A person who has a fasting blood sugar level of more than 6.4mmol/L or a routine blood sugar level of 11mmol/L is considered to have type 2 diabetes, especially if it is accompanied by symptoms of this type.
Type 2 vs. Type 1 Diabetes
Remember how insulin helps break down glucose into energy, i.e. that is what occurs in non-diabetics. In Type 1 diabetes, the body does not produce insulin or produces significantly less insulin that is needed by the body. However, in type 2 diabetes, this is what happens:
- Glucose passes through the pancreas and triggers the beta cells to produce insulin.
- The body does not have a problem producing insulin. The insulin carries out its role and directs glucose to the cells, including fat and muscle cells.
- However, in type 2 diabetes, the cells resist the insulin and refuse to accept the glucose. Alternatively, there is an agent present in the cell, which refuses to recognize the insulin, keeping it and the glucose out of the cell. The glucose does not go directly to the cells.
- Glucose is pushed back into the bloodstream and remains there, until external intervention e.g. medication.
In type 1 diabetes, the cell does not absorb the glucose; therefore the organs are unable to function due to a lack of fuel. In type 2 diabetes, some glucose may still make it inside the cells, although the energy acquired may not be enough to make the organ function correctly.
Causes of Type 2 Diabetes
The cause of type 2 diabetes is lifestyle and genetics. The following may increase a person’s risk of acquiring type 2 diabetes:
- Consuming a lot of carbohydrates and simple sugars
- Low physical activity, or sedentary lifestyle
- Being overweight or obese
- Hormonal imbalance, that results in an abnormal increase in appetite
- Having direct relatives with a history of diabetes e.g. Mother or Father
Why do these factors lead to Type 2 Diabetes?
These factors, except for genetics, can cause cells to be required to process too much glucose.
Imagine a pizza delivery guy, who delivers pizza for free. Every minute, he delivers a pizza to your house. Perhaps, for the first dozen boxes, you still get excited, because pizza is great. However, after a few dozen more, you would tell the pizza guy to stop delivering.
If he continues to deliver, you will stop opening the door to him, so he would send the pizza to your neighbors. But, your neighbor has been receiving the same amount of pizza and refused to accept it. The pizza guy would have no choice but to find a place to deliver the pizza. The pizza may become rotten and toxic, before he can find a new recipient, and when they eventually receive it, it causes them harm.
This is the exact relationship between your cells and glucose. Your cells receive too much glucose because of a high sugar intake. Therefore, it closes its doors and forces your body to find a new place for the glucose. This high level of glucose remains in your bloodstream, and it becomes toxic. When it travels to other organs, like your liver and kidneys, it harms them. This is when complications start to arise.
Symptoms of Type 2 Diabetes
The symptoms of type 2 diabetes are almost the same as Type 1 diabetes. However, how the symptoms develop and progress differ:
- In type 2 diabetes, the symptoms usually start to manifest upwards of the age of thirty. Whereas, in type 1 diabetes, the symptoms start as early as at 7 years old.
- The symptoms of type 2 diabetes occur gradually. While on the other hand, the symptoms of type 1 diabetes, as mentioned before, are sudden and are easier to identify. This is the reason a type 2 diabetic discovers the disease later in life. Statistics show, that type 2 diabetics are routinely diagnosed five to ten years after the initial symptoms have occurred.
Symptoms of Type 2 Diabetes, that are Rarely Present in Type 1 Diabetes
Due to the delayed onset of type 2 diabetes, symptoms may be present that are rarely seen in type 1 diabetes.
a. Acanthosis Nigricans(dark patches)
Dark patches can be present around the neck, underarms, and other parts of the body. This is due to insulin resistance and the skin’s inability to control the production of melanin.
However, many experts suggest acanthosis nigricans may be a coincidental symptom, as many type 2 diabetics are obese. Obesity often causes the folds in the skin to become darker.
b. Hair Lossor Thinning
New studies show that hair loss, or thinning, may be an indication of type 2 diabetes. The hair follicles weaken and new ones develop slower, due to a lack of fuel in the cells. This symptom is more visible in females than males.
When to See a Doctor
As with type 1 diabetes, having two or more of the symptoms should be evidence enough for your doctor to arrange a blood glucose test. However, anyone over the age of thirty is advised to have a regular urine test for sugar, even if there are no symptoms of diabetes.
Abnormal values in sugar level, both in the fasting blood sugar test and a urine test should be followed up by further tests.
Complications of Type 2 Diabetes
It is somewhat true that, when it comes to complications, all types of diabetes are the same. The complications, that result from type 2 diabetes, are the same as for type 1 diabetes. However, their development is slower.
