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Type 2 diabetes is a common chronic condition related to how the body metabolizes glucose (sugar). It is the most prevalent form of diabetes, accounting for approximately 90–95% of all diabetes cases worldwide. Understanding its causes, symptoms, and management strategies can help individuals maintain good health and reduce the risk of long-term complications.

Causes and disease mechanism

In a healthy body, insulin is a hormone produced by the pancreas, helps glucose move from the bloodstream into cells to be used for energy. In people with type 2 diabetes, the body either does not produce enough insulin or the cells do not respond properly to insulin, a condition known as insulin resistance. As a result, glucose builds up in the blood, leading to serious health problems.

Main causes of type 2 diabetes include:

• Insulin resistance: Body cells respond poorly to insulin, preventing glucose from entering cells efficiently.
• Impaired pancreatic function: The pancreas cannot produce sufficient insulin to compensate for insulin resistance.
• Key risk factors include:
  • Overweight and obesity, especially abdominal obesity.
  • Physical inactivity, which reduces insulin sensitivity.
  • Unhealthy diet high in processed foods, refined sugars, and saturated fats.
  • Genetic predisposition or family history of diabetes.
  • Age, with higher risk after 45 years, although younger individuals may also be affected.
  • Medical history such as hypertension, dyslipidemia, or gestational diabetes.

Symptoms of type 2 diabetes

Type 2 diabetes often develops gradually and may not cause noticeable symptoms in the early stages. As blood glucose levels rise, common symptoms may include:

• Frequent urination, especially at night.
• Persistent thirst despite adequate fluid intake.
• Ongoing fatigue or low energy.
• Increased hunger..
• Unexplained weight loss.
• Blurred vision or difficulty concentrating.
• Slow-healing wounds or recurrent infections.
• Itchy skin, particularly in the genital area. Some individuals remain asymptomatic until complications develop.

Diagnosis of type 2 diabetes

Type 2 diabetes is diagnosed through blood tests that measure blood glucose levels. Common diagnostic criteria include:

Fasting plasma glucose test

• Blood is drawn after at least 8 hours of fasting.
• Results:
  • Normal: < 100 mg/dL (5.6 mmol/L)
  • Prediabetes: 100–125 mg/dL (5.6–6.9 mmol/L)
  • Diabetes: ≥ 126 mg/dL (7.0 mmol/L)

HbA1c test

• Reflects average blood glucose levels over the previous 2–3 months.
• Results:
  • Normal: < 5.7%
  • Prediabetes: 5.7%–6.4%
  • Diabetes: ≥ 6.5%

Oral glucose tolerance test (OGTT)

• Blood samples are taken before and 2 hours after consuming a glucose solution (usually 75 g of glucose).
• 2-hour results:
  • Normal: < 140 mg/dL (7.8 mmol/L)
  • Prediabetes: 140–199 mg/dL (7.8–11.0 mmol/L)
  • Diabetes: ≥ 200 mg/dL (11.1 mmol/L)

Random blood glucose test

• Blood glucose is measured at any time of day, regardless of meals.
• Diabetes is diagnosed if blood glucose is ≥ 200 mg/dL (11.1 mmol/L) in the presence of classic hyperglycemia symptoms such as excessive thirst, frequent urination, or fatigue.

Important note:

• To confirm the diagnosis, physicians usually repeat tests on different days or combine multiple tests.
• Prediabetes is a warning stage that can progress to type 2 diabetes if not managed early.

Complications of type 2 diabetes

Poorly controlled type 2 diabetes can lead to serious complications, including:

1. Cardiovascular complications: Increased risk of heart disease, stroke, and hypertension due to atherosclerosis and narrowed blood vessels.

2. Nerve damage (diabetic neuropathy): Causes pain, numbness, or loss of sensation, especially in the hands and feet, and may lead to foot ulcers or amputation.

3. Kidney disease: Damage to small blood vessels in the kidneys may result in chronic kidney disease or the need for dialysis or kidney transplantation.

4. Eye complications: Diabetic retinopathy can cause blurred vision or blindness, with increased risk of cataracts and glaucoma.

5. Skin complications: Higher susceptibility to skin infections and other dermatological conditions.

6. Pregnancy-related complications: Poorly controlled diabetes during pregnancy increases the risk of congenital abnormalities and other serious health issues for the baby.

Treatment of type 2 diabetes

Although type 2 diabetes cannot be completely cured, it can be effectively managed with medication and lifestyle modifications.

1. Dietary management

• Increase intake of fiber-rich foods such as vegetables, whole grains, and legumes
• Choose lean protein sources like fish, poultry, and plant-based proteins.
• Limit sugar, sugary beverages, fried foods, and saturated fats.
• Eat smaller, more frequent meals to prevent sharp spikes in blood glucose.

2. Physical activity

• Engage in at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or yoga.
• Regular activity improves blood glucose control and cardiovascular health.

3. Medication

• Doctors may prescribe oral medications or injectable insulin to control blood glucose.
• Some medications improve insulin sensitivity or reduce glucose production by the liver.

4. Blood glucose monitoring

• Use a home glucose meter for regular monitoring.
• Record readings and review them with your doctor during follow-up visits.

5. Stress management

Stress can increase blood glucose levels. Relaxation techniques such as meditation, yoga, or leisure activities may help stabilize blood sugar.

Prevention of type 2 diabetes

Preventing type 2 diabetes requires proactive lifestyle changes:

• Maintain a healthy weight; losing 5–7% of body weight can significantly reduce risk.
• Follow a balanced diet with minimally processed foods.
• Exercise regularly; even 30 minutes per day can improve insulin sensitivity.
• Get adequate sleep, as chronic sleep deprivation increases insulin resistance.
• Undergo regular health check-ups to monitor blood glucose and risk factors.

Conclusion

Type 2 diabetes is a common chronic condition that often progresses silently and can cause serious complications if not well controlled. Early detection, lifestyle modification, adherence to treatment, and regular follow-up are key to maintaining good health and minimizing complications.

For consultation and follow-up of type 2 diabetes at DYM Medical Center Vietnam, please contact:

• DYM Medical Center Saigon: Room B101-B103, Basement 1, mPlaza Saigon Building, No. 39 Le Duan, Sai Gon Ward, Ho Chi Minh City

• DYM Medical Center Phu My Hung: Room 3A01, 3A Floor, The Grace Building, 71 Hoang Van Thai Street, Tan My Ward, Ho Chi Minh City

• DYM Medical Center Hanoi: B1 Basement, Epic Tower, Alley 19 Duy Tan, Cau Giay Ward, Ha Noi

• Hotline: 1900 29 29 37