Key points
- Type 2 diabetes is a long-term condition that affects your sugar levels
- It is typically caused by lifestyle and genetic factors
- Treating diabetes is lifelong and aims to control blood sugar levels
- Poor blood sugar control leads to many negative effects on health
What is type 2 diabetes mellitus?
Type 2 diabetes mellitus is a long-term condition characterised by abnormally high blood glucose levels. Type 2 diabetes in the UK affects about 1 in 10 people over the age of 40 and causes around 680 strokes and 530 heart attacks per week.
When a person ingests carbohydrates or sugary foods, this is absorbed and converted to glucose in the body. This is all carried in the blood before a hormone called insulin is released. When insulin is released it signals to the body cells to absorb a certain amount of glucose from the blood to maintain a balanced blood glucose level. The more glucose there is in the blood, the more insulin is released.
When persistently high levels of blood glucose result in equally high levels of insulin, often over many years, cells become resistant to the effects of insulin and do not respond to it in the same way. This means that rather than absorbing enough glucose to maintain a normal blood glucose level, they absorb only a little. The result is a persistently high blood glucose level.
Causes of Type 2 Diabetes
This condition is caused by a range of factors, primarily a combination of lifestyle factors such as obesity, lack of exercise, and an unhealthy diet.
Below are some type 2 diabetes risk factors. These increase your risk of developing type 2 diabetes:
- Obesity
- Sedentary lifestyle (lack of physical activity)
- Poor diet
- Genetics
- Smoking
- Alcohol
- Age
- High blood pressure
- Certain medicines (corticosteroids, diuretics, antipsychotic drugs)
Obesity is the greatest risk factor for developing type 2 diabetes. It is usually the result of a sedentary lifestyle and a poor diet with a high intake of fats and sugars. Obesity is responsible for 80%-85% of a person’s risk of developing type 2 diabetes.
There are also genetic factors that can increase a person’s risk of developing type 2 diabetes. Those from South Asian, Afro-Caribbean or African descent are more than twice as likely to develop the condition than those of other ethnicities. Those with a relative with the condition are more likely to develop type 2 diabetes.
What are the symptoms of type 2 diabetes?
The early stages of diabetes may not produce noticeable symptoms, and many people with diabetes are often diagnosed without exhibiting symptoms.
Type 2 diabetes symptoms include:
- Feeling thirsty all the time
- Passing a lot of urine, including during the night
- Constantly feeling very tired
- Repeated episodes of thrush or urine infections
- Blurred vision
- Unexpected weight loss
- Cuts taking longer to heal
These symptoms of diabetes can develop over a period of time before they become noticeable. If you have a combination of these symptoms, speak to a doctor as soon as you can to get tested.
Diagnosis
If type 2 diabetes is suspected, several tests may be carried out to aid a diagnosis. This may include a blood test and giving a urine sample.
The blood test will show your current blood sugar levels. This may be done as a fasting blood sugar test or a non-fasting blood test.
Your doctor may also do another blood test (called HbA1c) that can give an idea of what your blood sugar levels have been like over the past 3 months.
Treatment
If you are diagnosed with type 2 diabetes, you will need to continue life-long diabetes treatment. In some mild cases of diabetes, your doctor may decide that you don’t need medication straight away but will instead recommend lifestyle changes alongside monitoring of blood sugar levels.
Whether or not you need medication straight away, implementing lifestyle changes is recommended. Becoming more active during the day while reducing your carbohydrate and sugar intake will help to keep your blood sugar levels under control. This will prevent further complications of the disease and delay its progression.
In the next section, we will explore the most common type 2 diabetes medication used.
Metformin
Metformin is a drug that is commonly used to treat people with type 2 diabetes. If you are diagnosed as diabetic and need to take medicines to control it, your doctor will most likely prescribe metformin for you.
Metformin is usually taken twice a day with or after a meal. The first couple of weeks when you take this, you may get an upset stomach as your body tries to adjust to the new medicine. This is very common and usually gets better within two to three weeks.
Metformin will reduce your blood sugar levels and will consequently reduce any associated symptoms you might be experiencing.
One of the benefits of metformin is that it can also help you to lose weight. It is also very well-tolerated by most people and has few side effects.
If you are already taking metformin and need a refill of your prescription, you can order this through our online doctor. You can also use our app or website to order your NHS repeat medicines to your door.
It is very important to take this medicine regularly as directed by your doctor. By taking your medicine correctly, you can effectively control your diabetes and prevent further complications.
Other treatments
If metformin alone is not enough to control your blood sugar, you may have to take other antidiabetic medication alongside this. There are many medicines used to treat type 2 diabetes. The choice of drug used will depend on any other medicines you may be taking or other medical conditions you may have.
Advanced cases of type 2 diabetes may need treatment with different types of insulin injections and insulin pumps.
Effects of uncontrolled diabetes
It is of the utmost importance that you take your medication regularly and as prescribed by your doctor. It is equally important to make and maintain lifestyle changes (such as cutting down on carbohydrate intake) to ensure your blood sugar levels are well-regulated.
Uncontrolled blood sugar levels can lead to various health problems. This includes problems related to the heart, eyes, kidneys, feet, and nerves. It can also increase the risk of stroke. We will explore these in more detail.
Eyes
High blood sugar levels (especially coupled with consistently high blood pressure) can damage the eyes. This leads to what is called diabetic retinopathy, a significant cause of preventable sight loss in the UK. Diabetic retinopathy may cause weakening of eyesight or complete loss of vision.
Maintaining good control of your diabetes as well as attending regular eye tests will help to prevent the development of such complications.
Kidneys
Almost a fifth of patients with type 2 diabetes will have an issue with their kidneys. Uncontrolled diabetes can damage the kidneys. This damage typically occurs over a long period of time and is not reversible.
If the kidneys get damaged, they will not be able to filter your blood correctly, leading to a build-up of toxic waste products in your blood. This can in turn cause other health issues such as swelling in the hands and feet, fatigue, sickness, and blood in the urine.
As part of your monitoring regimen, your GP will check your kidneys yearly to ensure they are still healthy.
Nerves
One of the more serious and debilitating issues of poorly controlled diabetes is the resultant nerve damage. This can affect nerves all over the body, leading to pain, weakness or numbness in the affected part of the body.
This damage can affect your limbs. This may result in a reduced ability to feel pain or temperature, or conversely may cause sharp, shooting pain.
In some cases, nerve damage can affect your stomach, bowels or bladder, leading to diarrhoea, constipation or loss of bladder control.
If you think you are experiencing any signs of nerve damage, you should let your doctor know as soon as you can.
Feet
As we discussed in the previous section, nerve damage can lead to the inability to feel pain or respond to temperature changes.
In this case, if any trauma occurs to the feet, such as a cut or burn, this may go unnoticed for a long period of time. This could result in the cut or burn developing into an ulcer, perhaps even becoming infected. In the worst-case scenario, a serious infection leads to limb amputation.
To avoid these complications, it is vital to protect your feet at all times. It is recommended that you avoid walking barefoot outdoors and make sure to wear comfortable shoes.
If you can, check your own feet regularly for any physical damage or visit a podiatrist. You should have your feet checked at least annually by a podiatrist. By identifying any problems early, you can prevent more serious consequences.
Summary
As type 2 diabetes is a long-term condition, it is vital that you adhere to your medication and do not exceed the recommended intake of sugars and carbohydrates. Likewise, it is just as important to attend regular check-ups. Managing your diabetes well will protect you from developing more serious complications and will ensure that you keep as fit and healthy as possible when living with diabetes.