In fact, in early twentieth century, diagnosis of type 2 diabetes was not common. Patients were not diagnosed with diabetes, as the symptoms were diagnosed differently – as many were unassociated with diabetes.
According to experts, the complications of type 2 diabetes are preventable and reversible. The progress of these complications is gradual; and doctors often treat them, before they become worse.
Below are complications of Type 2 diabetes and how their progress differs from Type 1.
Type 2 diabetics may experience mild ketoacidosis, and unlike type 1 diabetes, ketoacidosis does not develop within twenty-four hours. Type 2 diabetics may only experience minor symptoms of ketoacidosis, when their blood sugar level is significantly higher than 17mmol/L.
2. Microvascular eye disease
Retinopathy is not common for type 2 diabetics. However, they are still prone to eye damages and disease, such as blurred vision and cataracts. If the patient has a history of glaucoma, their risk is doubled if they are diagnosed with type 2 diabetes.
3. Hearing Impairment
Diabetic patients may suffer from ear damage, if they do not control their blood sugar levels. However, the risk of hearing impairment with type 2 diabetes is higher. The reason, according to some experts, is that patients with type 2 diabetes acquire the disease at an older age. Their nerves are weaker and are more easily damaged by sudden fluctuations in blood sugar levels.
The nerve damage, caused by type 2 diabetes, is gradual. They rarely develop more serious neuropathy like mononeuropathy and automatic neuropathy. Most type 2 diabetics only suffer peripheral neuropathy, which is usually the loss of sensation in their feet and legs.
Type 2 diabetics may suffer from nephropathy, but it is not as uncontrollable as for type 1 diabetics.
In type 2 diabetes, the level of glucose in the blood fluctuates but rarely exceeds 17mmol/l, which is considered a dangerous level. The negative effect of glucose, on the kidneys, is milder so, it takes longer for them to fail. Also, the level of glucose is lower, the kidneys can continue to carry out their other functions.
6. Heart disease
Some experts do not believe that type 2 diabetes causes heart disease. They maintain that the heart disease develops alongside diabetes.
Type 2 diabetes can be triggered by passive lifestyle. The person may develop it because they are obese, physically inactive and eating high levels of carbohydrate. This lifestyle can also trigger heart disease.
However, research shows type 2 diabetes causes deterioration of the heart muscle, as it will increase the amount of plaque in the artery. This means the heart muscles will need to generate more pressure in order to move blood through those clogged up arteries. Also, it makes it difficult for the body to reduce excess cholesterol, which increases the risk of heart disease.
7. Slow Healing of wounds
Wound infection can be a far more serious complication in type 2 diabetes. Type 2 diabetic patients have slower healing than type 1 diabetic patients. In type 2 diabetes, the cells refuse to accept glucose, which is the source of energy required, to multiply and repair tissue. Therefore, patients’ wounds heal more slowly and become at risk of infection. In type 1 diabetes, the cells may receive the correct dose of glucose, when the patient has a sufficient insulin supply.
8. Skin pigmentation and irritation
Studies show that hyperglycemia may cause skin complications. However, because the cells of type 2 diabetics refuse to accept glucose, the skin doesn’t produce enough keratin. Their skin is usually rough, dull, dry and at risk of skin pigmentation and irritation.
9. Dental Decay and Gum Disease
Diabetics are more prone to dental decay and gum disease. However, type 2 diabetics are at a higher risk, because the gum muscles weaken due to insulin resistance. It also makes the mouth more prone to infections.
Also, if the person suffers from ketoacidosis, his/her teeth will weaken due to the acidity in the mouth.
10. Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
Patients with either type of diabetes may experience this condition. It is life threatening and may prove fatal if not treated within a few hours.
It occurs when the level of sugar in the blood reaches upwards of 33mmol/L. Severe ketoacidosis and neuropathy may occur and cause:
Weakness, fever – above 1010F, extreme thirst, hallucination, dark or murky urine, and drowsiness.
If you suspect you, or someone else, has this condition, go to the emergency room immediately, as treatment is critical.
N.B. Forcing the sudden drop of the person’s glucose level, may result in other life-threatening conditions.
11. Erectile dysfunction
This is where a man either cannot have an erection, or cannot maintain an erection for sufficient time, to have sexual intercourse. Uncontrolled blood sugar, whether for type 1 or type 2 diabetes, may result in erectile dysfunction. This is due to the small blood vessels easily rupturing following an erection. Also, the nerves surrounding the penis can be affected.
12. Vaginal itching
Women with type 2 diabetes may suffer from vaginal dryness, which can result in vaginal itching. The itching occurs on the labia and even on their thighs. It is caused by the presence of sugar in the urine. If the woman does not maintain a sufficient level of hygiene, she may develop vaginitis or a yeast infection (thrush.)