“Adult onset diabetes” is an outdated term for what is now widely known as Type 2 diabetes. This condition affects how the body processes blood sugar, or glucose, which is the body’s primary source of energy. Glucose comes from the foods we eat and is regulated by insulin, a hormone produced by the pancreas. When this system malfunctions, blood sugar levels can rise, leading to various health issues over time.
The Biological Process of Type 2 Diabetes
Type 2 diabetes alters how the body utilizes glucose for energy. Normally, after eating, glucose enters the bloodstream, prompting the pancreas to release insulin. Insulin acts like a key, unlocking cells in muscles, fat, and the liver, allowing glucose to enter and be used for energy or stored. Without proper insulin function, glucose remains in the bloodstream.
The primary issue in Type 2 diabetes is insulin resistance, where the body’s cells do not respond effectively to insulin. It is as if the cell’s lock no longer fits the insulin key well, preventing glucose from entering the cells efficiently. To compensate, the pancreas initially produces more insulin to overcome this resistance, working harder to maintain normal blood sugar levels. Over time, however, the pancreatic cells may become exhausted and unable to produce enough insulin, resulting in a sustained increase in blood glucose.
Recognizing the Symptoms
High blood sugar levels associated with Type 2 diabetes can manifest through several noticeable symptoms, though they often develop gradually and may be mild at first. These include:
Increased thirst, as kidneys work harder to remove excess sugar, leading to dehydration.
Frequent urination, as the body flushes out surplus glucose.
Unexplained weight loss, as the body burns fat and muscle for energy.
Fatigue, from cells not receiving enough glucose.
Blurred vision, due to high blood sugar affecting tiny blood vessels in the eyes.
Slow-healing sores or frequent infections, as elevated glucose impairs healing and weakens the immune system.
Key Risk Factors and Prevention
Type 2 diabetes development is influenced by both non-modifiable and modifiable risk factors. Non-modifiable factors include age, with risk increasing after age 45, though it is now seen in younger individuals due to rising obesity rates. Family history also plays a role, as individuals with parents or siblings with Type 2 diabetes face a higher risk due to genetic predispositions. Certain ethnic backgrounds, such as African American, Asian American, Latino/Hispanic American, Native American, or Pacific Islander, also have an increased likelihood of developing the condition.
Modifiable risk factors are influenced by lifestyle choices. Being overweight or obese, especially with excess weight around the abdomen, increases risk, as this fat can lead to insulin resistance. Physical inactivity is another factor, as regular movement helps lower insulin resistance, allowing the body to use insulin more effectively. Unhealthy eating habits, including diets rich in saturated fats and simple carbohydrates, contribute to increased risk.
Prevention strategies directly address these modifiable risks. Maintaining a healthy weight through balanced nutrition and regular physical activity is a preventive measure. Even a modest weight loss of 5% to 10% of body weight can reduce risk. Engaging in at least 150 minutes of moderate-intensity aerobic activity per week, like brisk walking, can help lower insulin resistance and reduce the risk of developing Type 2 diabetes. Adopting a diet focused on fruits, vegetables, and whole grains while limiting processed foods, red meat, and sugary drinks also supports prevention.
Medical Diagnosis and Ongoing Management
Diagnosing Type 2 diabetes involves specific blood tests ordered by a healthcare provider. The A1C test measures average blood sugar levels over the past two to three months, with a result of 6.5% or higher indicating diabetes. This test offers convenience as it does not require fasting. Another common diagnostic tool is the Fasting Plasma Glucose (FPG) test, which checks blood sugar levels after at least eight hours without food or drink; a result of 126 mg/dL or higher suggests diabetes.
The Oral Glucose Tolerance Test (OGTT) is a two-hour test that assesses how the body processes sugar. After fasting, a blood sample is taken, followed by consuming a sugary drink, and another blood sample is collected two hours later; a blood glucose level of 200 mg/dL or higher at the two-hour mark confirms a diabetes diagnosis. Two abnormal test results are needed for a definitive diagnosis, either from the same sample or from different samples.
Ongoing management of Type 2 diabetes is a lifelong commitment focused on keeping blood sugar levels within a target range to prevent complications. This involves:
Regular blood sugar monitoring, using a glucose meter or continuous glucose monitor.
Dietary planning, emphasizing healthy eating habits and often involving tailored meal plans.
Regular physical activity, aiming for at least 150 minutes per week to improve insulin sensitivity and manage blood sugar.
Medication, when lifestyle changes are insufficient. Metformin is often the first-line oral medication, reducing glucose production by the liver and improving insulin use.
Insulin therapy, administered via injection, which some individuals may eventually require to maintain blood sugar levels.