What is Type 2 Diabetes? Understanding the Diagnosis.
There are several different types of diabetes- maybe even more than you’d think. However, Type 2 diabetes is the most common as it accounts for about 90-95% of all cases of diabetes.
A common question upon diagnosis of type 2 diabetes is— what is it? What is actually happening in my body when I am diagnosed with type 2 diabetes?
Diabetes is hard to understand, especially when it’s new; however, if we break it down piece by piece it starts to make sense.
The simplest definition of diabetes is — too much sugar in the blood. Make sure that part sinks in, it doesn’t have to be more complicated. Keeping this easy helps assure it all comes together.
Next, you may wonder, ok if there is too much sugar in the blood then where is it coming from? The answer is— from the food we eat and also from our liver in the form of glycogen. Our liver is an organ that has many functions, but for this explanation consider it to be like a bank, holding onto sugar that is not needed immediately. The liver can release sugar as needed.
Next, the sugar has to get into our body’s cells to turn it into energy. This is where the main issue of type 2 diabetes occurs. You would think that the sugar should just enter the cells and get the job done, right? Well, unfortunately, it isn’t that easy. Our cells need a KEY to open up the door of the cell wall to let the sugar in. The sugar will try to enter the cell but will get rejected and bounce right off the cell wall without an all-important key to escort the sugar in. This key is a hormone produced by the pancreas called INSULIN. When insulin is present but doesn’t do its job (which is to open the cell’s door, also known as insulin receptors, to let the sugar in) this is called insulin resistance. In other words, the cells are incapable of accepting the sugar sitting right outside the door. If that sounds frustrating and annoying- it is!
What causes insulin resistance?
Insulin resistance can be caused by genetics, a sedentary lifestyle, being overweight, and stress, to name a few. When the cells’ doors do not open, sugar then accumulates in the bloodstream in large amounts. Our pancreas will produce more insulin to try to get cells to respond. Eventually, the pancreas can’t keep up, and blood sugar rises, setting the stage for prediabetes and type 2 diabetes.
Think- type 1 diabetes = no keys and type 2 diabetes = keys are present, but someone changed the lock. Rude! Now, every time you go to use your house key in your front door and you have to jingle it around to unlock the door, there’s a good chance you will think about insulin resistance— I know I do!
The next logical question that gets asked is- why did I get diabetes?
Believe it or not, the exact cause is not known; however, there are several known risk factors that increase a person’s risk of developing type 2 diabetes:
excess body fat
Diagnosis of type 2 diabetes can happen a few different ways.
Some people are symptomatic from elevated blood sugars which results in a physician appointment. Common symptoms are: frequent urination, constant thirst, increased hunger, blurry vision, cuts that will not heal, feet that burn or tingle, weight change, fatigue, itching, yeast or other infections, erectile dysfunction, or none.
Those with no symptoms usually find out the hard way. In my experience, a person typically goes to their routine physician appointment, the doctor orders labs, and the fasting blood sugar comes back above normal resulting in a diagnosis or pre-diabetes or type 2. A few different ways a person can be diagnosed is by a fasting blood sugar, oral glucose tolerance test (OGTT), random glucose test, and/or A1c level. A fasting blood sugar of 70-99mg/dL is considered normal, 100-125mg/dL falls in the pre-diabetes range, then anything over 126mg/dL is type 2 diabetes. An oral glucose tolerance test is a two-hour test that checks your blood sugar levels before and two hours after you drink a sweet drink that is provided to you. The result of an OGTT less than 140 mg/dL is normal, 140-199 mg/dL is pre-diabetes, and 200mg/dL is diabetes. A random glucose test can be done at any time of the day when severe symptoms are present. Diabetes is diagnosed when the reading is over 200 mg/dL. Lastly, an A1c reading less than 5.7% is normal, 5.8%-6.4% is pre-diabetes, and anything greater than 6.5% is diabetes.
Luckily, type 2 diabetes is a manageable disease.
Early action including diabetes self-management education is imperative. A new diagnosis is overwhelming, but taking the time to break it all down and understand it will help you have more “buy-in” in your overall management. After all, as Maya Angelou’s famous quote reads, “Do the best you can until you know better. Then when you know better, do better.” Don’t go at this alone, reach out, and give yourself the best gift you can after diagnosis- education. We are here for you!
Kristen Garron RD, LDN, CDE
Director of Group Education. Kristen joined IDS in 2018 after working for seven years as a clinical dietitian in a community hospital and eight years as lead instructor for a diabetes self-management education company. With a knack for making complex issues seem simple and relating to people with a strong sense of empathy, group diabetes education has become her specialty and her passion. “I think it’s important to create a warm, welcoming atmosphere,” says Kristen. “Everyone at IDS is that way – with patients and with each other. It’s tough enough living with diabetes; the least we can do is make those around us feel like family.” A graduate of LaSalle University (go Explorers!), Kristen majored in Nutrition while earning All- Conference honors in division-1 lacrosse. In keeping with IDS tradition, she remains very active with distance-running and weight-lifting. Kristen lives in West Chester, PA with her husband Tim, daughters Grace & Sadie, and dog Kirby. She enjoys traveling (visited 30 of 50 states and more than a dozen foreign countries so far), scrapbooking, and being outside with the kids and Kirby.