Let's Talk About Type 2 Diabetes

It’s hard to say there’s “good news” about any disease diagnosis, but if there’s a silver lining with type 2 diabetes, it’s this: You are very much in control of your destiny. Type 2 diabetes can often be successfully managed through the actions you take in everyday life. A healthy diet and regular exercise, along with prescribed medications, can give you your life back. Here’s the deal with type 2 diabetes.

什么是2型糖尿病？

If you know someone with diabetes, chances are they have type 2, which accounts for 90% to 95% of all diabetes cases in the United States.Other common typesinclude type 1, an autoimmune disorder, and gestational diabetes, which only happens during pregnancy.

与所有类型的糖尿病人有一个共同点：大量的血糖（或葡萄糖）的。

Here’s what happens if your body is working normally: After you eat, food from your meal is broken down into a sugar called葡萄糖（除其他事项外），用作你的整个身体的能量，大脑，心脏，肌肉细胞，以及一切其他来源依靠葡萄糖作为燃料。

葡萄糖进入血液和反应，你的胰腺释放胰岛素，一种激素，帮助葡萄糖走出你的血液进入部分细胞，使他们能够使用它的能量。

但在2型糖尿病，你的身体停止使用它有效地产生胰岛素，因此需要更多的胰岛素来帮助将葡萄糖转化成能量。最终，你的胰腺无法产生足够的胰岛素来跟上需求，你的血糖升高。（这比1型，在身体完全不产生胰岛素，从而导致血液中的葡萄糖，建立不同的。）

2型糖尿病是非常可治疗的，但不可治愈。有些人能够用健康的饮食和规律的运动，但许多需要服用药物，以及保持在检查。

因为，如果不及时治疗，2型糖尿病大大增加你的心脏疾病的风险，并可能导致像失明，肾功能问题，神经疼痛，足部问题，甚至截肢的并发症重要的是要及早正确诊断。

Who Gets Type 2 Diabetes?

Anyone of any age, weight, or race can get type 2 diabetes. That said, type 2 diabetes does run in families. It’s also more common in adults, in people who are overweight, and in black, Latino, and Asian communities.

An estimated 27 million to 28.5 million people in the United States have type 2 diabetes. Additionally, more than 80 million people have prediabetes, meaning their blood sugar is elevated, but not high enough to be diabetes. Prediabetes greatly increases the chances a person will go on to develop type 2.

是什么原因导致2型糖尿病？

Doctors don’t know exactly why some people get type 2 diabetes and others don’t. But it’s clear thatseveral things raise your odds得到它的：

• Ethnicity/race.Certain ethnic groups are more likely to develop type 2 than others, including African Americans, Latinos, Pacific Islanders and Hawaiians, Native Americans and Native Alaskans.

• Family history and genetics.There is no single type 2 diabetes “gene” to test for, but if type 2 runs in your family, that means you are at higher risk of developing it, too.

• High Body Mass Index (BMI).Higher levels of body fat, especially the kind that gathers in the belly, is linked to insulin resistance and risk of type 2 diabetes. Insulin resistance can also cause more weight gain, creating a frustrating cycle.

• 胰岛素抵抗。Type 2 often starts with insulin resistance—meaning that a person’s liver, muscles, adipose (fat) and other cells start to respond more slowly or weakly to insulin than they used to. Several things can contribute to insulin resistance, including certain medications, polycystic ovary syndrome, Cushing’s disease, and aging.

• Sedentary lifestyle.体力活动提升你的身体有效地使用胰岛素，降低高血糖的风险的能力。久坐使您的细胞对胰岛素不敏感，从而导致胰岛素抵抗和2型糖尿病的风险增加。

2型糖尿病症状

Having one or more of these symptoms doesn’t automatically mean you or a loved one has type 2 diabetes, but it does mean you should get checked out. Possible indications of type 2 diabetes include:

• 极度口渴：When there’s too much sugar in the bloodstream, your body pulls water from surrounding tissues to try and dilute it. That makes you dehydrated and thirsty. Some people with diabetes feel like no matter how much they drink, they can’t quench their thirst.

• 过度小便：在努力过滤掉血液中的含糖量高，你的肾脏呼呼。他们从倾倒你的血糖为你的尿液，创造更多的撒尿。在疾病的更高级阶段，膀胱周围神经损伤可能会导致一些人感到冲动频繁小便，即使很少或没有出来。你也有尿路感染（尿路感染）的风险较高。孩子可能会突然开始在夜间或白天有意外发生，即使他们已经便盆训练多年。

• The munchies:If you’re hungry all the time, even after a good meal, it could be a sign that your muscles and other tissues in your body aren’t getting the energy—a.k.a. glucose—they need from the food you’re eating, because it’s hung up in your bloodstream. Your muscles signal to your brain that they’re starving (even though you ate plenty), making you feel hungry and continuing the cycle.

• Fatigue:Type 2 diabetes can make you feel tired and weak because your brain, muscles, and other body systems aren’t getting the energy they need to work properly. Dehydration from frequent urination can make you tired, too. Listlessness and muscle weakness may also be a sign of a severe complication called ketoacidosis.

Tests for Type 2 Diabetes

The first step in getting a diabetes diagnosis is a blood test. You may have already had one or more of these tests during your yearly physical, or if you’ve ever been pregnant. (The U.S. Preventive Services Task Force recommends that anyone over age 40 with a BMI of 25 or higher should be screened, then checked every three years thereafter. People with additional risk factors should be screened earlier, and more often.)

If the test suggests you have diabetes, your doctor will likely perform additional testing to figure out whether it is type 2. Correct diagnosis is important since treatment differs depending on type.

