The abbreviation DM2 most commonly refers to Diabetes Mellitus Type 2, a chronic health condition that affects how the body regulates blood sugar, also known as glucose. This metabolic disorder is characterized by elevated glucose levels in the bloodstream, a state called hyperglycemia. DM2 represents the vast majority of all diabetes cases diagnosed globally.
The condition stems from the body’s inability to effectively use or produce enough insulin to manage glucose uptake. This persistent lack of blood sugar regulation defines the long-term nature of this disorder.
How Type 2 Diabetes Develops
The progression of Type 2 Diabetes begins with insulin resistance, where muscle, fat, and liver cells do not respond adequately to the insulin hormone. Insulin is a signaling molecule produced by the pancreas that acts like a key, unlocking cells to allow glucose to enter and be used for energy. When cells resist this signal, glucose accumulates in the blood instead of moving into the cells.
To overcome this resistance, the pancreas initially works harder by producing increasingly large amounts of insulin. This overproduction helps to keep blood glucose levels within a normal range for a period of time. However, this sustained high demand eventually exhausts the insulin-producing beta cells in the pancreas.
As pancreatic function declines, the body shifts to producing an insufficient amount of insulin relative to its needs. This lack of insulin, combined with the underlying insulin resistance, causes blood glucose levels to rise significantly and remain high. This is the point at which the full disorder of Type 2 Diabetes manifests.
The development of this condition is linked to several non-modifiable and modifiable factors. Age and a family history of diabetes are two factors that increase the likelihood of developing the condition. External elements like excess body weight, particularly around the abdomen, and physical inactivity also play a substantial role in promoting insulin resistance.
Common Signs and Symptoms
The presence of persistent high blood sugar often triggers several noticeable physical manifestations. Common early signs include increased thirst and frequent urination. These symptoms occur because the kidneys attempt to flush the excess glucose out of the body through urine, which pulls water along and leads to dehydration.
Many individuals also experience unexplained weight loss despite no changes in diet or activity level. This happens because the body cannot effectively use glucose for energy, causing it to break down muscle and fat stores for fuel instead. Other general symptoms include a persistent feeling of fatigue or lack of energy, which is a direct consequence of cells being starved of glucose energy.
High blood sugar levels can also affect the lens of the eye, causing temporary changes in shape that lead to blurred vision. Furthermore, wounds, cuts, or bruises may be slow to heal, and individuals may experience frequent infections, such as skin or urinary tract infections. Many people with Type 2 Diabetes, especially in the early stages, experience very mild symptoms or none at all, making routine screening important.
Confirming the Diagnosis
A diagnosis of Type 2 Diabetes is confirmed through standardized blood tests that measure glucose levels.
Diagnostic Tests
The following tests are used to confirm a diagnosis:
- The Hemoglobin A1C test provides an average blood glucose level over the preceding two to three months. A result of 6.5% or higher indicates diabetes.
- The Fasting Plasma Glucose (FPG) test measures blood sugar after a person has not consumed any calories for at least eight hours. A level of 126 milligrams per deciliter (mg/dL) or 7.0 millimoles per liter (mmol/L) or greater confirms diabetes. Results between 100 and 125 mg/dL suggest prediabetes.
- The Oral Glucose Tolerance Test (OGTT) measures blood glucose two hours after the patient drinks a standardized glucose-rich liquid. A two-hour plasma glucose value of 200 mg/dL (11.1 mmol/L) or higher is diagnostic.
In cases where a person is experiencing classic symptoms like excessive thirst and urination, a random plasma glucose test of 200 mg/dL or higher is also sufficient for diagnosis.
Living with and Managing Type 2 Diabetes
The management of Type 2 Diabetes relies on a foundation of lifestyle modifications and, when necessary, pharmacological treatments.
Lifestyle Modifications
Dietary changes are a cornerstone of management, focusing on replacing refined carbohydrates with whole grains and monitoring carbohydrate intake to prevent sharp blood sugar spikes. Working with a dietitian can help create a personalized nutrition plan focusing on whole foods, lean proteins, and healthy fats.
Regular physical activity is also a component of treatment, as it enhances insulin sensitivity. Aerobic exercise, such as brisk walking, improves the body’s glucose utilization, while resistance training helps build muscle mass, which is a primary site for glucose uptake. Guidelines suggest aiming for at least 150 minutes of moderate-intensity aerobic activity per week.
Medications
If lifestyle changes alone do not achieve target blood glucose levels, medication becomes necessary. The drug Metformin is usually the first-line medication prescribed, working primarily by reducing the amount of glucose the liver releases and improving the body’s response to its own insulin. Other classes of oral medications, such as SGLT2 inhibitors or GLP-1 agonists, may be added to further improve glucose control or provide cardiovascular benefits.
Insulin therapy may be introduced if the pancreatic beta cells become significantly impaired and oral medications are insufficient. Insulin is administered via injection or an insulin pump and comes in various types, including rapid-acting and long-acting formulas, to cover meal needs or provide a stable background level.
Monitoring
Consistent self-monitoring of blood glucose (SMBG) using a glucometer or a continuous glucose monitor (CGM) provides real-time data to gauge the effectiveness of the treatment plan. Regular follow-up appointments and A1C tests every three to six months are necessary to ensure blood sugar remains within a target range, typically below 7% for most adults. This continuous monitoring and adjustment are necessary for preventing long-term complications affecting the eyes, kidneys, and nervous system.