What is type 2 diabetes?
Diabetes is a disease in which blood glucose levels are above normal.
People with diabetes have problems converting food to energy.
After a meal, food is broken down into a sugar called glucose,
which is carried by the blood to cells throughout the body. Cells
use the hormone insulin, made in the pancreas, to help them
process blood glucose into energy.
People develop type 2 diabetes because the cells in the muscles,
liver, and fat do not use insulin properly. Eventually, the pancreas
cannot make enough insulin for the body’s needs. As a result, the
amount of glucose in the blood increases while the cells are starved
of energy. Over the years, high blood glucose damages nerves and
blood vessels, leading to complications such as heart disease, stroke,
blindness, kidney disease, nerve problems, gum infections, and
How can type 2 diabetes be prevented?
Although people with diabetes can prevent or delay complications
by keeping blood glucose levels close to normal, preventing or
delaying the development of type 2 diabetes in the first place is
even better. The results of a major federally
funded study, the Diabetes Prevention
Program (DPP), show how to do so.
This study of 3,234 people at high risk
for diabetes showed that moderate diet
and exercise resulting in a 5- to 7-percent
weight loss can delay and possibly prevent
type 2 diabetes.
Study participants were overweight and had
higher than normal levels of blood glucose,
a condition called pre-diabetes (impaired glucose
tolerance). Both pre-diabetes and obesity
are strong risk factors for type 2 diabetes.
Am I at Risk for Type 2 Diabetes?
Because of the high risk among some minority groups, about half
of the DPP participants were African American, American Indian,
Asian American, Pacific Islander, or Hispanic American/Latino.
The DPP tested two approaches to preventing diabetes: a healthy
eating and exercise program (lifestyle changes), and the diabetes
drug metformin. People in the lifestyle modification group exercised
about 30 minutes a day 5 days a week (usually by walking)
and lowered their intake of fat and calories. Those who took the
diabetes drug metformin received standard information on exercise
and diet. A third group received only standard information on
exercise and diet.
The results showed that people in the lifestyle modification group
reduced their risk of getting type 2 diabetes by 58 percent. Average
weight loss in the first year of the study was 15 pounds. Lifestyle
modification was even more effective in those 60 and older. They
reduced their risk by 71 percent. People receiving metformin
reduced their risk by 31 percent.
What are the signs and symptoms
of type 2 diabetes?
Many people have no signs or symptoms. Symptoms can also be so
mild that you might not even notice them. Nearly six million people
in the United States have type 2 diabetes and do not know it.
Here is what to look for:
- increased thirst
- increased hunger
- increased urination, especially at night
- weight loss
- blurred vision
- sores that do not heal
Types of Diabetes
The three main kinds of diabetes are type 1, type 2, and
Type 1 Diabetes
Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent
diabetes, is usually first diagnosed in children,
teenagers, or young adults. In this form of diabetes, the
beta cells of the pancreas no longer make insulin because
the body’s immune system has attacked and destroyed them.
Treatment for type 1 diabetes includes taking insulin shots or
using an insulin pump, making wise food choices, exercising
regularly, taking aspirin daily (for some), and controlling
blood pressure and cholesterol.
Type 2 Diabetes
Type 2 diabetes, formerly called adult-onset or noninsulin-dependent
diabetes, is the most common form of diabetes.
People can develop type 2 diabetes at any age, even during
childhood. This form of diabetes usually begins with insulin
resistance, a condition in which fat, muscle, and liver cells do
not use insulin properly. At first, the pancreas keeps up with
the added demand by producing more insulin. In time, however,
it loses the ability to secrete enough insulin in response
to meals. Being overweight and inactive increases the
chances of developing type 2 diabetes. Treatment includes
taking diabetes medicines, making wise food choices, exercising
regularly, taking aspirin daily, and controlling blood
pressure and cholesterol.
Some women develop gestational diabetes during the late
stages of pregnancy. Although this form of diabetes usually
goes away after the baby is born, a woman who has had
it is more likely to develop type 2 diabetes later in life.
Gestational diabetes is caused by the hormones of
pregnancy or a shortage of insulin.
Am I at Risk for Type 2 Diabetes?
Sometimes people have symptoms but do not suspect diabetes.
They delay scheduling a checkup because they do not feel sick.
Many people do not find out they have the disease until they have
diabetes complications, such as blurry vision or heart trouble. It is
important to find out early if you have diabetes because treatment
can prevent damage to the body from diabetes.
Should I be tested for diabetes?
Anyone 45 years old or older should consider getting tested for
diabetes. If you are 45 or older and overweight (see BMI chart on
pages 10 and 11), it is strongly recommended that you get tested.
If you are younger than 45, overweight, and have one or more of
the risk factors on page 5, you should consider testing. Ask your
doctor for a fasting blood glucose test or an oral glucose tolerance
test. Your doctor will tell you if you have normal blood glucose,
pre-diabetes, or diabetes.
What does it mean to have pre-diabetes?
It means you are at risk for getting type 2 diabetes and heart disease.
The good news is if you have pre-diabetes you can reduce the
risk of getting diabetes and even return to normal blood glucose
levels. With modest weight loss and moderate physical activity,
you can delay or prevent type 2 diabetes. If your blood
glucose is higher than normal but lower than the diabetes range
(what we now call pre-diabetes), have your blood glucose checked
in 1 to 2 years.
