Prediabetes and Insulin Resistance
Risk Factors
Symptoms and Diagnosis
Basal Insulin and Treatment
Diabetes Diet
Hyperglycemia and Hypoglycemia
Ketosis and the Keto Diet
Complications and Aging Well
Medically Reviewed by Kelly Kennedy, RD
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)
Among those people with diabetes, 7.2 million don't even know they have it, and now, more and more children and adolescents are being diagnosed with prediabetes and type 2 diabetes.
Whether you've been diagnosed with type 2 diabetes or have a family history of the disease, this condition can be scary. And with the required diet and lifestyle changes, as well as an increased risk for complications like amputations and heart disease, we don’t blame you for fearing it.
But living with type 2 diabetes doesn’t have to be devastating. In fact, when you know the facts about the disease, like how insulin resistance develops and how to mitigate it, how to spot the signs of diabetes, and what to eat if you receive a diagnosis, you can get the prompt treatment and diet resources you need to thrive.
Indeed, an increasing amount of research suggests you may even be able to reverse type 2 diabetes by making adjustments to your diet and lifestyle.
In this article, you’ll get a deep-dive primer on that information and more. So sit back, read up, and rest assured that type 2 diabetes doesn’t have to derail your life plans.
What Is Insulin Resistance, and How Can It Cause Prediabetes and Type 2 Diabetes?
For starters, it’s important to understand exactly what type 2 diabetes is. This type of diabetes is marked by high blood sugar that your body can’t bring down on its own. High blood sugar is called hyperglycemia; hypoglycemia is low blood sugar.
High blood sugar in type 2 diabetes is due to a condition called insulin resistance, which your doctor may have mentioned during your diagnosis and a corresponding drop in insulin production. These two factors are what makes type 2 diabetes different from type 1 diabetes, gestational diabetes, and other types of diabetes.
More in Type 2 Diabetes
Insulin — the hormone that allows your body to regulate sugar in the blood — is made in your pancreas. Essentially, insulin resistance is a state in which the body’s cells do not use insulin efficiently. As a result, it takes more insulin than normal to transport blood sugar (glucose) into cells, to be used immediately for fuel or stored for later use. A drop in efficiency in getting glucose to cells creates a problem for cell function; glucose is normally the body’s quickest and most readily available source of energy.
Insulin resistance doesn’t develop immediately, and often, people with the condition don’t show symptoms — which may make getting a diagnosis tougher.
As the body becomes more and more insulin resistant, the pancreas responds by releasing more and more insulin. This higher-than-normal level of insulin in the bloodstream is called hyperinsulinemia.
Insulin resistance sends your pancreas into overdrive, and while it may be able to keep up with the body’s increased demand for insulin for a while, this ability wanes. And when it does, your blood sugar levels will elevate — leading to prediabetes, the precursor of type 2 diabetes, or type 2 diabetes itself.
A prediabetes diagnosis doesn’t mean you’ll definitely develop type 2 diabetes. Catching the diagnosis quickly and then changing your diet and lifestyle can help prevent your health from worsening.
Even though prediabetes and type 2 diabetes are some of the most prevalent diseases in the world, altogether affecting 100 million Americans, researchers still aren’t completely sure what causes insulin resistance. (4,5)
One thing they do know? Diabetes is a multifactorial disease — meaning you can’t just stop eating sugar or start exercising to avoid getting the disease.
Here are some of the factors that may affect your risk of developing type 2 diabetes.
Obesity Being obese or overweight puts you at significant risk of developing type 2 diabetes.
Poor eating habits Eating too much of the wrong kinds of foods can increase your risk of type 2 diabetes. Studies have shown that eating a diet of calorie-dense, refined foods and beverages, such as sodas or fruit juices, and too little whole fruits, vegetables, and whole grains can significantly increase your risk of type 2 diabetes.
Too much TV time Research shows that watching too much TV (and too much sitting in general) may increase your risk of obesity, type 2 diabetes, and other ailments.
Not getting enough exercise Just as body fat interacts with insulin and other hormones to affect diabetes development, so does muscle. Lean muscle mass, which can be increased through exercise and strength training, plays a role in protecting the body against insulin resistance and type 2 diabetes.
Sleep habits Sleep disturbances can affect the body’s balance of insulin and blood sugar by increasing the demand on the pancreas. Over time, this can lead to type 2 diabetes. (10)
Polycystic ovarian syndrome (PCOS) By some estimates, a woman diagnosed with PCOS — a hormone imbalance disorder — has a greater risk of developing type 2 diabetes than her peers without PCOS.
Being over age 45 The older you get, the more likely you are to develop type 2 diabetes. But in recent years, an increasing number of children and teens have been diagnosed with prediabetes and type 2 diabetes.
continue reading below
How to Support a Family Member Who’s Been Diagnosed With Diabetes
Research on twins backs this up: Twins who are identical are more likely to both have diabetes compared with twins who are fraternal. And having a relative with diabetes may put you at a fourfold risk of developing the disease yourself.
