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Type 2 Diabetes is more common among people over 40. People who have Type 2 diabetes are not born that way. They usually start life with adequate and functional insulin levels, but with time, the glucose in the bloodstream gradually becomes resistant to the circulating insulin. This means that despite the presence of insulin in the blood, glucose isn’t moving to tissues as it should. Consequently, more insulin is required to get the same amount of glucose into the tissues as it used to.
Unfortunately, the body cannot always produce high amounts of insulin to meet the increased demand, and this causes insulin deficiency to creep in slowly.
Type 2 Diabetes is often associated with hypertension, dyslipidemia, central obesity, and PCOS, and this association is known as metabolic syndrome or insulin resistance syndrome.
CAUSES OF TYPE 2 DIABETES
The primary cause of insulin resistance is not fully known, but some strongly implicated factors include:
Genetics: Genetic factors contribute to the risk of developing Type 2 Diabetes, but many of these factors still rely heavily on environmental factors for activation.
Obesity: Obesity (BMI ≥ 30kg/m2 ) is a significant risk factor for Type 2 Diabetes. Obese people have up to 10 times increased risk of developing Type 2 Diabetes than people with normal BMI.
Sedentary Lifestyle: High levels of inactivity have also been linked to the development of insulin resistance and eventual diabetes.
Excess Insulin Antagonists: Some hormones have the opposite function as insulin. For example, Glucagon brings glucose out of its stored state into the bloodstream. Other types of insulin antagonists include growth hormone, thyroid hormone, adrenaline, and so on. When these hormones are circulating in excess, they subdue the effect of insulin.
Medications: Chronic or excessive use of certain drugs like corticosteroids, phenytoin, or thiazide diuretics can lead to glucose intolerance and eventually diabetes.
Pregnancy: Gestational diabetes is diabetes that first appears during pregnancy and often resolves afterwards. It is thought to be caused by pregnancy and placenta hormones.
SYMPTOMS OF TYPE 2 DIABETES
The first cardinal feature of Diabetes is hyperglycemia (excess sugar in the bloodstream), and this can present in several ways, including:
- Excessive thirst
- Excessive urination (in volume and frequency. Including at night)
- Foamy urine
- Unintentional weight loss
- Excessive hunger
- Nausea and Vomiting
- Blurring of vision
- Irritability, mood swings
- Vulva itching
- Recurrent genital candidiasis
- Excessive and recurrent tiredness
- Tingling or numbness of fingers and feet
- Recurrent infections
- Slow healing wounds
DIAGNOSIS OF TYPE 2 DIABETES
If you ever notice any of the above-listed symptoms, the best thing to do is to seek medical attention from a licensed medical practitioner. You would most likely be instructed to do blood tests, such as:
Urine Test: Various types of urine tests may be conducted. Regardless, the presence of glucose in urine may be a sign of diabetes.
Blood Test: There is a normal amount of sugar expected to be in the bloodstream before eating (during a fast) and after eating. These values are expressed in a range. Certain blood tests can reveal whether or not your blood sugar is within the normal range at a given time.
Glycated Haemoglobin: Glycated haemoglobin is a blood test that reflects how much sugar has been in your bloodstream in the past two to three months. When there is too much sugar in your blood, some of it attaches to your red blood cells, which carry oxygen around your body. These red blood cells live for about 2-3 months, so the glycated haemoglobin test gives an average of how much sugar has been in your blood during that time.
In Nigeria, blood sugar screenings are often available at hospitals, community health centres, and even mobile health campaigns.
COMPLICATIONS OF TYPE 2 DIABETES
If not quickly identified and treated, or if poorly managed, diabetes can progress and evolve into something worse. Some complications of type 2 diabetes include:
Hyperglycaemic Hyperosmolar State: This is a potentially fatal condition that may occur in people with Type 2 Diabetes Mellitus if not properly treated. It is characterised by extremely high blood sugar, dehydration, and an altered mental state (loss of consciousness, abnormal speech or behaviour, etc.). It may be caused by poor drug compliance, infection, or use of certain medications.
Hypoglycaemia: This is a common complication of diabetes. It is objectively defined as blood glucose less than 3.5mmo/L (or 63mg/dL) and can occur due to insulin overdose, use of certain medications, or hunger and fasting. It can also be triggered by excess alcohol intake or unaccustomed stress. Some signs and symptoms of hypoglycemia include hunger, sweating, trembling, difficulty concentrating, confusion, nausea, and headache.
Kidney Disease: Kidney disease that results as a complication of diabetes is known as diabetic nephropathy. Diabetic nephropathy is a common cause of kidney failure.
Poor Sight: If diabetes is left undiagnosed or poorly treated for long, it can begin to affect the retina in the eyes and eventually damage sight.
Diabetic Neuropathy: This is nerve damagecaused by long-standing, poorly treated diabetes. It can present as pins and needles sensations, numbness, muscle weakness, and so on. This can contribute to foot problems in diabetes known as diabetic foot.
MANAGING TYPE 2 DIABETES
Diabetes mellitus cannot be cured… yet. However, the good news is that Type 2 Diabetes can be managed—and in some cases, even reversed—through lifestyle changes, medications, and regular monitoring. Here’s how:
Eat a Healthy, Balanced Diet: Focus on whole grains, vegetables, lean protein (like fish and chicken), and healthy fats. Limit sugary drinks, pastries, and processed foods. Traditional Nigerian meals, like small portions of amala, eba, pounded yam, akpu, or fufu with vegetable soup, can be diabetes-friendly when portions are controlled.
Stay Active: Aim for at least 30 minutes of exercise most days of the week. Walking, jogging, dancing, and even farming or house chores count as physical activity. Regular activity helps lower blood sugar and improves overall health.
Lose Excess Weight: Losing even a small amount of weight can significantly improve your blood sugar levels.
Take Your Medications: Ensure you take your diabetes medications or insulin as directed by your doctor. Don’t skip doses or take more than prescribed.
Monitor Your Blood Sugar: Invest in a glucometer (a device to measure blood sugar at home) and check your levels regularly.
Regular Doctor Visits: Routine checkups with your healthcare provider can help detect complications early and adjust your treatment plan as needed.
CAN TYPE 2 DIABETES BE PREVENTED?
Absolutely! Learning about the prevalence of diabetes in your family can give you an idea of how likely you are to develop it, too. Regardless of your risk level, healthy practices like eating balanced diets regularly and in controlled portions, maintaining a healthy weight, and exercising regularly, can help to prevent Type 2 Diabetes.
