What is Diabetes?

The condition, marked by high blood sugar, is on the rise worldwide.

Diabetes is a disease that’s characterized by high blood sugar, which doctors refer to as hyperglycemia.

What makes type 2diabetes different from type 1 diabetes, gestational diabetes, and other types of diabetes is the underlying cause of high blood sugar. In type 2 diabetes, the two main contributors to high blood sugar are insulin resistance and reduced production of insulin by the pancreas.

Insulin Resistance

Insulin resistance is a state in which the body’s cells do not use insulin efficiently. As a result, it takes more insulin than normal to transport glucose (the main type of sugar found in the bloodstream) into cells, where it can be used for fuel or stored for later use.

It’s not entirely clear why some people develop insulin resistance and others don’t. Obesity, which is the main risk factor for developing type 2 diabetes. Is  known to increase insulin resistance.

But not all people with type 2 diabetes are obese — and not all obese people develop the condition — so other issues such as genetics are contributing factors as well.

 Reduced Insulin Production

Insulin resistance develops over time, and as the body becomes more and more insulin resistant, the pancreas responds by releasing more and more insulin. This higher-than-normal level of insulin in the bloodstream is called hyperinsulinemia.

For a while, the pancreas may be able to keep up with the body’s increased need for insulin, and blood sugar levels may stay within the normal range — about 70 to 100 mg/dl before meals and lower than 140 mg/dl after meals. Eventually, however, the pancreas can no longer keep up, and blood sugar levels begin to rise.

In the early stages, higher-than-normal blood sugar may cause no symptoms. But catching it early is important, because over time, high blood sugar can have negative effects on just about every part of the body.

Type 2 Diabetes Symptoms

Fatigue, increased thirst, irritability, and hunger – type 2 diabetes causes many symptoms that can be mistaken for other conditions.

Because type 2 diabetes develops slowly, and symptoms generally come on gradually, they may go unnoticed for a long time, or they may be attributed to something else.

For example, increased thirst may be chalked up to a hot summer, or fatigue may be interpreted as a sign of aging or stress.

This is unfortunate, because even short-term high blood sugar diminishes your quality of life. And if high blood sugar persists for a long time, it can eventually cause complications such as eye or kidney disease that cannot be completely reversed with improved blood sugar control.

Type 2 diabetes can cause a wide range of signs and symptoms, including:

  • Fatigue
  • Dry mouth
  • Thirst
  • Excessive urination
  • Hunger
  • Weight loss
  • Blurry vision
  • Cloudy thinking
  • Irritability
  • Wounds that won’t heal

Frequent infections may also be a sign of type 2 diabetes. In women, vaginal yeast infections are particularly common. Yeast infections can also occur on the skin and, in men, in the groin.

Other infections associated with undiagnosed type 2 diabetes include gum infections, urinary tract infections (particularly in women), slowly healing wounds with subsequent infections, and infections of the feet.

Symptoms in Men

Type 2 diabetes symptoms are generally the same for men and women.

  • However, urological problems such as erectile dysfunction (ED) — the inability to achieve or maintain an erection — have been associated with all forms of diabetes, including type 2.
  • According to the National Diabetes Information Clearinghouse, 20 to 75 percent of men with any type of diabetes have ED.
  • Researchers believe diabetes causes sexual function problems in men due to damage to the body’s autonomic nervous system (ANS), which controls circulation.
  • If you have the symptoms of ED, it may be a sign you have diabetes.
  • Another urological problem associated with diabetes in men is retrograde ejaculation, or the release of semen into the bladder during ejaculation. Symptoms include reduced semen during ejaculation.

Symptoms in Women

  • Women with type 2 diabetes are at increased risk for vaginal yeast infections.
  • This is because type 2 diabetes has been associated with increased yeast in the vaginal area.
  • Experts believe these vaginal infections will also lead to urinary tract and bladder infections, as both yeast and bacteria multiply when blood sugar is elevated.

Is Obesity a risk factor of Type 2 Diabetes?

Is a Sedentary Lifestyle Raising Your Risk of Type 2 Diabetes?

As obesity becomes a bigger issue worldwide, so does the risk of type 2 diabetes.

Obesity, or the state of having too much body fat, is a fast-growing problem: More than one-third of adults, almost 18 percent of children and more than 20 percent of teenagers are now obese in the United States, according to the Centers for Disease Control and Prevention (CDC).

Obesity can also raise the risk of many health problems, including type 2 diabetes. In fact, it’s the number-one risk factor for type 2 diabetes.

Body Mass Index (BMI)

Obesity is generally assessed using body mass index, or BMI, which takes both height and weight into account and is expressed in units of kg/m2 (kilograms per meter squared).

You can calculate your BMI by finding your weight in kilograms and your height in meters and plugging them into our online BMI calculator.

Note that children should use a different BMI calculator than adults. The CDC provides this calculator for children ages 2 through 19.

