Type 2 Diabetes Explained – Basics, Risk, and Helpful Tips
August 27, 2021
There are many types of diabetes: type 1 diabetes (an autoimmune disease), latent autoimmune diabetes (an autoimmune disease that is sometimes misdiagnosed as type 2 diabetes), gestational diabetes, and prediabetes, which leads to type 2 diabetes if not treated.
Between them, an estimated 34.2 million people have diabetes (10.5 percent of the U.S. population) costing a staggering 327 billion dollars a year.
According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), an estimated 88 million adults ages 18 years or older (34.5 percent of U.S. adults) have prediabetes, and sadly, among adolescents ages 12 to 18 years, more than 1 in 6 (18 percent of U.S. adolescents) have prediabetes.
Gestational diabetes is a type of diabetes that develops during pregnancy in women who don’t already have diabetes. About 6 percent of U.S. women who gave birth in 2016 had gestational diabetes. About 50 percent of U.S. women with gestational diabetes go on to develop type 2 diabetes.
So, what exactly is type 2 diabetes?
After you eat or drink, the food or beverage is broken down into glucose, also known as blood sugar. This process signals insulin to be released by the beta cells in the Islets of Langerhans, a group of pancreatic cells. Insulin then lowers glucose levels in the bloodstream by making the glucose available to cells.
A simpler description that is a helpful visual for many people is that insulin, a hormone created by the pancreas, is the key that unlocks the door to the cell to let in the glucose so it can be used by the cell for energy.
If there is excess glucose, insulin signals your body to store it in the muscles and the liver. This storage form of glucose is called glycogen and can be used by the body if blood glucose levels decrease.
The problem is when blood glucose remains high, and the body overproduces insulin to keep blood glucose levels normal. Over time, the body has built a resistance to insulin and as a result more and more is needed to handle the excess glucose in the body.
Eventually, the pancreas can no longer produce enough insulin and the result is higher blood sugar levels, and ultimately prediabetes leading to type 2 diabetes.
Type 2 diabetes versus type 1
The two types of diabetes that are commonly known are type 1 and type 2. While they both cause abnormality in the body’s blood sugar level, it is still necessary to know what distinguishes one from the other.
Type 1 and type 2 diabetes are lifelong diseases characterized by a high or low concentration of sugar in the bloodstream. Type 1 only accounts for 5% of the overall population of people with diabetes. Type 2, on the other hand, is statistically more prevalent. In addition, type 1 diabetes can have an early onset, but type 2 typically starts after the age of 40.
The main distinguishing factor between the two lies in how the pancreas functions in each of them. In type 1 diabetes, the insulin-producing beta cells in the pancreas are destroyed by the body’s immune system; hence, the pancreas cannot produce insulin anymore.
In type 2 diabetes, the pancreas can still produce insulin but it does not make enough supply. However, there are certain instances wherein even if the pancreas can still produce enough supply, the body may not be able to use the insulin properly. This is due to certain genetic mutations. Read this blog post to learn more about type 1 diabetes.
What causes type 2 diabetes?
According to neuroendocrinologist Dr. Robert Lustig, type 2 diabetes is caused by insulin, sugar, and lack of dietary fiber.
He states that “…our processed food diet is the primary culprit. It is high-sugar, low-fiber, toxic, addictive, ubiquitous, and detrimental to society. Therefore, I’ve dedicated my efforts to reduce its impact on people and the environment. I’ve also determined that processed food is not going away, no matter how I may want it to. Partly because it’s cheap, partly because it’s convenient, and partly because it’s addictive.”
Other risk factors include:
- Being overweight–which of course is tied into insulin– especially when fat is stored mainly in the abdomen
- Age, although it can develop in children
- Race and ethnicity. People who are Black, Hispanic, Native American, Asian and Pacific Islanders are more likely to develop type 2 diabetes
- According to the American Diabetes Association, “You inherit a predisposition to the disease, then something in your environment triggers it. Lifestyle also influences the development of type 2 diabetes. Obesity tends to run in families, and families often have similar eating and exercise habits.”
