In type 2 diabetes, the pancreas still makes some insulin, and in fact in the early stages often called pre-diabetes, there can be very high amounts of insulin produced. This is due to insulin resistance. Over time, the pancreas works harder and harder to lower the blood glucose levels. After a period of time the pancreas starts to produce less and less insulin. If you can make lifestyle changes at the stage of pre-diabetes it is possible to prevent or delay the progression to type 2 diabetes.

Insulin is the key to open the doors from your blood stream, to take glucose to the muscles and cells of the body. In type 2 diabetes, it is like the key is not the right size or is broken and so glucose from the food you eat can not get across into the cells and muscles. Your pancreas keeps trying to produce higher levels of insulin to cope. This of course puts stress on the pancreas.

Type 2 diabetes occurs due to a mixture of genetic and environmental factors. Although there is a strong genetic link meaning if it is in your family you are at higher risk, this risk is even more increased when there are also lifestyle factors such as high blood pressure,  being overweight or obese, not being active enough, eating an unhealthy diet and having the classic ‘apple shape’ body where extra weight is carried around the waist.

Type 2 diabetes can usually be managed at first with with healthy eating and regular physical activity. This includes structured exercise and simply moving more in your day. However, over time most people with type 2 diabetes will also need tablets and many will also need insulin. It is important to note that this is just the natural progression of the disease, and taking tablets or insulin as soon as they are required can result in fewer complications in the long-term.

There is currently no cure for type 2 diabetes.

What causes type 2 diabetes?

While there is no single cause of type 2 diabetes, there are well-established risk factors.

Some of these can be changed and some cannot.

You are at a higher risk of getting type 2 diabetes if you:

• have a family history of diabetes
• are older (over 55 years of age ) - the risk increases as we age
• are over 45 years of age and are overweight
• are over 45 years of age and have high blood pressure
• are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
• are over 35 years of age and are from Pacific Island, Indian subcontinent or Chinese cultural background
• are a woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.

What are the symptoms of Type 2 Diabetes?

One of the problems with type 2 diabetes, is that many people have no symptoms at all, while for other people signs are ignored as a part of ‘getting older’. By the time type 2 diabetes is diagnosed, the complications of diabetes may already be present and sometimes a complication is what takes you to the doctor in the first place.

Symptoms include:

• Being excessively thirsty
• Need to wee more often than normal
• Feeling tired and lethargic
• Always feeling hungry
• Having cuts that heal slowly
• Itching, skin infections
• Blurred vision
• Gradually putting on weight
• Mood swings
• Headaches
• Feeling dizzy
• Leg cramps.

 Type 2 diabetes and your emotional wellbeing

There is a lot of guilt associated with type 2 diabetes. Because being overweight or obese is a strong risk factor, many people feel blamed for developing type 2 diabetes.  However this is ONE RISK factor. There are many other reasons - not everyone who gets type 2 diabetes is overweight and not everyone who is overweight gets type 2 diabetes. I know lean, young people with type 2 diabetes. I know overweight people who have type 2 diabetes, but it is not their fault.

Community awareness campaigns about prevention can lead to misunderstandings, frustration and blame.

It is important to remember it is never your fault.

If you are overweight, there are many reasons why people become inactive, overweight or make poor dietary choices. We are all human. In addition emotional eating, often going back many years, can be a factor in overweight and obesity. Addressing these issues and any underlying mental illness or worry, can help you to get on track with a healthier lifestyle, feel better about yourself and manage your diabetes. I have spoken to thousands of people who say they feel guilty about their diabetes, about what they eat and in general feel unhappy and miserable about themselves. Dealing with these things is critical.

Preventing Type 2 Diabetes

Diabetes Australia report that it is estimated  up to 60% of type 2 diabetes can actually be prevented if detected early enough, and that if you are at risk of type 2 diabetes you can delay and even prevent it by following a healthy lifestyle.

This includes:

• Maintaining a healthy weight
• Regular physical activity including just moving more in your day
• Making healthy food choices
• Managing blood pressure
• Managing cholesterol levels
• Not smoking.

 Managing Type 2 Diabetes

While there is currently no cure for type 2 diabetes, you can live a long and healthy life through management with changes to your lifestyle and medication.

Type 2 diabetes can sometimes initially be managed through lifestyle modification including a healthy diet and regular exercise. However, as the disease progresses, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. These tablets are intended to be used in conjunction with healthy eating and regular physical activity, not as a substitute. Diabetes tablets are not an oral form of insulin and they require insulin to be present in the body to be effective.

Eventually it may be necessary to start taking insulin to control blood glucose levels, when your body is no longer producing enough insulin of its own. Sometimes tablets may be continued in addition to insulin.

The aim of diabetes management is to keep blood glucose levels as close to ‘normal' as possible, that is between 4 to 6 mmol/L (fasting), as this will help prevent both short-term and long-term complications.

Regular blood glucose monitoring is necessary to see if the treatment being followed is adequately controlling blood glucose levels.

No matter which medication or management plan your doctor prescribes, make sure you follow their instructions. The pattern and frequency will depend on the individual, the tables and your circumstances.

Read more here at Diabetes Australia about managing type 2 diabetes.

Remember with good support and a healthy lifestyle you can live a long and happy life despite having been diagnosed with diabetes.