Type 2 Diabetes Control – The Facts About Diabetes

Maintaining effective type 2 diabetes control is often a challenge, even for the most dilligent of patients, after all, type 2 diabetes is usually a condition caused by lifestyle factors, whereby the body can’t properly store and use fuel for energy. The body’s main source of fuel being the sugar glucose, which is derived from food following the digestion process. Following the breakdown of foods into their requisite components, the Glucose portion enters the bloodstream and is normally used by the cells for energy. However to use glucose, the body needs to produce a hormone called insulin (made by the pancreas). The production of Insulin and its usability is essential as it allows glucose to leave the bloodstream and enter the body’s cells.

The development of type 2 Diabetes occurs when the body either isn’t able to make any or enough insulin, or when it can’t properly make use of the insulin it makes. This is commonly referred to as Insulin resistance, whereby some people with diabetes, develop a resistance to the effects of insulin. In cases like these, the insulin is still produced, but the body isn’t able to respond and use the insulin as it should. Regardless of whether or not the body produces enough insulin or is unable to use insulin properly, the end result is usually excessively high levels of glucose in the blood, also known as hyperglycemia, and calls for extremely good type 2 diabetes control of blood sugar levels.

type 2 diabetes control

There are three types of diabetes:

• type 1 diabetes,
• type 2 diabetes, and
• gestational diabetes.

Approximately 9 out of 10 people with diabetes will actually have type 2 diabetes, which is also known as adult onset diabetes, or as it was sometimes known in the olden days as sugar diabetes. In modern times however, more and more younger people of childhood age are being diagnosed with type 2 diabetes, essentially due to the rise in obesity, inactivity, and a poor fast food, low value nutrition diet.

Sometimes a precursor to developing full blown diabetes is when people find their bodies don’t handle glucose as well as normally. This is called impaired glucose tolerance (IGT), and if not treated and controlled in it’s early stages will eventually lead to Diabetes. Approximately 40% of these people eventually actually go on to develop type 2 diabetes.

Causes of Type 2 Diabetes

In simple terms, the cause of type 2 diabetes is due to either the pancreas not making enough insulin and/or the body not being able to use it properly. No one knows the exact cause of why type 2 diabetes develops in some people and not others, but it’s more likely to occur in people who are:

• over 40 years of age
• overweight, or obese
• genetically predisposed due to a family history of diabetes
• developed gestational diabetes during a pregnancy
• have given birth to a baby that is more than 4 kg (9 lbs)
• have high blood pressure
• have high cholesterol
• have IGT or impaired fasting glucose
• are of Aboriginal, Polynesian, Hispanic, Asian, South Asian, or South African descent

type 2 diabetes blood sugar test

Symptoms and Complications of Type 2 Diabetes

The initial progressive development of type 2 diabetes in people can often be extremely invisible, with little or no symptoms being evident, and sometimes people can go years without experiencing any noticeable symptoms, but as the disease progresses and blood sugar levels rise, symptoms will eventually develop. The typical type 2 diabetes symptoms that people who have poor type 2 diabetes control can expect to experience are as follows;

• excessive thirst and occassionally increased appetite
• reduced sensation or feeling, including numbness, or pins and needles or pain in the hands and feet
• dry, itchy skin
• common and regular bladder and/or vaginal infections
• frequent need to pass urine
• blurred vision
• male impotence (erectile dysfunction)
• slow healing of cuts or sores
• extreme and often sudden tiredness, especially within an hour or so following meals

Unfortunately, undiagnosed people with diabetes who have had relatively good type 2 diabetes control, isn’t always straight forward to diagnose, as many of these people with undiagnosed type 2 diabetes can go undiscovered for several years and are usually not actually diagnosed until they go to the doctor with symptoms or complications of diabetes. In fact it is suggested that there are a significant number of people living everyday lives that are already diabetic, and yet haven’t been diagnosed.

Avocado - Good Diabetic food

People with ineffective type 2 diabetes control are at greater risk of developing other health issues due to their diabetes because of damage to the small blood vessels and nerves as a result of the high levels of glucose in the blood. They are also exposed to a much higher risk of atherosclerosis (which is a hardening of the large cardiac arteries), which can often result in early heart attack, (unexpected death) serious strokes, and at least poor blood flow to the legs and feet which can even end with the need to amputate ‘dead’ limbs. Make no mistake, diabetes may seem like a silent, weak disease, but the reality is it is like rust in a car, working from the inside out. Leave it unattended, and it will destroy the entity.

