The Truth About Type 2 Diabetes – Risk Factors, Prevention, and Management Tips

Did you know more than 34 million Americans live with diabetes, which is the seventh leading cause of death? The costs, both medical and economical, for those with this disease are astronomical. Learning more about prediabetes and type 2 diabetes and then taking steps to prevent it can help save your life and wallet.

The number of adults diagnosed with diabetes has more than doubled as the baby boomer generation ages, and the United States population becomes more overweight. Diabetes is the leading cause of blindness, kidney dialysis, and non-traumatic foot amputation in the United States. In addition, diabetes isn’t just a physical condition. It can wreak mental havoc due to its chronic nature, daily maintenance routine, and social stigma.

Despite these bleak statistics, there is hope in the form of prevention. Diabetes education is the key to reducing these numbers by preventing those at risk from developing it and helping people diagnosed with diabetes live a longer, healthier life. On this page, you’ll find a complete overview of what diabetes is, the different types of diabetes, risk factors, and tips to manage and prevent diabetes.

What is Diabetes?

Diabetes is a chronic (long-lasting) disease that affects how your body turns food into energy. As we eat, food is broken down into sugar (glucose) and releases into the bloodstream. When blood sugar rises, your pancreas releases a hormone called insulin to help regulate it. Insulin acts as a key to unlock cells to use glucose for energy, and when you have diabetes or prediabetes, your body either doesn’t make enough or is unable to use insulin. As a result, too much glucose stays in your bloodstream, resulting in high blood sugar. Over time, high blood sugar damages your body and can cause heart disease, vision loss, kidney disease, and other serious health problems.

The Different Types of Diabetes

The term diabetes may sound familiar, but it is a complicated disease. Common myths include that overeating sugar causes it, and it can only affect people who are morbidly obese. There are also multiple types of diabetes. There is no shame in having diabetes, and it can strike anyone regardless of age, gender, race, or socioeconomic status.

Type 1 Diabetes – An Autoimmune Disorder

Type 1 diabetes, previously called insulin-dependent or juvenile diabetes, is usually diagnosed in children, teens, and young adults, but it can develop at any age. Approximately five to 10 percent of people with diabetes have type 1, making it less common than type 2 diabetes. When you have type 1 diabetes, the body produces an autoimmune reaction where the body destroys the cells in the pancreas that make insulin. 

Gestational Diabetes – Diabetes During Pregnancy

Gestational diabetes develops in pregnant women who don’t already have diabetes. Between two and 10 percent of pregnancies will result in gestational diabetes. As a pregnant woman gains weight and her hormones change, the body cannot make or use enough insulin, resulting in insulin resistance.

Most pregnancies will face insulin resistance toward the end, but a diagnosis of gestational diabetes typically happens during the 24th to 28th week of pregnancy during blood or glucose challenge tests. Gestational diabetes normally goes away after your baby is born, but having it increases both your and your baby’s risk of developing type 2 diabetes in the future. If you are already overweight, you can reduce your risk of gestational diabetes by participating in regular physical activity and losing weight before you get pregnant.

Type 2 Diabetes – The Silent Disease

Type 2 diabetes, also called adult-onset diabetes, is the most common diabetes condition, accounting for approximately 90 to 95 percent of all diagnosed cases of diabetes. With type 2 diabetes, your body cannot produce enough insulin to regulate and use glucose in your blood, resulting in high blood sugar levels. While there is no cure for type 2 diabetes, it can be prevented or delayed with healthy lifestyle changes such as losing weight, eating healthy food, and being active. 

Signs and symptoms of type 2 diabetes often develop slowly, causing many people to live with it unchecked for years, with high blood sugar damaging their bodies over time. Common symptoms include:

• Increased thirst
• Frequent urination
• Increased hunger
• Unintended weight loss
• Fatigue
• Blurred vision
• Slow-healing sores
• Frequent infections
• Numbness or tingling in the hands or feet
• Areas of darkened skin, usually in the armpits and neck

While it is a serious medical condition, with proper management and lifestyle changes, you can feel better, stay healthier, and have an improved quality of life than if you leave diabetes unchecked.

