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Diabetes mellitus type 2 in adults

What is it?

Diabetes (di-uh-BE-tez) is also called diabetes mellitus (MEL-i-tus). There are three main types of diabetes. You have type 2 diabetes. It may be called non-insulin dependent or adult onset diabetes. With type 2 diabetes, your body has trouble using insulin. Your body may also not make enough insulin. If there is not enough insulin or if it is not working right, sugar will build up in your blood. Type 2 diabetes is more common in overweight people who are older than 40 years and are not active. Type 2 diabetes is also being found more often in children who are overweight. There is no cure for diabetes but you can have a long and active life if your diabetes is controlled.

How did I get type 2 diabetes?

  • Insulin (IN-sul-in) is a hormone (a special body chemical) made by your pancreas (PAN-kree-us). The pancreas is an organ that lies behind the stomach. Much of the food you eat is turned into sugar in your stomach. This sugar goes into your blood and travels to the cells of your body to be used for energy.
  • Insulin acts as a "key" to help sugar enter the cells. If there is not enough insulin or if it is not working right, sugar will build up in your blood. With type 2 diabetes, you may have better control of your diabetes with the right diet and exercise. You may also need to take oral medicine (pills) to help your body make more insulin or to use insulin better. You may also need insulin shots.
  • No one knows for sure what causes type 2 diabetes. Type 2 diabetes runs in families. You are more likely to get it if someone else in your family has type 2 diabetes.
  • You are also more likely to get type 2 diabetes if you are overweight. Being overweight makes it harder for your body to use the insulin it makes. This is called insulin resistance. In insulin resistance, your pancreas will keep making insulin to try to control your blood sugar. Your body will not use the insulin as it should when it is resistant to insulin.

Signs and Symptoms:

The signs and symptoms of type 2 diabetes may happen slowly over months or years. Some people have signs and symptoms that are so mild that they do not notice them. You may have one or more of the following symptoms of hyperglycemia (hi-per-gli-SE-me-ah) or high blood sugar:

  • More thirsty than usual.
  • Passing more urine than usual.
  • More hungry than usual.
  • Abdominal (belly) pain.
  • Nausea (upset stomach) or vomiting (throwing up).
  • Problems seeing clearly.
  • Losing weight for no reason.
  • Very dry skin.
  • Vaginal infections (in-FEK-shuns) in women.

What is hypoglycemia?

People that have diabetes can sometimes have hypoglycemia (hi-po-gli-SE-me-ah). This is a condition that happens when your blood sugar level has fallen too low. It may be caused by taking too much diabetes medicine (insulin or pills). It may also be caused by skipping meals, eating less than usual, or exercising more than usual. Ask your caregiver for more information about hypoglycemia.

It is very important to treat symptoms of low blood sugar right away. If you have low blood sugar, eat or drink a source of carbohydrate. Some examples of carbohydrates are eight ounces (one cup) of skim milk, four ounces (one-half cup) of juice, or five to six hard candies. The following are signs and symptoms of hypoglycemia:

  • Becoming confused or having difficulty paying attention.
  • Becoming crabby or grumpy.
  • Becoming sweaty.
  • Feeling faint (lightheaded).
  • Feeling hungry.
  • Feeling tired.
  • Feeling like your heart is beating very fast.
  • Feeling shaky.
  • Headache.
  • So sleepy you cannot be awakened.

What is ketoacidosis?

Diabetes may also cause ketoacidosis (ke-toh-as-i--DO-sis). This is a condition that happens when your blood sugar stays too high for too long without being treated. This can cause your body to start breaking down body fats for energy rather than using blood sugar. Wastes called ketones are left behind. Ketoacidosis can be very serious and needs to be treated right away. Ask your caregiver for more information about ketoacidosis. The following are signs and symptoms of ketoacidosis:

  • More thirsty than usual.
  • Passing more urine than usual.
  • Confused or trouble thinking clearly.
  • Fatigue (feeling tired).
  • Fast deep breathing at rest.
  • Fruity-smelling breath.
  • Nausea (feeling sick to your stomach) and vomiting (throwing up).
  • Stomach pain.
  • So sleepy you cannot be awakened.

What is Hyperosmolar Hyperglycemic Nonketotic Syndrome?

