About 1 in 10 Americans have diabetes, and approximately 90 to 95 percent of them have type 2 diabetes. Type 2 diabetes is a chronic condition that affects the way your body uses insulin, a hormone that regulates the movement of sugar into your cells. This condition causes your body to either resist the effects of insulin or not produce enough insulin to maintain normal glucose levels.

Type 2 diabetes most often develops in people over age 45, but it also affects kids and teens, typically due to childhood obesity.

Causes of Type 2 Diabetes

Type 2 diabetes is caused when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin.

The pancreas creates a hormone called insulin that helps the cells turn glucose from the food you eat into energy. Type 2 diabetes develops when this process does not work as well as it should and the cells don’t respond normally to insulin-this is called insulin resistance. Instead of moving into the cells, sugar builds up in the bloodstream. As the blood sugar levels increase, the pancreas creates more insulin to try to get the cells to respond. Eventually the insulin-producing cells become damaged and can’t make enough insulin to meet the body's demands.

Many of the risk factors for developing type 2 diabetes are tied to genetics and lifestyle. These factors include:

  • Weight - Individuals with higher weight are at risk for developing type 2 diabetes. When people gain weight and have more cells in their bodies, they will need more insulin to reach these cells and get glucose into them instead of leaving it circulating in the bloodstream.
  • Inactivity - The less active you are, the more likely you will have elevated blood sugars as your body uses less blood glucose. Weight gain from lack of exercise can also lead to insulin resistance.
  • Waist Circumference - People with a higher waist circumference have a greater risk of type 2 diabetes. The risk of type 2 diabetes rises for men with a waist circumference greater than 40 inches or women with a waist greater than 35 inches.
  • Family history - The risk of type 2 diabetes increases if you have a parent or sibling who has type 2 diabetes.

Type 2 Diabetes Symptoms

Type 2 diabetes symptoms often develop slowly and can be so mild you don’t notice them. It’s possible to have type 2 diabetes for years and not know it.

Some of the symptoms of type 2 diabetes include:

  • Increased thirst
  • Frequent urination
  • Increased hunger
  • Unintended weight loss
  • Fatigue
  • Irritability
  • Blurred vision
  • Wounds that don't heal
  • Frequent infections
  • Areas of darkened skin, usually in the armpits and neck
  • Tingling or numbness in the hands or feet
  • Recurring yeast infections

How Does Weight Affect Diabetes?

When an individual who is predisposed to diabetes has excess weight, the cells in the body become less receptive to the insulin released by the pancreas. More fatty tissue means more cells that are likely to be insulin resistant. Some studies show that fat cells are more resistant to insulin than cells in the muscle.

For those with a higher weight, losing just 5 to 10 percent of your body weight can reduce the risk of diabetes. Physical activity not only helps you control your weight, but uses up glucose found in the blood as energy and makes your cells more receptive to insulin.

Ways to Prevent or Control Type 2 Diabetes

For many people at risk for or living with type 2 diabetes, the condition may be prevented or well-controlled with risk factor modification and adoption of a healthier lifestyle. Nutrition and physical activity are key to managing type 2 diabetes. Some ways to prevent or control type 2 diabetes include:

  • Nutritious foods - Have plenty of vegetables and lean proteins. When choosing carbohydrates, incorporate healthy forms including fruit, whole grains, and beans. Stay hydrated with water and other non-sugary beverages.
  • Getting active - Try to get at least 30 to 60 minutes of moderate physical activity or 15 to 30 minutes of vigorous aerobic activity every day. Walking, running, swimming, and biking are great options. Pair these workouts with strength training, like yoga or weightlifting.
  • Losing weight - If you're overweight, losing 5 to 10 percent of your body weight can reduce the risk of type 2 diabetes. Focus on sustainable, long-term changes to your eating and exercise habits. 
  • Avoiding being sedentary - Sitting still for periods of time can increase your risk of type 2 diabetes. Try to get up and move every 30 minutes.
  • Quitting smoking - Tobacco use is associated with increased blood sugar levels and insulin resistance. Individuals who smoke are much more likely to develop diabetes than those that don't. People with diabetes who smoke have a more difficult time controlling their blood sugar levels.

Sometimes medication is recommended to help manage type 2 diabetes. However, even if you take medication, healthy lifestyle choices - particularly losing weight or maintaining a healthy weight - are necessary for preventing or managing type 2 diabetes. 

At Coastal Medical, we offer Diabetes and Diabetes Prevention programs for our patients to help them learn more about this disease and take a proactive approach to preventing or controlling diabetes. Our Obesity Medicine program also helps patients on their journey to a healthy weight. Talk with your Coastal Medical primary care provider to determine if these programs may be right for you.

Amanda Hawkins, BSN, RN, CDCES, CDOE

Amanda Hawkins, BSN, RN, CDCES, CDOE, is a diabetes nurse educator with Coastal Medical