Prediabetes -Time to Rewind Your Risk

Don’t let the “pre” in prediabetes fool you into thinking it is something you can put off addressing. Over a third of U.S. adults, approximately 88 million, have prediabetes, and more than 84 percent of them don’t know they have it. This critical phase is the only time you can reverse and prevent diabetes. This condition is the precursor to diabetes because your blood glucose (sugar) levels are higher than normal but are not high enough to be called diabetes. You can have prediabetes for years but have no apparent symptoms, which is why it often goes undiagnosed.

If you know you have prediabetes or have a high risk of developing diabetes, you have two choices – ignore it and end up with diabetes or take action now to reduce your risk. But what happens if you don’t know you have it? It’s important to talk to your doctor about testing if you have any of the nine risk factors of diabetes.

9 Diabetes Risk Factors

Your chance of developing diabetes is a combination of your genes and your lifestyle. To determine if you are at risk for type 2 diabetes, complete the Type 2 Diabetes Risk Test. The most common risk factors for type 2 diabetes are:

1. Age: As we age, we are more at risk for developing diabetes. Specifically, being over the age of 45 puts you at higher risk.
2. Weight: Being overweight can put you at risk for prediabetes and type 2 diabetes. The more fat we have in our bodies, the more resistant our cells are to insulin.
3. Family History: You are at an increased risk if anyone in your immediate family (mother, father, sister, or brother) has a diabetes diagnosis.
4. Race: Diabetes occurs more often in individuals who are African-American, Asian-American, Hispanic/Latino-American, and Pacific Islander backgrounds.
5. Physical Inactivity: Exercising less than three days a week can put you at risk. You can easily change this risk factor by increasing your activity levels.
6. Sex: Women with polycystic ovarian syndrome, those diagnosed with gestational diabetes during pregnancy, and those who delivered a baby weighing nine pounds or more are at an increased risk.
7. High Blood Pressure: If you’ve ever had a blood pressure reading of 140/90 or higher or have a diagnosis of high blood pressure, you are at increased risk.
8. Low HDL Cholesterol: You’re at an increased risk if your “good” cholesterol is less than 35 mg/dL.
9. Abnormal Triglyceride Levels: Triglycerides are a type of fat in the bloodstream. Unhealthy levels of triglycerides above 250 mg/dL increase your risk.

If you have multiple risk factors or currently have prediabetes, you can do things to rewind your risk factors.

Tools to Prevent Type 2 Diabetes

While you can’t control your genes, you can change your lifestyle. You can do three things to prevent or delay the onset of diabetes – eat right, exercise regularly, and maintain a healthy weight. You don’t have to make significant changes in your routine to rewind your risk of diabetes. Adding in small steps can add up to big results over time. Even losing 10 percent of your total body weight can improve blood pressure, blood cholesterol, and blood sugars and lower your risk of type 2 diabetes by 58 percent. 

Lifestyle changes can seem challenging at first, but you can be successful by utilizing tools available to you and leaning into support from your family, friends, and health care team. 

Increase Your Daily Exercise

Physical activity is just one part of your journey to preventing or delaying the impact of type 2 diabetes.

Just 30 minutes a day will get you over the recommended 150-minute-per-week mark. Regular activity throughout the day that gets your heart pumping can take off weight, make you feel better, and lower your blood sugar. Getting fit is a commitment you make to yourself, your family, and your health.

You can start small by using some creative thinking to incorporate small bursts of activity throughout the day.

• Park further away when working or shopping. 
• Take the stairs at work or when running errands. 
• Go for a walk during your break or at lunchtime. 
• Try a new hobby such as biking, yoga, hiking, kayaking, swimming, or something else.

