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Health Condition

Type 2 Diabetes

About This Condition

Diabetes mellitus is an inability to metabolize carbohydrates resulting from inadequate insulin production, absence of insulin production, or impaired utilization of insulin. Other forms of diabetes (such as diabetes insipidus and gestational diabetes) are not included in this discussion.

There are several types of diabetes mellitus including type 1, type 2, and gestational diabetes, as well as diabetes insipidus, and a more recently recognized form of adult-onset diabetes called latent autoimmune diabetes in adults (LADA).1 This article concerns type 2 diabetes, which has also been called adult-onset diabetes or non-insulin-dependent diabetes. However, type 2 diabetes also may affect children and may also require treatment with insulin. With type 2 diabetes, the pancreas often makes enough insulin, particularly when a person is first diagnosed, but the body has trouble using it. Type 2 diabetes frequently responds well to natural therapies; however, if the condition is not well managed, the body may be unable to continue to make adequate insulin, requiring treatment with insulin. For many people with type 2 diabetes, lifestyle changes and/or oral glucose lowering medications are able to keep the condition well-managed.

People with diabetes cannot properly process glucose, the main sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, the cells of the body are starved for glucose, because without insulin, glucose cannot enter cells. People with diabetes are at increased risk for heart disease, atherosclerosis, cataracts, retinopathy, stroke, poor wound healing, infections, and damage to the kidneys and nerves. In addition, those with diabetes have a higher mortality rate if they also have high homocysteine levels.2 The risk of diabetes-related health complications can be decreased with proper blood sugar management and a healthy lifestyle.

Reducing Your Risk

To help keep you in top health, our experts recommend these steps:

  • Lose a little, win better health. Healthy weight is one of the keys to keeping type 2 diabetes at bay. If you carry extra pounds, losing just 5% to 10% of your body weight—that’s 10 to 20 pounds on a 200-pound person—may improve blood sugar control. Select Eating Right, above, for more on weight management.
  • Feast on fiber. Fiber is important for keeping blood sugar and insulin levels stable. If you don’t get enough from food, a fiber supplement may be a good addition to your diabetes prevention plan. Select Eating Right, above, for more healthy eating tips.
  • Consider the options. Even people who don’t have diabetes may benefit from medications to manage diabetes risk factors. If you fall into the “pre-diabetes” category, or the disease runs in your family, talk to your doctor about whether medications are right for you. Select Medicines, above, for more information.
  • Consider your heritage. This is especially important for Asian Americans, because there is evidence that this population is at an increased risk for diabetes at a relatively lower BMI than the general population. In the 2015 American Diabetes Association guidelines, the BMI cutoff point for recommending a diabetes screening for overweight or obese people was changed from 25 kg/m2 to 23 kg/m2 for Asian Americans, who have one or more additional risk factors for diabetes. This means screening in this population should begin even when a person’s BMI falls into what is considered the healthy BMI range for the general population.3
  • Mobilize your motivation. Consider a tool, such as a pedometer to up your game. For some people, tracking steps taken per day, or other get-fit activities, is a great motivator to reaching better health. Select Personal Care, above, for more ideas on tools for a healthier life.
  • Avoid prolonged sitting. All individuals, including those with diabetes, should limit the amount of sedentary time by breaking up extended periods of sitting (more than 90 min). This means frequent breaks while working at a desk, watching television, or engaging in other sedentary pursuits, such as reading or sewing.4 Stand up, stretch, move around, and shake out the kinks!
  • Quit smartly. If you smoke, talk to your health care provider about safe ways to help you quit. Although e-cigarettes have become popular in recent years, they should not be used as an alternative to smoking or to facilitate smoking cessation.4

Living With It

Our experts recommend the following top tips to support your blood sugar levels—and your life:

  • Become a mix master. Eating a mix of protein, fat, and fiber with each meal and snack is a great way to balance blood sugar. Add a small handful of nuts to your fruit, for example, for a mid-afternoon nosh. Eating Right, above, provides more great ideas for diabetes-friendly nutrition approaches.
  • Master your medications. If you take medicines to manage your diabetes, ask your doctor, nurse, or pharmacist for a complete explanation of how and when to take them, and whether they are safe to use with other medicines and supplements. Medicines, above, will give you an introduction to commonly prescribed diabetes medications.
  • Work with an expert. Nutrition therapy delivered by a registered dietitian (RD) is recommended for all people with type 2 diabetes; it should begin at diagnosis or at first referral for medical nutrition therapy (MNT), should be comprised of three to four encounters lasting 45–90 minutes, and should be completed within three to six months. At least one follow-up encounter is recommended annually to reinforce lifestyle changes and to evaluate and monitor outcomes that indicate the need for changes in MNT or medication(s); an RD should determine whether additional MNT sessions are needed.6
  • Track with accuracy. Finding the right tools to track your condition is important. Learn all you can about the features and costs of various glucose monitors. It may be worth a little more if you like extra features, such as an option to download your results to a computer. Select Personal Care, above, for more ideas on tools for a healthier life. Regular follow-up visits with a diabetes health care practitioner, including downloading and reviewing glucose monitoring results, is important.7
  • Spice it up. Fenugreek, a seed commonly used to flavor Indian and Asian dishes, may help prevent blood sugar spikes after meals. Select Vitamins, above, for the full scoop on supplements for diabetes support.

References

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3. 2015 Position Statement on Classification and Diagnosis of Diabetes. American Diabetes Association [cited 2015 Feb 15]. Available from URL: http://care.diabetesjournals.org/content/38/Supplement_1/S8.full.

4. 2015 Position Statement on Foundations of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunization. American Diabetes Association [cited 2015 Feb 16]. Available from URL: http://care.diabetesjournals.org/content/38/Supplement_1/S20.full.

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6. Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association. American Diabetes Association [cited 2015 Feb 16]. Available from URL: http://care.diabetesjournals.org/content/37/7/2034.

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37. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006;29:1826-32.

38. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17:548-55 [review].

39. Evans GW. The effect of chromium picolinate on insulin controlled parameters in humans. Int J Biosocial Med Res 1989;11:163-80.

40. Gaby AR, Wright JV. Diabetes. In Nutritional Therapy in Medical Practice: Reference Manual and Study Guide. Kent, WA: 1996, 54-64 [review].

41. Anderson RA, Polansky MM, Bryden NA, Canary JJ. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr 1991;54:909-16.

42. Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes. J Trace Elem Exp Med 1999;12:91-8.

43. Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables. Metabolism 1983;32:894-9.

44. Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism 1987;36:896-9.

45. Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994;17:1449-52.

46. Hermann J, Chung H, Arquitt A, et al. Effects of chromium or copper supplementation on plasma lipids, plasma glucose and serum insulin in adults over age fifty. J Nutr Elderly 1998;18:27-45.

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