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EndocrineICD-10: E11.9Affects approximately 37 million Americans (about 1 in 10)

Type 2 Diabetes

Also known as: T2D, Adult-Onset Diabetes, Non-Insulin-Dependent Diabetes, Type 2 Diabetes Mellitus

Type 2 diabetes is a chronic metabolic condition characterized by insulin resistance and relative insulin deficiency, leading to elevated blood sugar levels. It accounts for 90-95% of all diabetes cases and is strongly associated with obesity, physical inactivity, and genetic factors. While type 2 diabetes is a progressive condition, it can often be managed or even put into remission through lifestyle modifications, medications, and regular monitoring.

Symptoms

Increased thirst and dry mouth
Frequent urination
Increased hunger
Fatigue
Blurred vision
Slow-healing wounds or frequent infections
Numbness or tingling in hands and feet (peripheral neuropathy)
Areas of darkened skin (acanthosis nigricans)
Unexplained weight loss (in some cases)

Causes

  • Insulin resistance (cells don't respond properly to insulin)
  • Progressive beta-cell dysfunction in the pancreas
  • Genetic predisposition
  • Excess body fat, especially visceral (abdominal) fat
  • Sedentary lifestyle

Risk Factors

  • Overweight or obesity (BMI ≥ 25)
  • Physical inactivity
  • Family history of type 2 diabetes
  • Age 45 and older
  • African American, Hispanic, Native American, or Asian American ancestry
  • History of gestational diabetes or prediabetes

Diagnosis

  • HbA1c test (≥6.5% indicates diabetes; 5.7-6.4% indicates prediabetes)
  • Fasting plasma glucose (≥126 mg/dL)
  • Oral glucose tolerance test (≥200 mg/dL at 2 hours)
  • Random plasma glucose (≥200 mg/dL with symptoms)

Treatment

  • Lifestyle modifications (healthy diet, regular exercise, weight loss)
  • Metformin (first-line oral medication)
  • SGLT2 inhibitors (empagliflozin, dapagliflozin) with cardiovascular and renal benefits
  • GLP-1 receptor agonists (semaglutide, liraglutide) for glucose control and weight loss
  • Other oral agents (sulfonylureas, DPP-4 inhibitors, thiazolidinediones)
  • Insulin therapy when oral medications are insufficient

Prevention

  • Lose 5-7% of body weight if overweight or obese
  • Engage in at least 150 minutes of moderate exercise per week
  • Follow a balanced diet emphasizing whole grains, vegetables, and lean protein
  • Limit sugary beverages and processed foods
  • Get screened regularly if you have prediabetes or risk factors

When to See a Doctor

  • You have risk factors for diabetes and have not been screened
  • You experience increased thirst, frequent urination, or unexplained fatigue
  • Your blood sugar is consistently above target despite medication
  • You develop numbness in your feet, vision changes, or slow-healing wounds

Frequently Asked Questions

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