Type 2 Diabetes: Symptoms, Causes, Tests and Treatment

7 min read · Conditions · By the Asthra Health Care team

What is type 2 diabetes?

When you eat, food like rice, chapati and sugar is broken down into glucose, which enters the blood. A hormone called insulin, made by the pancreas, helps glucose move into the body's cells for energy. In type 2 diabetes, the cells stop responding well to insulin and the pancreas slowly makes less of it. Glucose then builds up in the blood.

Type 2 diabetes is very common in India and often runs in families. It usually starts after the age of 30, but it is now seen in younger adults and even teenagers who are overweight and not very active. Left uncontrolled, it can harm the eyes, kidneys, nerves, heart and feet.

Type 2 diabetes: causes and risk factors

There is no single cause. Genes play a big part, and South Asians tend to develop diabetes at a lower body weight than many other groups. Extra fat around the belly is a strong warning sign, even in people who do not look overweight.

Stress, poor sleep and some medicines, such as long-term steroids, can also push sugar up. Having one or more of these risk factors does not mean you will surely get diabetes, but it does mean you should test your sugar regularly and start healthy habits early.

• A parent, brother or sister with diabetes
• Belly fat or being overweight
• Little physical activity and long hours of sitting
• Diet high in white rice, maida, sweets, fried snacks and sugary drinks
• High blood pressure or high cholesterol
• Diabetes during a past pregnancy (gestational diabetes) or PCOS

Symptoms to watch for

Many people have no symptoms for years, which is why testing matters. When symptoms appear, they build up slowly and are easy to ignore as tiredness or age. Common signs include passing urine often, especially at night, feeling very thirsty, tiredness, blurred vision, weight loss without trying, slow-healing cuts, repeated skin or urine infections, itching around the private parts, and tingling or numbness in the feet.

How type 2 diabetes is diagnosed

Diabetes is confirmed with simple blood tests. A fasting blood sugar is taken after at least eight hours without food. The HbA1c test shows your average sugar level over the past two to three months and does not need fasting. Sometimes a doctor orders a glucose tolerance test, where blood is checked before and two hours after a sugary drink.

Your doctor will usually repeat an abnormal result on another day to confirm it, unless symptoms are clear. Adults above 30, and anyone with risk factors, should get checked regularly even when they feel well. Pregnant women are also screened, since diabetes in pregnancy needs special care.

Treatment: medicines and daily habits

Treatment aims to keep sugar close to the target your doctor sets, while also controlling blood pressure and cholesterol. Diet and exercise are the base of every plan. Most people also need medicines, and some later need insulin. This is not a failure; diabetes changes over time and treatment changes with it.

Diabetes medicines must be taken only on a doctor's prescription. Never start, stop or change them on your own, even when sugar readings look good. Doctors often combine two or more medicines when one is not enough. Tell your doctor if you have kidney or liver disease, or are pregnant or planning pregnancy, as the choice of medicine may change.

Living well with diabetes

Small, steady changes work better than strict diets you cannot keep. Fill half your plate with vegetables, a quarter with dal, pulses, egg, fish or chicken, and a quarter with rice, millets like ragi, or chapati. Cut down on sweets, fruit juices and fried snacks. Whole fruits in moderate portions are fine for most people.

Aim for a brisk walk or other activity most days, and break up long sitting time. Check your feet daily for cuts or blisters, avoid walking barefoot, and stop smoking and alcohol. Get your eyes, kidneys and feet checked at least once a year.

Low sugar and sick days

Some diabetes medicines and insulin can drop sugar too low, especially if you skip a meal. Signs include shaking, sweating, fast heartbeat, confusion and hunger. Take glucose, sugar or a sweet drink at once and then eat a proper meal. During fever, vomiting or diarrhoea, sugar can swing up or down, so check more often and call your doctor for advice. Your doctor or pharmacist can explain how your own medicines behave and what to do if a dose is missed.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.