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Type 2 Diabetes

Medically Reviewed | Updated: January 2024

Quick Facts

Prevalence:

37.3 million Americans have diabetes (11.3% of population)

Primary Cause:

Insulin resistance and impaired insulin secretion

Key Risk Factors:

Obesity, sedentary lifestyle, genetics, age >45

Reversible:

Yes, through lifestyle and nutritional interventions

What is Type 2 Diabetes?

Type 2 diabetes is a chronic metabolic condition characterized by elevated blood glucose (sugar) levels resulting from insulin resistance and relative insulin deficiency. Unlike Type 1 diabetes (an autoimmune condition), Type 2 diabetes develops gradually and is largely preventable and reversible through lifestyle modifications.

In Type 2 diabetes, your body's cells become resistant to insulin—a hormone that helps glucose enter cells for energy. The pancreas initially compensates by producing more insulin (hyperinsulinemia), but over time, it cannot keep up with demand, leading to elevated blood sugar levels.

Common Symptoms

Increased thirst and urination

Polyuria and polydipsia

Unexplained weight loss

Despite normal or increased appetite

Fatigue and weakness

Lack of energy throughout the day

Blurred vision

Due to fluid shifts in the eye

Slow-healing wounds

Cuts and bruises take longer to heal

Tingling or numbness

In hands or feet (neuropathy)

Diagnostic Criteria

According to the American Diabetes Association (ADA), Type 2 diabetes is diagnosed when any of the following criteria are met:

A1C

Hemoglobin A1C ≥ 6.5%

Reflects average blood glucose over 2-3 months

FPG

Fasting Plasma Glucose ≥ 126 mg/dL

After at least 8 hours of no caloric intake

2h

2-Hour Plasma Glucose ≥ 200 mg/dL

During oral glucose tolerance test (OGTT)

RPG

Random Plasma Glucose ≥ 200 mg/dL

With classic symptoms of hyperglycemia

Evidence-Based Treatment Approaches

Nutritional Therapy (First-Line)

Ketogenic and Low-Carbohydrate Diets: Multiple RCTs demonstrate that carbohydrate restriction (20-50g/day for ketogenic, <130g/day for low-carb) significantly reduces HbA1c (0.9-2.0%), promotes weight loss, and enables medication reduction in 50-87% of participants.

Key Benefits:

  • • Improved glycemic control and insulin sensitivity
  • • Reduced need for diabetes medications
  • • Weight loss and improved cardiovascular markers
  • • Lower triglycerides and increased HDL cholesterol

Source: Diabetes Care 2023; American Diabetes Association Guidelines

Weight Management

Weight loss of 5-10% of body weight significantly improves glycemic control, blood pressure, and lipid profiles. Greater weight loss (>15%) can lead to diabetes remission in many cases.

Source: Endocrine Society Clinical Practice Guidelines

Physical Activity

ADA recommends 150+ minutes/week of moderate-intensity aerobic activity plus 2-3 sessions/week of resistance training. Exercise improves insulin sensitivity and glucose uptake independent of weight loss.

Source: American Diabetes Association Standards of Care

Pharmacotherapy (When Needed)

When lifestyle modifications are insufficient, medications like metformin (first-line), GLP-1 agonists, SGLT2 inhibitors, or insulin may be prescribed. However, nutritional interventions often reduce or eliminate medication needs.

Source: ADA/EASD Consensus Report 2023

Prevention Strategies

The Diabetes Prevention Program (DPP) demonstrated that intensive lifestyle intervention reduced diabetes incidence by 58% in high-risk individuals:

Achieve and maintain healthy weight

BMI 18.5-24.9 kg/m²

Follow low-glycemic diet

Minimize refined carbs and added sugars

Regular physical activity

150+ minutes/week moderate exercise

Regular screening if at risk

Check fasting glucose and A1C annually

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