Type 2 Diabetes

If you have type 2 diabetes, the body has difficulty keeping blood sugar levels low enough. Symptoms of type 2 diabetes often come slowly. Exercise and good food can help lower blood sugar levels, but you may also need medication.

Diabetes is a collective name for some diseases that all provide high levels of sugar in the blood. In addition to type 2 diabetes, there is type 1 diabetes and pregnancy diabetes. Type 2 diabetes is most common and usually occurs in adulthood. Diabetes was previously called diabetes because the level of sugar in the blood is elevated.

Symptoms of Type 2 Diabetes

Common symptoms of type 2 diabetes are the following:

  • You get tired and powerless.
  • You become more thirsty.
  • You kiss more and more often.
  • You get impaired vision and look foggy.
  • You can get itching in the genital area.

In type 2 diabetes, the blood sugar value usually increases for several years. The symptoms therefore come slowly and can be variously strong. Many people do not know that they have type 2 diabetes because the disease sometimes does not produce any symptoms at all. 

When and where should I seek care?

If you think you have type 2 diabetes, contact a health care provider. You can contact many receptions by logging in .

Investigations

In order for the doctor to diagnose type 2 diabetes, you must submit both blood and urine tests:

  • The blood sample P-glucose  shows what you have for blood sugar value when the sample is taken. P stands for plasma that is part of the blood. Glucose is another name for sugar.
  • The blood sample HbA1C shows how blood sugar levels have been two to three months before the sampling. HbA1c is also called long-term sugar test.

The blood tests show if you have diabetes, but not what type. If you are over 40, have some abdominal obesity and type 2 diabetes in your family, the likelihood is that you have type 2 diabetes.

Sometimes you may need to have more blood tests to help your doctor determine what type of diabetes you have.

More investigations

If you are diagnosed with type 2 diabetes you will be examined further. The purpose is to find out if you have other conditions that can increase the risk of arteriosclerosis. For example, it may be elevated blood fat or elevated blood pressure. In such cases, these are treated to prevent myocardial infarction and stroke.

Two to three months after you have been diagnosed with type 2 diabetes, you will have a blood test to check the composition of the blood fats.

After the investigations

You should find out who you should contact, and when, to find out the answers after sampling and surveys. You should also find out who to contact if you get worse.

What can I do for myself?

You can do a lot yourself to influence your blood sugar value. By exercising, having good eating habits and quitting smoking you can prevent and to some extent lower your blood sugar value yourself. If you are overweight, exercise and changing eating habits can cause you to lose weight, which is also good for your blood sugar value.

Exercise

Physical activity is the most effective way to increase cell sensitivity to insulin. By increasing the sensitivity, the cells absorb the sugar contained in the blood more quickly, thus avoiding high blood sugar levels. The effect on the insulin sensitivity of a workout, such as a brisk walk or cycling for 30-40 minutes, remains for up to two days.

It’s good if you have three walks a week, but the more often you exercise the better. A walk should last for about 30 minutes. It is also good to activate more muscle groups at the same time, for example, walking can have a better effect than walking without rods.

All movements in everyday life give effect. These are examples of good exercise in everyday life:

  • To vacuum.
  • Taking the stairs instead of the elevator.
  • Getting off the bus or train a bus stop earlier and walking instead.

Physical activity is also good for, for example, blood pressure, blood fats, skeletal calcium and weight loss. Exercising regularly also reduces the risk of cardiovascular disease.

Eat good food

Good eating habits can largely affect type 2 diabetes. With good food and eating habits you can get better blood sugar value, better blood fats, lose weight and reduce the risk of other diseases. You can also postpone or reduce the need for blood sugar lowering drugs.

What is good food in diabetes is intensively debated, but there is scientific support that the following foods have a good effect:

  • fruit
  • vegetables
  • root
  • legumes
  • wholegrain
  • fisk
  • nuts and peanuts
  • coffee.

You can drink some wine or beer for the food, but avoid drinking alcohol on an empty stomach or in excessive amounts.

It may feel like a big change to change your habits, but you rarely need to change all your food .

