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Type 2 Diabetes


Definition:

Type 2 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

Alternative Names:

Noninsulin-dependent diabetes; Diabetes - type 2; Adult-onset diabetes

Symptoms:

People with type 2 diabetes often have no symptoms at first. They may not have symptoms for many years.

Early symptoms of diabetes may include:

  • Bladder, kidney, skin, or other infections that are more frequent or heal slowly
  • Fatigue
  • Hunger
  • Increased thirst
  • Increased urination

The first symptom may also be:

Exams and Tests:

Your doctor may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Diabetes blood tests:

Diabetes screening is recommended for:

  • Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years
  • Overweight adults (BMI greater than 25) who have other risk factors
  • Adults over age 45 every 3 years

If you have been diagnosed with type 2 diabetes, you need to work closely with your doctor. You will likely need to see your doctor every 3 months. At these visits, you can expect your doctor to:

  • Check your blood pressure
  • Check the skin and bones on your feet and legs
  • Check if your feet are becoming numb
  • Examine the back part of the eye with a special lighted instrument

The following tests will help you and your doctor monitor your diabetes and prevent problems.

  • Have your blood pressure checked at least every year (blood pressure goals should be 140/80 mm Hg or lower).
  • Have your A1c test (hemoglobin A1c) every 6 months if your diabetes is well controlled. Have the test every 3 months if your diabetes is not well controlled.
  • Have your cholesterol and triglyceride levels checked yearly.
  • Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
  • Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
  • See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.
Support Groups:

There are many diabetes resources that can help you understand more about type 2 diabetes. You can also learn ways to manage your condition so you can live well with diabetes.

Outlook (Prognosis):

Diabetes is a lifelong disease and there is no cure.

Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar level.

Possible Complications:

After many years, diabetes can lead to serious problems:

  • You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.
  • Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be amputated. Infection can also cause pain and itching in other parts of the body.
  • Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, stroke, and other problems. It can become harder for blood to flow to your legs and feet.
  • Nerves in your body can get damaged, causing pain, tingling, and numbness.
  • Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.
  • High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well as they used to. They may even stop working so that you need dialysis or a kidney transplant.
Prevention:

You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.

References:

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

Stone NJ, Robinson JG, Lichtenstein AH, Goff DC Jr, Lloyd-Jones DM, Smith SC Jr, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med. 2014 Mar 4;160(5):339-43.

Eisenbarth GS, Polonsky KS, Buse JB. Type 2 diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 31.

Inzucchi SE, Sherwin RS. Type 2 diabetes mellitus. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 237.

Pories WJ, Mehaffy JH, Staton KM. The surgical treatment of type two diabetes mellitus. Surg Clin North Am. 2011;91:821-836.


Review Date: 6/18/2013
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 05/14/14

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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