验血

• A1C (or glycated hemoglobin) test.This common test measures what percentage of your red blood cells have been coated with glucose over the past two to three months. The higher your blood sugar, the higher your score. An A1C result below 5.7 is considered normal; 5.7 to 6.4 is prediabetic; 6.5 or above suggests diabetes.

• Fasting blood sugar test.你吃或水以外的任何东西喝血前将绘制的第一件事是在早晨。下每分升100毫克的结果是正常的;100〜125毫克/分升是糖尿病前期;126毫克/分升指示糖尿病。你的医生可能会要你诊断之前做测试两次。

• 随机血糖检测。Blood is drawn at any time of day, whether you’ve eaten recently or not. A result of 200 mg/dL means you may have diabetes.

• Antibody test.To help differentiate between type 1 and type 2 diabetes, your doctor may also draw blood for an “autoantibody” test, to see if your immune system is attacking your pancreas. People with type 1 often test positive for several specific autoantibodies, while those with type 2 (or the rare monogenic diabetes) won’t.

尿检

Your doctor may want to test your urine for ketones, chemicals your body produces when it breaks down fat for energy. The test can be done at home or in a lab or doctor’s office by peeing into a specimen cup.

非常高的水平酮是酮症酸中毒的迹象，糖尿病的潜在致命的并发症，需要紧急治疗。的条件是最常见的1型糖尿病患者但在很少的情况下可以与2型发生为好。

治疗2型糖尿病

你怎么去有关管理状况将取决于多种因素，包括你的血糖模式，病史，生活方式，义务，财务和个人喜好。你的医生会与你谈论不同的方式来治疗疾病，其中包括：

Eating Smart

虽然有糖尿病没有官方的饮食，应该不用说，含糖，脂肪的食物是不是你的身体需要时，它已经与高血糖挣扎。

Research shows that plant-based diets, Mediterranean diets (rich in vegetables and seafood), and low-carbohydrate diets can all lower blood sugar and reduce the risk of developing type 2 diabetes or improve symptoms if you already have it.

Not sure how to start one of these programs? A registered dietitian or certified diabetes educator can help you plan meals based on these principles and figure out how to fit healthy eating into your budget and lifestyle.

锻炼

没有人要求你在这里缩放珠穆朗玛峰，但如果你想击败这个病，你必须要继续前进！通过锻炼使您的细胞对胰岛素甚至各地块可以帮助每天散步更敏感改善你的血糖水平。

此外，国家的指导原则要求最少150分钟的每周中等强度的运动（这是一个天，每周五次30分钟）的，所以即使你没有2型，你仍旧需要起床和移动。

Taking Oral Medications

If you have type 2 diabetes, there’s a chance you will be able to manage your blood sugar with exercise and what you eat. But you mayneed medication了。

There are a lot of different drugs that can help lower blood sugar—your doctor might recommend one, or a combination of medications, based on your particular case. Some common type 2 medications include:

• Actos和Avandia(thiazolidinediones) reduce circulating fat concentrations and improve sensitivity to insulin.
• Amaryl,Glucotrol和Micronase(sulfonylureas),Prandin和Starlix(meglitinide), and的Januvia和Onglyza(DPP-4 inhibitors), trigger the pancreas to produce more insulin.
• Farxiga,Invokana和Jardiance(SGLT2 inhibitors) boost the amount of sugar the kidneys can remove from your blood.
• Glyset和Orecose(alpha-glucosidase inhibitors) slow the digestion and breakdown of starches into glucose and regulate how much glucose is absorbed by the small intestine.
• Metformin(brands names Glucophage, Glumetza, Fortamet, Riomet) slows the breakdown of carbohydrates into sugar, and reduces how much glucose your liver produces.

Taking Insulin

不是每个人2型糖尿病患者胰岛素需求，但也有一些。有几种不同的方式把它 - 最常见的方式是注射胰岛素用注射器，通常在腹部，上臂，大腿，臀部或。有些人觉得使用注射“笔”更容易。

谁需要每天多次注射的人有时更喜欢真实戴在身上的胰岛素泵，并通过一个小导管自动提供胰岛素，你的皮肤下的遗迹。

检查血糖

Some people with type 2 diabetes may need to check their blood glucose occasionally, others need to do it multiple times a day.

Most people use a home glucose meter to do this. To use it, you poke a fingertip with a specialized lancet “pen” then drop the blood onto a test strip in the meter. For some people who have to check levels often, it makes more sense to use a continuous glucose monitor (CGM). A CGM is a tiny sensor inserted under the skin of your abdomen, arms, or thighs that checks glucose levels in body fluids regularly and will alert you if levels fall too low.

Getting Blood Tests

2型糖尿病人应该有一个A1C（或糖化血红蛋白）测试每年两到四次。如果水平上去了，你的医生会决定改用了你的药物，或鼓励你把更多的重点放在你的饮食和锻炼目标。

Living With Type 2 Diabetes

Because of the associations between type 2 diabetes, BMI, and physical activity, there’s often a misguided sense that people with the disease have caused their condition themselves.

需要澄清的是,吃太多o外卖、闲逛n the couch does not cause type 2 diabetes. A poor diet and lack of exercise does increase your risk, but there are other factors at play. Two people can be overweight, have a strong family history, sedentary lifestyle, and eat fast food—and one will get type 2, while the other won’t. Type 2 diabetes is a complex disease with multiple causes and (fortunately) solutions.

The really good news is that many of those solutions are things you can do starting right now. Along with medication, you can greatly improve your odds of reducing type 2 symptoms and living a full and happy life by following a Mediterranean or plant-based diet, reducing consumption of high-sugar foods, and squeezing in 30 minutes of moderate exercise, five days a week. No one is saying it’s easy, but neither is living with type 2 diabetes. Start making changes now. You’ve got this.