Avoid smoking

There are many risks of smoking if you have diabetes, including the risk of damage to the small blood vessels in the kidneys, in the feet and in the retina of the eyes. The risk of having a heart attack or stroke doubles. If you smoke, it is therefore good if you can quit. If you need help to quit smoking , your doctor can tell you what support is available.

It is unclear if snuff increases the risk of complications in diabetes.

Check your eyes

You should regularly have your eyes examined with so-called eye photography. This is because a blood sugar value that is too high for a long time can damage the small blood vessels in the retina of the eye. In the long run, it can cause vision to deteriorate.

With eye photography, the doctor can detect early changes in the retina that you yourself do not notice. You can then receive treatment on time and prevent vision from deteriorating.

How often you should examine your eyes depends, among other things, on how long you have had diabetes. It is usually one to three years between surveys. An eye reception will send a notice to you when it’s time to investigate.

Shot the teeth

It is good to go to the dentist regularly. The reason is that an elevated blood sugar value for a long time can make it easier to get tooth decay  or tooth decay . It is also important to take care of your teeth carefully.

Tell your dentist or dental hygienist that you have diabetes. They can then give you information on how to care for your teeth and what to think about.

You may be entitled to a special dental allowance, STB. The dental allowance means that you do not have to pay the full price for a dentist visit.

Shot the feet

High blood sugar levels for an extended period of time can degrade the feeling in your feet without noticing it. If you then get a wound, such as a scab, it may take time before you discover it. Therefore, it is important that you take care of your feet. Here are some tips:

  • Examine your feet daily to see if you have received wounds or marks after, for example, shoes. If you find it difficult to examine your feet yourself, you can ask a relative for help.
  • Using spacious shoes, it reduces the risk of getting abrasions.
  • Feel free to lubricate your feet with softening cream to avoid dry cracks. This is especially important during the winter as it is easier to get dry cracks.
  • Visit a foot therapist regularly, especially if you can’t take care of your feet yourself.

If you get a wound, it can heal more slowly due to the impaired blood circulation. For the same reason, the wound can also be infected more easily. Take care of the wounds that occur, and pay attention if a wound heals slowly or becomes infected.

In the worst case, an infected wound that is not taken care of can lead to a fire. 

Treatment

If exercise and changing eating habits are not enough, you may need medicines to lower your blood sugar, preferably at a value approaching the blood sugar value of a person without diabetes. It is also important to prevent and treat high blood pressure and high blood fats.

The goal of the treatment is to avoid the complications that can occur due to elevated blood sugar value, such as damage to the body’s large and small blood vessels.

Medicines at high blood sugar value

You may need to be treated with blood sugar lowering drugs already when you are diagnosed with type 2 diabetes, but it may also take several years before you need medication.

It is most common to start with medication in the form of tablets. There are different types of blood sugar lowering drugs that work in different ways. What you get depends, for example, on your weight and how your kidneys work.

Gradually, you may need to step up the treatment, often by combining different types of tablets. 

Insulin

To achieve a good blood sugar value, most people with type 2 diabetes eventually need to supplement treatment with insulin. You may also need insulin when you are diagnosed, but it usually takes several years. What is a good blood sugar value is determined from person to person? The goal is to discuss you and your doctor together.

If you use insulin, you have to check your blood sugar value yourself with a blood test in your finger. Even if you are not treated with insulin, it can sometimes be good to measure your blood sugar value yourself. How often differ from person to person, ask your diabetes nurse for advice.

Drugs at high blood pressure

One goal is for the blood pressure to be below 140/85 mmHg. If you have only slightly elevated blood pressure it may be enough to eat less salt, lose weight and exercise more.

If this is not enough to lower your blood pressure, you may need medication to lower your blood pressure.

Medicines for high blood fats

In type 2 diabetes, it is common to have too high levels of harmful blood fats. The composition of the blood fats is improved by, among other things, good eating habits, exercise, not smoking and if the blood sugar value improves, but you may need medicines to lower the blood fats.

Even if you have fairly low levels of blood fats, you may need medication if you also have several risk factors for cardiovascular disease. Examples of risk factors are high blood pressure and smoking. If you have had a myocardial infarction or stroke, you should be treated with a low-fat drug.

