What is it?
Type 2 diabetes is a condition where your body does not produce enough insulin, or it does not respond properly to the insulin that is produced. This results in high levels of sugar building up in your blood stream, which leads to the symptoms and complications of diabetes. The first stage in developing Type 2 diabetes is insulin resistance. This is means that your body is not properly responding to the insulin produced by your pancreas. Your pancreas tries to make up for this by producing more and more insulin until it eventually burns out and produces very little insulin.
Signs and symptoms of Type 2 diabetes can include the following:
- Excessive thirst, also called polydipsia
- Frequent urination, also called polyuria
- Excessive hunger, also called polyphagia
- Unintentional weight changes (gain or loss)
- Extreme fatigue or lack of energy
- Blurred vision
- Frequent or recurring infections
- Tingling or numbness in hands and feet
- Trouble maintaining or getting an erection
- Slow-healing sores or cuts
- Itching of the skin (usually around the vaginal or groin area)
- Frequent yeast infections
- Velvety dark skin changes of the neck, armpit, and groin, called acanthosis nigricans
If you are experiencing any of these symptoms speak with your doctor about being tested for diabetes.
There are many risk factors for developing Type 2 diabetes, some you can change, and some you can’t. If any of the following risk factors apply to you, consider speaking with your doctor about being tested for diabetes.
- Being over the age of 40
- Men are at higher risk of developing Type 2 diabetes than women
- I have a family member (parent or sibling) with diabetes
- Being a member of a high-risk population (Aboriginal, Hispanic, South East Asian, Asian, or African descent)
- Being physically inactive
- Having had gestational diabetes (diabetes during pregnancy)
- Being diagnosed with pre-diabetes or high blood pressure
- I am overweight, especially if you carry your weight on your abdomen and around your waist
For more information on the risk factors for developing Type 2 diabetes and how it is diagnosed click here.
Diabetes complications happen when your blood sugar levels are consistently high. The complications are divided into two types; those that affect the large blood vessels in your body (macrovascular), and those that affect the small blood vessels (microvascular). Macrovascular complications include heart disease, stroke, and high blood pressure. Microvascular complications affect the eyes, kidneys, and nerves.
For more information on the complications of diabetes click here.
Type 2 diabetes is a progressive disease and the treatment of it is progressive as well. What treatments your healthcare team recommends to you may change over time.
The first step in treating Type 2 diabetes is making positive lifestyle changes. These include trying to lose weight, following a healthy diet, and increasing physical activity. These changes help reduce insulin resistance and can lower your blood sugar levels.
After beginning to change your lifestyle, your doctor may prescribe you pills to help you manage your blood sugar levels. These medications work in many different ways, from squeezing more insulin out of your pancreas, to helping your cells to use insulin more effectively.
This type of medication works to help control blood sugar levels by helping your cells take sugar from your bloodstream, as well as decreasing the amount of sugar your liver releases. The most common biguanide medication is Metformin (also known as Glucophage or Glumetza). Metformin is usually taken twice per day, once in the morning, and once at night. Follow the directions given to you by your doctor or pharmacist.
These medications work to assist in blood sugar control by causing the cells of your pancreas to release more insulin, and by improving insulin’s action on your cells. The two most common types of these medications are gliclazide (or Diamicron) and repaglinide (or GlucoNorm). GlucoNorm is shorter acting and should be taken just prior to meals. If you are not going to be eating do not take your GlucoNorm tablet. These medications can cause low blood sugars, so it is important for you to know how to treat hypoglycemia. Always follow the directions given to you by your doctor or pharmacist.
These medications make your body more sensitive to the insulin it is making, and decrease how much sugar is made by your liver. Thiazolidinediones are marketed under the name Actos, and are usually taken once a day, at the same time each day. Follow the directions given to you by your doctor or pharmacist.
This type of medication slows the absorption of sugar into your bloodstream after a meal. It should be taken with the first bite of your meal to help keep your blood sugar levels after a meal within your target range. This medication is also known as Acarbose.
DPP-4 inhibitors work to improve your blood sugar levels by improving the insulin levels in your body after a meal, and by decreasing the amount of sugar made by your body. This type of medicine is sold under the names Januvia, Trajenta, or Onglyza. This type of medication will not cause low blood sugars. Speak with your doctor or pharmacist about whether a DPP-4 inhibitor can help you with managing your diabetes.
Currently GLP-1 agonists are only available as a once daily or once weekly injection, not in a pill form. It works to help control your blood sugars by increasing insulin release from your pancreas, as well as slowing down your digestion. The twice daily GLP-1 agonist is marketed as Byetta (Exenatide) and the once daily GLP-1 agonist is marketed as Victoza (Liraglutide). Once weekly GLP-1 agonists are marketed as Trulicity (Dulaglutide) and Bydureon (Exenatide XR). Speak with your doctor or pharmacist about whether a GLP-1 agonist can help you with managing your diabetes.
SGLT-2 inhibitors help to manage your blood sugar levels by increasing the amount of sugar you lose in your urine. It does this by stopping your kidneys from reabsorbing the sugar it has filtered. These medications are sold as Invokana (Canagliflozin), Forxiga (Dapagliflozin) and Jardiance (Empagliflozin).
If you have any questions about the medications you take to manage diabetes speak with your doctor, pharmacist, or diabetes educator.
Blood Glucose Monitoring
A very important part of managing diabetes is monitoring your blood sugar levels. A blood glucose meter is used to monitor your blood sugar levels, using a small drop of blood from your finger.
Learn more about monitoring your blood sugars.
While insulin therapy isn’t always required in treatment of Type 2 diabetes. At some point your doctor may recommend that you start using insulin to manage your diabetes. Insulin injections are given using a syringe or an insulin pen.
Long-acting insulin is usually taken once or twice per day and is designed to provide you with a constant background level of insulin to lower your blood sugars. This type of insulin is often used along with oral medications. Long-acting insulin is chemically named insulin glargine or insulin detemir, and is marketed under the names Lantus, Basaglar or Levemir. New longer-acting insulin is now available in Canada and these are chemically named insulin glargine U300 or insulin degludec, and are marketed under the names Toujeo or Tresiba.
Rapid-acting insulin is usually taken before a meal to help your body deal with large amounts of carbohydrates. This type of insulin lasts for a very short time in your body. It is used in combination with long-acting insulin as part of multiple daily injection therapy, or in an insulin pump. Rapid-acting insulin is chemically named insulin aspart, insulin lispro, or insulin glulisine, and is marketed under the names NovoRapid, Humalog, or Apidra. A new faster-acting rapid insulin is now available in Canada and is chemically named insulin aspart, marketed under the name Fiasp.
For more information on insulin therapy speak with your healthcare team and read here on insulin therapy
Emotional support is an important part of diabetes care. Connecting with other people living with diabetes that understand the struggles living with diabetes can bring, can make a big difference in your life. Getting support from your family and friends can also be a great way to reduce your stress.