Understanding Type-2 Diabetes: Causes, Diagnosis, and Treatment Options

Type-2 diabetes is a common condition among individuals across the globe. The Centers for Disease Control and Prevention (CDC) reports that of the more than 37 million Americans living with all forms of diabetes, approximately 90-95% of them have type-2 diabetes. Yet, some cases go unreported so those figures are likely underestimated.

Unlike type-1 diabetes, type-2 is preventable and even sometimes reversible. Dr. Jennifer Winter of Fort HealthCare offers her expert advice on this condition, including causes, diagnostic process, and treatment options.

What Causes Type-2 Diabetes?

Type-2 diabetes occurs when a person’s blood sugar levels become too high, due to what’s called insulin resistance. This means that even though the body is still making insulin, one’s system is no longer responding the way it should to insulin production. How does that happen?

There is a genetic predisposition, but type-2 diabetes is often exacerbated by an overabundance of caloric intake. When that happens, individuals set their body up to have more insulin than it needs.

“You eat, your body has sugar, the insulin helps you store it and use it. That process can ultimately lead to needing too much insulin, which then predisposes your body to carry extra weight, and extra weight tends to make your body less sensitive or more resistant to the insulin you have,” explains Dr. Winter. “Then, you develop this process where your system is not doing what it’s supposed to do, and you end up with type-2 diabetes.”

She describes sugar to be very “sticky.” Meaning, it sticks to blood cells and blood vessel walls and incites inflammation. The result can be a buildup of plaque in the arteries, which in turn can lead to issues such as heart attack, stroke, kidney disease, or blindness.

Type-2 Diabetes Symptoms—And the Diagnostic Process

The most common symptoms surrounding type-2 diabetes include increased thirst and urination, fatigue, blurred vision, slow-healing sores or frequent infections, and areas of darkened skin—particularly around the neck and armpits. If any of these symptoms present, especially in combination, it’s essential to visit with a primary care provider to explore a type-2 diabetes diagnosis.

A few different tests exist to diagnose type-2 diabetes. The following recaps parameters surrounding each one—from what is considered normal, into prediabetes, and then a full diabetes diagnosis.

Hemoglobin A1c Test

• A1c Level: Measures the average blood sugar level over the past 2-3 months
• Normal: Less than 5.7%
• Prediabetes (at risk): 5.7% to 6.4%
• Diabetes: 6.5% or higher on two separate tests

Fasting Blood Sugar Test

• Blood sample taken after an overnight fast
• Normal: Less than 100 mg/dL
• Prediabetes: 100 to 125 mg/dL
• Diabetes: 126 mg/dL or higher on two separate tests

Oral Glucose Tolerance Test (OGTT)

• Fasting required
• Blood sugar measured initially and then two hours after drinking a sugary solution
• Normal: Less than 140 mg/dL
• Prediabetes: 140 to 199 mg/dL
• Diabetes: 200 mg/dL or higher

Random Blood Sugar Test

• Blood sample taken at a random time, regardless of when you last ate
• Diabetes: Blood sugar level of 200 mg/dL or higher, along with symptoms of diabetes

It’s important to note that a single test result indicating high blood sugar doesn’t necessarily mean a person has diabetes. Repeat tests may be conducted on different days to confirm the diagnosis. Additionally, one’s healthcare provider will consider symptoms, medical history, and risk factors when making a diagnosis.

What Is the Best Way to Address Type-2 Diabetes?

Once someone has been diagnosed with type-2 diabetes, there are a number of subsequent strategies to help them navigate their diabetes journey. From a blood sugar perspective, it’s essential to regularly monitor a person’s glucose levels. Doing so helps identify certain triggers that may cause a spike.

Another approach is to have a discussion about lifestyle habits. If someone is living a sedentary life, daily movement can make a significant difference. Dr. Winter advises a minimum of three hours of exercise per week.

“Anything that gets your heart rate up, gets you moving, that’s our first line goal for people. It doesn’t have to be zero to a hundred in one week. We just want patients to start the process of re-establishing their routines and getting back into regular activity.”

Aligned with physical activity is the element of a healthy diet. The standard American diet is fraught with processed foods, which tend to promote more insulin resistance. Dr. Winter encourages eating foods like fruits and vegetables, whole grains, and lean protein.

Aside from lifestyle changes, various medications offer a solution. Each requires an individual approach to a patient’s unique circumstances. It’s crucial to visit with one’s provider to determine the right medication option to ensure optimal outcomes.

To get more information about type-2 diabetes, and the treatment options available, please visit the Diabetes Education department.