Gastric bypass

So-called gastric bypass can be a treatment method if you have type 2 diabetes and obesity with a BMI value above 40.

Gastric bypass can also be a treatment if you have a BMI value above 35 and difficult to achieve good blood sugar levels, blood pressure or blood fats despite drugs and changing lifestyle.

Gastric bypass is also called obesity surgery.

Revisit

If you have type 2 diabetes, you are entitled to regular contact with healthcare professionals who have specialized knowledge of diabetes. Most often, it is a diabetes nurse at your health care center. You also see your doctor at the health center regularly. They can give you help, advice, and support, but most of the treatment you take care of yourself.

You should visit your doctor at least once a year. You will receive a notification when it is time for a return visit. The purpose is to see how the treatment is going, as well as to detect and treat any damage that may occur due to diabetes.

The doctor or diabetes nurse will do the following:

  • Measure your blood pressure.
  • Check blood circulation and skin on the feet.
  • Take an HbA1c blood test to see how the treatment is going.

You can also get your heart examined with the ECG.

What happens in the body?

The cells in the body need the energy to function. The cells get energy from sugar that is transported in the blood, especially in the form of grape sugar. Grape sugar is also called glucose.

In order for the cells to absorb the sugar, they need the hormone insulin. The blood sugar that is not absorbed by the cells is stored in the liver and in the muscles for later needs. The liver functions in this way as a sugar supply. The saved blood sugar is called glycogen.

Insulin is formed in the pancreas into small groups of hormone-forming cells called Langerhans islands or beta cells and is released especially after eating. In type 2 diabetes, the insulin produced by the pancreas does not suffice and the cells become more difficult to absorb the sugar in the blood. The body’s cells also become less sensitive to insulin, called insulin resistance.

Increasing blood sugar levels in diabetes is also due to the liver leaking too much sugar into the blood if you do not eat, which leads to high blood sugar levels in the morning before breakfast. Another word for high blood sugar value is hyperglycemia.

Impaired glucose tolerance

If your blood sugar value rises a lot after eating and does not go down as expected, even though you do not have diabetes, you may have so-called impaired glucose tolerance. This is because the cells are less sensitive to insulin or the pancreas does not produce enough insulin. It can also be a combination of these two.

Having glucose tolerance may be a sign that you are developing type 2 diabetes. It takes several years for type 2 diabetes to develop and you can slow it down yourself by exercising, reviewing your eating habits, losing weight and quitting smoking if you smoke.

The increased amount of urine is due to high blood sugar

With untreated diabetes you kiss more and more often. This is because when the blood sugar level is high enough, sugar leaks to the urine. Sugar in urine absorbs water from the body and the amount of urine increases, which in turn makes you thirstier.

What is the cause of type 2 diabetes?

The exact cause of type 2 diabetes is unknown, but the risk of developing the disease is often hereditary and is largely affected by lifestyle.

Too much and unhealthy food combined with lack of exercise increases the risk of being overweight, which in turn increases the risk of insulin resistance and type 2 diabetes.

If you are also exposed to stress, have high demands and at the same time have little opportunity to influence your situation yourself, the amount of stress hormone cortisol in the blood increases. Out in the tissues, it is converted into cortisone which increases abdominal obesity and decreases insulin sensitivity in the cells of the muscles. Abdominal obesity is more harmful than fat around the hips, for example.

Smoking also increases the risk of getting diabetes.

Complications and sequelae

Complications in large blood vessels

The most serious consequence of type 2 diabetes is that the pulmonary arteries become more fat-rich. Atherosclerosis means that deposits of fat, blood cells and connective tissue are formed on the inside of the blood vessels. The blood then becomes more difficult to pass. In the heart, it can lead to angina, and in the legs to the so-called window-sill disease. In the longer term, it can lead to a fire. This is because the circulation in the legs becomes acutely impaired.

Another danger of atherosclerosis in the arteries is that it is easier to form small blood clots that can stop the blood flow and cause a heart attack. If it gets stuck in a coronary artery in the brain you can get a stroke. It is primarily myocardial infarction and stroke that increases the risk of dying prematurely in type 2 diabetes.

