Type 2

Diabetes
Mellitus
Megan Schleigh
King University
What is Type 2 Diabetes?

Type 2 diabetes occurs when the

body cannot properly use insulin,
a hormone that regulates blood
sugar. This is also known as insulin
resistance.
What Happens In the Body?

When we eat, our bodies break down complex

carbohydrates into glucose, the fuel we need. The
pancreas releases insulin that acts as a kind of key
to unlock the cells, allowing glucose to enter and
be absorbed.

In Type 2, the pancreas initially produces extra

insulin, but eventually cannot keep up with
production in order to keep blood sugar levels in
check. Without insulin, sugar stays in the blood
and can cause serious damage to the entire body.

(Beyond Type 1, n. d.)

 Risk Factors
 Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue you
have, the more resistant your cells become to insulin. However, you don't have to be overweight to
develop type 2 diabetes.
 Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is
greater than if your body stores fat elsewhere, such as your hips and thighs.
 Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps
you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
 Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes.
 Race. Although it's unclear why, people of certain races — including blacks, Hispanics, American
Indians and Asian-Americans — are more likely to develop type 2 diabetes than whites are.
 Age. The risk of type 2 diabetes increases as you get older, especially after age 45. That's probably
because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2
diabetes is also increasing dramatically among children, adolescents and younger adults.
 Prediabetes. Prediabetes is a condition in which your blood sugar level is higher than normal, but
not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type
2 diabetes.
 Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of
developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4
kilograms), you're also at risk of type 2 diabetes.
 Polycystic ovarian syndrome. For women, having polycystic ovarian syndrome — a common
condition characterized by irregular menstrual periods, excess hair growth and obesity — increases
the risk of diabetes.

(Mayo Clinic, 2018)

 Signs and Symptoms
Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have
type 2 diabetes for years and not know it. Look for:
 Increased thirst and frequent urination. Excess sugar building up in your
bloodstream causes fluid to be pulled from the tissues. This may leave you
thirsty. As a result, you may drink — and urinate — more than usual.
 Increased hunger. Without enough insulin to move sugar into your cells, your
muscles and organs become depleted of energy. This triggers intense hunger.
 Weight loss. Despite eating more than usual to relieve hunger, you may lose
weight. Without the ability to metabolize glucose, the body uses alternative
fuels stored in muscle and fat. Calories are lost as excess glucose is released in
the urine.
 Fatigue. If your cells are deprived of sugar, you may become tired and irritable.
 Blurred vision. If your blood sugar is too high, fluid may be pulled from the
lenses of your eyes. This may affect your ability to focus.
 Slow-healing sores or frequent infections. Type 2 diabetes affects your ability
to heal and resist infections.
 Areas of darkened skin. Some people with type 2 diabetes have patches of
dark, velvety skin in the folds and creases of their bodies — usually in the
armpits and neck. This condition, called acanthosis nigricans, may be a sign of
insulin resistance.

(Mayo Clinic, 2018)

 How to Prevent Type
2 Diabetes
 Eat healthy foods. Choose foods lower in fat and
calories and higher in fiber. Focus on fruits,
vegetables and whole grains.
 Get physical. Aim for a minimum of 30 minutes
of moderate physical activity a day. Take a brisk
daily walk. Ride a bike. Swim laps. If you can't fit
in a long workout, spread 10-minute or longer
sessions throughout the day.
 Lose excess pounds. If you're overweight, losing
7 percent of your body weight can reduce the
risk of diabetes. To keep your weight in a healthy
range, focus on permanent changes to your
eating and exercise habits. Motivate yourself by
remembering the benefits of losing weight, such
as a healthier heart, more energy and improved
self-esteem.

(Mayo Clinic, 2018)

 How the Disease is Diagnosed
 Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar
level for the past two to three months. An A1C level of 6.5 percent or higher on two
separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is
considered prediabetes, which indicates a high risk of developing diabetes. Normal
levels are below 5.7 percent.
If the A1C test isn't available, or if you have certain conditions — such as if you're
pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) —
that can make the A1C test inaccurate, your doctor may use the following tests to
diagnose diabetes:
 Random blood sugar test. A blood sample will be taken at a random time.
Regardless of when you last ate, a random blood sugar level of 200 or higher suggests
diabetes, especially when coupled with any of the signs and symptoms of diabetes,
such as frequent urination and extreme thirst.
 Fasting blood sugar test. A blood sample will be taken after an overnight fast. A
fasting blood sugar level less than 100 is normal. A fasting blood sugar level from 100
to 125 mg/dL is considered prediabetes. If it's 126 mg/dL or higher on two separate
tests, you have diabetes.
 Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood
sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are
tested periodically for the next two hours. A blood sugar level less than 140 mg/dL is
normal. A reading between 140 and 199 indicates prediabetes. A reading of 200 or
higher after two hours may indicate diabetes.

(Mayo Clinic, 2018)

 Exercise

Eat well

How Do I
Manage Type Maintain a healthy weight

2 Diabetes? Check your blood sugar regularly

If lifestyle changes aren’t enough, use oral medication or insulin therapy

(Beyond Type 1, n. d.)