Diabetes may also cause Hyperosmolar (hi-per-oz-MO-ler) Hyperglycemic (hi-per-gli-SE-mik) Nonketotic (non-ke-TOT-ik) Syndrome (SIN-drom) (HHNS). This is a condition that happens most often in older adults with type 2 diabetes. It is usually caused by illness or an infection. With HHNS, blood sugar levels rise and the body tries to get rid of the extra sugar in your urine. If HHNS continues for a long time, you can become very dehydrated. This is a very serious condition and needs to be treated right away. The following are signs and symptoms of HHNS:

  • Having a high blood sugar level greater than 600 milligrams/deciliter (mg/dl).
  • Having a very dry mouth.
  • Feeling more thirsty than usual.
  • Having warm, dry skin with no sweat.
  • Having a very high fever (greater than 101°F).
  • Feeling very sleepy or confused.
  • Having a loss of vision (seeing).
  • Having hallucinations (seeing or hearing things that are not there).

The best way for you to avoid HHNS is to do the following:

  • Check your blood sugar several times a day. Talk to your caregiver about checking your blood sugars. They can tell you what blood sugar levels you should have and when to call if your blood sugars are too high or too low.
  • When you are sick, check your blood sugar more often. Drink an eight-ounce glass of liquid (caffeine-free and alcohol-free) every hour. Talk to your caregiver about your sick day plan.

Can diabetes cause other health problems? High blood sugar levels may damage other body tissue and organs over time. Diabetes can even cause death without treatment. If your blood sugar is well controlled, other health problems may not happen. Having uncontrolled diabetes can damage your nerves, veins, and arteries (blood vessels). This can increase your chance of having a heart attack or stroke. Your chances of having eye problems, kidney problems, nerve problems, and infections also increase.

Wellness Recommendations:

The most important thing you must do is control your blood sugar. Caregivers will work with you to help keep your blood sugar levels within a "target range." This means that your blood sugar is not too high or too low. To do this you have to find the right balance of diabetes medicine, food intake, and physical activity. Food puts sugar in your body and raises blood sugar levels. Diabetes medicine and physical activity lower blood sugar levels.

You can help control your blood sugar by eating the right foods. A diabetes nurse or a dietitian will help you learn what to eat and how food affects your diabetes. A diet high in fiber is helpful in diabetes.

  • You should not drink more than 1 or 2 servings of alcohol more often than 1 or 2 times a week. If you use alcohol, drink it with meals. A serving is the same as 4 ounces of wine, 12 ounces of beer, or 1-1/2 ounces of hard liquor (like gin or whiskey). Drinking alcohol without having food in your stomach may cause a drop in your blood sugar.
  • Exercising helps your body better use sugar and insulin. This helps keep your blood sugar level under control. It also makes the heart stronger, lowers blood pressure, and helps you keep an ideal body weight. You may also feel less anxious about your diabetes and feel better about yourself if you exercise. Ask caregivers to help plan the best exercise program for you. Start exercising when your caregiver says it is OK.
  • If you smoke, you should stop. Smoking damages the heart and lungs. It may also put you at a higher risk of getting diabetes.

Medical Care:

You may need to take medicine to control your blood sugar. You may need to go into the hospital for more tests and treatments.

How do I check my blood sugar levels? Your caregiver will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in your blood. There are many different kinds of monitors. All monitors use a small drop of blood. Usually the blood is from a prick on your finger. Caregivers will help you choose the monitor that is best for you.

Dietary Measures:

  • A vegetarian diet and/or a high fiber diet will decrease blood sugars and help you lose weight. It will also help prevent or control diabetes.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

  • American ginseng (Panax quinquefolium) may be helpful and has been studied in people with diabetes.
  • Bitter melon (Momordica charantia) may be helpful and has been studied in people with diabetes.
  • Capsaicin creams (Capsicum frutescens) from the cayenne pepper, applied to the skin over the affected area, may help diabetic nerve pain. Initial applications are irritating but after the first couple of weeks the irritation goes away. The hands should be washed after application of the cream, unless the hands are the treated areas, in which case, they should be washed 30 minutes after application.
  • Chinese ginseng (Panex ginseng) may be helpful and has been studied in people with diabetes.
  • Cinnamon (Cinnamomum cassia) may be helpful and has been studied in people with diabetes, type 2.
  • Evening primrose (Oenothera biennis) oil may be helpful and has been studied in people with diabetes.
  • Fenugreek (Trigonella foenum-graecum) is helpful for diabetes and has been studied in people.
  • Gymnema (Gymnema sylvestre) may be helpful and has been studied in people with diabetes.
  • Prickly pear cactus (Opuntia fulginosa) may be helpful and has been studied in people with diabetes.
  • Psyllium (Plantago isphagula) may be helpful and has been studied in people with diabetes.

