Diabetes Mellitus Type 2 In Adults

What is diabetes mellitus type 2?

Diabetes mellitus is a disease that affects how your body makes insulin and how it uses glucose (sugar). Insulin is a hormone that helps your body use sugar by allowing the sugar to enter cells. With type 2 diabetes, your body has trouble using insulin or is not making enough insulin. This type of diabetes usually begins in adulthood but may start during puberty or before.

What causes diabetes mellitus type 2?

No one knows for sure what causes type 2 diabetes. Normally, when the blood glucose level increases, the pancreas (an organ behind the stomach) makes insulin to lower the level. In type 2 diabetes, you may have insulin resistance. This means your pancreas keeps making insulin but your body cannot use the insulin correctly. After many years, your pancreas may just stop making insulin. When this happens, sugar will build up even more in your body.

What puts me at risk for diabetes mellitus type 2?

You have a higher risk for type 2 diabetes if you weigh more than your caregiver suggests, and one or more of the following:

• Your blood sugar level is higher than normal, but not yet high enough to be diagnosed diabetes.
  
  
• You have high blood pressure or high cholesterol (fat) levels in your blood.
  
  
• You do not get any exercise.
  
  
• You have a history of heart disease.
  
  
• You have a family member with diabetes.
  
  
• You have had gestational diabetes or have given birth to a baby weighing more than 9 pounds.
  
  
• You have polycystic ovary syndrome (PCOS).
  
  
• You are African American, Latino, Native American, Asian American, or Pacific Islander.

What are the signs and symptoms of diabetes mellitus type 2?

• More thirst than usual
  
  
• Frequent urination
  
  
• Blurred vision
  
  
• More hunger than usual

How is diabetes mellitus type 2 diagnosed?

You may need tests to check for type 2 diabetes mellitus starting at age 45, even if you do not have any risk factors or symptoms. If you weigh more than your caregiver suggests and you have one or more risk factors, ask your caregiver about tests for diabetes mellitus type 2. Type 2 diabetes is diagnosed with blood sugar tests. Caregivers will test your blood sugar level twice to be sure that you have diabetes. You may have any of the following blood sugar tests:

• Blood glucose: This may be the first blood sugar test done if you have symptoms of diabetes.
  
  
• Fasting plasma glucose: After you have fasted (no food or liquid) for 8 hours, your blood sugar level is checked.
  
  
• Oral glucose tolerance test (OGTT): Your blood will be drawn 2 or more times during this test. After you have fasted, the first sample of blood will be taken. You will then be given a glucose drink. Two hours after you drink the liquid, the second sample of blood will be taken.
  
  
• Hemoglobin A1C (HbA1C) test: This blood test shows the average amount of sugar in your blood over the past 2 to 3 months. Ask your caregiver how often you should have this test performed and what your value should be.

How is diabetes mellitus type 2 treated?

Type 2 diabetes can be treated and controlled most of the time. The goal is to keep your blood sugar at normal levels. You can do this by eating the right foods and exercising. You may also need to take diabetes medicine.

How do I check my blood sugar levels?

Your caregiver will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in your blood. The monitor uses a small drop of blood from a prick on your finger. Ask your caregiver what your blood sugar value should be before and after you eat. Ask him when, how, and how often you should check your blood sugar level. You may have to check your blood sugar level at least 3 times each day. Write your blood sugar results in a diary each time you check them. Bring the diary with you when you see your caregiver. This can help you and your caregiver see if your diet, activities, or medicine need to be changed.

What other health problems can diabetes mellitus type 2 cause?

Uncontrolled high blood sugar levels may damage other body tissues and organs over time. You are at risk of the following problems if your sugar levels are always high. Ask your caregiver what tests you need to monitor for these problems:

• Eye problems that may cause blurred vision or even blindness.
  
  
• Heart attack, stroke, and other problems due to poor circulation.
  
  
• Kidney damage that may cause kidney failure.
  
  
• Nerve damage in the feet. This may cause numbness and an increased risk of foot ulcers.
  
  
• Damage to other nerves. This may cause heartbeat problems when you exercise and make you feel faint when you stand up. Nerve damage can also cause problems with delayed stomach emptying, and other problems.

What can I do to help prevent or manage diabetes mellitus type 2?

• Medical monitoring for diabetes and preventing complications:
  
  
  • Prediabetes: Ask your caregiver about prediabetes and the blood tests you may need to check for signs of diabetes.
    
    
  • Blood pressure and cholesterol: Your caregiver may want you to have additional visits to monitor your blood pressure and cholesterol (fat levels in the blood).
    
    
  • Eye health: Ask caregivers if you need to have yearly eye exams to check for retinopathy (an eye disease).
    
    
  • Kidney health: Ask caregivers if you need yearly urine tests to check for nephropathy (kidney disease).
    
