Type 2 diabetes

Type 2 diabetes is a metabolic disease. It causes glucose to collect in the blood. With this type of diabetes, insulin is not properly absorbed and used by the body’s somatic cells. Type 2 diabetes is often noticed in older people. That is why it is called “adult-onset diabetes”.

Type 2 diabetes is much more common than type 1 diabetes. Approximately 90 percent of people with diabetes have type 2 diabetes.

Some people need to make only small changes to their lives in order to manage their diabetes. For some, more physical activity and slight weight loss is sufficient.

Others require continuous treatment in the form of tablets or insulin. In these cases, it is particularly important for the patient to understand the disease and know what they can do to manage it.

If diabetes is left untreated, blood glucose values become permanently elevated. This can go unnoticed at the beginning. Type 2 diabetes can develop over time without any symptoms. A continuously elevated blood glucose level can cause the following symptoms:

• strong thirst
• increased urinary urgency
• fatigue and listlessness
• nausea
• dizziness

When blood glucose levels are extremely elevated, a person may also experience impaired consciousness or unconsciousness – a condition known as diabetic coma.

The body’s organs need sugar (glucose) as a source of energy for their metabolic processes. The hormone insulin helps to distribute glucose effectively throughout the body.

Insulin is produced in the pancreas and released into the bloodstream when the blood glucose level increases.

With the help of insulin, cells in the liver and muscles, for example, can absorb the glucose in the blood. If this process is impaired, the glucose is not used properly. This makes the glucose level in the blood rise.

A blood glucose level that is too high is known as hyperglycemia.

With type 2 diabetes, the pancreas produces enough insulin, but it does not have the correct effect on somatic cells and tissue. The medical term for this is insulin resistance.

Various risk factors contribute to type 2 diabetes. They include:

• being overweight and lack of physical activity
• smoking
• a low-fiber diet that is high in fat and sugar
• some medications that impair sugar metabolism
• genetic predisposition: the disease is prevalent in some families.

If a person with diabetes does not receive proper long-term treatment, there is consistently too much glucose in the blood and blood vessels can become damaged. This leads to a heightened risk of heart attack, stroke, and circulatory problems in the legs and feet (peripheral arterial occlusive disease, pAOD). 

There is also a higher risk if the patient has high blood pressure. Even small blood vessels in the eyes, nerves, and kidneys can become damaged. This can cause gradual visual impairment, sensory disorders, and kidney damage.

Damage to the nerves and circulatory disorders caused by diabetes can, for example, lead to “diabetic foot”. With this condition, pain in the foot can hardly be felt and a wound that heals poorly can develop as the result of a bruise or small injury. Since the legs and feet have poor circulation, the ability of wounds to heal is also impaired.

There are many things a person can do to avoid type 2 diabetes.

An important role is played by lifestyle, in particular a balanced diet and sufficient physical activity. People who are overweight are advised to lose weight.

If a person is at high risk of diabetes, changing the diet and increasing the level of physical activity can often delay diagnosis by several years. It is not yet clear if these measures can completely prevent type 2 diabetes. 

Type 2 diabetes develops slowly. For this reason, people often have very few or even no symptoms at first. An elevated glucose level in the blood or urine is often only discovered during a routine examination.

If type 2 diabetes is suspected, the doctor will first ask about symptoms and other illnesses. Then, a physical examination and blood glucose test is completed.

To check glucose levels before the first meal of the day and over the course of the day, blood is drawn multiple times. The blood is tested by a lab. The HbA1c level provides information about the average blood glucose level over the last two to three months.

If the blood glucose level is so high that it causes typical symptoms to appear, glucose is often also detected in the urine. In Germany, easy-to-use urine test strips are available in medical practices and pharmacies.

The kind of treatment that is useful and appropriate for patients with type 2 diabetes depends on many different factors, important ones being age, physical condition, other diseases, overall life situation, and personal goals.

A change in lifestyle can make a big difference. Simply losing weight and increasing physical activity can improve the effectiveness of insulin and lower the blood glucose level.

Those who quit smoking also reduce their risk of cardiovascular disease. Some people are able to manage their type 2 diabetes and the associated risks with these types of changes in lifestyle alone.

People with more severe type 2 diabetes often rely on medication to lower their glucose levels. Some take tablets and others administer insulin shots or incretin mimetics – hormone-like substances used to encourage the body’s own production of insulin. It is also possible to combine tablets with injections. The most common medications for the treatment of type 2 diabetes (antidiabetics) are metformin, gliptins, and sulfonylurea.

More information about type 2 diabetes and medication that may be required can be found at gesundheitsinformation.de.

There are things a person with type 2 diabetes can do to prevent the need for medication. The first is to lose at least a little weight, even if this can be challenging. Even small changes in lifestyle, such as being more physically active, can have a positive effect. For example, it can be beneficial to develop the habit of walking more.

If these measures are insufficient, medication is considered. However, it must be taken regularly over a longer period of time. Many find it hard to get used to the idea of taking a medication for their entire lives, especially if they don’t feel sick and don’t feel the effects of the medication right away.

In particular, treating type 2 diabetes shortly after diagnosis can be a challenge. However, understanding the disease makes it easier to view treatment as a normal part of daily life in order to enhance the quality of life.

No matter which treatment is selected, it is important for people to have a good understanding of the disease and to know what they themselves can do about it.

The support of a doctor and other medical specialists is important, for example by those who offer counseling in diabetes and nutrition, as well as a podiatrist.

People can also take part in a disease management program. This structured treatment program includes training and consulting in diabetes, and comprehensive medical care by diabetes specialists.