Type 2 Diabetes

More than 90% of diabetics around the world have type 2 diabetes, which accounts for around 400 million adults (age 20-79). Several hundred million more have prediabetes or are otherwise at high risk for developing the disease. These figures are due to see significant rises over the coming decades, with type 2 diabetes incidence topping 500 million by 2030. It is also estimated that nearly half of the global cases of type 2 diabetes go undiagnosed. The majority of these undiagnosed cases are in developing nations, and now more than 75% of type 2 diabetics are from “low and middle income countries.” Type 2 diabetes is an unquestionable global epidemic.

Type 2 diabetes was previously referred to as “adult-onset” diabetes, and “non-insulin dependant” diabetes, but can, and increasingly is, diagnosed at any age. In fact, the rising incidence of type 2 diabetes in children around the world is one of the greatest epidemiologic crises of our time. Diabetic children historically suffered almost exclusively from type 1 diabetes. Furthermore, in advanced cases of type 2 diabetes, insulin may be required as a form of treatment and management.  For these reasons, it is no longer correct to refer to type 2 diabetes as either adult-onset or non-insulin dependent diabetes.

The other common form of diabetes, gestational diabetes, occurs in pregnant women and is a risk factor for type 2 diabetes.

Type 2 diabetes is characterized by insulin resistance, decreased insulin production by the pancreas, or a combination of the two. The result is consistently high levels of glucose in the blood without proper monitoring, modification to diet and lifestyle, and medication when necessary.

Symptoms of type 2 diabetes can be mild to severe. Common symptoms include fatigue, frequent and excessive urination, extreme thirst, slow-healing wounds, dizziness and blurred vision, numbness or tingling in the extremities of the body (feet, hands, arms and legs), and occasional sharp or shooting pains. Over time these symptoms, if not managed properly, can advance to severe diabetes complications such as neuropathy, retinopathy, nephropathy, and cardiovascular disease.

Type 2 diabetes is highly preventable. Many epidemiologists have suggested for a number of years that at least 90% of diabetes cases can be avoided through healthful eating and living active and mindful lifestyles.

There are both modifiable and non-modifiable risk factors for type 2 diabetes. Genetics and age are examples of non-modifiable risk factors, while obesity, poor dietary habits and inactivity are examples of modifiable risk factors. While those with a genetic predisposition for diabetes are at higher risk, they can still prevent the disease in the majority of cases by diligently limiting modifiable risk factors. Insulin resistance, prediabetes and even metabolic syndrome are major risk factors for type 2 diabetes that are also reversible through healthful and mindful lifestyle choices.

Type 2 diabetes is manageable. Many aspects of diabetes can be self-managed by living actively and mindfully and practicing healthful eating that focuses on the overall health of the individual. Diabetes is a complex and debilitating disease if not properly managed. Complications can range from mild to severe to fatal, and many diabetics remain unaware that most diabetes complications can be mitigated through changes in diet and lifestyle, and the administration of oral medications and insulin injections for more advanced stages of type 2 diabetes.

A growing body of research is also suggesting that type 2 diabetes itself is at least partially reversible, especially in its early stages if diagnosis has not been delayed. In the same light, advancement of the disease can be stopped or significantly delayed through health-conscious modifications to eating and lifestyle and an integrated approach to diabetes management.

Resources and Further Reading

A comprehensive resource for global diabetes statistics and trends:
http://www.diabetesatlas.org/resources/2017-atlas.html

Two solid and detailed resources for type 2 diabetes:
https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/what-is-type-2-diabetes/

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes

An important study from 2001 that documented the highly preventable nature of type 2 diabetes through healthy lifestyle choices:
http://www.nejm.org/doi/10.1056/NEJMoa010492?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov

A study showing that early stage type 2 diabetes is partly reversible through dietary modifications: 
http://care.diabetesjournals.org/content/39/11/2080