What is type 2 diabetes and how can you prevent it?

By Heather and ​Dr Harry

With the rise in obesity has come a rise in harmful health consequences such as type 2 diabetes. These two conditions go together in so many cases that we are realistically facing a 'diabesity' epidemic. The scary thing is that diabetes can be a silent illness - the symptoms don't really shout out 'diabetes!' - and by the time you realise it, it's too late to reverse the damage to your body. But don't despair. The good news is that diabetes is simple to diagnose, and even modest amounts of physical activity can really improve the lot for the person with diabetes.

So, what is type 2 diabetes?  If you have diabetes, you have too much sugar in your blood. Type 2 diabetes affects overweight and obese people, young and old. It is different from type 1 diabetes, which generally starts in teenagers or in early adulthood (we will not talk about type 1 diabetes, since it is not associated with being overweight).

Blood sugar can be measured in two ways: directly and indirectly. 

The direct measurement is straightforward - you get a blood sample and measure the amount of sugar (more specifically, the sugar glucose). The result tells you the blood sugar level at that particular moment in time.
 
The indirect measurement is again a blood test. But the result gives you an indication of the average amount of sugar that was in your blood over the last 3 months! It's a kind of long-term check of sugar control and is called the HbA1c test.

• An HbA1c level of less than 5.7% is normal
• An HbA1c level of 5.7% to 6.4% indicates 'pre-diabetes'
• HbA1c level of more than 6.5% indicates diabetes

Note that the result of HbA1c is given as a percentage: it does not tell you what your blood sugar is doing right now, but how it has been doing over the last 3 months or so. It's no good getting your HbA1c checked to diagnose diabetes - for that you need a direct blood glucose test.

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Why are blood sugar levels high in type 2 diabetes?  After a meal, your food is broken down into basic units including sugars such as glucose. Sugar is supposed to be taken out of the blood stream and into the growing tissues or organs by insulin. Insulin production is meant to rise when blood sugar rises and fall when blood sugar falls.

People with type 2 diabetes: 

• Do not make enough insulin for their body's needs and/or
• Do not use insulin properly. In other words, they are insulin resistant

You are at risk of getting type 2 diabetes if you:

• Are overweight or obese
• Have diabetics in their family
• Are pre-diabetic

You might have type 2 diabetes if you:  

• Get thirsty a lot more than usual 
• Need to urinate a lot more frequently, particularly at night
• Are unusually tired
• Suffer from blurred vision
• Suffer from tingly or numb hands or feet
• Suffer from a lot of infections or have sores that take a long time to heal

Remember that having these symptoms does not necessarily mean you have diabetes; the only way to diagnose diabetes with certainty is by measuring your blood sugar level. 

If you have any concerns, consult your healthcare provider! 

What is the lifestyle of a person with type 2 diabetes like?  To control the condition a diabetic person has to:

• Take medication daily and/or inject insulin for life, to control their blood sugar levels
• Importantly, they need to monitor their blood sugar levels regularly. Many diabetics check their blood sugar at least once a day, often more times if they are injecting insulin, to control their blood sugar levels carefully
• In addition, eating healthily and doing exercise becomes vital in order to maintain a stable body weight and to reduce large fluctuations in blood sugar

Type 2 diabetes is greatly helped by exercise because exercise helps your body become less insulin resistant. Some people, when they are first diagnosed with type 2 diabetes, can remain off medication for many years if they commit to an exercise and weight management program, and eat healthily. 

A pre-diabetic state can even be reversed by taking action to remedy the overweight or obese contribution to the insulin resistance. That has got to be the silver lining to that particular cloud.

Are there any other risks associated with having diabetes or a high HbA1c?  Unfortunately, yes. The risk of developing one or more of the following problems rises if you have type 2 diabetes:

• Cardiovascular disease: this means high blood pressure, heart disease such as angina, or fatal heart attacks, mini-strokes or fatal strokes and circulatory problems which can lead to amputations if severe.
• Eye problems which can cause the blurred vision in the early stages and visual loss if the issue goes unchecked
• Kidney disease which can cause the frequent urination in the early stages, and kidney failure (requiring dialysis) if severe
• Nerve damage which can cause the tingly feelings in the hands and feet in the early stages but can progress to total loss of feeling

What's the cure for diabetes?  There isn't one. The best you can do is manage the condition. Some have argued that you can cure type 2 diabetes by going on a calorie-restricted diet for two months. However, this is the same solution of managing weight revealed as a new solution!

If you successfully manage to lose weight and are allowed to come off medication, you have to maintain that weight to stay of the meds. If you become obese again it is likely that problems in managing your blood sugar will recur.

Inspiration: This article was inspired by a blog written by Dan Hon. He was told that he was pre-diabetic but according to his own account, he thought the doctors were wrong. In January 2012, a couple of years after the warning, he was diagnosed with type 2 diabetes. He's upset with himself for not listening to the good advice of his doctors and has since becoming an exercise fanatic but of course that won't cure the diabetes. He's currently a fan of tracking health data. A big thank you to the  Fat Creep™ fanatic, Styles J, that led us to this blog.

Sources: patient.co.uk, diabetes.com and diabetes.org.uk  

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​Although your personal finances and your business success are my primary interest, I believe you only operate at peak efficiency when you're fit and healthy. If you feel good, it filters through to your work. To help you with that, click for your free ebook: The Quick Guide to Sexy
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