DM2 is the medical abbreviation for type 2 diabetes. It is a chronic condition that affects the way the body regulates and uses sugar, known as glucose, for fuel. This disorder is characterized by high blood sugar levels, which develop over time. Unlike some other conditions, type 2 diabetes is not something a person is born with but emerges gradually as the body’s systems for managing glucose become less effective.
Understanding Type 2 Diabetes
In a body without diabetes, food is broken down into glucose, which enters the bloodstream. This rise in blood sugar signals the pancreas to release a hormone called insulin. Insulin acts like a key, unlocking cells to allow glucose to enter and be used for energy, which helps maintain healthy blood sugar levels.
The development of type 2 diabetes begins with a state called insulin resistance. In this condition, cells in the body’s muscles, fat, and liver do not respond efficiently to insulin’s signal. To compensate for this resistance, the pancreas ramps up its insulin production to force glucose into the cells and keep blood sugar levels normal.
Over time, this compensatory effort can exhaust the insulin-producing beta cells within the pancreas. These cells may eventually fail to produce enough insulin to overcome the body’s resistance. At this point, glucose accumulates in the bloodstream, leading to high blood sugar, or hyperglycemia, which is the defining feature of type 2 diabetes. The liver can also contribute by releasing too much glucose into the blood.
Key Risk Factors
A combination of factors that cannot be changed and those related to lifestyle choices contribute to the risk of developing type 2 diabetes. Non-modifiable risks are those an individual cannot control. Age is a factor, with the risk increasing for individuals over 45. A family history of the condition also elevates risk, as genetics play a role in susceptibility.
Certain ethnic backgrounds are associated with a higher predisposition for type 2 diabetes. Individuals of Black, Hispanic, Native American, and Asian American descent have a greater statistical likelihood of developing the condition. These genetic and ancestral factors can influence body composition and metabolic function in ways that increase vulnerability.
Lifestyle-related factors, which are modifiable, also heavily influence risk. Being overweight or having obesity is a primary risk factor, as excess body fat, particularly around the abdomen, is linked to increased insulin resistance. Physical inactivity is another contributor, as are dietary patterns high in processed foods and sugary drinks.
Common Signs and Symptoms
The onset of type 2 diabetes symptoms is often gradual and can be subtle enough to go unnoticed for years. One of the most common signs is increased thirst, known as polydipsia, and frequent urination, or polyuria. These occur because high blood sugar levels force the kidneys to work overtime to filter the excess glucose. When the kidneys can’t keep up, extra sugar is excreted into the urine, dragging fluids along and leading to dehydration and thirst.
Another frequent symptom is increased hunger, or polyphagia. Even though there is plenty of glucose in the blood, it cannot get into the cells to be used for energy. This lack of cellular fuel can trigger persistent feelings of hunger. This can also lead to unexplained weight loss, as the body may start breaking down muscle tissue and fat for energy.
Other indicators may include:
- Persistent fatigue, as cells are deprived of the sugar they need for energy.
- Blurred vision when high blood sugar levels pull fluid from the lenses of the eyes.
- Slow-healing sores or frequent infections, as high glucose levels can impair the immune response.
- Numbness or tingling in the hands or feet from nerve-related issues.
The Diagnostic Process
Confirming a diagnosis of type 2 diabetes involves specific blood tests that measure glucose levels. The Glycated Hemoglobin (A1C) test provides an average of your blood sugar levels over the preceding two to three months. An A1C level of 6.5% or higher on two separate occasions indicates diabetes.
Another diagnostic tool is the Fasting Plasma Glucose (FPG) test. This test measures your blood sugar after an overnight fast of at least eight hours. A fasting blood sugar level of 126 milligrams per deciliter (mg/dL) or higher on two separate tests is diagnostic for diabetes. Values between 100 and 125 mg/dL are classified as prediabetes.
For some individuals, an Oral Glucose Tolerance Test (OGTT) may be used. This test requires fasting overnight, after which a baseline blood sample is taken. You then drink a sugary liquid, and your blood sugar levels are tested over the next two hours. A blood sugar reading of 200 mg/dL or higher two hours after the solution suggests diabetes.
Approaches to Management
The management of type 2 diabetes begins with lifestyle modifications. These changes are foundational to controlling blood sugar and involve dietary adjustments and increased physical activity. Healthy eating focuses on a balanced intake of fruits, vegetables, lean proteins, and whole grains, while managing carbohydrate intake. Regular exercise, such as 150 minutes of moderate-intensity activity per week, helps improve the body’s sensitivity to insulin.
When lifestyle changes alone are insufficient, oral medications are prescribed. Metformin is the first-line medication used. It works by reducing the amount of glucose produced by the liver and improving how the body uses insulin. If metformin is not effective enough, other classes of oral drugs may be added, which work through different mechanisms.
In some cases, injectable medications, including insulin, become necessary if the pancreas’s ability to produce insulin declines. There are various types of insulin, from long-acting forms that provide a steady background level to short-acting ones taken before meals. The management plan is highly individualized and adjusted over time based on blood sugar monitoring and A1C test results.