Supplements:

  • Alpha lipoic acid may be helpful for diabetes and has been studied in people.
  • B vitamins (B1 (thiamine), B6 (pyridoxine), or B12 (cyanocobalamin)) may be helpful for diabetes and diabetic nerve problems.
  • Biotin has been used, but has not been studied in people who have diabetes.
  • Chromium may be helpful for diabetes and has been studied in people.
  • Fish oil (DHA, EPA) may be helpful and has been studied in people with diabetes.
  • Glucomannan may be helpful for diabetes and has been studied in people.
  • Guar gum may be helpful for diabetes and has been studied in people.
  • Magnesium may be helpful for diabetes and has been studied in people.
  • Vanadium is helpful for diabetes and has been studied in people.
  • Vitamin E may be helpful for diabetes and has been studied in people.
  • Zinc may be helpful for diabetes and has been studied in people.

Complementary Therapies:

  • Traditional Chinese Medicine (TCM), which combines acupuncture and herbs, has been used to treat diabetes.
  • Stress may affect diabetes.

Do's and Don'ts

  • Keep your appointments to your caregivers. Bring your diabetes record book with you every time you visit caregivers. A diabetes record book is where you write your blood sugar after you take it. Your diabetes educator may also want you to use the record book to keep track of what you eat and how much diabetes medication (insulin or pills) you take.
  • Take special care of your skin, feet, or any sores or cuts you have on your body. Diabetes can change your body's ability to fight infection because your blood sugar is higher than normal. High blood sugar can damage nerves and blood vessels. Because of this, blood and oxygen cannot get to your body tissues. You may lose feeling in your feet because of nerve damage.
  • Brush and floss your teeth every day. See your dentist 2 times a year to have your teeth cleaned and checked.
  • Wear a medical alert bracelet that says you have diabetes. You may get one from the MedicAlert Foundation. Call or write to them at:
  • MedicAlert Foundation 2323 Colorado Avenue Turlock, CA 95382 Phone: 1-888-633-4298 Web Address: http://www.medicalert.org
  • There is a lot to learn about diabetes and you should learn all that you can. Ask your caregiver, diabetes nurse, or dietitian (di-uh-TIH-shun) about classes for diabetics. The more you know about diabetes, the easier it will be for you to control your disease and to live an active life. Call or write the following organization for more information:
  • American Diabetes Association National Service Center 1701 North Beauregard Street Alexandria, VA 22311 Phone: 1-800-DIABETES Web Address: http://www.diabetes.org

Other ways of treating your symptoms:

Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

  • You would like medicine to treat diabetes mellitus.
  • Your symptoms have not gone away or improved by these self-help measures.
  • You have any of the following signs or symptoms of high blood sugar:
  • Blurry vision.
  • Fatigue (feeling very tired).
  • Hungry all of the time but losing weight without trying.
  • Loss of feeling, pain or tingling in your hands or feet.
  • Sores that take a long time to heal or very dry skin.
  • Urinating often.
  • Very thirsty and drinking a lot of liquids.
  • Vaginal infections.
  • You have any of the following signs or symptoms of low blood sugar:
  • Becoming confused or acting "spacy" or drunk.
  • Becoming crabby or grumpy.
  • Becoming sweaty.
  • Feeling faint (lightheaded).
  • Feeling hungry.
  • Feeling tired.
  • Feeling like your heart is beating very fast.
  • Feeling shaky.
  • Headache.
  • You have burning or stinging when you urinate or are urinating often and passing small amounts of urine. These may be signs that you have a bladder infection.
  • You are vomiting (throwing up).
  • You have questions about what you have read in this document.

SEEK CARE IMMEDIATELY IF:

You are having trouble thinking clearly.

You are feeling worse even though you are following your caregiver's directions.

You have signs of a heart attack:

  • Chest pain that spreads to your arms, jaw, or back.
  • Nausea (upset stomach).
  • Trouble breathing.
  • Sweating.
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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Last Updated: 4/4/2014

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