BMI levels for adults are categorized as follows:

  • Normal weight: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Obesity: 30 or greater

BMI is fairly accurate at identifying adults as normal weight, overweight, or obese, with a few exceptions: It may overestimate body fat in muscular individuals such as athletes, and it may underestimate body fat in older people and others who have lost muscle mass.

The relative risk of developing type 2 diabetes begins to rise at a BMI of 25, and gets progressively higher as BMI increases.

However, in some ethnic groups, notably South Asians, the risk of type 2 diabetes has been found to start at a lower BMI than for the general American population. For this group, overweight — and increased risk of type 2 diabetes — begins at a BMI of 23.1.

Waist Circumference

BMI is not the only tool for assessing diabetes risk. In 2012, researchers in England reviewed data on more than 28,500 people enrolled in the EPIC (European Prospective Investigation into Cancer and Nutrition) study to see how waist circumference influenced the risk of developing type 2 diabetes.

Their findings included the following:

  • Overweight men with a waist circumference of 40 inches or more had a 10-year incidence of diabetes similar to obese men with the same waist circumference.
  • Overweight women with a waist circumference of 35 inches or more had a 10-year incidence of diabetes similar to obese women with the same waist circumference.
  • Obese men with a waist circumference of 40 inches or more were 22 times more likely to develop diabetes than men with a BMI between 18.5 and 22.4 and a waist circumference of less than 37 inches.
  • Obese women with a waist circumference of 35 inches or more were almost 32 times more likely to develop diabetes than women with a BMI between 18.5 and 22.4 and a waist smaller than 31 inches.

Unlike BMI, which reflects overall fatness, waist circumference gives a measure of the amount of visceral fat, or fat surrounding the abdominal organs. Abdominal fat (around the waistline) is strongly linked to type 2 diabetes.

Sitting too much may be endangering your health.

Type 2 diabetes is often called a “lifestyle disease,” because many of its risk factors are related to how people live. The good news: Those risk factors are modifiable, meaning you can take steps to change them.

One risk factor that’s been getting attention lately is being sedentary, or spending prolonged amounts of time sitting.

Risks of Inactivity

  • Numerous studies have examined the effects of being sedentary. Some measure being sedentary by the daily number of hours spent sitting while others use the number of hours spent watching television every day.
  • In either case, the more hours spent being sedentary, the higher risk of chronic health problems, including higher blood sugar levels, higher levels of insulin resistance, obesity, type 2 diabetes, cardiovascular disease, cancer, and even an increased risk of death.
  • People who are sedentary also tend to spend less time outdoors, so they may have lower vitamin D levels than people who get out more. (The body makes its own vitamin D when skin is exposed to sunlight.)
  • Low vitamin D levels have been associated with a higher risk of type 2 diabetes, although it is not yet clear whether the vitamin D itself is the cause of the increased risk.

Physical Activity

Physical activity is generally defined as “any bodily movement produced by skeletal muscles that results in energy expenditure.” Many health organizations currently recommend that most adults perform at least 30 minutes of physical activity daily.

The American College of Sports Medicine also recommends performing strength training (two to three times a week) and flexibility exercises and exercises that improve balance, such as tai chi (two to three times a week).

Following these recommendations may not be enough to improve health or prevent chronic disease, however, if you spend the rest of the day sitting. The simple solution:

Get up and move more.

Becoming More Active

Unfortunately, the American way of life encourages being sedentary with its increased use of computers, for both work and entertainment; fewer physically active jobs; and cities and rural areas that are difficult to navigate on foot or by bicycle.

So what should you do to push back against this trend and get more active?

  1. Anything that gets you out of your chair periodically standing, walking, stretching, doing household chores is better than spending uninterrupted hours sitting.
  2. Set a timer, if necessary, to remind yourself to get up every 30 to 60 minutes.
  3. Even if you normally work sitting down, stand up to talk on the phone or perform other functions that can be done standing.
  4. Use a pedometer to tally your daily steps, and challenge yourself to gradually increase how much you walk.
  5. Rather than shopping online, go to brick-and-mortar stores so you can walk around while looking at merchandise.
  6. Plan more recreational activities, such as taking dance classes or walks in a park.
  7. At work: Take the stairs, not the elevator or escalator.

Make It Fun

People are more inclined to engage in activities they perceive as pleasurable, so get adventurous and find the ones you most enjoy. You’ll likely love those mini-breaks and being more active, and you’ll be taking the right steps toward reducing your risk of type 2 diabetes and improving your overall health.

Preventing Complications

You can reduce the risks of long-term damage from diabetes by:

  • Achieving and maintaining good control of your blood glucose levels.
  • Controlling high blood pressure and high blood cholesterol.
  • Keeping all appointments with your healthcare team.
  • Reporting any concerns about your health to your doctor.
  • Following a healthy lifestyle.

Your doctor or nurse will check your diabetes every year to ensure that you aren’t developing complications.

Your annual check-up should include:

  • Blood pressure
  • HbA1c test
  • Blood cholesterol
  • Kidneys
  • Eyes
  • Feet