Your ethnicity or race may affect your risk for type 2 diabetes as well. Data suggest African-Americans, Hispanic or Latino Americans, and certain Native-American groups have a higher risk of type 2 diabetes than Caucasian-Americans.
How to Spot the Signs and Symptoms of Type 2 Diabetes, and Receive a Diabetes Diagnosis
During the early stages of the disease, type 2 diabetes often doesn’t present any symptoms at all. Still, you should be aware of the symptoms and early warning signs, such as:
Frequent urination and extreme thirst
Medically Reviewed by Kelly Kennedy, RD
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)
Among those people with diabetes, 7.2 million don't even know they have it, and now, more and more children and adolescents are being diagnosed with prediabetes and type 2 diabetes.
Whether you've been diagnosed with type 2 diabetes or have a family history of the disease, this condition can be scary. And with the required diet and lifestyle changes, as well as an increased risk for complications like amputations and heart disease, we don’t blame you for fearing it.
But living with type 2 diabetes doesn’t have to be devastating. In fact, when you know the facts about the disease, like how insulin resistance develops and how to mitigate it, how to spot the signs of diabetes, and what to eat if you receive a diagnosis, you can get the prompt treatment and diet resources you need to thrive.
Indeed, an increasing amount of research suggests you may even be able to reverse type 2 diabetes by making adjustments to your diet and lifestyle.
In this article, you’ll get a deep-dive primer on that information and more. So sit back, read up, and rest assured that type 2 diabetes doesn’t have to derail your life plans.
What Is Insulin Resistance, and How Can It Cause Prediabetes and Type 2 Diabetes?
For starters, it’s important to understand exactly what type 2 diabetes is. This type of diabetes is marked by high blood sugar that your body can’t bring down on its own. High blood sugar is called hyperglycemia; hypoglycemia is low blood sugar.
High blood sugar in type 2 diabetes is due to a condition called insulin resistance, which your doctor may have mentioned during your diagnosis and a corresponding drop in insulin production. These two factors are what makes type 2 diabetes different from type 1 diabetes, gestational diabetes, and other types of diabetes.
More in Type 2 Diabetes
Insulin — the hormone that allows your body to regulate sugar in the blood — is made in your pancreas. Essentially, insulin resistance is a state in which the body’s cells do not use insulin efficiently. As a result, it takes more insulin than normal to transport blood sugar (glucose) into cells, to be used immediately for fuel or stored for later use. A drop in efficiency in getting glucose to cells creates a problem for cell function; glucose is normally the body’s quickest and most readily available source of energy.
Insulin resistance doesn’t develop immediately, and often, people with the condition don’t show symptoms — which may make getting a diagnosis tougher.
As the body becomes more and more insulin resistant, the pancreas responds by releasing more and more insulin. This higher-than-normal level of insulin in the bloodstream is called hyperinsulinemia.
Insulin resistance sends your pancreas into overdrive, and while it may be able to keep up with the body’s increased demand for insulin for a while, this ability wanes. And when it does, your blood sugar levels will elevate — leading to prediabetes, the precursor of type 2 diabetes, or type 2 diabetes itself.
A prediabetes diagnosis doesn’t mean you’ll definitely develop type 2 diabetes. Catching the diagnosis quickly and then changing your diet and lifestyle can help prevent your health from worsening.
Even though prediabetes and type 2 diabetes are some of the most prevalent diseases in the world, altogether affecting 100 million Americans, researchers still aren’t completely sure what causes insulin resistance. (4,5)
One thing they do know? Diabetes is a multifactorial disease — meaning you can’t just stop eating sugar or start exercising to avoid getting the disease.
Here are some of the factors that may affect your risk of developing type 2 diabetes.
Obesity Being obese or overweight puts you at significant risk of developing type 2 diabetes.
Poor eating habits Eating too much of the wrong kinds of foods can increase your risk of type 2 diabetes. Studies have shown that eating a diet of calorie-dense, refined foods and beverages, such as sodas or fruit juices, and too little whole fruits, vegetables, and whole grains can significantly increase your risk of type 2 diabetes.
Too much TV time Research shows that watching too much TV (and too much sitting in general) may increase your risk of obesity, type 2 diabetes, and other ailments.
Not getting enough exercise Just as body fat interacts with insulin and other hormones to affect diabetes development, so does muscle. Lean muscle mass, which can be increased through exercise and strength training, plays a role in protecting the body against insulin resistance and type 2 diabetes.
Sleep habits Sleep disturbances can affect the body’s balance of insulin and blood sugar by increasing the demand on the pancreas. Over time, this can lead to type 2 diabetes. (10)
Polycystic ovarian syndrome (PCOS) By some estimates, a woman diagnosed with PCOS — a hormone imbalance disorder — has a greater risk of developing type 2 diabetes than her peers without PCOS.