 Monitoring your
Blood Sugar
 Depending on your treatment plan, you may need
to check and record your blood sugar level every
now and then or, if you're on insulin, multiple times
a day. Ask your doctor how often he or she wants
you to check your blood sugar. Careful monitoring is
the only way to make sure that your blood sugar
level remains within your target range.
 Sometimes, blood sugar levels can be
unpredictable. With help from your diabetes
treatment team, you'll learn how your blood sugar
level changes in response to food, exercise,
alcohol, illness and medication.

(Mayo Clinic, 2018)

Diet
Contrary to popular perception, there's no
specific diabetes diet. However, it's
important to center your diet on these high-
fiber, low-fat foods:
 Fruits
 Vegetables
 Whole grains
 You'll also need to eat fewer animal
products, refined carbohydrates and
sweets.

(Mayo Clinic, 2018)

 Exercise
 Everyone needs regular aerobic exercise, and
people who have type 2 diabetes are no
exception. Get your doctor's OK before you
start an exercise program. Then choose
activities you enjoy, such as walking,
swimming and biking. What's most important is
making physical activity part of your daily
routine.
 Aim for at least 30 minutes of aerobic exercise
five days of the week. Stretching and strength
training exercises are important, too. If you
haven't been active for a while, start slowly
and build up gradually.
 A combination of exercises — aerobic
exercises, such as walking or dancing on most
days, combined with resistance training, such
as weightlifting or yoga twice a week — often
helps control blood sugar more effectively
than either type of exercise alone.
 Remember that physical activity lowers blood
sugar. Check your blood sugar level before any
activity. You might need to eat a snack before
exercising to help prevent low blood sugar if
you take diabetes medications that lower your
blood sugar.

(Mayo Clinic, 2018)

 Medication Therapy

Some people who have type 2 diabetes

can achieve their target blood sugar
levels with diet and exercise alone, but
many also need diabetes medications or
insulin therapy. The decision about which
medications are best depends on many
factors, including your blood sugar level
and any other health problems you have.
Your doctor might even combine drugs
from different classes to help you control
your blood sugar in several different
ways.

(Mayo Clinic, 2018)

 Short-Term Complications:
Hypoglycemia
Hypoglycemia is the state of low blood sugar and is
caused by too much insulin or too little sugar in the body.
It is defined as a blood sugar below 70 milligrams per
deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L).
Untreated, it may result in seizures, unconsciousness and
sometimes death.
 What are symptoms of hypoglycemia?
Anxious feeling, behavior change similar to being drunk,
blurred vision, cold sweats, confusion, cool pale skin,
difficulty concentrating, drowsiness, excessive hunger,
fast heartrate, headache, nervousness, nightmares,
restless sleep, shakiness, slurred speech, or unusual
tiredness or weakness
 What causes hypoglycemia?
You can go low if you miss a meal, don’t eat enough food
for the amount of insulin you’ve taken or exercise a lot.
It’s imperative to monitor and treat low blood sugars
immediately in order to prevent severe hypoglycemia and
unconsciousness.

(Beyond Type 1, n. d.)

How do I treat hypoglycemia?
It’s important to know that treatment of hypoglycemia depends on the
severity of the low blood sugar reading, and whether or not the
person having a “hypo” is alert.
 If person is awake…
-Treat with simple carbohydrates (15 grams)
-Glucose tabs (4 tablets)
-Glucose gel (1 tube) (ideal for people with gastroparesis because
delayed absorption)
-Regular soda (4 ounces or half cup)
-Juice (4 ounces or half cup)
-Granulated sugar (4 teaspoons)
*Blood glucose should be checked 15 minutes after treatment, and if
blood glucose remains <70 mg/dl, another 15 grams of simple
carbohydrates should be given.
 If person is unconscious…
-Treat with glucagon and call emergency services

(Beyond Type 1, n. d.)

 Short-Term
Complications:
Hyperglycemia
 Your blood sugar level can rise for many
reasons, including eating too much, being sick
or not taking enough glucose-lowering
medication.
 Check your blood sugar level often, and watch
for signs and symptoms of high blood sugar —
frequent urination, increased thirst, dry
mouth, blurred vision, fatigue and nausea. If
you have hyperglycemia, you'll need to adjust
your meal plan, medications or both.

(Mayo Clinic, 2018)

 Short-Term
Complications: DKA
Diabetic ketoacidosis (DKA) is a complication from
diabetes that can be serious and life-threatening. DKA
is often a common factor when first diagnosed with
Type 1 diabetes, but also can occur during
management of the disease. When the body is not
receiving enough insulin to break down glucose,
it forces the body to start breaking down fat as
fuel. Ketones are then released into the body.
Causes can include:
 Lack of insulin
 Consistent high blood sugar levels (hyperglycemia)
 Lack of food in the system due to illness/nausea
 Overnight low blood sugars (hypoglycemia)
 Infection
 Dehydration

(Beyond Type 1, n. d.)

