Type 2 diabetes is a lifelong condition in which the body is unable to properly regulate the amount of glucose in the blood. It develops when the body doesn't respond to the natural hormone insulin. It often occurs as a result of being overweight but there can also be other factors, including genetics. However, lifestyle changes and medicines can help you manage type 2 diabetes.
Type 2 diabetes is also known as non-insulin-dependent diabetes mellitus.
Glucose is a simple form of sugar found in foods and sugary drinks - it's absorbed as a natural part of digestion.
One function of your blood is to carry glucose around your body. When glucose reaches body tissues, such as muscle cells, it's absorbed and converted into energy. Insulin helps with the absorption process so it's critical for regulating the glucose concentration. If you have a shortage of insulin, glucose can build up in your blood.
Insulin is secreted into the blood by your pancreas - a gland that also produces digestive juices and is found behind your stomach. If your cells don't respond properly to insulin, this can cause glucose to build up in your blood. This is called insulin resistance. You can develop this if you're overweight or type 2 diabetes runs in your family. Having insulin resistance means your pancreas needs to produce more and more insulin to control blood glucose levels. Eventually your body can't produce enough insulin so your levels rise and diabetes develops.
There are two main types of diabetes: type 1 and type 2. Almost 900,000 Australians have diabetes.
Type 2 diabetes is more common, affecting about 90 percent of Australians with diabetes.
Many people with type 2 diabetes have no symptoms, and it's often discovered accidentally after routine medical check-ups or following screening tests for other conditions.
If you do have symptoms of type 2 diabetes, they might include:
You may also have noticed a change in your weight over recent months. You may have gained weight (causing diabetes) or lost weight as a result of high blood glucose levels. It's also possible that your weight hasn't changed at all.
Your symptoms may be very mild and can go unnoticed for years.
Long-term complications of type 2 diabetes are similar to those of type 1 diabetes.
You'll need to have annual check-ups to monitor whether you've developed any complications.
Rarely, if a severe infection occurs or type 2 diabetes isn't diagnosed or is poorly controlled, people with the condition can develop hyperosmolar non-ketotic coma (HONK).
HONK is caused if blood sugar rises to very high levels. It causes:
Eventually it can cause drowsiness and loss of consciousness. HONK needs to be treated in hospital.
In the long term, uncontrolled high blood glucose (hyperglycaemia) can be very damaging to your health and can increase your risk of heart disease, stroke, kidney failure, nerve damage and blindness.
Type 2 diabetes develops when your body becomes resistant to insulin. This happens when your body's tissues don't respond well to insulin and so can't make use of the glucose in the blood for energy. Your pancreas responds by producing more insulin and your liver, where glucose is stored, releases more glucose.
Eventually your pancreas becomes less able to produce enough insulin and your tissues become more resistant to insulin. As a result, blood glucose levels slowly start to rise.
It can take several years for blood glucose to reach a level that causes symptoms of type 2 diabetes.
You're more likely to develop type 2 diabetes if you:
If you think you may be developing diabetes, visit your GP. Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.
You may also be asked to have a blood test to measure the level of glucose in your blood. This might be a fasting glucose test, which is taken after you haven't eaten for at least eight hours, or a random glucose test done at any time.
If your GP can't make a definite diagnosis after these tests, you may have a glucose tolerance test. This measures how your blood glucose level changes over time after you swallow a sugary drink. Before having this test, you'll need to fast overnight.
Your care will probably be managed by your GP. However, you may be referred to a specialised diabetes clinic.
Some people with type 2 diabetes can initially control their condition with lifestyle changes alone.
If lifestyle changes alone don't reduce your glucose levels, you may be prescribed medicines to increase insulin production and strengthen its effect. Some examples are listed below:
Two or more of the medicines listed here can be given in combination as they may give better control than one on its own. Your doctor and diabetes educator can advise on which treatments are most appropriate for you.
It's very important to keep your blood pressure and the level of cholesterol in your blood well controlled. High blood pressure and high cholesterol levels have been linked to heart attack and stroke - you're more at risk of these and other complications if you have diabetes.
It's important to try to lower your cholesterol levels through lifestyle measures such as changing your diet, losing excess weight and taking regular exercise. However, if these don't work, you're likely to be prescribed a medicine to help lower your cholesterol.
You may also be given medicines to control your blood pressure if lifestyle changes including those mentioned above aren't enough to do this.
If lifestyle changes and oral medicines don't control your blood glucose levels, you may need to start insulin injections in addition to, or instead of, tablets.
You will usually give insulin injections to yourself once or twice a day, using either a traditional needle or a pen-type syringe with refillable cartridges. There are different kinds of insulin that work at different rates and for different lengths of time. Each can have varying rates of success in different people - ask your doctor for advice on which type is best for you.
You may be able to monitor your blood glucose levels with a home test kit. This involves taking a pinprick of blood from your finger and putting a drop on a testing strip. A meter will read the result automatically. However, self-monitoring isn't usually recommended unless you're using insulin injections. More research is needed to find out whether self-monitoring is an effective way of controlling blood glucose.
You can adjust both your diet and insulin to keep your blood glucose level within the normal range. Your 'normal' range will be specific to you but a general guide for adults is:
Your GP or diabetes educator can guide you on how to monitor and manage your blood glucose and will give you continuing support.
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Last published: 30 July 2011.
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