What Are the Early Signs of Type 2 Diabetes?

In type 2 diabetes, the body's cells cannot take up glucose properly, leading to high levels of glucose in the blood.

Diabetes is a chronic disease characterized by increased blood sugar (glucose) level.  Diabetes is caused by either insufficient insulin secretion or resistance to that hormone’s action. 

Insulin is produced by the pancreas and helps process the glucose in the blood. Thus, with inadequate insulin, the bodies can’t burn all the blood sugar for energy in an efficient way. This means the glucose level in the blood rises, causing a variety of symptoms and when severe may even lead to death. 

An estimated 9.4% of the population in the United States (30.3 million) were affected by diabetes in 2017, according to the report by the U.S. Centers for Disease Control and Prevention (CDC).

Factors that influence the development of type 2 diabetes include:

• Genetic factors
• Increased intake of carbohydrates
• Excessive intake of calorie
• Obesity
• High-risk ethnic background
  • Asian 
  • Hispanic 
  • Native American 
  • African American
  • Asian American 
• Lack of physical activity
• Sedentary lifestyle
• Age greater than 45 years
• Family history of diabetes
• History of diabetes during pregnancy
• Ovarian cyst diseas

The classic symptoms of type 2 diabetes seen in the early stages are

• Increased thirst
• Increased urine frequency
• Increased appetite
• Urinating frequently at night
• Weight loss
• Fatigue

The symptoms which occur in the later stages are

• Blurred vision
• Numb or tingling hands and feet
• Wounds that heal slowly
• Increased infections than usual
• Low blood sugar level

Most frequently, however, type 2 diabetes does not cause any symptoms for several years and may go unnoticed.

Diabetes, if poorly controlled or left untreated, can lead to severe complications, which are as follows:

• It may affect different organs of the body especially, the heart, eye, kidney, and nerves.
• It may affect the eyes causing blindness in adults.
• It is a major contributor to end-stage kidney disease in the United States.
• It can lead to leg amputation.
• There is an increased rate of post-surgery pneumonia.
• The risk of stroke is higher.
• The death rate is higher among COVID-19 patients with an underlying diabetic condition.

The different diagnostic criteria set by the American Diabetes Association are:

• A fasting glucose level of 126 mg/dL, or higher
• An oral glucose tolerance test which shows 200 mg/dL or higher
• A random glucose test of 200 mg/dL or higher in a patient showing typical symptoms of increased blood glucose level
• A hemoglobin A1C (HA1C), the test should show a result of 6.5% or higher

Goals of treatment are as follows:

• Preventing blindness or end-stage kidney disease, through control of blood sugar level and blood pressure
• Preventing stroke or heart disease by controlling cholesterol, blood pressure, and tobacco use.
• Preventing nerve damage by controlling blood sugar

Drugs that are used to treat diabetes are known as anti-diabetic medications. The different classes of antidiabetic drugs used are:

• Biguanides: metformin
• Sulfonylureas: glyburide, glipizide
• Meglitinide derivatives: repaglinide
• Alpha-glucosidase inhibitors: acarbose
• Glucagon-like peptide: semaglutide
• Thiazolidinediones: pioglitazone
• Dipeptidyl peptidase 4 inhibitors: sitagliptin
• Amylinomimetics: pramlintide
• Selective sodium-glucose transporter inhibitors: dapagliflozin, canagliflozin
• Bile acid sequestrants: colesevelam
• Rapid-Acting insulins
• Intermediate-acting insulins
• Long-acting insulins
• Dopamine agonists: bromocriptine

Diabetes can be well-controlled by controlling the symptoms, but it cannot be completely cured as it is a chronic disease. Hence, prevention is key.

• Lead a healthy lifestyle by reducing weight.
• Ensure a balanced diet with proper nutrition.
• Avoid junk food or extremely fatty foods.
• Exercise daily for 30-40 minutes.
• Limit the intake of alcohol and refrain from smoking tobacco.
• Increasing the intake of some essential minerals such as magnesium has shown to decrease the risk of diabetes.
• Monitor the blood sugar level from time to time.
• Be conscientious about your annual eye check-ups.