Type 2 Diabetes
World Health Organisation (WHO) explains type 2 diabetes as the body’s inability to effectively use the insulin it produces. In simple terms the insulin made by the pancreas is either not enough or the insulin is unable to work properly. The cells in the body are unable to respond to the insulin as well as they should.
The prevalence of type 2 diabetes is globally expanding with high links to obesity and sedentary or inactive lifestyles. Previously it was more prevalent in adults; however, due to the increasing number of children with obesity, the diagnosis of type 2 diabetes is now on the rise.
Though diet and lifestyle is closely linked to type 2 diabetes, there are risk factors which increases an individual’s risk to developing type 2 diabetes.
People living with type 2 diabetes are more vulnerable to various forms of both short- and long-term complications, which often lead to their premature death.
Risk factors to type 2 diabetes
- Weight – being overweight or obese increases the risk
- Family history – An individual’s risk of type 2 diabetes is increased up to 6 fold if a parent, sibling or child has diabetes.
- Lack of activity – a sedentary lifestyle increases the risk of type 2 diabetes. Being physically active enables the body use up glucose and enables the cells to be more sensitive to insulin. As little as a 2% weight loss encourages glucose uptake and a 5% weight loss encourages a reduction in heart disease as weight loss encourages better blood pressure, blood glucose and cholesterol control.
- Race and ethnicity – though unfounded as to why certain races such as Africans, Caribbean’s, Asians, etc. are more at risk of type 2 diabetes, it is presumed that the diet within these communities contributes greatly to the prevalence.
- Polycystic ovaries – a condition where the ovaries become enlarged and contain a lot of fluid-filled sacs (follicles) surrounding the eggs causing irregular periods. This can lead to insulin resistance and weight gain which are contributory factors to type 2 diabetes.
- A history of gestational diabetes – developing diabetes in pregnancy or having a baby over 4kg increases the reoccurrence of type 2 diabetes.
- Pre-diabetes – An Individual with pre-diabetes is one whose blood sugar is higher than normal but not high enough to be diagnosed as type 2 diabetes.
- Though the blood sugar levels are not high enough, there is still an exposure to risks similar to the individual who has type 2 diabetes. It is also referred to as impaired glucose tolerance, borderline diabetes, impaired fasting glucose, impaired glucose regulation or non-diabetic hyperglycaemia.
- People with pre-diabetes are usually unaware as they do not usually show symptoms.
- If pre-diabetes is discovered early, there is an opportunity to reverse it and prevent it from going on to a full diagnosis of type 2 diabetes. To achieve this, a diet and lifestyle change is recommended.
This video by Diabetes UK provides a very detailed explanation of this process as below.
SYMPTOMS OF DIABETES
The main symptoms of type of diabetes include:
- Increased thirst and urination
- Fatigue (When you are very tired)
- Recurring genital thrush
- Numbness or tingling in feet or hands
- Sores that are slow to heal or do not heal
- Unexplained weight loss (you lose weight without trying) – More weight loss in type 1
- Blurred vision
- Dry skin or blushing skin
An individual may sometimes not show symptoms. A lack of symptoms does not excuse the occurrence of diabetes within the body.
There are some other symptoms which can be considered life threatening. This is often referred to as diabetic Ketoacidosis (DKA). These symptoms include
- Fruity smelling breath
- Dry skin or blushing skin
- Nausea or vomiting
- Abdominal (stomach) pain
- Difficulty in breathing
- Confusion or difficulty concentrating
If you have any of these life threatening symptoms, you need to seek urgent medical attention.
Complications of Diabetes
If diabetes is left untreated or with suboptimal glycaemic (sugar) management, it can lead to processes referred to as glucose toxicity (excess sugar in circulation harming the body) and lipotoxicity (excess fat in circulation harming the body). Some examples of diabetes complications include:
- Cardiovascular disease examples include strokes, heart attacks, narrowing of the arteries (atherosclerosis) etc.
- Nerve damage (neuropathy)– A raised glucose levels can cause injuries to the walls of small blood vessels called capillaries which are a source of nourishment to the nerves particular the legs. This can lead to numbness, burning, pain, tingling, slow healing wounds and a possible amputation.
- In men, erectile dysfunction can occur due to nerve damage to the genitals.
- Increase risk of Kidney damage (nephropathy) leading to diabetes: the kidneys play an important role in filtering (removing) waste from the bloods. When blood sugars are raised, this process of filtration can be damaged leading to kidney failure.
- Increase risk of damage to the eyes (diabetic retinopathy): leading to poor eyesight or blindness. The blood vessels of the retina can be damaged which can potentially lead to blindness. Other causes of eye damage from diabetes include glaucoma.
- Increased risk of dental disease: Raised blood glucose can increase the occurrence of dry mouth and gum disease
- Increased risk of low mood (depression) often forgotten and not mentioned but dealing with diabetes can be cumbersome. Improper management of mental health can lead to complications with diabetic management.
- Increased risk of vascular dementia (vascular dementia)
- Increased risk of harm to mother and child during pregnancy (e.g. still birth).