If you leave exercise to chance, you probably won’t do it. You have to make adding in exercise a way of life. You don’t have to spend an hour at the gym each day. Simple tweaks can quickly add up to serious activity that makes a significant impact over time.

Maintain a Healthy Weight

What does a healthy weight look like for you? Your answer will depend on your age, activity level, and overall health. The goal of a healthy weight is to feel your best and reduce any health risks. To get started, you could use BMI and waist circumference as references to gauge where you are now and help you pinpoint a goal number. 

If there were an easy way to lose weight and keep it off, everyone would be doing it. Setting your goal is step one. Next, you need to make small changes to your lifestyle over time to increase your chances of success. They call it a health journey for a reason. It is going to take time and effort on your part to be successful. You’ll need to learn new eating and physical activity habits, but losing 10 to 20 pounds can make a big difference in your overall health and self-esteem. 

Watch What You Eat

Healthy eating habits can help you achieve and maintain a healthy weight, support your nutrient needs, and reduce your risk for chronic diseases. Try to release the inner cringe you feel when you hear the word “diet.” Eating fewer calories doesn’t necessarily mean eating less food. It is all about balancing the calories you consume with the calories your body uses.

When deciding what to eat or drink, choose options that are filling and full of nutrients. These foods include vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry. Also, make sure your choices contain little or no saturated fat, sodium, or added sugars.

Follow these guidelines when creating a healthy eating plan:

• Identify your appropriate calorie level based on whether you need to lose, gain, or maintain your weight.
  
• Create a diet low in added sugars, saturated fats, and sodium.
• Meal plan before you go to the grocery store. 
• Read nutrition labels to make the best food choices.
• Watch your portion size at meals.
• Add in fiber to keep you full, regulate your GI system, and control your blood sugar and cholesterol levels. 
• Enjoy comfort foods and sweets in moderation or try lower-calorie versions.
• Don’t drink your calories! Water is the best choice to wet your whistle.

Typically you have more control over your food choices and meal preparation when eating at home. Healthy eating starts at the grocery store and ends on your plate. Commit to weekly meal preparation and cooking healthy meals at home at first. Use an app or food diary to track what you eat and the calories you are consuming. 

Ease into a healthy eating lifestyle by adding in a salad at the beginning of each dinner. Leafy greens provide nutrients and fill you up faster. Quickly eliminate extra calories by switching from soda to water or unsweet tea or coffee. If you need help creating or sticking to a meal plan, consider meeting with a dietitian about the best strategies for your lifestyle and food palate. 

Increase Your Physical Activity Level

Physical activity is one way to control blood sugar levels and help your body process insulin. An active lifestyle is the key to maintaining a healthy weight. Physical activity can be brisk walks, housework, yard work, dancing, swimming, or bicycling. Anything that gets your heart beating faster or makes your muscles work counts. The CDC recommends getting 150 minutes of moderate to intense physical activity per week, with two days dedicated to muscle-strengthening activities. 

Don’t let the triple-digit number make you sweat. You can break this up into smaller amounts of about 25 minutes a day or one hour three days a week. In addition, you can try a yoga class or add small hand weights to your walk to incorporate muscle work.

To make sure you stick with it, start with activities, locations, and times you enjoy. For example, don’t commit to a 5:00 AM run if you aren’t a morning person! Instead, schedule a lunch or evening walk every day. Start slowly and work your way up to more physically challenging activities. 

National Diabetes Prevention Program

Making these lifestyle changes isn’t easy, and you don’t have to do it alone. One tool available to use is a CDC-recognized lifestyle change program that is proven to aid in healthy changes through habit formation necessary to prevent diabetes. The Diabetes Prevention Program is delivered by CDC-recognized providers around the United States, including USPM. All lifestyle change programs are one year in duration. As new habits are established, participants see benefits, such as more energy, more stable blood sugar levels, and less stress as they enjoy a healthier lifestyle.