Doing My Part: Getting Started
Making big changes in your life is hard, especially if you are faced
with more than one change. You can make it easier by taking these
- Make a plan to change behavior.
- Decide exactly what you will do and when you will do it.
- Plan what you need to get ready.
- Think about what might prevent you from reaching your
- Find family and friends who will support and encourage you.
- Decide how you will reward yourself when you do what you
Your doctor, a dietitian, or a counselor can help you make a plan.
Here are some of the areas you may wish to change to reduce your
risk of diabetes.
Reach and Maintain a Reasonable Body Weight
Your weight affects your health in many ways. Being overweight
can keep your body from making and using insulin properly. It can
also cause high blood pressure. The DPP showed that losing even a
few pounds can help reduce your risk of developing type 2 diabetes
because it helps your body use insulin more effectively. In the DPP,
people who lost between 5 and 7 percent of their body weight significantly
reduced their risk of type 2 diabetes. For example, if you
weigh 200 pounds, losing only 10 pounds could make a difference.
Body mass index (BMI) is a measure of body weight relative to
height. You can use BMI to see whether you are underweight,
normal weight, overweight, or obese. Click here to view the BMI table.
- Find your height in the left-hand column.
- Move across in the same row to the number closest to your
- The number at the top of that column is your BMI. Check
the word above your BMI to see whether you are normal
weight, overweight, or obese.
If you are overweight or obese, choose sensible ways to get in
- Avoid crash diets. Instead, eat less of the foods you usually
have. Limit the amount of fat you eat.
- Increase your physical activity. Aim for at least 30 minutes
of exercise most days of the week.
- Set a reasonable weight-loss goal, such as losing 1 pound a
week. Aim for a long-term goal of losing 5 to 7 percent of
your total body weight.
Make Wise Food Choices Most of the Time
What you eat has a big impact on your health. By making wise food
choices, you can help control your body weight, blood pressure, and
- Take a hard look at the serving sizes of the foods you eat.
Reduce serving sizes of main courses (such as meat), desserts,
and foods high in fat. Increase the amount of fruits and
- Limit your fat intake to about 25 percent of your total calories.
For example, if your food choices add up to about 2,000 calories
a day, try to eat no more than 56 grams of fat. Your doctor or a
dietitian can help you figure out how much fat to have. You can
check food labels for fat content too.
- You may also wish to reduce the number of calories you have
each day. People in the DPP lifestyle modification group lowered
their daily calorie total by an average of about 450 calories.
Your doctor or dietitian can help you with a meal plan that
emphasizes weight loss.
- Keep a food and exercise log. Write down what you eat, how
much you exercise—anything that helps keep you on track.
- When you meet your goal, reward yourself with a nonfood item
or activity, like watching a movie.
Be Physically Active Every Day
Regular exercise tackles several risk factors at once. It helps you
lose weight, keeps your cholesterol and blood pressure under
control, and helps your body use insulin. People in the DPP who
were physically active for 30 minutes a day 5 days a week reduced
their risk of type 2 diabetes. Many chose brisk walking for exercise.
If you are not very active, you should start slowly, talking with your
doctor first about what kinds of exercise would be safe for you.
Make a plan to increase your activity level toward the goal of being
active at least 30 minutes a day most days of the week. Choose activities you enjoy. Here are some ways to work extra
activity into your daily routine:
- Take the stairs rather than an elevator or escalator.
- Park at the far end of the lot and walk.
- Get off the bus a few stops early and walk the rest of the way.
- Walk or bicycle instead of drive whenever you can.
Take Your Prescribed Medications
Some people need medication to help control their blood pressure
or cholesterol levels. If you do, take your medicines as directed.
Ask your doctor whether there are any medicines you can take to
prevent type 2 diabetes.
Hope Through Research
We now know that many people can prevent type 2 diabetes
through weight loss, regular exercise, and lowering their intake of
fat and calories. Researchers are intensively studying the genetic
and environmental factors that underlie the susceptibility to obesity,
pre-diabetes, and diabetes. As they learn more about the molecular
events that lead to diabetes, they will develop ways to prevent and
cure the different stages of this disease. People with diabetes and
those at risk for it now have easier access to clinical trials that test
promising new approaches to treatment and prevention. For information
about current studies, see ClinicalTrials.gov.
Diabetes - Staying
head to toe
If you have diabetes, controlling your
sugar is always the first priority. A healthy
diet, regular exercise and good medical
care can help.
When your blood sugar is under
control you’re also at lower risk for
complications from diabetes. High
blood sugar levels can damage your
nerves and blood vessels.
When levels are too high it can cause
damage and disease in your eyes, teeth
and feet. That’s why these parts of your
body need special care, according to
the American Diabetes Association.
Eyes. To keep your eyes healthy,
get an eye exam every year. You
should also go to the doctor if:
- Your vision gets blurry.
- You see double.
- Your eyes hurt.
- You see spots.
Teeth and gums. Have your teeth
cleaned and checked every 6 months.
Brush your teeth, front and back,
twice daily with a soft brush. Floss
once a day. See your dentist if you
notice any problems with your
gums or teeth.
Feet. Wash and dry your feet
every day. Use lotion to keep the
skin from drying out.
Check every day for sores, blisters,
calluses or swelling. Don’t try to treat
calluses or corns at home. See your
Cut toenails straight across. Look
for sharp edges—they can cut your
Check shoes inside and out for
sharp objects before you put them
on. Pebbles, nails or even a torn
shoe lining could cause problems.