What is type 2 diabetes?

Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia) resulting from the body's inability to properly use insulin or to produce enough insulin. 

Several factors contribute to the development of type 2 diabetes, including genetics, lifestyle factors (such as poor diet, lack of physical activity, and obesity), and environmental influences. It typically develops in adults, although it is increasingly being diagnosed in children and adolescents, especially due to rising rates of obesity.

Type 2 diabetes can lead to various complications if not managed properly, including cardiovascular disease, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), and other serious health issues.  Early detection and intervention are crucial for effectively managing type 2 diabetes and reducing the risk of complications. 

Type 2 diabetes symptoms include:

• Fatigue
• Increased thirst and dry mouth
• Increased urination
• Frequent vaginal or urinary infections
• Erectile dysfunction
• Increased hunger
• Neuropathy (numbness, tingling in feet and hands)
• Blurred vision
• Slow-healing sores or frequent infections
• Weight gain

It's important to note that some people with type 2 diabetes may not experience any symptoms initially, so regular check-ups and screenings are essential for early detection, especially for those at higher risk due to factors like family history, obesity, or sedentary lifestyle. 

There are several ways to determine if you have type 2 diabetes:

1. Symptoms: If you experience symptoms as mentioned above.. 

2. Blood tests: 

• Fasting blood sugar of 126 mg/dL or higher on two separate occasions
• HbA1c of 6.5% or higher. If your HbA1c is between 5.7 and 6.4, you are considered prediabetic.
• An oral glucose tolerance test that shows a blood sugar of 200 mg/dL or higher after 2 hours

If you suspect you may have type 2 diabetes or have any of the risk factors, it's crucial to consult a healthcare professional for proper diagnosis and management. 

Everyone has glucose, a type of sugar, in their blood at all times. Sugar is a source of energy—it can supply the cells in your body with the energy they need to perform critical functions, ranging from powering your brain to fueling your muscles during high intensity exercise.

When eating a typical Indian diet, most of the sugar in your blood comes from a particular food source—carbohydrates, also called carbs. Starchy foods such as bread, potatoes, pasta, rice, baked goods and table sugar are commonly referred to as carbs, but “carbs” actually refers to a type of molecule inside these foods. There are also high levels of carbohydrate molecules in most fruit, fruit juices and sugary beverages.

During digestion, your body breaks down these chains of sugar units into pieces that it can absorb. That’s why when you eat foods containing carbs, it raises your blood glucose.

The Role of Insulin

Once this sugar has been absorbed into your bloodstream, it needs to get inside your cells. That’s where insulin comes into play. Insulin is a chemical messenger produced by your body. Insulin helps move the sugar from out of your blood into your cells, so that it can be used for energy.

So each time you eat and your blood sugar rises, your body releases insulin in order to move the sugar into the cells. But if for some reason the body stops responding to the signal of insulin, then the sugar cannot adequately enter your cells, and so it stays in your blood. This causes high blood sugar.

Insulin Resistance 

Type 2 diabetes is caused by insulin resistance, a condition in which cells stop responding properly to the signal of insulin. While the root causes of insulin resistance are not fully understood, the bottom line is that adding more insulin does not fix the underlying problem. While your insulin will still rise in response to eating food, since your cells are not responding to its signal, your blood sugar cannot be moved into cells effectively. This leaves you with both high blood sugar and high insulin.

Insulin resistance is associated with many health problems in addition to type 2 diabetes and prediabetes, including metabolic syndrome, polycystic ovary syndrome (PCOS), atherosclerotic heart disease, fatty liver disease, and more.

The standard of care for treating type 2 diabetes typically involves a combination of lifestyle modifications and medications. Here's a summary of the standard treatment approach:

1. Lifestyle modifications:

• Dietary changes: Emphasizing a balanced diet while limiting added sugars and processed foods.
• Regular physical activity: Engaging in regular exercise, such as brisk walking, yoga, or strength training.
• Weight management: Achieving and maintaining a healthy weight.

2. Medications:

• First-line medication: Metformin is usually recommended as the initial medication for most people with type 2 diabetes, as it improves insulin sensitivity and lowers blood sugar levels.
• Additional medications: Depending on individual needs and treatment goals, other oral medications or insulin therapies may be prescribed.

3. Monitoring:

• Regular monitoring of blood glucose levels through self-testing with a glucometer to assess the effectiveness of treatment and make adjustments as needed.
• Periodic assessments of HbA1c levels to provide a measure of overall blood sugar control over the past 3-4 months.

Diabetes reversal  is the process of returning glucose levels below those diagnostic of diabetes. 

Because type 2 diabetes is diagnosed based on elevated blood sugar, if your blood sugar remains normal without the use of diabetes-specific medications (other than metformin) and you achieve an HbA1c below 6.5% (as defined by an international panel of experts), you have reversed your type 2 diabetes. 

However, we recommend your long term goal should be to get your HbA1c below 5.6., preferably without the need for Metformin as well.

“Remission” is another term that’s often used interchangeably with “reversal.” While the definitions are slightly different—the goal is the same—to control diabetes and return blood sugar to below diagnostic thresholds.

It's important to emphasize that not everyone with type 2 diabetes may be able to achieve diabetes reversal, and individual results may vary. 

Our Personalized Health Coaching Program offers a proven approach to combat insulin resistance and reverse diabetes. Through personalized guidance for nutrition, exercise  and other lifestyle modifications, we empower individuals to reclaim control over their metabolic health. 

Join us on this transformative journey towards optimal metabolic health.