Let’s Review: Men and Type 2 Diabetes

Type 2 diabetes, once called non-insulin-dependent diabetes or adult-onset diabetes, is the most common form of diabetes, affecting 90% to 95% of the 13 million men with diabetes.

The rates of diabetes have dramatically risen in all states. One of the biggest jumps was among men.

The risk for type 2 diabetes usually goes up with age. The American Diabetes Association recommends that people who don’t have other risk factors for the condition should start getting tested after age 45.

Unlike people with type 1 diabetes, people with type 2 diabetes make insulin. But it’s not enough, or their body doesn’t recognize the insulin and use it the way it should. This is called insulin resistance.

When there isn’t enough insulin or the insulin is not used as it should be, sugar (glucose) can’t get into your cells to be used for fuel. Sugar builds up in the blood, and your cells don’t work the way they should. Other problems linked with the buildup of sugar in the blood include:

• Dehydration. The buildup of sugar in the blood can make you urinate more. When the kidneys lose the sugar through the urine, a large amount of water is also lost, causing dehydration.
• Hyperosmolar nonketotic diabetic coma. When a person with type 2 diabetes becomes severely dehydrated and doesn’t drink enough fluids to make up for the fluid losses, they may have this life-threatening complication.
• Damage to the body. Over time, high sugar levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and put someone at risk of atherosclerosis (hardening) of the large arteries that can cause a heart attack or stroke.

Who Gets Type 2 Diabetes?

Anyone can get type 2 diabetes. But the risk is highest in people who:

• Are obese or overweight
• Have family members who have type 2 diabetes
• Have metabolic syndrome (a cluster of problems that include high cholesterol, high triglycerides, low HDL or “good” cholesterol and high LDL or “bad” cholesterol, and high blood pressure)
• Don’t get up and around a lot
• Eat a diet high in sugar and refined carbohydrates and low in fiber and whole grains
• Are African American, Hispanic,  American Indian, or Alaska Native. There is also a higher risk for some Pacific Islanders and Asian Americans

In addition, older people are more likely to get the disease because aging makes the body less tolerant of sugars.

Although it is more common than type 1 diabetes, type 2 diabetes is less well understood. It is probably caused by several things and not a single problem.

Type 2 diabetes can run in families, but the exact nature of how it’s inherited or the identity of a single reason for it in your genes is not known.

What Are the Symptoms of Type 2 Diabetes?

The symptoms of type 2 diabetes vary from person to person but may include:

• More thirst
• More hunger (especially after eating)
• Dry mouth
• Nausea and occasional vomiting
• Frequent urination
• Fatigue (weak, tired feeling)
• Blurred vision
• Numbness or tingling of the hands or feet
• Frequent infections of the skin or urinary tract

Rarely, a person may be diagnosed with type 2 diabetes after showing signs of it in a hospital while in a diabetic coma.

How Is Type 2 Diabetes Diagnosed?

If your health care provider suspects type 2 diabetes, they will first check for signs of it in your blood (high blood sugar levels). In addition, they may look for sugar or ketone bodies in your urine.

Tests used to diagnose type 2 diabetes include a fasting plasma glucose test and a casual plasma glucose test.

Complications of Type 2 Diabetes

If your type 2 diabetes isn’t controlled well, you could get serious or life-threatening complications, including:

• Retinopathy. People with type 2 diabetes may already have eye problems related to the disease. And over time, people who don’t have eye problems related to diabetes may get some form of eye problem. It’s important to control not only sugars, but also blood pressure and cholesterol to stop eye diseases from getting worse. Fortunately, the vision loss isn’t significant in most.
• Kidney damage. The risk of kidney disease rises over time, meaning the longer you have diabetes, the greater your risk. This complication carries significant risk of serious illness — such as kidney failure and heart disease.
• Poor blood circulation and nerve damage. Damage to nerves and hardening of the arteries lead to less sensation and poor blood circulation in the feet. This can bring on more infections and a higher risk of ulcers that heal poorly. In turn, this can significantly raise the risk of amputation. Damage to nerves may also lead to digestive problems, such as nausea, vomiting, and diarrhea.

Plenty. Studies show that 90% of cases of type 2 diabetes could be prevented — or significantly delayed — simply through a healthier diet and enough physical activity. The big proof of that came in a study of 3,234 people who were overweight and had higher blood glucose levels, putting them in the crosshairs of diabetes risk.

Those who followed a program of exercise and diet geared to losing excess weight — in this case, an average of 15 pounds — lowered their risk of diabetes by 58%. Those in the 60-and-older set cut their risk by 71%. And these were people who already had a high risk of diabetes. Keep your weight in the normal range and stay active, experts say, and you stand an excellent chance of never getting diabetes.

How Is Diabetes Treated?

A diabetes diagnosis isn’t the end of the world. In some cases, lifestyle changes can keep the disease entirely under control. Still, many people with diabetes need to take oral or injectable medications that lower blood sugar levels. 

When these aren’t enough to do the job, insulin (which is inhaled and/or injected) may be necessary, sometimes along with oral drugs. Several new drugs that work with insulin to improve blood sugar management have been approved by the FDA.

While treatment has improved, controlling diabetes remains a challenge, which is why experts focus on prevention.

What Else Do I Need to Know About Diabetes?

Experts say that a healthy diet designed to prevent type 2 diabetes includes whole grains, fruits, and vegetables, and avoids sugar and refined carbohydrates.

Studies suggest that alcohol may actually protect against diabetes. Combining data from 15 studies, researchers found that moderate alcohol consumption reduced the risk of type 2 diabetes by almost 30%. But excessive drinking increased the risk. Here, as always, the word is moderation, such as one drink daily. 

Sources:

National Diabetes Information Clearinghouse: “Type 2 Diabetes: What You Need to Know.”

Intellihealth: “What Is Type 2 Diabetes?”

UpToDate: “Patient information: Diabetes mellitus type 2: Overview (Beyond the Basics).”

American Heart Association.

Diabetes Care: “Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes: A meta-analysis of prospective observational studies.”

David Ludwig, MD, PhD, associate professor of pediatrics, Children’s Hospital, Boston.

Journal of the American Medical Association: “Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women.”

National Institutes of Health National Diabetes Information Clearinghouse.

American Diabetes Association.

American Heart Association.

News release, FDA.