Type 2 diabetes was previously called adult onset diabetes. Type 2 diabetes is the most common form of diabetes, at least 80% of people with diabetes have type 2 diabetes. In type 2 diabetes the pancreas still produces insulin but the insulin is not effective in lowering the blood glucose. This is often referred to as insulin resistance. Unlike type 1 diabetes, type 2 diabetes is often related to obesity. There is a much higher incidence of type 2 diabetes in obese patients. The incidence of type 2 diabetes has gone up in the US over the last several decades and that is thought to be in a large part due to an increase in obesity in the US over the same time period.
Because of the insulin resistance found in type 2 diabetes, the glucose is not efficiently regulated in the body. The circulating blood sugars will be too high and the glucose is not able to be taken out of the blood stream into the vital organs in the normal way. This can lead to long term consequences such as heart disease, stroke, kidney failure, blindness, and circulatory problems. If type 2 diabetes is treated, many of these long term complications can be avoided.
Hemoglobin A1C is a protein marker that can be followed with blood tests to see how well type 2 diabetes is controlled. Hemoglobin A1C is a marker that reflects the average blood glucose over the previous 3 months. As the diabetes is controlled the Hemoglobin A1C will go down. The goal in managing type 2 diabetes is to keep the Hemoglobin A1C below 6.5%. This test is a key piece of information for doctors and patients with type 2 diabetes to manage the blood glucose levels.
Type 2 diabetes can be managed in a variety of ways and only about 30% of patients will ever need Insulin. The first step of treatment involves lifestyle changes, specifically diet and exercise. In many cases this will be tried first and Hemoglobin A1C levels will be followed to see if this is enough to get the diabetes under control. If lifestyle changes are not enough to control the type 2 diabetes, there are a number of oral medications that can be used to help control the blood glucose levels. Insulin is used when the diabetes is not able to be controlled with a combination of lifestyle changes and oral medication.
When patients have diabetes there are a number of screening tests that my be necessary. The Hemoglobin A1C will need to be followed to watch for blood sugar levels. An annual eye exam with an ophthalmologist is recommended because of the risk of retina problems and blindness in diabetics. A complete foot exam is also important. Diabetics have an increase risk of problems with the toes and feet due to issues with circulation. Diabetes is the most common cause for non-traumatic amputations in the lower extremities. Blood tests looking for cholesterol levels, and kidney function are important part of health maintenance for people with diabetes. A urine test for kidney function can also be of value. It important to get a flu shot every year and to get a pneumonia vaccine.