Understanding Type 2 Diabetes

Understanding Type 2 Diabetes

What Is Type 2 Diabetes?

Type 2 diabetes is a lifelong disease that prevents the body from using insulin as it should. People with type 2 diabetes are said to have insulin resistance.  Middle-aged and older people are more likely to get this type of diabetes. It used to be called adult-onset diabetes. Type 2 diabetes also affects children and adolescents, mainly due to childhood obesity.

Type 2 diabetes is an alteration in the way the body regulates and uses sugar (glucose) for fuel. This long-term (chronic) condition causes excessive circulation of sugar in the blood. Eventually, high blood sugar can lead to circulatory, nervous, and immune disorders.

In type 2 diabetes, there are mainly two work-related problems. Your pancreas does now no longer produce sufficient insulin — a hormone that regulates the motion of sugar into your cells — and cells reply poorly to insulin and absorb much less sugar.

There’s no treatment for kind 2 diabetes, however dropping weight, consuming food well and exercise permit you to control the disease. If weight loss program and workouts are not sufficient to control your blood sugar, you could additionally want diabetes medicines or insulin therapy.

Signs and Symptoms of Type 2 Diabetes

Symptoms of type 2 diabetes can be so mild that you don’t notice them. About 8 million people who have it don’t know it. Symptoms include:

  • Being very thirsty 
  • Peeing a lot 
  • Blurred vision 
  • Being irritable
  • Tingling or numbness in hands or feet 
  • Tiredness/feeling tired 
  • Sores that won’t heal 
  • Yeast infections that come back 
  • Feeling hungry 
  • Losing weight without trying 
  • Getting more infections

Causes of Type 2 Diabetes

Your pancreas produces a hormone called insulin. Help your cells turn glucose, a type of sugar, from the foods you eat into energy. People with type 2 diabetes produce insulin, but their cells don’t use it as well as they should. At first, your pancreas produces more insulin to try to get glucose into the cells. Eventually it fails to keep up and glucose builds up in the blood instead.

Usually, a combination of things causes type 2 diabetes. They might include:


Scientists have discovered several DNA fragments that affect how your body produces insulin.

Extra Weight

Being overweight or obese can lead to insulin resistance, especially if you carry extra pounds around your belly.

Metabolic Syndrome

People with insulin resistance often suffer from a group of conditions such as high blood sugar, excess fat around the waist, high blood pressure and high cholesterol, and low triglycerides.

Too Much Glucose from Your Liver

When your blood sugar is low, your liver produces and sends out glucose. After eating, your blood sugar rises, and your liver usually slows down and stores its glucose for later, but some people’s livers don’t. They continue to produce sugar.

Poor Communication Between Cells

Sometimes cells send the wrong signals or don’t pick up messages correctly. When these problems affect how cells make and use insulin or glucose, a chain reaction can lead to diabetes.

Broken Beta Cells

If insulin-producing cells send the wrong amount of insulin at the wrong time, blood sugar is kicked out. High blood sugar can also damage these cells.

How Insulin Works

Insulin is a hormone that comes from the gland behind and below the stomach (pancreas). Insulin regulates how the body uses sugar in the following way: 

  • Sugar in the blood causes the pancreas to secrete insulin.
  • Insulin circulates in the blood, allowing sugar to enter cells. 
  • The amount of sugar in the blood drops. 
  • In response to this decrease, the pancreas releases less insulin.

The Role of Glucose

Glucose which is some sugar is a main source of energy for cells that make up muscles and other tissues. The use and regulation of glucose are as follows:

  • Glucose comes from two main sources: food and the liver. 
  • Glucose is absorbed into the bloodstream, where it enters cells with the help of insulin. 
  • Your liver stores and produces glucose.

When the glucose levels are low, as when you have not eaten a little, the liver breaks with glycogen storage in glucose to keep your glucose level in a normal range.

In type 2 diabetes, this process does not work well. Instead of moving into cells, sugar builds up in the blood. As blood sugar rises, insulin-producing beta cells in the pancreas release more insulin. Eventually, these cells deteriorate and can no longer produce enough insulin to meet the body’s needs.

Risk Factors

Factors that may increase the risk of type 2 diabetes include:


Being overweight or obese is a major risk.

Fat Distribution

Storing fat primarily in the abdomen, rather than the hips and thighs, indicates higher risk. The risk of type 2 diabetes increases if you are a man with a waist circumference greater than 40 inches (101.6 centimetres) or a woman taller than 35 inches (88.9 centimetres).


The less active you are, the greater the risk. Physical activity helps control weight, uses glucose for energy, and makes cells more sensitive to insulin.

Family History

The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes.

Race And Ethnicity

Although it’s not clear why, people of certain races and ethnicities, including blacks, Hispanics, Native Americans and Asians, and Pacific Islanders, are more likely to develop type 2 diabetes than whites.

Blood Lipid Levels

An increased risk is associated with low levels of HDL (high density lipoprotein) cholesterol, the “good” cholesterol, and high triglyceride levels.


The risk of type 2 diabetes increases with age, especially after age 45.


Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classified as diabetes. If left untreated, prediabetes often progresses to type 2 diabetes.

Pregnancy-Related Risks

The risk of developing type 2 diabetes increases if you developed gestational diabetes during pregnancy or if you gave birth to a baby that weighs more than 4 kilograms.