Is type 2 diabetes insulin-dependent?
While it is true that people with type 2 diabetes cannot use the insulin produced by the pancreas properly, they may not be insulin-dependent. Switching to a healthier diet and developing an exercise program can often lead to weight loss which may decrease the insulin dosage or possibly stop it altogether.
In fact, insulin therapy may only be needed when a situation calls for it such as:
- the person is sick
- the person is taking drugs that affect the body’s insulin resistance
- the person needs surgery
- the person is pregnant
How type 2 diabetes is diagnosed
Type 2 diabetes can be diagnosed using the blood test A1C, which is a glycated hemoglobin test that indicates your blood sugar level for the past two to three months. Below 5.7% is normal, 5.7% to 6.4% is diagnosed as prediabetes, and anything 6.5% or higher on two separate tests indicates type 2 diabetes.
Another test is a blood draw taken after an overnight fast. Less than 100 mg/dL (5.6 mmol/L) is normal. 100 to 125 mg/dL (5.6-6.9 mmol/L) is diagnosed as prediabetes, and 126 mg/dL (7 mmol/L) or higher on two separate tests is considered diabetes.
Another test less commonly used but is used for pregnant women to test for gestational diabetes, is the oral glucose test, where the pregnant woman drinks a sugary drink at the doctor’s office and blood sugar is tested periodically.
Less than 140 mg/dL (7.8 mmol/L is normal, 140 to 199 mg/dL (7.8 mmol/L and 11.0 mmol/L is prediabetes, and 200 mg/dL (11.1 mmol/L) or higher after two hours suggests diabetes.
What are the complications of type 2 diabetes?
Many major organs can be affected by type 2 diabetes, including your heart, nerves, eyes, kidneys, and blood vessels. You may suffer from slow healing, hearing impairment, sleep apnea, skin problems (bacterial and fungal infections), and even dementia.
There is evidence showing an increased risk for certain cancers including colon, postmenopausal breast, pancreatic, liver, bladder, non-Hodgkin’s lymphoma, and endometrial.
Another complication is non-alcoholic fatty liver disease (NAFLD), sometimes referred to as the silent liver disease because it can take years before symptoms appear.
About 100 million individuals in the United States are estimated to have NAFLD. Sadly, NAFLD has more than doubled in children in the past 20 years. NAFLD can lead to the more serious disease, nonalcoholic steatohepatitis.
How to prevent and manage type 2 diabetes?
If you have insulin resistance, you want to become the opposite—more insulin sensitive— meaning your cells are more effective at absorbing blood sugar so less insulin is needed.
What helps you to become more insulin sensitive? Physical activity.
Start moving today; perhaps you like to walk or do Pilates, or dance. You will sleep better, perhaps lose weight, and for many physical activities assists with stress reduction.
Of course, what you eat is vital to avoid prediabetes and type 2 diabetes. Many people have had success on the high-fat, low carbohydrate ketogenic diet, as fat is satiating and does not directly raise blood sugar. That said, it has been difficult for many to stay on this diet long-term.
There are many very low or low carbohydrate diets available that also assist in regulating blood sugar, but again, can be difficult to maintain. Remember we are all biochemical individuals and what works for one person might not work for another.
Find a healthy way of eating that works for you so you can stick with it long-term.
For many the answer is simply eat real food. Real food is not processed or ultra-processed food that has been stripped of dietary fiber, most often contains added sugar, and is high in the inflammatory omega 6 fatty acids.
As Dr. Lustig notes, real food feeds the gut and protects the liver. He states he “is not against vegan, I’m also not for it. I’m not against keto, I’m also not for it. Basically, I’m for real food.”
Listen to Dr. Robert Lustig’s interview here.
With this in mind, visit Foogal today to learn how we can help you prevent or manage type 2 diabetes through healthy eating.
Disclaimer: This content is provided for informational purposes only, and does not intend to substitute professional medical advice, diagnosis, or treatment.