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What is Type 2 diabetes and why does it occur?


There are two main types of diabetes, known as "Type 1 Diabetes" and "Type 2 Diabetes".

These two conditions are generally considered to be 2 different and separate conditions, so it is important to understand the differences between the two.

Some old names for Type 2 Diabetes include: “Adult Onset Diabetes”, “Non Insulin dependent diabetes mellitus” and “NIDDM”. These old names should not be used, as they are no longer considered correct.

Important Stuff to Know

Type 2 diabetes is the most common type of diabetes. Of all people with diabetes, 90% have Type 2 diabetes. It is also quite common in the general population. Studies show that between 5% and 10% of any given population have Type 2 diabetes.

Some ethnic groups, like the South African Indian population, are more prone to developing diabetes, and in these groups, the percentage is even higher.

Type 2 diabetes usually happens in older people, but recently, more and more younger people, and sometimes even children, develop Type 2 diabetes.

Type 2 diabetes is a disorder of a person's metabolism, and its primary characteristic is high blood glucose. There are two main reasons for the high blood glucose:

  • Insulin resistance
  • Lack of insulin

Insulin resistance

Insulin resistance means that the cells of the body do not fully respond to insulin that is released. In other words, the insulin that is present, does not work as well as it should.

As a result, glucose remains in the blood instead of being moved into the cells. In addition, glucose is also not moved into the liver for storage. In the early stages of Type 2 diabetes, the pancreas produces larger amounts of insulin to try and overcome this resistance.

Lack of insulin

This occurs as the condition progresses. Over time, the pancreas produces less and less insulin, and eventually, the pancreas will stop producing insulin.

What are the symptoms of Type 2 diabetes?

The symptoms of Type 2 diabetes are all based on the fact that there is high blood sugar. The symptoms include:

  • Extreme thirst
  • Frequent urination
  • Lethargy, fatigue and drowsiness
  • Blurred vision
  • Sudden weight loss
  • Increased appetite, hunger

When the blood sugar is stabilised by treatment, these symptoms go away.

Important: In many people with Type 2 diabetes, even though they have raised blood glucose levels, these levels are not high enough to cause these symptoms. When this happens, the person will have no symptoms, and not even know that they have diabetes!

Type 2 diabetes is also associated with other conditions like high blood pressure and increased cholesterol and blood fats levels.

So why does Type 2 diabetes occur?
Type 2 diabetes is precipitated by a number of lifestyle factors, including:

  • Obesity
  • Lack of physical activity
  • Poor diet

Important: Type 2 diabetes is a progressive condition!

By the time a person is diagnosed with Type 2 diabetes, they have probably had the condition for 7 – 10 years! In the early stages, there are no symptoms, so it is usually not picked up early.

Over time, the pancreas produces less and less insulin, until eventually, there is no insulin produced. It is important to realise that the condition progresses, because the treatment of a person with Type 2 diabetes needs to change as a result of the progression.

 

How is Type 2 diabetes treated?

The primary treatment is to lose weight and increase physical activity. This slows down the progression of the condition, and dramatically improves the health risk of the person with Type 2 diabetes.There are certain medicines that are used:

  • Medicines to reduce insulin resistance (e.g. Metformin)
  • Medicines to promote more insulin secretion from the pancreas
  • Insulin

It is important to know that over time, all people with Type 2 diabetes may require insulin. Your doctor should monitor your blood glucose levels and change your therapy if your medicines are not working well enough.

Myths and Misconceptions – what NOT to believe

  • Type 2 diabetes only occurs in older, fat people. Not true! Type 2 diabetes usually occurs in older, overweight people, but it is occurring more and more in young people.
  • You have Type 2 diabetes if you are on tablets, and you have Type 1 diabetes if you are on insulin. Incorrect! Type 1 and Type 2 diabetes are two different conditions. They can even occur at the same time in some people.
  • Insulin resistance causes overweight. Very wrong! Being overweight actually causes insulin resistance.
  • As long as I avoid sugar I will be fine. No! It is best to follow a healthy diet that is also low in saturated fats and low in salt.

Goals and Recommendations – Be SMART

  • Lose weight slowly by following a healthy diet plan and increasing your physical activity. Aim to lose a maximum of 1 kg per week.
  • Know your numbers! Keep track of your blood glucose, cholesterol and blood pressure.
  • If your blood glucose is not controlled by your current medicine, ask your doctor about intensifying your therapy. Do not regard insulin as a last resort medicine.

Take Home Messages – What to Remember

  • Type 2 diabetes is a specific type of diabetes. It is a condition of insulin resistance and progressive lack of insulin.
  • The primary treatment of Type 2 diabetes is to lose weight, and to maintain a level of physical activity.
  • Type 2 diabetes is a progressive condition. This means that medicine therapy should change over time. Eventually, insulin may be required.
  • High blood pressure and raised cholesterol levels are equally as important as blood sugar levels. Make sure that these are all controlled.