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Type 2 Diabetes: Living With the Disease
- Topic Overview
-
Health Tools
- FAQs
- Causes of High and Low Blood Sugar
- Symptoms
- What Happens
- What Increases Your Risk
- When to Call a Doctor
- Exams and Tests
- Treatment Overview
- Prevention
- Home Treatment
- Medications
- Surgery
- Other Treatment
- Related Information
- References
- Credits
Although your experience with type 2 diabetes may be different from that of others with the disease, everyone with diabetes has to pay attention to eating a healthy, balanced diet and exercising regularly. Eating too much carbohydrate can cause your blood sugar levels to rise quickly. A plate format is a simple way to plan a balanced diet. For information, see:
It is important to have a healthy eating lifestyle—including eating whole grains, lean meats, fish, vegetables, fruits, and low-fat milk products—and to reduce calorie intake if you need to lose weight. You may be able to keep your blood sugar levels within your target range with only these measures for a while. But you will likely need to take oral diabetes medicines as time goes on.
As diabetes progresses, your
pancreas 
may produce less and less
insulin. If your blood sugar level is persistently
high, it also may cause your pancreas to produce less insulin. This is called
glucose toxicity. When your pancreas produces too little or no insulin, you
will have to give yourself shots of insulin.
Because it is difficult to achieve the perfect balance of insulin and blood sugar level that your body would have if you didn't have diabetes, you will experience high blood sugar levels from time to time. If you take insulin or certain oral diabetes medicines, you also may experience low blood sugar. Early treatment of high or low blood sugar can prevent a medical emergency.
What could happen if your blood sugar level is very high?
Symptoms of high blood sugar (hyperglycemia) usually develop gradually over a period of hours or days. Early symptoms are increased thirst, frequent urination, increased hunger, and blurred vision. But you may not have any early symptoms. If your blood sugar level continues to rise and you do not drink enough liquids, you can become dehydrated.
If you do not take your diabetes medicine (pills or insulin), or if you have a severe infection or other illness or become severely dehydrated, your blood sugar may rise to a dangerous level called a hyperosmolar state. Left untreated, the condition can lead to coma and death. Hyperosmolar state usually is treated in a hospital and often in the intensive care unit. There you are closely observed and receive frequent blood tests for glucose and electrolytes. You will receive insulin and other fluids through a vein (intravenous, or IV) to bring your blood sugar down and correct the dehydration.
Complications
Long-term diabetic complications are caused by persistently high blood sugar levels continuing over months or years. You may already have one or more complications, because you may have had the disease for several years before being diagnosed. There are four types of complications:
- Microvascular disease,
which affects your eyes or kidneys.
Diabetic retinopathy (eye disease) and
diabetic nephropathy (kidney disease) develop without
early noticeable signs. You are also at risk for other eye diseases, such as
cataracts and
glaucoma.
- Macrovascular disease, which affects your heart and the large blood vessels throughout your body. Diabetes damages the lining of large blood vessels and contributes to developing atherosclerosis. Atherosclerosis and a greater tendency toward blood clot formation can lead to peripheral arterial disease, heart attack, or stroke.
- Diabetic neuropathy, which affects the nerves in your body.
Diabetic neuropathy can decrease or completely block
the movement of nerve impulses or messages to organs, legs, arms, and other
parts of your body. Nerve damage can affect both the functioning of internal
organs, such as the stomach (gastroparesis), and your ability to
feel pain when injured. When blood vessels and nerves are affected, broken
bones (fractures) and joint deformities can develop within weeks without
noticeable pain, especially in your feet (Charcot foot).
- Weakened immune system, which puts you at risk for difficult-to-treat and persistent infections and delayed healing of wounds, especially in your feet. Severe infections in your feet may lead to amputation.
Other health problems
People with diabetes often already have other health problems, such as high blood pressure and high cholesterol, or they develop them as diabetes progresses. These conditions can contribute to the start of complications from diabetes or can make complications worse.
Can the progression of diabetes be prevented?
From the time you are diagnosed with diabetes, work closely with your doctor to keep your blood sugar levels within your target range. If you do so, you may slow the progression of any complication you already have and prevent or delay others. You also may feel better and be more in control of your life.
Eat a balanced diet. If you are overweight, reduce your calorie intake to lose some weight. Losing as little as 10 to 20 pounds can improve your blood sugar levels. Try to do at least 2½ hours a week of moderate activity. One way to do this is to be active 30 minutes a day, at least 5 days a week.2, 3 Resistance exercise like weight lifting or even yard work is also helpful.
More information |
| Author: | Judy Dundas | Last Updated: August 18, 2009 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism | |
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