Type 2 diabetes (T2D) is a growing epidemic that afflicts more than 29 million people in the United States today. Sadly, most diabetics feel helpless and clueless about how to reverse their condition. Another concern is that many of those with T2D are not even aware they have diabetes – and 90% of those who have a condition known as prediabetes are not aware of their circumstances, either. Most people do not realize that T2D is a preventable disease and can be reversed.
T2D is different from Type 1 diabetes, which is dubbed “juvenile onset diabetes” affecting around one in 250 Americans. Occurring in individuals younger than age 20, it has no known cure. In type 1 diabetes, your own immune system ravages the insulin-producing cells of your pancreas. Type 1 diabetics need to be supplemented with insulin for the rest of their lives as failure to do so will rapidly result in death.
Type 2 diabetes occurs when the body produces insulin, but it doesn’t work well – it is unable to process glucose appropriately or lower glucose levels effectively due to insulin resistance. T2D used to be referred to as “adult-onset” diabetes, but it is becoming more common in children and teenagers as well as adults of all ages. It now accounts for 90-95% of all diabetes. Glucose, (the end product of carbohydrate digestion), is needed for cells for energy and growth. Insulin helps glucose enter cells for either oxidation (burning) or storage (of excess glucose as glycogen in the liver). With insulin resistance, glucose cannot properly enter cells. Instead of the cells using glucose as fuel, it builds up in the bloodstream, leading to hyperglycemia (high blood sugar). For a while, the pancreatic beta-cells pump out more insulin to compensate for the added demand so blood sugar levels stay under control. However, eventually the pancreas cannot keep up and the body tips over into diabetes. As insulin output falls, blood sugar climbs. T2D is now defined as an epidemic.
The definition of T2D has changed over the years. For example, in the 1970’s a fasting blood sugar over 140 resulted in a diagnosis; in 1997 it was decided that a fasting blood sugar over 126 was diabetes. That “little” alteration converted over 1.6 million people into diabetics. Medical treatment guidelines have also changed strikingly since the 1980s.
People with T2D are at risk for developing many complications. Some of the complications include: heart disease, vascular disease (including hypertension, heart attack, stroke), poor circulation (causing problems such as foot ulcers), eye damage (retinopathy that can lead to blindness), kidney disease (progressing to kidney failure), bone fractures, arthritis, various types of cancer, increased inflammation without resolution, poor wound healing, dental disease, loss of cognitive function and neuropathy (nerve damage). In the beginning stages of diabetes, many people have no symptoms or mild symptoms that aren’t suspected of being diabetes. Symptoms may include: increased thirst, increased hunger, increased urination (especially at night), sores that don’t heal, fatigue, unaccounted for weight loss, and blurred vision.
Glycated hemoglobin (HbA1c), a measure of long-term average blood sugar, was previously used only to monitor glucose control, but is now used to diagnose diabetes. Also, the optimum HbA1c seems to vary between patients. A glucose tolerance test is usually used and/or random glucose, fasting glucose, and two-hour glucose concentrations after an oral glucose (a refined sugar) challenge.
Next month’s article will continue this discussion of Type 2 Diabetes.