Overview

Type 2 diabetes is a medical condition that affects how your body uses sugar (glucose). Normally, when you eat food, your body breaks down the carbohydrates in the food into sugar, which then enters your bloodstream. This triggers the pancreas to release insulin into your bloodstream.

Insulin acts as a key that unlocks the cell and allows glucose to enter. Once inside the cell, glucose is either used for energy or stored for later use.

In people with type 2 diabetes, insulin either isn't produced in sufficient amounts or the cells become resistant to insulin. When your body is insulin resistant, the sugar in your bloodstream can't enter your cells properly, and it starts to build up, causing high blood sugar levels.

Over time, high blood sugar levels can lead to serious health problems, such as heart disease, kidney problems, nerve damage, and eye problems. That's why it's important for people with type 2 diabetes to manage their blood sugar levels and work with their doctor to control their condition.

Treatment for type 2 diabetes often involves making lifestyle changes, such as eating a healthy diet, being physically active, and losing weight if needed. In some cases, medication or insulin therapy may also be necessary to help the body use insulin more effectively.

Diagnosis

Your healthcare provider will likely provide you with an assessment for diabetes if you have symptoms and/or risk factors.

Risk factors

• Being overweight
• Being inactive
• Have family history of type 2 diabetes
• Have high cholesterol
• Old age
• Being pregnant

Symptoms

• Increased thirst
• Increase in frequency and volume of urination
• Unintended weight loss
• Tingling/numb hands and/or feet
• Tiredness
• Increased hunger

If you are at increased risk of diabetes or present with any of these symptoms, your healthcare provider will begin by ordering blood tests.

The main tests are a fasting blood glucose test and an A1C.

A fasting blood glucose test checks for the amount of glucose in your blood after not eating for 12 hours. If this number is abnormally high (7mmol/L or higher), it is an indication of diabetes.

The A1C is an additional test that can be done to assess how high your blood sugar has been over the past 3 months. This is an effective means to determine how well your blood sugar has been controlled for a longer period of time.

Once you have a diabetes diagnosis, these tests continue to be effective in assessing how well your diabetes is being controlled.

Medications

There are 9 main medication types used to treat type 2 diabetes.

Acarbose

Acarbose is a medication that works to prevent breakdown of carbohydrates into glucose. This stops excess glucose absorption and therefore prevents an increase in blood sugar.

Glucagon-like Peptide-1 (GLP-1) Receptor Agonists

AGLP-1 receptor agonists work in diabetes to increase inulin secretion and decrease glucagon production when blood sugar is present. This helps to store glucose away and make use of it while it is present.

Dipeptidyl peptidase-4 (DPP-4) Inhibitors

DPP-4 is an enzyme that breaks down GLP-1 and other hormones. Inhibiting this hormone results in increased insulin secretion and decreased glucagon production when blood sugar is increased.

Meglitinides

Metformin is the first line treatment for type 2 diabetes mellitus. It works both by reducing glucose production in the liver and increasing insulin sensitivity in the liver and muscles. This is effective in both lowering blood glucose and reducing the risk of cardiovascular-related events, such as a heart attack.

Metformin

Metformin is the first line treatment for type 2 diabetes mellitus. It works both by reducing glucose production in the liver and increasing insulin sensitivity in the liver and muscles. This is effective in both lowering blood glucose and reducing the risk of cardiovascular-related events, such as a heart attack.

Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors

SGLT2 inhibitors work in the kidneys by increasing the amount of glucose you lose in your urine. This helps to lower your blood glucose as well as lower your risk of developing cardiovascular disease, heart failure, and kidney dysfunction.

Sulfonylureas (SU)

Sulfonylureas work in diabetes by increasing the amount of insulin secreted directly from the pancreas. This works quickly to help with blood sugar reduction in diabetes.

Thiazolidinediones (TZD)

Thiazolidinediones are medications that increase insulin sensitivity and glucose uptake in fat and muscle after meals. They also work to decrease glucose production from the liver.

Insulin

Insulin injections work in the body in a way that mimics endogenous insulin secretion. This helps to lower blood sugar by allowing it to be stored in cells for future energy use.