Understanding Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes in Singapore. It is a chronic condition that occurs because of a problem in how the body regulates and utilises carbohydrates (glucose sugar), the primary energy source. Unlike Type 1 diabetes, in which the pancreas produces little or no insulin, Type 2 diabetes primarily develops due to insulin resistance, where the body’s cells do not respond effectively to insulin (the hormone responsible for glucose metabolism). Over time, the pancreas may also produce less insulin, compounding the problem. Type 2 diabetes typically develops in adulthood; nonetheless, nowadays, we see more and more younger people developing this condition.
Unlike Type 1 diabetes, Type 2 diabetes can be preventable if detected and managed at an early stage with lifestyle changes. If left unmanaged, however, it can lead to serious health complications like heart disease, kidney failure, nerve damage, and vision loss.
The primary causes of Type 2 diabetes include obesity, a sedentary lifestyle, genetic factors, and poor diet. It is most commonly diagnosed in adults over the age of 45, but it can also occur in the late 20s, particularly with increasing obesity rates in Singapore and Asia. Preventative measures like maintaining a healthy weight, engaging in regular physical activity, and eating a balanced diet can significantly reduce the risk of developing Type 2 diabetes.
Although there is currently no cure for the advanced stage of Type 2 diabetes, seeking specialised care from an Endocrinologist can help you manage your condition well and even achieve remission if detected early.
Signs and Symptoms of Type 2 Diabetes
The signs and symptoms of Type 2 diabetes develop more gradually than the symptoms of Type 1 diabetes, which can make them harder to notice initially. Common symptoms include:
- Increased thirst and frequent urination: As excess glucose builds up in your bloodstream, fluid is pulled from the tissues, making you thirsty. As a result, you may drink and urinate more than usual.
- Increased hunger: Insulin resistance and high blood glucose levels can lead to increased hunger, despite eating.
- Unintended weight loss: Though less common than in Type 1 diabetes, unexplained weight loss can occur in Type 2 diabetes.
- Fatigue: When your cells are deprived of sugar, you may become tired and irritable.
- Blurred vision: If your blood sugar level is too high, fluid may be pulled from your eyes’ lenses, impairing your ability to focus.
Other symptoms can include slow-healing sores or wounds, tingling or numbness in your hands or feet, recurring yeast infections, and areas of darkened skin rashes, particularly in the armpits and neck. These signs and symptoms can act as early warnings and should prompt an individual to seek medical advice.
Sometimes, the symptoms of type 2 diabetes are so mild that people don’t notice them and thus left undiagnosed. Therefore, individuals may feel perfectly well until complications happen. Regular health screenings, including blood glucose tests and routine check-ups, are advised for individuals aged 40 and above every 3 years. Those with risk factors like family history or unhealthy lifestyle habits may need more frequent diabetes screenings.
Diagnosing Type 2 diabetes involves several tests that measure blood glucose levels. The primary diagnostic tools include:
- Glycated haemoglobin (A1C) test: This test measures the average blood glucose levels over the past two to three months. An A1C level of 6.5% or higher on two separate tests typically indicates diabetes.
- Fasting blood sugar test: Blood sugar levels are tested after an overnight fast. A fasting blood sugar level from 100 to 125 mg/dL is considered prediabetes, and 126 mg/dL or higher on two separate tests indicates diabetes.
- Oral glucose tolerance test: After fasting, you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A reading of 200 mg/dL or higher after two hours suggests diabetes.
Managing Type 2 diabetes requires an individualised comprehensive approach that typically includes lifestyle changes, monitoring blood sugar levels, and medications. Key management strategies include:
- Lifestyle modifications: Diet and exercise are the cornerstones of managing Type 2 diabetes. A diet rich in fruits, vegetables, whole grains, and lean proteins can help manage blood glucose levels. Regular physical activity also helps improve blood sugar control.
- Medication: Many people with Type 2 diabetes require medications to help manage their blood sugar levels. These can include metformin, which helps reduce glucose production in the liver, and other drugs that increase insulin sensitivity or help the pancreas produce more insulin.
- Regular monitoring: It is crucial to monitor blood sugar levels. This can be done at home with a blood glucose monitor or through regular visits to a healthcare provider.
Type 2 diabetes is a manageable condition, mainly when detected early and treated with a combination of lifestyle changes and medication. Understanding the signs and symptoms, undergoing regular screenings, and adhering to a management plan are essential to preventing complications and maintaining good health.
If you experience symptoms of Type 2 diabetes, book an appointment with Dr Vikram Sonawane, the Medical Director of Harmony Thyroid Endocrinology and Diabetes Centre and an experienced Endocrinologist. He is well-versed in Type 2 diabetes and can provide expert treatment for Type 1 diabetes and gestational diabetes.
Dr Vikram is well-versed in the treatment and management of prediabetes, diabetes and complex diabetic cases such as peripheral vascular disease, diabetic foot ulcers, diabetic neuropathy and diabetic kidney disease. His expertise ensures comprehensive care tailored to each patient’s unique needs, from early intervention to managing advanced complications.
References:
- Clinic M. Type 2 diabetes – symptoms and causes. Mayo Clinic. Published March 14, 2023. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193#:~:text=Type%202%20diabetes%20is%20mainly
- WebMD. Type 2 Diabetes: The Basics. WebMD. Published December 6, 2020. https://www.webmd.com/diabetes/type-2-diabetes