Type 2 diabetes is a chronic illness that affects millions of people worldwide. It is caused by the body’s inability to efficiently use insulin to regulate blood sugar levels. Over time, having high blood sugar levels can lead to serious health complications impacting many organs and tissues in the body. While there is currently no cure for type 2 diabetes, managing the disease through lifestyle changes, medication and monitoring blood sugar levels can help prevent or delay associated health problems.
Type 2 diabetes develops when the body becomes resistant to insulin or does not make enough insulin. Insulin is a hormone produced in the pancreas that allows the body’s cells to take in sugar (glucose) from the bloodstream for energy. In type 2 diabetes, the body’s cells do not respond properly to insulin. This causes sugar to build up in the bloodstream instead of being absorbed by cells. Over time, high blood sugar levels can damage nerves, blood vessels, eyes and other organs. With proper management and treatment, people with type 2 diabetes can live long, healthy lives.
The primary causes of type 2 diabetes are genetic susceptibility and lifestyle factors such as obesity and physical inactivity. Other key contributors include older age, family history of diabetes, history of gestational diabetes, and belonging to certain racial or ethnic groups. Globally, type 2 diabetes is more common in black, Latino and Native American communities. In recent decades, rates of type 2 diabetes have skyrocketed due to the obesity epidemic and increasingly sedentary lifestyles. According to the Centers for Disease Control and Prevention, over 34 million Americans had diagnosed or undiagnosed diabetes as of 2015.
Fortunately, type 2 diabetes has modifiable risk factors that, if addressed early through lifestyle changes, can often prevent or delay onset of the disease. Losing even a small amount of weight through diet and exercise is one of the most effective ways to reduce diabetes risk and improve blood sugar control for those who already have it. Regular physical activity has been shown to lower insulin resistance, enhance the body’s use of glucose, and assist with weight management. Studies demonstrate that 150 minutes per week of moderate activity such as brisk walking can cut diabetes risk in half.
Dietary modifications also play an integral role in diabetes self-management and prevention. Choosing whole, unprocessed foods and limiting sugar intake, red meat and refined carbohydrates helps maintain healthy insulin and blood sugar levels. A Mediterranean style diet rich in vegetables, fruits, whole grains, legumes, nuts, seeds and fish has demonstrated benefits for diabetes management. It is also important for people with diabetes to carefully monitor portion sizes and distribute carbohydrates evenly throughout meals to prevent spikes and drops in blood glucose.
For individuals already diagnosed with type 2 diabetes, pharmacological treatment may be needed in addition to lifestyle changes to achieve proper blood sugar control. Available medication options include insulin, oral medications like metformin, sulfonylureas and others, newer drug classes like GLP-1 receptor agonists, and newer technologies like continuous glucose monitors. The appropriate treatment plan is customized for each patient based on factors like current blood sugar levels, other health conditions and risk of complications. The goal of drug therapy is to safely lower blood sugar to a target range without causing problems like low blood sugar or side effects.
Achieving and maintaining good glycemic control is critical for preventing or delaying diabetes-related medical issues. When blood sugar levels remain high over the long term, it increases the risk of nerve damage (diabetic neuropathy), eye damage (retinopathy), kidney disease (nephropathy), heart disease and stroke, skin and foot problems, hearing impairments, and other complications. That is why following the prescribed medication regimen and lifestyle recommendations from one’s healthcare provider is so important for type 2 diabetes self-care. Frequent monitoring of blood glucose levels through home testing also helps individuals and doctors evaluate what is and is not working to regulate blood sugar.
While type 2 diabetes currently has no cure, ongoing research seeks to better understand the disease mechanisms driving uncontrolled glucose levels and find new approaches for prevention or therapy. Some promising areas of investigation include bariatric surgery, stem cell transplants, dietary supplements, plant-derived medications and medical devices. Scientists are working to leverage knowledge gained from large longitudinal epidemiological and genetic studies. The ultimate goal is to develop life-changing cures or functional cures that could restore or maintain normal blood sugar control without the need for chronic medical management.
Type 2 diabetes remains a serious chronic illness. Through advances in treatment, education and awareness, it has become an increasingly manageable condition when diagnosed early and properly cared for. Lifestyle changes in diet, activity level and weight management are pillars of both prevention and successful treatment. Along with medication as needed, consistent blood glucose monitoring and follow up with healthcare providers help those with diabetes stay healthy, active and prevent or delay devastating complications. By understanding risk factors and symptoms, people can empower themselves to prevent or better cope with type 2 diabetes through informed self-care. With ongoing commitment to ongoing clinical studies and clinical breakthroughs, hopefully one day a complete cure will be found to end the diabetes epidemic worldwide.
Andrew Stroud