Type 2 Diabetes

Type 2 diabetes is a progressive condition in which the body becomes resistant to the normal effects of insulin and/or gradually loses the capacity to produce enough insulin in the pancreas. We do not know what causes type 2 diabetes. Type 2 diabetes is associated with modifiable lifestyle risk factors. Type 2 diabetes also has strong genetic and family related risk factors.

Type 2 diabetes:

• Is diagnosed when the pancreas does not produce enough insulin (reduced insulin production) and/or the insulin does not work effectively and/or the cells of the body do not respond to insulin effectively (known as insulin resistance)
• Represents 85–90 per cent of all cases of diabetes
• Usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups including children, adolescents and young adults
• Is more likely in people with a family history of type 2 diabetes or from particular ethnic backgrounds
• For some the first sign may be a complication of diabetes such as a heart attack, vision problems or a foot ulcer
• Is managed with a combination of regular physical activity, healthy eating and weight reduction. As type 2 diabetes is often progressive, most people will need oral medications and/or insulin injections in addition to lifestyle changes over time.

Type 2 diabetes develops over a long period of time (years). During this period of time insulin resistance starts, this is where the insulin is increasingly ineffective at managing the blood glucose levels. As a result of this insulin resistance, the pancreas responds by producing greater and greater amounts of insulin, to try and achieve some degree of management of the blood glucose levels. This as mentioned occurs over a very long period of time.

As this over production of insulin occurs over a very long period of time, the cells in the pancreas that produce insulin wear themselves out, so that by the time someone is told that they have type 2 diabetes, they have lost 50 – 70% of those cells that produce insulin. This means that type 2 diabetes is a combination of ineffective insulin and not enough insulin. Type 2 diabetes is a progressive condition and the progression is with the ongoing destruction of the cells in the pancreas that produce insulin.

Type 2 diabetes can often initially be managed with healthy eating and regular physical activity. 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 condition, and taking tablets or insulin as soon as they are required can result in fewer complications in the long-term.