Type 2 diabetes: causes, symptoms and treatment

What type 2 diabetes is

Insulin is a hormone that helps your body use glucose for energy. In type 2 diabetes the body stops using it properly, so blood glucose climbs and, over time, damages the nerves and blood vessels.

WHO says more than 95% of people with diabetes have type 2. Once called adult-onset diabetes, it now occurs more and more often in children. Unlike type 1 diabetes, it is often preventable.

Symptoms, if there are any

The most common symptoms are:

• Feeling very tired.
• Peeing more than usual.
• Feeling thirsty all the time.
• Losing weight without trying to.
• Blurred vision, cuts that take longer to heal, or itching around the genitals or repeated thrush.

Not everyone gets symptoms. WHO notes they can be mild and take years to be noticed, so some people are only diagnosed after complications have started. Get checked if you are at higher risk, even if you feel well.

Causes and who is more likely to get it

Being overweight, not getting enough exercise and genetics all play a part. The NHS says you may be more at risk if:

• You are white and over 40, or over 25 and from a South Asian, Chinese, Black African or Black Caribbean background.
• A parent, brother or sister has type 2 diabetes.
• You are overweight and not very physically active.
• You have a condition that raises the risk, such as high blood pressure.

Women who had diabetes during pregnancy (gestational diabetes) are also at higher risk of type 2 diabetes later, according to WHO.

How it is diagnosed

Type 2 diabetes is diagnosed with a blood test that measures how high your blood glucose is. Results usually take a few days.

You may be told you have prediabetes: blood glucose higher than normal but not high enough to be diabetes. It raises your future risk, and healthier eating and more exercise can help. Read what the HbA1c test means and how it sits alongside other common blood tests.

How it is usually managed

Lifestyle changes come first, and sometimes they bring blood glucose back to a normal level, which is called remission. NHS advice includes:

• Eat fruit, vegetables, wholegrain foods such as oats and wholemeal bread, and pulses such as chickpeas and lentils.
• Aim for at least 2.5 hours a week of walking or another activity that leaves you out of breath.
• Lose weight if you have been told you are overweight, stop smoking and limit alcohol.
• Do not switch to a very strict low-calorie diet without talking to a health professional, especially if you take insulin or other diabetes medicine.

If you need medicine, a doctor may discuss tablets that help your body handle insulin or let extra sugar pass out in your urine, an injected medicine for some people with heart disease or obesity, or insulin if other medicines are not enough. Your doctor decides what suits you.

Regular checks are part of treatment. The NHS recommends an HbA1c test every 3 to 6 months, foot checks, eye screening, and checks of weight, cholesterol, blood pressure and kidneys at least once a year.

Complications to know about

• Damage to blood vessels, which can lead to heart disease and stroke.
• Foot ulcers and infections, which in some cases lead to amputation.
• Sight problems, including diabetic retinopathy and blindness.
• Kidney problems and gum disease.

See a doctor if you have blisters or cracked skin on your feet, pain, tingling or numbness, or worsening vision. Good blood glucose control and regular check-ups lower the chance of complications.

Living with diabetes in the UAE

Heat. The NHS lists people with long-term conditions such as diabetes among those more at risk of heat exhaustion and heatstroke. Drink more cold drinks, avoid the sun between 11am and 3pm, and learn the warning signs of heat illness.

Fasting in Ramadan. Diabetes UK explains that people who are ill or have a medical condition do not have to fast, and this can include diabetes. If you plan to fast, talk to your doctor first: your risk depends on your HbA1c, any complications and whether your medicines, such as insulin, can cause low blood sugar. Diabetes UK advises checking your blood sugar more often, notes that checking does not break the fast, and says you must break the fast if your blood sugar drops below 4 mmol/l or rises above the level your doctor has given you.

When to see a doctor, and when to call 998

Call 998 or go to the nearest emergency department if you have type 2 diabetes and are peeing a lot, feel very thirsty, feel sick, feel confused, very sleepy or drowsy, or get short of breath. These can be signs of hyperosmolar hyperglycaemic state (HHS) or diabetic ketoacidosis (DKA), which can be life threatening. Do not drive yourself.

Get an urgent appointment if you take diabetes medicine and have vomiting, diarrhoea or a very high temperature. Do not stop your medicine unless a doctor tells you to. Book a routine appointment if you think you might have diabetes or you are in a higher-risk group.

General practitioners, family medicine and internal medicine doctors on medicAI work at independent facilities licensed by DHA or DoH. A video call suits going through results, while foot and eye checks happen in person.