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What is type 2 diabetes?

Type 2 diabetes (sometimes called type 2 "diabetes mellitus") is a disorder that disrupts the way your body uses sugar.

All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. If there is not enough insulin, or if the body stops responding to insulin, sugar builds up in the blood. That is what happens to people with diabetes.

There are 2 different types of diabetes. In type 1 diabetes, the problem is that the body makes little or no insulin. In type 2 diabetes, the problem is that:



What are the symptoms of type 2 diabetes?

Type 2 diabetes usually causes no symptoms. When symptoms do occur, they include:

Needing to urinate often

Intense thirst

Blurry vision



If type 2 diabetes rarely causes symptoms, why should I care about it?

Even though type 2 diabetes might not make you feel sick, it can cause serious problems over time, if it is not treated. The disorder can lead to:

Heart attacks

Strokes

Kidney disease

Vision problems (or even blindness)

Pain or loss of feeling in the hands and feet

The need to have fingers, toes, or other body parts removed (amputated)



How do I know if I have type 2 diabetes?

To find out if you have type 2 diabetes, your doctor can do a blood test to measure the amount of sugar in your blood.



How is type 2 diabetes treated?

There are a few medicines that help control blood sugar. Some people need to take pills that help the body make more insulin or that help insulin do its job. Others need insulin shots.

Sometimes, people with type 2 diabetes also need medicines to reduce the problems caused by the disease. For instance, medicines used to lower blood pressure can reduce the chances of a heart attack or stroke.

Medicines are not the only tool to manage diabetes. Being active, losing weight, eating right, and not smoking can all help people with diabetes stay as healthy as possible.



Can type 2 diabetes be prevented?

Yes, it can. To reduce your chances of getting type 2 diabetes, the most important thing you can do is control your weight. If you already have the disorder, losing weight can improve your health and blood sugar control. Being active can also help prevent or control the disorder.



What are the goals of type 2 diabetes treatment?

The goals of treatment for type 2 diabetes (sometimes called type 2 "diabetes mellitus") are:



How is type 2 diabetes treated?

Type 2 diabetes can be treated with:

Your doctor  will work with you to make a treatment plan that is right for you.



What diet and lifestyle changes might be part of my treatment?

As part of your treatment, your doctor might recommend that you:

Making these lifestyle changes is as important as taking your medicines.



What medicines are used to treat type 2 diabetes?

Different medicines can be used to treat type 2 diabetes. The first medicine that most people with type 2 diabetes take is a pill called metformin.



How do I know if my treatment is working?

One way to know if your treatment is working is to check your blood sugar level. People can use a device called a "blood glucose monitor" to check their blood sugar level at home. If your doctor recommends that you use a blood glucose monitor, he or she will teach you how and tell you when to use it.

Your doctor can also do a blood test called an "A1C." This test checks what your blood sugar level has been over the past 2 to 3 months.



What if my blood sugar level is still higher than normal?

If your blood sugar level is still higher than normal after you have been taking metformin for 2 to 3 months, your doctor might add a second medicine to your treatment.



Which second medicine will I take?

There are different medicines your doctor can prescribe. The choice will depend, in part, on your weight, your other health problems, and if you want to use a shot.

Some of these medicines can cause low blood sugar as a side effect. Symptoms of low blood sugar can include:

Low blood sugar should be treated quickly because it can cause you to pass out. Your doctor will tell you ahead of time how to treat low blood sugar.



What is insulin?

Insulin is a medicine that lowers a person's blood sugar level. People who use insulin might use it as a second medicine, or as their only medicine. It usually comes in the form of a shot that people give themselves. One brand of insulin comes in the form of a powder that is breathed into the lungs.

If your doctor prescribes insulin, he or she will tell you which form to use and show you how to give yourself a shot, if needed. He or she will also tell you:

An insulin dose often needs to change when a person gets sick, has surgery, travels, or eats out. Ask your doctor or  how to change your dose during these times.



What other treatments might I need?

Sometimes, people with type 2 diabetes need medicines to treat health problems that often affect people with diabetes. For example, people who have high blood pressure might take medicines to lower their blood pressure. This can reduce their chances of having a heart attack or stroke.



When should I see my doctor ?

