UNDERSTANDING TYPE 2 DIABETES

Type 2 diabetes is the most common form of diabetes. For many people (but not all) it can be prevented through following a healthy lifestyle.

While type 2 diabetes cannot be cured, it can be managed and people with type 2 diabetes can and do live active and healthy lives.

What is type 2 diabetes?

Diabetes is the result of the body not creating enough insulin to keep blood glucose (sugar) levels in the normal range. Everyone needs some glucose in their blood, but if it’s too high it can damage your body over time.

In type 2 diabetes, either the body doesn’t produce enough insulin, or the cells in the body don’t recognise the insulin that is present. The end result is the same: high levels of glucose in your blood.

For many people (but not all) type 2 diabetes can be prevented by making healthy food choices and staying active.

There is a clear link between type 2 diabetes and high blood pressure (hypertension) and / or disordered levels of fats (cholesterol) in the blood (the medical name for this is dyslipidaemia). This combination of diabetes with hypertension and dyslipidaemia is sometimes called ‘the Metabolic Syndrome’ or Syndrome X.

When does type 2 diabetes normally occur?

Type 2 diabetes most often occurs in adulthood usually after the ages of 30 – 40 years. However, increasing numbers of teenagers and children are developing type 2 diabetes.

Who is most likely to develop type 2 diabetes?

Some groups of people are more likely to develop type 2 diabetes:

  • European 40 years of age or older

  • Māori, Asian, Middle Eastern or Pacific Island descent aged 30 years or older

  • Diabetes in your family (grandparents, parents, brothers or sisters)

  • High blood pressure

  • Overweight (especially if you carry most of your weight around your waist)

  • Diagnosed as having pre-diabetes (also known as impaired glucose tolerance) – this occurs when the glucose (sugar) in your blood is higher than normal, but not high enough to be called diabetes

Symptoms of type 2 diabetes

You may have had type 2 diabetes for many years without realising it. Not everyone has symptoms. Symptoms may include:

  • Feeling tired and lacking energy

  • Feeling thirsty

  • Going to the toilet often

  • Getting infections frequently

  • Getting infections which are hard to heal

  • Poor eyesight or blurred vision

  • Often feeling hungry

If you have any of the above symptoms, discuss these with your doctor.

Diagnosis

Diabetes is diagnosed by blood tests which can be organised through your doctor. If you are very unwell you should seek medical assistance
immediately.

Does type 2 diabetes run in families?

If you have a blood relative with type 2 diabetes you are more likely to develop type 2 diabetes yourself. However type 2 diabetes sometimes occurs in people who have no one in their family with the condition.

Is type 2 diabetes curable?

In people with type 2 diabetes, glucose builds up in the blood. But with good management, your blood glucose levels may go down to normal again. But this does not mean you are cured. Instead, a blood glucose level in your target range shows that your treatment plan is working and that you are taking care of your diabetes.

How do I start treating and managing my type 2 diabetes?

In a nutshell: some people with type 2 diabetes may be able to manage their diabetes through diet and exercise, or by taking tablet medication. However, eventually many people with type 2 will manage their diabetes with insulin as well.

Your doctor will advise you on what treatment is best for you, but whatever this may be, healthy food choices and staying active is important. The goal is to lower your blood glucose and improve your body’s use of insulin. This is achieved through:

  • A healthy diet

  • Exercise

  • Weight loss

The focus of your food choices and regular exercise is to achieve and maintain healthy blood glucose levels. Losing weight helps your body use insulin better.

You may also have to take medication. Type 2 diabetes is a progressive condition. This means that over time you will gradually produce less and less insulin. Although you may be able to manage your blood glucose levels in the healthy range by eating healthy food and having regular exercise for a number of years, most people come to need tablets or insulin as well as their food and exercise plan.

Learn more about Diabetes Management here and download the My Diabetes Journey app from the App Store or Google Play to help you manage your diabetes.

NZSSD Type 2 Diabetes Management Guidance

The New Zealand Society for the Study of Diabetes has developed national up to date and evidence-based guidance for the management of type 2 diabetes in adults with support of the Ministry of Health. The guidance is designed as a concise pragmatic resource for all health professionals working with people with type 2 diabetes in New Zealand and will be updated as evidence and practice changes.

How do most people feel about having type 2 diabetes?

When they are diagnosed with type 2 diabetes, most people feel very anxious, sad and fearful. That is perfectly natural.

Mixed in with these feelings may also be a sense of relief. Why? Well, there is a feeling of certainty that comes with finding out just what it is that has been wrong (when you have undiagnosed type 2 diabetes you may have been unwell and tired for some time but haven’t known what the problem was). It can be a relief to get a diagnosis but also a shock to learn it is diabetes.

Your own personal experience plays an important part in how you will react to, and cope with, your diabetes. Many of you will know someone who had, or has, diabetes. How they coped (or not) will influence how you feel. People who successfully coped with diabetes will be positive role models for you. Those who had a bad diabetes experience, on the other hand, may make you feel more fearful.

But, it’s important to remember that everyone has their own personal choices to make about the way they choose to live with their diabetes. The other thing to remember is that with increasing knowledge about diabetes, and ever more sophisticated tools to deal with diabetes, there never has been as ‘good’ a time to have diabetes as now (although it may not seem like it at the moment!). At this point in time, you’ve never had a better opportunity to live a long, happy and healthy life.

Become a role model

Although most people are shaken by a diagnosis of type 2 diabetes many people come to see the diagnosis in a more positive light, as a wake-up call. It is often an incentive to become more active, to eat healthier food and to manage your body weight.

It can also be an opportunity for you to make a positive difference to those around you, be they your friends or your immediate and larger family. You taking a positive and active approach to living with your diabetes can sometimes act to improve the health and happiness of your entire family group.

You can make a very practical difference too. The skills you learn to manage your diabetes may be the very skills your children or other family members need to prevent them developing type 2 diabetes at all.

What are some of the practical things I can do to cope?

Things you can do for yourself to help you cope with type 2 diabetes include:

  • Taking time out so you can have space within which to make the emotional and practical adjustments you need.

  • Talking to others. Share your thoughts and feelings with your friends and family. Spend time with those who can support you and understand your feelings. Talk to other people with diabetes. Their insights will help you and it’s important for you to know that you are not alone.

  • Take time to learn the skills you need to manage your diabetes. But remember you can’t learn it all at once. Don’t be too hard on yourself. Take it one step at a time.

  • Seeing a dietitian to get the most up-to-date information and support for your food choices.

  • Attending local diabetes groups or classes or visit a diabetes nurse educator.

  • Making contact with your local diabetes organisation and seeing if they run support groups or have other resources.

  • Having some counselling if you find living with diabetes especially hard.

  • When you do make changes to your lifestyle don’t try doing it all at once. One manageable step at a time is best. And don’t forget to give yourself a pat on the back when you achieve each step.

  • Looking around in your community for groups or activities that may help you make changes, for example, activity groups, walking groups, dance classes etc.

  • Don’t expect miracles overnight. Your adjustment process will have its highs and its lows. It doesn’t follow a set pattern. Be prepared for setbacks and bad patches. But remember that getting back on track is only a moment away.