Type 2 diabetes control becomes extremely important to control blood sugar levels, as damage caused to the small blood vessels can also affect the eyes, kidneys, and nerves. Diabetic damage to eyes, specifically the retina, is called diabetic retinopathy and this is one of the leading causes of blindness. Also damage to the kidneys, called diabetic nephropathy, can lead to kidney failure and the need for permanent dialysis. Other damage to the nerves that supply the legs and arms and gastrointestinal tract is called diabetic neuropathy. Some people with diabetes who develop peripheral neuropathy (damage to the nerves in the legs) and have poor blood flow to the legs may eventually need an amputation.

When blood glucose levels become excessively high, particularly if there are other associated stresses such as an infection, then people with poor type 2 diabetes control can usually become confused, and dizzy, and may even develop seizures. This is likely to lead to a condition known as non-ketonic hyperglycemia-hyperosmolar coma and requires urgent immediate medical attention.

Fortunately for type 2 diabetics, the complications of diabetes can be prevented, delayed, or slowed by controlling blood glucose levels to as close to the normal range as possible using a combination of sensible controlled eating, regular exercise, often prescribed medications, and even regular insulin injections.

Diagnosing Type 2 Diabetes

The diagnosis of type 2 diabetes involves the taking of a fasting blood sample and check the blood sugar levels. If the fasting blood glucose level is 7.0 mmol/L (126 mg/dL) or higher, a diagnosis of diabetes is made. Occasionally some medical professionals require two consecutive high blood sugar readings (7.0 plus) to make a definitive type 2 diabetes diagnosis. If the fasting blood glucose level is between 6.1 mmol/L and 6.9 mmol/L, the person has impaired fasting glucose and is at risk for developing type 2 diabetes, which will require the patient to undergo a strict diet and exercise regime to try and return their blood sugar reading to normal.

If a ‘non fasting’ blood test reveals blood glucose levels of 11.1 mmol/L or higher, and the classic diabetes symptoms are present (e.g., increase thirst, increase urination, unexplained weight loss) then this too is likely to lead to a type 2 diabetes diagnosis.

Diabetes medic alert bracelet

Treating and Preventing Type 2 Diabetes

The main goal of type 2 diabetes control is to be able to maintain the levels of glucose in the blood to be within the normal range, as much as possible. This requires focussed attention on many lifestyle factors such as weight control, diet, and exercise as these all contribute to effective (or poor) management of type 2 diabetes control. The most important means of controlling type 2 diabetes is through nutritional means.

There is a small percentage of type 2 diabetics who are thin and within normal weight ranges, however the majority of people (90%) are either overweight, or obese. Even being able to lose a little of the weight, like 2 kg to 5 kg (5 lbs to 10 lbs) can have a positive impact in lowering blood glucose levels. For many people, simply following a healthy diet, avoiding processed foods, alcohol, and eating more fruit and vegetables as well as following an exercise program may be all that is needed to control glucose levels. For others, unfortunately, healthy eating and exercise wont be enough to maintain lower blood glucose levels.

For these people, there will be the need to take prescribed diabetic medications in order to try and keep glucose levels within a healthy range. Type 2 diabetes control medications are usually taken by mouth in the form of tablets which should always be taken around meal times or as prescribed by your doctor. However, eventually medications can become ineffective at keeping blood glucose levels down, and either stronger doseages may be required, or even  different prescription drugs that work in different ways may be necessary. In many instances a doctor may even recommend moving onto insulin injections.

