complex and confusing time for patients when they get a new diagnosis. So that group does a fantastic job in helping patients understand so that they can be empowered and do well in managing their diabetes.
Type 2 Diabetes Treatment
Treatment aims to:
- Maintain blood sugar at levels as close to normal as possible
- Prevent or delay complications
- Control other conditions that you may have, like high blood pressure and high cholesterol
Medications That Manage Glucose Levels
Medication taken by mouth may include:
- Biguanides reduce the amount of glucose made by the body
- Sulfonylureas encourage the pancreas to make more insulin
- Insulin sensitizers to help the body use insulin better
- Starch blockers to decrease the amount of glucose absorbed into the blood
- Sodium-glucose co-transporter 2 (SGLT-2) inhibitors to increase glucose excretion in urine
- Bile acid binders
These medicines must be injected, with a shot:
- Incretin-mimetics stimulate the pancreas to produce insulin and decrease appetite, which can assist with weight loss
- Amylin analogs replace a protein of the pancreas that is low in people with type 2 diabetes
- Insulin
You'll need insulin if:
- Your body doesn't make enough of its own insulin
- You can't control your blood sugar with lifestyle changes and other medicines
Learn about controlling your glucose and avoiding complications with diet, exercise and self-care.
Stay on Track: Blood Glucose Testing
You can check the level of glucose in your blood with a blood glucose meter. Checking your blood glucose levels during the day can help you stay on track. It will also help your doctor determine if your treatment is working. Keeping track of blood sugar levels is especially important if you take insulin.
Regular testing may not be needed if your diabetes is under control and you don't take insulin. Talk with your doctor before stopping blood sugar monitoring.
An HbA1c test may also be done at your doctor's office. This is a measure of blood glucose control over a long period of time. Doctors advise that most people keep their HbA1c levels below 7%. Your exact goal may be different. Keeping HbA1c in your goal range can help lower the chance of complications.