Most people with diabetes see their doctor  every 3 or 4 months. When you see your doctor , he or she will talk with you about your medicines and blood sugar levels. If your blood sugar levels are not in control, your doctor   might make changes to your treatment plan.

Taking care of diabetes can be hard, and some people feel sad or worried about their diabetes. Let your doctor know if you feel this way so that he or she can help.



Why is diet important in diabetes?

Diet is important, because it is part of diabetes treatment. Many people need to change what they eat and how much they eat to help treat their diabetes. It is important for people to treat their diabetes so that they:

Changing your diet can also help treat obesity, high blood pressure, and high cholesterol. These conditions can affect people with diabetes and can lead to future problems, such as heart attacks or strokes.



Who will work with me to change my diet?

Your Doctor or Diabetes Educator / Dietitian will work with you to make a food plan to change your diet.



Do I need to eat at the same times every day?

When and how often you should eat depends, in part, on the diabetes medicine that you take. For example, people who use a certain type of insulin or who take diabetes pills that increase insulin levels (called "sulfonylureas") should eat meals at the same time each day. This helps prevent people from getting low blood sugar.

People who use an insulin pump, insulin before each meal, or pills that improve the way insulin works (called "metformin") do not always have to eat meals at the same time. That's because people who use these treatments have a smaller chance of getting low blood sugar.



What do I need to think about when planning what to eat?

Our bodies break down the food we eat into small pieces called carbohydrates, proteins, and fats.

When planning what to eat, people with diabetes need to think about:

It is best to get your carbohydrates from fruits, vegetables, whole grains, and low-fat milk.

"Monounsaturated" and "polyunsaturated" fats are better for you. Foods with these types of fat include fish, avocado, olive oil, and nuts.



What can I do if I need to lose weight?

If you need to lose weight, you can:

If you are worried about your weight, size, or shape, talk with your doctor, diabetes educator, or dietitian so that he or she can help.



Can I eat the same foods as my family?

Yes. You do not need to eat special foods if you have diabetes. You and your family can eat the same foods. Changing your diet is mostly about eating healthy foods and not eating too much.



What are the other parts of diabetes treatment?

The other parts of diabetes treatment are:

Some people with diabetes need to learn how to match their diet and exercise with their medicine dose. For example, people who use insulin might need to choose the dose of insulin they give themselves. To choose their dose, they need to think about:

If the diet and exercise do not match the medicine dose, a person's blood sugar level can get too low or too high. Blood sugar levels that are too low or too high can cause problems.



What are the benefits of exercise?

Exercise has many benefits. It can:



What are the main types of exercise?

There are 3 main types of exercise. They are:

It's important to have all 3 types of exercise in your exercise program. That way, your body, muscles, and joints can be as healthy as possible.



Should I talk to my doctor or diabetes educator before I start exercising?

If you have not exercised before or have not exercised in a long time, talk with your doctor or diabetes educator before you start a very active exercise program.

If you have heart disease or risk factors for heart disease (like high blood pressure or diabetes), your doctor might recommend that you have an exercise test before starting an exercise program.

When you start an exercise program, start slowly. For example, do the exercise at a slow pace or for a few minutes only. Over time, you can exercise faster and for longer periods of time.



What should I do when I exercise?

Each time you exercise, you should:



How often should I exercise?

Doctors recommend that people exercise at least 30 minutes a day, on 5 or more days of the week.

If you can't exercise for 30 minutes straight, try to exercise for 10 minutes at a time, 3 or 4 times a day.



When should I call my doctor?

If you have any of the following symptoms when you exercise, stop exercising and call your doctor or nurse right away:



What if I don't have time to exercise?

Many people have very busy lives and might not think that they have time to exercise. But it's important to try to find time to exercise, even if you are tired or work a lot. Exercise can increase your energy level, which might even help you get more work done.

On days when you really can't find time to exercise, there are ways that you can be more active. For example, you can:

Spending a lot of time sitting still – for example, watching television or working on the computer – can be bad for your health. Try to get up and move around whenever you can.



What else should I do when I exercise?

To exercise safely and avoid problems, be sure to:



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Dr. Ashwini Joshi

MBBS DNB Medicine, MRCP UK
Consultant Physician and Diabetologist

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