Type 2 Diabetes Management in 2020

You must have heard of the term ‘Diabetes’ or ‘Diabetes Mellitus’. But, do you have a basic idea about this medical problem? 

What is Diabetes?

Diabetes is a metabolic disease which leads to a very high blood sugar or blood glucose. It occurs when:

  • The organ pancreas, is not able to make insulin, or 
  • The body can’t use the insulin effectively.
What is type 2 diabetes

What are Types of Diabetes

  1. Type 1 Diabetes 
  2. Type 2 Diabetes
  3. Gestational Diabetes

What is Type 2 Diabetes?

Type 2 diabetes, also called adult-onset diabetes, is a chronic medical condition that affects the way your body metabolizes or processes blood sugar (glucose). It was previously called non-insulin dependent diabetes mellitus (NIDDM).

With type 2 diabetes, the body resists insulin and in the later stages, it doesn’t even produce sufficient insulin.


At first, the symptoms of type 2 diabetes are so mild that you won’t even get to notice them. 

The most common prodromes are:

  • Frequent urination
  • Excessive hunger
  • Increased thirst
  • Fatigue
  • Blurred vision
  • Itchy skin
  • Dry mouth
  • Unintended weight loss

If your blood sugar is high for a prolonged period of time, the following clinical manifestations may add up to the above list:

  • Slow-healing sores
  • Yeast infections
  • Acanthosis nigricans (dark patches on your skin)
  • Diabetes peripheral neuropathy (nerve damage) 
  • Foot pain

Don’t take these warning signs casually. Consult a doctor to prevent the worsening of your condition.

Cause or etiology of Type 2 Diabetes 

Obesity and an inactive lifestyle serve as the most significant triggers which cause Type 2 Diabetes Mellitus

It might also occur due to higher production of glucose in the liver, genetic influence, metabolic syndrome, or beta-cell dysfunction in the pancreas. 

A combination of these conditions leads to type 2 diabetes. However, the exact reason for the onset of this disease is yet to be known. 

The organ pancreas produces the hormone insulin- which regulates the body’s glucose. In Type 2 Diabetes, the body becomes resistant to insulin. This, in turn, forces the pancreas to release more insulin.

Eventually, glucose starts building up in your body and leaves the cells void of energy. In the worst case, the beta cells of the pancreas get damaged and are unable to produce more insulin.

What are the risk factors for type 2 diabetes?

Since the exact cause of diabetes is not known, certain factors increase the probability of getting type 2 diabetes.  

A person is said to be at a higher risk of having Type 2 Diabetes, due to these following factors:

  1. A family history of diabetes (A sister, brother, or parent who has type 2 diabetes)
  2. If the person is of 45 years of age, or older.
  3. Their ethnicity is African American, Alaska Native, Native American, Asian American, Hispanic or Latino, or Pacific Islander American.
  4. Women having a condition called polycystic ovarian syndrome (PCOS).
  5. if the person is already a prediabetes
  6. If they have high levels of triglycerides

However, there are some other factors which are in the person’s control. That is, If the person is –

  1. Overweight or obese due to which the cells become more resistant to insulin.
  2. Stressed
  3. Consuming an excess of junk food or smoking cigarettes.
  4. Having a sedentary lifestyle

These are  all controllable factors.

Diagnosis and Tests

Doctors use blood tests to diagnose type 2 diabetes. These tests confirm the diagnosis of this disease:

  • Glycated hemoglobin (A1C) test – It determines the average blood sugar level of a patient over the past two to three months. A1C test measures the amount of sugar attached to hemoglobin. Type 2 diabetes, in India, is diagnosed when the A1C is over 6.5 percent.
  • Fasting plasma glucose test – It determines the blood sugar level on an empty stomach. If the fasting blood sugar is 126 mg/dL or higher, the person is said to be diabetic.
  • Random plasma glucose test – This test is performed if you have symptoms of diabetes. It can be done at any time without considering your last meal. The random blood sugar level of 200 mg/dL or higher suggests that you have diabetes.
  • Oral glucose tolerance test (OGTT) – the test checks the blood glucose before and 2 hours after you drink a sugary liquid. If the blood sugar level is 200 mg/dL or more after 2 hours, then you have diabetes.

Type 2 Diabetes Treatment

Lifestyle changes

The following lifestyle changes help to bring the blood sugar level back to normal: 

  • Do exercise and aerobic activity daily – It helps the cells to use insulin.
  • Control your weight – It can reduce your A1C levels and risk of cardiovascular disease.
  • Healthy diet – Consume food that is rich in fiber and carbohydrates.
  • Proper sleep – To control the blood glucose level, you must have a proper sleep.

If these lifestyle changes are not able to control type 2 diabetes, the medications might help.


  • Metformin – It lowers the production of glucose in the liver and improves the body’s sensitivity to insulin. (preferred medication)
  • Sulfonylureas – The oral medications which help your body secrete more insulin.
  • Meglitinides – It stimulates the pancreas to release more insulin. The medication is fast-acting but short-durational.
  • Thiazolidinediones – It makes the body’s tissues more sensitive to insulin. It has serious side effects and therefore, not the first-choice treatment. 
  • DPP-4 inhibitors – A milder medication to reduce blood sugar levels.
  • GLP-1 receptor agonists – It slows digestion and enhances the blood glucose levels.
  • SGLT2 inhibitors – The medications inhibit the reabsorption of glucose in the kidney and thereby, lower blood sugar.
  • Alpha-glucosidase inhibitors – It helps your body break down starchy foods and table sugar which lowers the blood sugar.

Insulin therapy

In insulin therapy, the hormone, insulin, is injected in the body through needle, insulin pump, or inhaler. Insulin treatment varies from person to person. Low blood sugar (hypoglycemia) is a possible side effect of insulin.

Type 2 Diabetes Complications

Type 2 diabetes mellitus is even life-threatening if the treatment is not done for a long time. Some of the potential complications are:

  1. Cardiovascular disease, or heart disease (most likely to happen).
  2. Vision problems (diabetic retinopathy)
  3. Stroke
  4. High blood pressure or hyperglycemia
  5. Nerve damage (neuropathy)
  6. Kidney damage (nephropathy)
  7. Depression
  8. Alzheimer’s disease 

Type 2 Diabetes Prevention

Before diabetes is detected, there is a phase where the blood sugar level is high but not high enough to be diagnosed as diabetes. This condition is called prediabetes. There is a chance to prevent the conversion of prediabetes into diabetes.

To prevent the onset of type 2 diabetes:

  • Avoid a sedentary lifestyle
  • Exercise regularly and lose weight if you are obese.
  • Quit smoking
  • Follow a ketogenic or very-low-carb diet
  • Drink water and avoid beverages that are high in sugar.

The Bottom Line

Prevention is better than cure. Therefore, acquire healthy habits and avoid a sedentary lifestyle. Don’t take diabetes casually just because it develops gradually.  

If you notice even 1% sign of diabetes, consult a doctor and steer clear of the unpleasant end result.

How to handle Type 2 Diabetes during COVID 19 lockdown/quarantine

1. Anxiety levels are all-time high due to lockdown.
2. Stress increases blood pressure and ultimately leads to diabetes.

To prevent these situations, utilise your time effectively. Workout regularly, enhance your skills, have a sound sleep everyday and spend time with your family members.

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