Polycystic Ovary Syndrome

Polycystic ovary syndrome – a common condition characterized by irregular periods, excessive body hair and obesity – increases the risk of diabetes

Areas of dark skin, usually on the armpits and neck. This condition often indicates insulin resistance.


Type 2 diabetes affects many important organs, including the heart, blood vessels, nerves, eyes, and kidneys. In addition, factors that increase the risk of diabetes are risk factors for other serious chronic diseases. Diabetes management and blood sugar control can reduce the risk of these complications or coexisting conditions (comorbidities).

Potential complications of diabetes and common comorbidities include:

Heart And Vascular Disease

Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis).

Nerve Damage (Neuropathy) In the Limbs

High blood sugar over time can damage or destroy nerves, causing tingling, numbness, burning, pain, or possible loss of sensation that usually begins on the tips of the toes or fingers and gradually spreads upwards.

Other Nerve Damage

Damage to the nerves of the heart can contribute to irregular heart rhythms. Damage to the nerves in the digestive system can cause problems with nausea, vomiting, diarrhoea, or constipation. For men, nerve damage can cause erectile dysfunction.

Kidney Disease

Diabetes can lead to chronic kidney disease or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

Eye Damage

Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and can damage blood vessels in the retina, potentially leading to blindness.

Skin Diseases

Diabetes can make you more susceptible to skin problems, including bacterial and fungal infections.

Slow Healing

Left untreated, cuts and blisters can become serious infections that can heal poorly. Severe damage could require amputation of the toe, foot, or leg.

Hearing Impairment

Hearing problems are more common in people with diabetes.

Sleep Apnea

Obstructive sleep apnea is common in people with type 2 diabetes. Obesity may be the main contributing factor to both conditions. It is unclear whether treating sleep apnea improves blood sugar control.


Type 2 diabetes appears to increase the risk of Alzheimer’s disease and other disorders that cause dementia. Poor blood sugar control is linked to faster decline in memory and other thinking skills.

Lifestyle Changes

You may be able to reach your target blood sugar level with diet and exercise alone.

Weight Loss

Losing excess pounds can help. While losing 5% of your body weight is a good thing, losing at least 7% and keeping it off seems like the ideal. This means that someone who weighs 180 pounds can alter their blood sugar levels by losing about 13 pounds. Weight loss can seem overwhelming, but portion control and eating healthy foods are a good place to start.

Healthy Eating

There is no specific diet for type 2 diabetes. A Registered Dietitian can teach you about carbohydrates and help you come up with a meal plan you can stick to.

Focus on: 

  • Eat fewer calories 
  • Cut down on refined carbs, especially sweets 
  • Add fruits and vegetables to your diet 
  • Eat more fibre


Aim for 30 to 60 minutes of physical activity each day. You can walk, cycle, swim, or do anything else that gets your heart rate up. Pair it with strength training, like yoga or weightlifting. If you are on a blood sugar lowering medication, you may need a snack before a workout.

Monitor Your Blood Sugar

Depending on your treatment, particularly if you are taking insulin, your doctor will tell you if and how often you need to test your blood sugar.


If your lifestyle changes are not helping you achieve your target blood sugar levels, you may need medication. Some of the most common for type 2 diabetes include:

Metformin (Fortamet, Glucophage, Glumetza, Riomet)

This is usually the first drug used to treat type 2 diabetes. It reduces the amount of glucose produced by the liver and helps the body respond better to the insulin it produces.


This group of drugs helps your body produce more insulin. They include glimepiride (Amaryl), glipizide (Glucotrol, Metaglip), and glyburide (DiaBeta, Micronase).


They help your body produce more insulin and work faster than sulfonylureas. You can take nateglinide (Starlix) or repaglinide (Prandin).


This group of drugs helps your body make more insulin. They include glimepiride (Amaryl), glipizide (Glucotrol, Metaglip), and glyburide (DiaBeta, Micronase).


Like metformin, they make you more sensitive to insulin. You could get pioglitazone (Actos) or rosiglitazone (Avandia). They also raise your risk of heart problems, so they aren’t usually a first choice for treatment.

Dpp-4 Inhibitors

These medications linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia) help lower your blood sugar levels, but they can also cause joint pain and could inflame your pancreas.

Glp-1 Receptor Agonists

You take these medications with a needle to slow digestion and lower blood sugar levels. Some of the most common ones are exenatide (Byetta, Bydureon), liraglutide (Victoza), and semaglutide (Ozempic).

SGLT2 Inhibitors

These help your kidneys filter out more glucose. You might get canagliflozin (Invokana), dapagliflozin (Farxiga), or empagliflozin (Jardiance). Empagliflozin has also proven effective in reducing the risk of hospitalization or death from heart failure.


You might take long-lasting shots at night, such as insulin detemir (Levemir) or insulin glargine (Lantus).


Even if you change your lifestyle and take your medicine as directed, your blood sugar may still get worse over time. That doesn’t mean you’ve done something wrong. Diabetes is progressive, and many people eventually need more than one drug.

When you take more than one drug to control your type 2 diabetes, that’s called combination therapy. You and your doctor should work together to find the best mix for you. Usually, you’ll keep taking metformin and add something else.


Saravavan Nadarajan (Vanan)

Vanan, fitness expert and leader at EzFit Singapore, specializes in holistic training—home-based, boot camps, and corporate fitness—with over a decade of industry experience.