Type 2 Diabetes: Living With the Disease

Topic Overview

Is this topic for you?

This topic is for adults who have had type 2 diabetes for more than a few months. Before reading this topic, you may want to read Type 2 Diabetes: Recently Diagnosed.

If this topic does not answer your questions, see:

• Type 2 Diabetes, if you want to learn about type 2 diabetes but do not have the disease.
• Type 2 Diabetes: Recently Diagnosed, if you have been told recently that you have type 2 diabetes.
• Type 2 Diabetes in Children, if your child has been diagnosed with this disease.
• Type 2 Diabetes: Living With Complications, if you have eye, kidney, heart, nerve, or blood vessel disease caused by your diabetes.

If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.

What is diabetes?

Type 2 diabetes is a lifelong disease that develops when the pancreas cannot produce enough insulin or when the body's tissues become resistant to insulin. Insulin is a hormone that helps the body’s cells use sugar (glucose) for energy. It also helps the body store extra sugar in muscle, fat, and liver cells.

How can you manage diabetes?

You play a major role in managing your diabetes. The most important thing is to control your blood sugar. To do this:

• 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. There are many ways to manage how much and when you eat. Your doctor, a diabetes educator, or a dietitian can help you find a plan that works for you.
• Exercise regularly. Get at least 30 minutes of exercise on most, preferably all, days of the week. Exercise helps control your blood sugar by using glucose for energy during and after activity. It also helps you stay at a healthy weight; lower high cholesterol; raise HDL, or "good," cholesterol; and lower high blood pressure.
• Take your medicine or insulin as directed, if prescribed by your doctor.
• Check your blood sugar levels regularly, as advised by your doctor.

The goal is to keep your blood sugar in a target range. You and your doctor may decide to keep your blood sugar as close to normal as possible. This is called tight control. It’s the best way to reduce your chance of having more problems from diabetes. These are called complications.

Taking care of your diabetes takes time and energy every day. But it will help you feel better and may prevent, or at least delay, complications.

How can you deal with high and low blood sugar?

Even when you are careful and do all the right things, you can have problems with high or low blood sugar. It is important to know what signs to look for and what to do if this happens.

High blood sugar (hyperglycemia) usually happens over a few days or weeks. Early symptoms include:

• Feeling very thirsty.
• Urinating more often than usual.
• Feeling very hungry.
• Having blurred vision.

People with diabetes can get high blood sugar for many reasons, including not taking their diabetes medicines, eating more than usual (especially sweets), not exercising, or being sick or under a lot of stress. If you have high blood sugar, follow your treatment plan for lowering it. This may mean taking missed doses of insulin or medicine. Call your doctor if you don't know what to do. Treating high blood sugar is important. If it is left untreated, it can lead to hyperosmolar state, a dangerous condition.

You can get low blood sugar (hypoglycemia) if you take insulin or a sulfonylurea pills for diabetes. It can happen suddenly. Early symptoms include:

• Sweating.
• Feeling weak.
• Feeling shaky.
• Feeling very hungry.

Symptoms of low blood sugar may vary over time. You may also have these symptoms if you have a sudden large drop in blood sugar, even though the level does not drop below the normal or near-normal range. Eat 1 tablespoon of sugar, ½ cup of orange juice, or another carbohydrate. Wait 15 minutes, and then check your blood sugar.

What are the complications of diabetes and their symptoms?

Over time, high blood sugar can cause complications such as problems with your eyes, heart, blood vessels, nerves, and kidneys. High blood sugar also makes you more likely to get serious illnesses or infections. Complications can lead to blindness, kidney failure, removal of a limb (amputation), heart attack, stroke, and death. This is why it is so important to keep your blood sugar in your target range.

If you had the disease several years before you were diagnosed, you may already have a complication from diabetes. Even if you don't have problems now, the longer you have diabetes, the more likely you are to get one or more complications.

Be sure to tell your doctor if you notice any new symptoms, such as chest pain, numbness, or a shooting pain in your hands or feet.

How can you prevent complications?

You may be able to prevent, or at least delay, problems from diabetes by keeping your blood sugar level as close to normal as you can. Treatment of high blood pressure or high cholesterol can also help. If you smoke, quit. Smoking increases your risk for complications.

If you are age 30 or older, talk to your doctor about whether to take a low-dose aspirin each day to help prevent heart attack, stroke, or other large blood vessel disease. People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.¹

See your doctor every 3 to 6 months. During these visits, your doctor will review your treatment and do tests and exams to see if your blood sugar is staying within your target range and if you have any complications. It’s also important to have regular checkups with your eye doctor and dentist. Diabetes can cause vision and dental problems.

Will your treatment change over time?

The goal of treatment is to always keep your blood sugar as close to your target range as you can. At first, you may be able to treat diabetes with diet and exercise alone. At some point, you may need to use insulin or take pills to control your diabetes.

You always need to:

• Eat a balanced diet with enough calories to help you stay at a healthy weight. If you are overweight, reduce your calorie intake to lose some weight.
• Get regular exercise.
• Check your blood sugar regularly during the day, as advised by your doctor.

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Author:	Caroline Rea, RN, BS, MS	Last Updated August 14, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism
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