There are a number of oral diabetic medications, which are also called oral hypoglycemics. They all work with the aim of lowering blood glucose, and therefore effect some form of type 2 diabetes control:

The best known and most commonly prescribed type 2 diabetes control medications are;

• sulfonylureas:
This family of medications includes gliclazide, glimepiride, and glyburide.
They are widely recommended for type 2 diabetes and work by stimulating the pancreas to release insulin. These medications don’t work for type 1 diabetes.
• biguanides:
These medications include metformin and these work to improve insulin sensitivity and to reduce the glucose produced by the liver.
• acarbose:
These medications prolong the absorption of carbohydrates after a meal. These pills need to be taken with or just after a meal to be effective
• thiazolidinediones:
This family of medications includes pioglitazone and rosiglitazone and their function is to improve insulin sensitivity.
• meglitinides:
This family of medications includes repaglinide and nateglinide. They lower postprandial (after meals) glucose levels through stimulating the release of insulin by the pancreas.
• dipeptidyl peptidase-4 inhibitors:
This class of medications includes sitagliptin and saxagliptin, and they work by helping to improve insulin release from the pancreas as well as decreasing the release of glucose from the liver.
• GLP-1 analogs:
This class of medications include liraglutide, which is a synthetic form of the hormone GLP-1. This medication helps the body to release insulin when the blood sugar levels are high, and also helps to reduce the release of sugar from the liver. It is taken as a daily injection under the skin.

Doctors may often suggest one or more types of medications in combination for effective type 2 diabetes control. Regular blood glucose self-monitoring is important for people who are taking medications. This can be achieved through the use of a personal blood glucose monitoring kit. As there are many types of blood glucose meters available, it may be worthwhile talking to your doctor or pharmacist about which blood glucose testing meter is going to be best for you.

tomatoes for a good diabetes diet

As part of effective type 2 diabetes control and management, you need to aware of the signs and symptoms of abnormal blood glucose levels and know how to properly monitor your blood glucose levels using a home glucose meter. You should always try to keep a supply of glucose tablets or sugar rich candy with you at all times to manage times when your blood glucose levels become too low (hypoglycemia).

Typical symptoms of low blood sugar levels include:
• clammy cold feeling skin
• dizziness
• headache
• hunger
• irritability
• nausea
• nervousness
• rapid heart rate
• shakiness
• sweating
• weakness

For the prevention of complications from effective type 2 diabetes control, you must follow your diabetes management plan which should include a well-balanced nutritious diet containing lots of fruits and vegetables and an exercise regime of at least 30 minutes each and every day. Also, if you do take medications for your diabetes, it is essential that these are taken exactly as prescribed.

Caring for your body to prevent long term complications from poor type 2 diabetes control

• Foot care:

Poor circulation and nerve damage as a result of diabetes over time reduce the sensitivity in the feet. Therefore, it’s essential to maintain a regular check of your feet, looking for any blisters, sores, or cuts. Always ensure your feet are clean and dry and always protect them by wearing socks and comfortable fitting shoes.
• Eye care:

Diabetes has the capability of robbing diabetics of their sight through retinopathy. Therefore, it is paramount that you have your eyes checked by an eye doctor (ophthalmologist) at least once a year. When any problems are discovered and they are treated early, most serious complications can be avoided.

Broccoli - good food for the diabetic diet

• Skin care:

Elevated blood glucose levels and poor circulation can potentially lead to skin problems for instance an injury can take a long time to heal or you may suffer from frequent skin infections. It’s important to wash every day with a mild soap and warm water, taking good care of any cuts or scrapes with proper cleansing and bandaging.

• Education:

People with type 2 diabetes should read up on, and educate themselves as much as possible about this disease and how to maintain effective type 2 diabetes control. The more you know about the illness, the better prepared you should be to manage it daily. There should be diabetes education programs available from your local hospital, or community health center, and also many pharmacists are qualified provide diabetes education.

*All medications usually have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®) whereas the common name is the medical name for the medication (e.g., acetaminophen). Since a medication may have many brand names, but only one common name, the medication has been referred to by its’ common name. For more information on brand names, speak with your doctor or pharmacist.

The main focus of this site is to share with others, the ways to achieve  type 2 diabetes control with tips and guidelines as to how best to overcome the pain and problems type 2 diabetes can cause in our lives. take a look through the various articles and pages of this site, subscribe to our updates, and newsletters, and together we can come up with ways that works for ourselves to all live long and healthy lives. Check out our Diabetes friendly recipes page for healthy diabetic diet recipes, or participate in the Type 2 Diabetes Forum.