Living with Type 2 Diabetes

An Overview of Diabetes

/ Author:  / Reviewed by: Joseph V. Madia, MD

You feel fine most of the time.

Well, now that you think about it, you have lost some weight and don't know why. But that's a good thing, right? You can always stand to lose a few.

Then again, cuts or bruises do take forever to heal, but that's no big deal - is it?

Hmmmm, and you have noticed that you have some sort of minor infection happening on a regular basis - a skin, or gum or bladder thing.

You don't think much of these things.

But these symptoms should not be ignored.

You may have type 2 diabetes, a chronic disease that plagues millions of Americans and millions more who don't even know they have it.

What is type 2 diabetes?

Diabetes - in its simplest form - is an energy problem.

Your body breaks down all the sugars and starches from the food you eat into glucose. Glucose is the basic fuel your body needs to operate. The pancreas makes insulin to get glucose into your cells, where it's stored to be used later for energy.

Type 2 diabetes messes all this up. Insulin doesn't get where it's supposed to be, causing what's known as insulin resistance.

The pancreas tries to fix this major glitch by producing more and more insulin, but the attempts are futile. Not enough insulin can be produced to meet the body's demand. It's sort of like pouring sugar through a collander.

The result is type 2 diabetes.

Could I have diabetes?

Only your doctor and blood work can determine if you have diabetes. But if you have one or more of the following, you could be at risk or may already have type 2 diabetes. Risk factors include:

  • Being overweight or obese because fat screws up how your body uses insulin
  • Eating poorly
  • Carrying too much weight around your waist
  • Not exercising on a regular basis
  • Having a family history of the disease
  • Being over the age of 45 - although type 2 diabetes is now epidemic among (mostly overweight or obese) children
  • Having high blood pressure
  • Having unhealthy cholesterol levels (HDL of less than 35 mg/dL or triglycerides over 250 mg/dL)
  • Having had gestational diabetes during pregnancy or polycystic ovarian syndrome

People of different races and ethnicities are also more prone to have type 2 diabetes, including:

  • African Americans
  • Hispanic Americans
  • Native Americans
  • Asian Americans
  • Native Hawaiians
  • Pacific Islanders

What are the symptoms of diabetes?

What's tricky about this disease is that you may indeed feel fine. Type 2 diabetes develops over time, often with no symptoms.

However, there are symptoms, including:

  • Blurred vision
  • Erectile dysfunction
  • Tingling or numbness in hands/feet
  • Fatigue
  • Frequent or slow-healing infections
  • Increased appetite and/or thirst
  • More frequent urination

How is type 2 diabetes diagnosed?

A series of blood tests are performed to diagnose this disease, including:

Fasting blood glucose level

  • You'll be asked not to eat or drink for some period of time, usually over night
  • Your blood glucose levels are measured
  • Diabetes is diagnosed if you have two readings higher than 126 mg/dL

Hemoglobin A1c Test

  • Test is used to help monitor blood glucose levels
  • In 2010, American Diabetes Association (ADA) recommended its use to diagnose pre-diabetes
  • Less than 5.7% - Normal
  • Between 5.7% - 6.4% - Pre-diabetes
  • 6.5% or higher - Diabetes

Oral glucose tolerance test

  • Diabetes is diagnosed if glucose levels are higher than 200 mg/dL after 2 hours

Random blood glucose level - without fasting

  • Diabetes is suspected if:
  • Levels are higher than 200 mg/dL
  • Combined with other symptoms - increased thirst, urination and fatigue
  • This test must be confirmed and verified with a fasting blood glucose test

How is type 2 diabetes treated?

The first goal will be to get your blood glucose levels under control. This may be achieved primarily through diet and exercise, or medication may also be needed.

Ongoing treatment is vitally important to maintain blood glucose levels and to prevent complications.

Diabetes is a disease that has to be managed on a daily basis. It can feel overwhelming at first. But learning the basics, getting organized and performing regular checks can save a lot of misery down the road by avoiding serious complications.

Basic diabetes management

Your healthcare provider or a diabetes educator will help you learn basic diabetes management skills. You'll learn:

  • How to test and track your blood glucose
  • What (and what not) to eat; when to eat; how much to eat of various recommended foods
  • Meal planning that suits your lifestyle
  • Weight management techniques - including how to lose weight if necessary
  • What types of regular exercise are best for you
  • How to take medications if they're prescribed
  • How to know and treat low and high blood sugar
  • What supplies you'll need, where to buy them and how to store them

Medications for treating type 2 diabetes

Sometimes diet and exercise aren't enough to control your blood sugar levels. In this case, your doctor may prescribe medications. Here are the types of medicines you may be prescribed:


  • Diabinese
  • Glucotrol and Glucotrol XL
  • Micronase
  • Glynase
  • Diabeta
  • Amaryl


  • Prandin
  • Starlix


  • Glucophage and Glucophage XR
  • Glumetza
  • Fortamet
  • Riomet


  • Avandia

Alpha-glucosidase inhibitors

  • Precose
  • Glyset

DPP-4 Inhibitors

  • Januvia
  • Onglyza

Oral combination therapy

  • Drugs may be used together


Your doctor may order insulin for you. This can be taken through shots or an insulin pump.

Other medications

There are two additional injectable drugs that are used to treat diabetes:

  • Symlin
  • Byetta

What are possible type 2 diabetes complications?

Diabetes is a devious disease. It can affect many parts of your body. That's why taking charge of the disease from the start is so important, along with regular visits with your healthcare provider.

Your doctor may also prescribe medications to prevent complications that can arise from type 2 diabetes. These include:

  • Heart disease
  • Stroke
  • Kidney disease
  • Nerve damage
  • Eye diseases and problems (cataracts, glaucoma)
  • Foot problems
  • High blood pressure
  • High cholesterol
  • Infections of skin, urinary tract
  • Erection problems

Can diabetes be prevented?

Yes. Achieving and maintaining a healthy weight and staying physically active are your best weapons for warding off not only diabetes, but most all chronic diseases. A good start is to begin making vegetables and fruits a bigger part of your diet.

Where can I get support?

If you or a friend have been newly diagnosed, you'll want to visit the American Diabetes Association website at

Here you'll find all sorts of great information, management tools and support from other people living with diabetes.

Review Date: 
June 3, 2011