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What is Type 2 diabetes?

Type 2 diabetes, also called non-insulin-dependent diabetes, is a disorder that occurs when your pancreas doesn't produce enough insulin to meet your body's needs or your body stops being able to use insulin, leading to abnormally high levels of sugar in your blood.

Normally, when you eat carbohydrates, such as bread, pasta, fruits, or vegetables, these foods get broken down into glucose (sugar), your body's favorite fuel. This fuel then travels through your bloodstream until it's "unloaded" into your cells by insulin, which functions a little like a team of chemical dockworkers. But when you have Type 2 diabetes, your body either stops producing enough insulin or becomes unable to use it properly. That makes it difficult for the sugar in your blood to get into your cells, so it builds up in your bloodstream. Your cells don't get enough fuel to function properly and literally begin starving to death. If left untreated, diabetes can lead to heart disease, kidney disease, chronic infections, or other life-threatening conditions. But with treatment, you can control it.

What causes Type 2 diabetes?

Experts don't yet know. They do know that diabetes runs in families and that carrying excess body fat and not getting enough exercise increase the likelihood of developing it, since those things interfere with your body's ability to use insulin. The best way to avoid developing diabetes is to maintain your recommended weight and exercise regularly.

What are the symptoms?

Early on, there are often no symptoms. In fact, many people find out they have Type 2 diabetes only when they develop one of its life-threatening complications. Early clues that you should see your doctor include some combination of the following:

  • Increased frequency of urination
  • Sweet-smelling urine
  • Increased thirst and hunger
  • Feeling weak, tired, or irritable
  • Feeling sick to your stomach or vomiting
  • Having cuts and bruises that take a long time to heal
  • Frequent infections of the skin, gums, vagina, or bladder
  • Blurry vision
  • Tingling or numbness in your hands or feet
  • Dry, itchy skin
Who gets Type 2 diabetes?

Every day 2,200 people in the United States are diagnosed with diabetes, and more than 90 percent of the estimated 16 million Americans who have diabetes are told that it's Type 2. You're most likely to develop the disease if you are obese, are over the age of 45, or have a family history of diabetes. Leading a sedentary life or being African American, Hispanic American, or Native American also puts you at higher risk. So does having gestational diabetes (a form of diabetes that occurs during pregnancy) or giving birth to a baby weighing nine pounds or more.

What are my treatment options?

Unfortunately, there is no cure for diabetes. Once it develops, you'll have it for the rest of your life. But that doesn't mean you can't live a healthy, active life. The key is to keep your blood-sugar levels as close to normal as possible. Work with your doctor and a dietitian to develop a plan to balance eating, which raises blood-sugar levels, with exercise, which lowers them. Maintaining a healthy weight is also important to making blood-sugar levels easier to control. For many Type 2 diabetics, regular exercise and weight control are all it takes. Others require medication to keep their blood sugar in line; this might mean insulin shots to make up for what the pancreas is not producing, oral medications to boost insulin production or to help the body use insulin, or both the injections and the pills.

How can I manage my diabetes?

Work closely with your doctor and a nutritionist or certified diabetes educator. The more closely you manage your disease, the less likely you are to have complications. And doctors are learning more all the time about how to better treat diabetes and control blood sugar.

Here are some tips:

Watch what you eat. A healthful diet for a person with diabetes is not all that different from a healthful diet for a person who doesn't have diabetes. Like everyone else, you need a balance of fruits, vegetables, whole grain cereals and breads, dairy products, and protein from sources such as meat, fish, and beans. Like everyone else, too, you need to limit fat and sugar. But unlike everyone else, you need to be utterly vigilant about staying within your limits. Schedule your meals and activities to prevent your blood-sugar level from getting too high or too low; eating small frequent meals throughout the day instead of three large ones can help.

Watch your sugar intake, too. For decades sugar was essentially forbidden to diabetics because it was believed to increase blood sugar more than would other carbohydrates such as those from pasta or potatoes. But new studies show that isn't so. This doesn't mean you can eat all the sweets you want, though. Sugar still counts as a carbohydrate, so if you eat a sugary food, you'll have to forgo another carbohydrate-rich item. And because sweets often contain empty calories (and lots of fat), you're likely to forgo valuable nutrients as well when you make this trade-off. If you have a sweet tooth, consider artificial sweeteners. They satisfy sweet cravings without adding calories or raising blood-sugar levels, so indulging is safer.

Get regular exercise. Your body uses more energy when it's active, so exercise usually causes blood-sugar levels to fall. It also appears to help insulin work better and is key to taking off extra pounds and maintaining a healthful weight. If you need insulin or another medication to control your diabetes, it's a good idea to check your blood-sugar level before a workout to make sure it's not too low. If it is, eat a snack.

Maintain a healthful weight. In some cases, losing as little as 10 to 20 pounds is enough to bring blood-sugar levels back to normal.

Manage stress. Physical stress such as overexertion, illness, or injury can cause blood-sugar levels to rise. Mental stress can make blood sugar either rise or fall. Either way, being rundown and stressed-out makes diabetes harder to control, so it's important to get enough rest and to learn to relax. Good stress-busting techniques include meditation, deep breathing exercises, physical exercise, and regular massages.

Test your blood-sugar level. To keep your blood-sugar level under control, you have to know what it is, and the only way to do that is to test yourself regularly -- a few times a day or once a week, depending on your condition. (Consult your doctor about how often you should check this.) To test your blood, you'll prick your finger and place a drop of blood on a strip of test paper, then either wait for the strip to change color and match it to a color chart or use a blood-glucose meter to get a reading. Talk to your doctor about other tests you might need, including a yearly eye exam.

Allow for hormonal shifts. If you're a woman, you should be aware that your menstrual cycle, a pregnancy, or the use of birth control pills or IUDs that use hormones can cause big fluctuations in your blood-sugar level, making it harder to control. Talk to your doctor about how to factor these things in so you can better manage your diabetes. Also, if you've been through menopause, consider hormone replacement therapy. Two recent studies have shown that women with Type 2 diabetes who've gone through menopause can significantly lower their blood-sugar levels by taking supplemental estrogen.

Copyright 1999 Consumer Health Interactive and Consensus Health Corporation

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