    
  • Foot health: Ask your caregiver about a yearly foot exam and ask for more information about foot care with diabetes.
  
  
• Weight loss: Ask caregivers if you need to lose weight, and how much weight you need to lose. Ask them to help you with a weight loss program.
  
  
• Medicines: Take your medicines as ordered by your caregiver. Ask for more information about the medicines that you need to take.
  
  
• Diet: A dietitian will help you create a meal plan that will help you to keep your blood sugar levels under control. This caregiver may suggest the following:
  
  
  • Choose foods low in fat, saturated fat, cholesterol, and sodium. Examples of low-fat foods are lean cuts of meat, fish, skinless poultry (chicken and turkey), and low-fat milk. Use less table salt and limit foods that are high in sodium. Some foods that are high in sodium are soy sauce, processed meats (bologna, hot dogs), crackers, potato chips, and soups.
    
    
  • Choose foods that are good sources of fiber and complex carbohydrates, such as vegetables, whole grain breads and cereals, and legumes. Legumes include garbanzo, pinto, and kidney beans, and lentils.
    
    
  • The dietitian may suggest you limit how much carbohydrate you eat at one time to prevent your blood sugar from getting too high. Carbohydrates are also found in fruit and dairy foods such as milk and yogurt. Limit or avoid sweets, such as candy, desserts, or regular soda that contain simple carbohydrates from sugar. When you eat simple carbohydrates, sugar moves into your blood too fast.
    
    
  • Never skip a meal to control your blood sugar level, because it can fall too low.
  
  
• Exercise: Regular exercise helps your blood sugar levels stay in the best range, and decreases your risk of heart disease. It can also help you lose weight, and improve how you feel overall. Do at least 30 minutes of moderate exercise, 5 days a week. Also do resistance training (using weights) 3 times a week. Work with your caregiver to plan the best exercise program for you.
  
  
  • Check your blood sugar level. Do this before and after you exercise to learn how your blood sugar responds to exercise. Caregivers may tell you to change the food you eat or the amount of insulin you take.
    
    
  • Do not exercise if your blood sugar less than 100 mg/dL. If your blood sugar is less than 100 mg/dL, eat or drink a carbohydrate snack before you exercise. This will help you avoid low blood sugar. Examples of carbohydrate snacks are 4 to 6 crackers, 1/2 banana, 8 ounces (1 cup) of milk, or 4 ounces (1/2 cup) of juice.
    
    
  • Have a carbohydrate snack available during and after exercise. Drink fluids before, during, and after exercise. Wear good socks and footwear to prevent sores and blisters on your feet.
    
    
  • Avoid vigorous activities if you have ketones in your urine.

What other things may I need to do for diabetes mellitus type 2?

• Immunizations: When you have diabetes, you can get very sick if you get the flu or pneumonia. Vaccines can help you from getting these illnesses:
  
  
  • Influenza vaccine: This vaccine helps prevent influenza (flu). Everyone older than age 6 months should get a yearly influenza vaccine. Get the vaccine as soon as it is available, usually in October or November each year.
    
    
  • Pneumococcal polysaccharide vaccine: This vaccine is also called PPV. It helps prevent pneumococcal disease, such as pneumonia. Adults ages 65 years and older should get the vaccine. People who are at higher risk for pneumococcal disease also may need the vaccine.
  
  
• Limit alcohol: Limit the amount of alcohol you drink. Alcohol affects your blood sugar levels and can make it harder to manage your diabetes. Too much alcohol can also damage your brain, heart, and liver. Alcohol raises your risk for high blood pressure, stroke, and certain types of cancer. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1 1/2 ounces of liquor. If you drink alcohol, talk to your caregiver.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking harms your body in many ways. It can worsen the problems that can occur with diabetes, such as poor blood flow to your feet. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

Where can I find support and more information?

Diabetes is a life-changing disease for you and your family. Accepting that you have diabetes may be hard. You may want to see a mental health worker (talk therapist). This caregiver can help you take an active role in managing your diabetes. Contact the following for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 800 - 342-2383
  Web Address: http://www.diabetes.org
  

When should I contact my caregiver?

Contact your caregiver if:

• You are vomiting or have an upset stomach.
  
  
• You feel very weak or very tired.
  
  
• You feel dizzy, have headaches, or are easily irritated.
  
  
• You have red, dry skin.
  
  
• You have numbness in your arms or legs.
  
  
• You have questions or concerns about your disease, medicine, or care.

When should I seek immediate care?

Seek immediate help or call 911 if:

• You have ongoing, severe abdominal pain, sometimes spreading to your back. You may also be vomiting.
  
  
• You are having trouble staying awake or focusing.
  
  
• You are shaking or sweating.
  
  
• You have blurred or double vision.
  
  
• Your breath has a fruity, sweet smell.
  
  
• Your breathing is deep and labored, or rapid and shallow.
  
  
• Your heartbeat is fast and weak.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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