Signs and Symptoms of DKA
Early symptoms
 High levels of ketones in urine
 Very high blood glucose levels
 Frequent urination
 Dehydration
 Extreme thirst

More extreme warning signs

 Constant fatigue
 Flushed skin
 Nausea or stomach pain
 Vomiting
 Shortness of breath
 Fruity smell on the breath
 Disorientation

(Beyond Type 1, n. d.)

 How to Prevent
DKA
DKA is prominent when you are ill, due to
factors such as stress hormones and
dehydration. To avoid going into DKA be sure to
take precautions such as:
 Drinking lots of water
 Take the appropriate doses of insulin as
instructed by your doctor
 Eat what you can
 Test blood sugar often
 Test for ketones

(Beyond Type 1, n. d.)

 How To Test For
DKA
How to test for ketones
 Ketone strips (urinalysis) can be purchased at any
pharmacy. Follow the directions given in the
instructions insert, and match the result on the
stick with the accompanying color chart.
When to test for ketones
 If you are experiencing any of the symptoms listed
above
 If you have a flu or any other kind of virus
(recommended to test every 4 to 6 hours)
 If your blood glucose levels are consistently higher
than 240
When to see a doctor
 If urinalysis test shows high levels of ketones, or if
you experience any extreme symptoms, contact a
doctor immediately.

(Beyond Type 1, n. d.)

 Short-Term
Complications: HHS
Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a
complication of type 2 diabetes. It involves extremely high
blood sugar (glucose) level without the presence of
ketones.

HHS is a condition of:

 Extremely high blood sugar (glucose) level
 Extreme lack of water (dehydration)
 Decreased alertness or consciousness (in many cases)

(U.S. National Library of Medicine, 2018)

Causes of HHS HHS is more often seen in
people with type 2 diabetes
who don't have their diabetes
under control. It may also occur
in those who have not been
diagnosed with diabetes. The
condition may be brought on by:
 Infection
 Other illness, such as heart
attack or stroke
 Medicines that decrease the
effect of insulin in the body
 Medicines or conditions that
increase fluid loss
 Running out of, or not taking
prescribed diabetes
medicines

(U.S. National Library of

Medicine, 2018)
 Symptoms of HHS
Symptoms may include any of the following:
 Increased thirst and urination (at the beginning of the
syndrome)
 Feeling weak
 Nausea
 Weight loss
 Dry mouth, dry tongue
 Fever
 Seizures
 Confusion
 Coma
 Symptoms may get worse over days or weeks.

When to Contact a Medical Professional

 This condition is a medical emergency. Go to the
emergency room or call the local emergency number
(such as 911) if you develop symptoms of HHS.

(U.S. National Library of Medicine, 2018)

 Long-Term Complications
Potential complications can develop over time if blood glucose levels aren’t diligently
managed. Some of the risks to the body are mildly irritating or debilitating while
others are more serious and potentially life threatening.

(Beyond Type 1, n. d.)

Long-Term Complication: Retinopathy
 Retinopathy, or loss of eyesight, is an eye complication caused by damage to
the blood vessels in the retina, and is, unfortunately, quite common among
people who experience high blood sugar levels over an extended period of
time.
 It can occur before you notice any changes in your vision.
 Eyesight loss, even in its milder forms, is less likely to occur if you’re careful
to keep your blood sugar levels close to the normal baseline.

(Beyond Type 1, n. d.)

 Long-Term
Complication: Skin
Conditions
Bacterial infections, such as styes, boils, infections of hair
follicles, and deep infections of and underneath the skin
and nails are common without proper control of blood
sugar levels.

Fungal infections (yeast infections) are another potential

skin complication, resulting in rashes that run rampant in
the warm, moist creases of skin, like under the breasts,
between fingers and toes, in the armpits, the groin and
under the foreskin in uncircumcised men.

Localized itching can also be a symptom of diabetes,

caused by a yeast infection, dry skin, or poor circulation,
which causes the lower parts of the legs to be most
irritated.

(Beyond Type 1, n. d.)

Long-Term Complication: Cardiovascular
Disease
Type 2 diabetes have a higher risk for heart attack, stroke, chest pain or heart
disease.

(Beyond Type 1, n. d.)

 Long-Term Complication:
Neuropathy
Unmonitored blood glucose levels can cause nerve
damage in the legs, feet, and hands, which might
lead to pain, numbness, increased sensitivity or
weakness. Treating nerve damage and protecting
your body means keeping your blood glucose levels
in the target zone.

(Beyond Type 1, n. d.)

Long-Term Complication:
Kidney Damage
 Kidneys, the body’s filters, can become
seriously damaged due to unmonitored blood
glucose levels. The most severe complications
in the kidneys may lead to kidney failure or
irreversible end-stage kidney disease, which
may require dialysis or a transplant.

(Beyond Type 1, n. d.)

 References
Beyond Type 1. (n. d.). Retrieved from https://beyondtype1.org/

Mayo Clinic. (2018). Type 2 diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc

-20351193

U.S. National Library of Medicine. (2018). Diabetic hyperglycemic hyperosmolar syndrome. Retrieved from https://medlineplus.gov/ency/

article/000304.htm