How Can I Manage My Type 2 Diabetes?

Diabetes is a high-maintenance, chronic illness that requires daily management to keep it in check. People with diabetes need to make healthy food choices, maintain a healthy weight, move more every day, and take their medicine even when they feel good. If you keep your condition under control, you can still live a full and healthy life.

Diabetes Care Checklist

Taking care of yourself is so important once you have a diabetes diagnosis. You will have more energy, be less tired and thirsty, make fewer trips to the bathroom, and have fewer complications.

• Blood sugar checks: Check up to several times a day as directed by your doctor. Keep a record of your numbers and share them with your health care team.
• Foot check: Use a mirror if you can’t see the bottom of your feet or ask a family member for help. Immediately let your doctor know if you have any cuts, redness, swelling, sores, blisters, corns, calluses, or other changes to the skin or nails.
• Diabetes medicines: Take the amount prescribed by your doctor, even when you feel good.
• Physical activity: Get at least 150 minutes of moderate exercise, such as brisk walking or riding a bike, each week.
• Healthy eating: Eat healthy foods that give you the nutrition you need and help your blood sugar stay in your target range.
• Doctor visits and lab tests: At each visit, your doctor will review your blood pressure, weight, self-care plan, and medicines. The doctor will also monitor your blood sugar and A1C levels. You may also need to get flu, pneumonia, or hepatitis b shots, complete kidney and cholesterol tests, and schedule regular eye exams.
• Dental visits: Get your teeth and gums cleaned at least once a year (more often if your doctor recommends), and let your dentist know you have diabetes.

If you need help, your doctor can refer you to Diabetes Self-Management Education and Support (DSMES) services. This program includes a health care team that will teach you how to stay healthy and incorporate what you learn into your routine.

Type 2 Diabetes Medication Management

If losing weight and healthy eating isn’t enough to manage your blood sugar levels, your doctor may prescribe a medication regimen to reduce your glucose levels. Take your medications as directed, and never change a dose or stop taking them without consulting your doctor.

There are common medications people diagnosed with diabetes use to keep their condition controlled:

• Metformin is an oral diabetes medicine that helps control blood sugar levels. 
• A Glucagon-like peptide-1 (GLP-1) receptor agonist helps release insulin when you need it and lower the amount of glucose made by your liver.
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors prevent glucose from being reabsorbed in your kidney.
• Insulin is used to regulate blood glucose and comes in various forms that are injected or inhaled.

You may also require blood pressure medication, cholesterol medication, or aspirin therapy, depending on your health and symptoms. Keep a list of all of the medicine you’re taking, including vitamins and herbal supplements, so you can review it with your doctor. Make sure to discuss the best timing for each dose and what you should do if you miss one. It can be difficult to keep up with, but you can build an effective medication routine with some organization and planning. 

Mental Health and Diabetes

Mental health affects every part of our daily lives. It can impact how we handle stress, navigate our relationships, make decisions, and feel. Once you have diabetes, it is something you must manage every day of your life. That is hard and can lead to feeling as if diabetes is controlling you and your life instead of the other way around. During a given 18-month timespan, 33 to 50 percent of people with diabetes experience diabetes distress, or feelings of stress, guilt, or denial that arise from living with diabetes and the burden of self-management. 

If you are struggling with your mental health, sticking to your diabetes care plan can be even more challenging. People with diabetes are two to three times more likely to have depression than people without diabetes. Unfortunately, only 25 to 50 percent of people with diabetes and depression get diagnosed and treated. Anxiety, or feelings of worry, fear, or being on edge, can also mimic the symptoms of low blood sugar. So if you’re feeling anxious, try checking your blood sugar and treat it if it’s too low. 

It is vital to establish a health care team that includes an endocrinologist, primary care, mental health counselor, a diabetes educator, and a diabetes support group to help you navigate the day-to-day maintenance and highs and lows you may experience. You are never alone; help is always a phone call or Google search away.