Complications in small blood vessels

There is also a risk of complications in small blood vessels. They are rarely life-threatening in the same way as the complications of large blood vessels. But they can cause you damage to the retina of the eye, kidney damage and damage to nerves that can cause loss of sensation, usually in the feet and legs. Men can sometimes find it difficult to get and keep their positions.

Women can have problems with reduced sensation, which can lead to difficulty getting orgasm. Another problem may be dry mucous membranes and difficulties for the vagina to become sufficiently moist. Lubricants available at pharmacies can be a good tool.

The disease can worsen

In type 2 diabetes, the blood sugar value tends to slowly increase over the years. This worsening of the disease is partly due to the fact that the body’s cells become even less sensitive to insulin and partly because the pancreas’s production of insulin is reduced.

The ability of the pancreas to produce insulin is damaged if you have too high blood sugar levels for a long time. The rate of deterioration varies between people. This depends, among other things, on weight, food, exercise, possible stress and smoking.

Too low blood sugar

If you are treated with insulin or with tablets that increase the release of insulin from the pancreas, the blood sugar value can sometimes be too low. It’s called feeling or hypoglycemia. Common symptoms are that you:

  • sweat
  • gets shaking
  • gets palpitations
  • getting hungry
  • gets dizzy
  • becomes uneasy and easily irritated
  • get hard to concentrate.

If your blood sugar level drops further, you may become unconscious.

If you feel slight symptoms, you can measure your blood sugar level to see if it is due to a low blood sugar value. If the blood sugar value is too low, you can eat something sweet, for example 2-3 tablets of grape sugar. Even a glass of milk or juice can help. However, so-called light drinks do not benefit because they do not contain sugar. When the feelings are over, it can be good if you eat something, such as a sandwich.

If you have more severe symptoms, eat something immediately before measuring your blood sugar value. You should eat something that increases blood sugar levels quickly, such as some grape sugar tablets, sugar cubes or drink a glass of milk or juice.

When treated with certain tablets, too low blood sugar levels can last for a long time and therefore it is difficult to raise yourself. If you have low blood sugar levels shortly after you have succeeded in raising your blood sugar value, you should seek care directly at a health care center or emergency room.

Feelings of low blood sugar are uncommon but may be due to the following:

  • You have eaten too little.
  • You’ve had vomiting.
  • You’ve had diarrhea.
  • You have exerted yourself more physically and for a longer period, for example, that you have walked for a whole day.
  • You’ve been drinking a lot of alcohol.

As you get older and if you then lose weight you may need to reduce or even end the blood sugar lowering treatment. Otherwise, the blood sugar value may be too low.

Living with type 2 diabetes

A good life despite the disease

If you have been diagnosed with type 2 diabetes, it may initially take time to accept and get used to the disease. How you react is individual. Some may initially end up in a crisis,  but most find good ways to live with the disease. Although diabetes cannot be cured, good treatment is available.

It can be helpful to meet others who have similar experiences. For example, at the Diabetes Association and the Diabetes Organization, you can get support and more information. In many parts of the country there are also local associations .

Most people with type 2 diabetes are slowly getting worse insulin sensitivity. The deterioration can last for over ten years. But it is important to remember that it is always possible to slow down this development by exercising, quitting smoking and having good eating habits.

Patient pod about type 2 diabetes: “You can live long with your diabetes if you take care of yourself.”

Pregnancy and type 2 diabetes

Pregnant women can have a transient form of type 2 diabetes called pregnancy diabetes. If you are pregnant, you may have a blood test taken at the maternity care center to measure your blood sugar value.

After birth, blood sugar levels return to normal. If you have had pregnancy diabetes, you have an increased risk of developing type 2 diabetes later in life and your blood sugar value should be followed up.

Getting pregnant

If you have had pregnancy diabetes, or if you have type 2 diabetes, you should try to have as good a blood sugar value as possible when planning to become pregnant. During the first three months of pregnancy, the risk is greatest that the fetus will be damaged by high blood sugar levels.

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