Being over age 45 The older you get, the more likely you are to develop type 2 diabetes. But in recent years, an increasing number of children and teens have been diagnosed with prediabetes and type 2 diabetes.
continue reading below
How to Support a Family Member Who’s Been Diagnosed With Diabetes
Research on twins backs this up: Twins who are identical are more likely to both have diabetes compared with twins who are fraternal. And having a relative with diabetes may put you at a fourfold risk of developing the disease yourself.
Your ethnicity or race may affect your risk for type 2 diabetes as well. Data suggest African-Americans, Hispanic or Latino Americans, and certain Native-American groups have a higher risk of type 2 diabetes than Caucasian-Americans.
How to Spot the Signs and Symptoms of Type 2 Diabetes, and Receive a Diabetes Diagnosis
During the early stages of the disease, type 2 diabetes often doesn’t present any symptoms at all. Still, you should be aware of the symptoms and early warning signs, such as:
Frequent urination and extreme thirst
Sudden or unexpected weight loss
Increased hunger
Blurry vision
Dark, velvety patches of skin (called acanthosis nigricans)
Fatigue
Wounds that won’t heal
If you have one or more risk factor for type 2 diabetes and notice any of these signs, it’s a good idea to call your doctor, as you may have type 2 diabetes.
Common Diagnostic Tests for Type 2 Diabetes
Receiving a prompt diagnosis is crucial for controlling diabetes. The American Diabetes Association suggests that if you’re age 45 or older and overweight, you should be screened for type 2 diabetes every three years.
To screen you for type 2 diabetes, your doctor may administer one of the following tests:
Glycated hemoglobin (A1C) test A1C is a two- to the three-month measurement of your average blood sugar levels. While an A1C of 5.7 or below is normal, anything between 5.7 and 6.4 percent signals diabetes and a reading of 6.5 percent or higher on two different tests suggest you have diabetes.
7 Unusual Signs and Symptoms of Type 2 Diabetes
Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. If you have a fasting blood sugar level of fewer than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes.
A1C and fasting glucose are common tests used to diagnose diabetes, but if you’re pregnant or have a hemoglobin variant, your doctor may use another method, such as:
Oral glucose tolerance test
If you have one or more risk factor for type 2 diabetes and notice any of these signs, it’s a good idea to call your doctor, as you may have type 2 diabetes.
Common Diagnostic Tests for Type 2 Diabetes
Receiving a prompt diagnosis is crucial for controlling diabetes. The American Diabetes Association suggests that if you’re age 45 or older and overweight, you should be screened for type 2 diabetes every three years.
To screen you for type 2 diabetes, your doctor may administer one of the following tests:
Glycated hemoglobin (A1C) test A1C is a two- to the three-month measurement of your average blood sugar levels. While an A1C of 5.7 or below is normal, anything between 5.7 and 6.4 percent signals diabetes and a reading of 6.5 percent or higher on two different tests suggest you have diabetes.
7 Unusual Signs and Symptoms of Type 2 Diabetes
Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. If you have a fasting blood sugar level of fewer than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes.
A1C and fasting glucose are common tests used to diagnose diabetes, but if you’re pregnant or have a hemoglobin variant, your doctor may use another method, such as:
Oral glucose tolerance test
Random blood sugar test
If you’ve been diagnosed with type 2 diabetes, you may be prescribed the oral medication Glucophage (metformin), which can help lower your blood sugar levels.
But metformin is not the only diabetes medication at your disposal. Other treatments for type 2 diabetes include:
Sulfonylureas and meglitinides This type of drug works by stimulating the pancreas to produce more insulin
Alpha-glucosidase inhibitors These drugs can help slow digestion of certain carbs, to help prevent blood sugar spikes after you eat.
Thiazolidinediones (TZDs) This group of drugs helps increase insulin sensitivity, in turn stabilizing your blood sugar levels.
The Top Diabetes Treatment Options for Better Blood Sugar Control
DPP-4 inhibitors These drugs block an enzyme called dipeptidyl peptidase 4 from being produced, allowing the body to crank out more insulin.
GLP1 antagonists This class of drugs helps increase insulin secretion from the pancreas and slows glucose from being absorbed in the gut.
Apart from these medications, treating diabetes effectively means taking a well-rounded approach: You’ll need to eat well, exercise, and manage stress because all these factors can affect your blood sugar levels. Staying healthy with diabetes also requires caring for yourself — like protecting your feet, practicing oral hygiene, and tending to your mental health.
Do You Need Basal or Bolus Insulin to Manage Type 2 Diabetes?
If you’re unable to control your blood sugar with medication, diet, and lifestyle, you may need to add basal or bolus insulin to your treatment regimen.
Basal insulin can help control your blood sugar when you’re between meals or at night when you’re asleep. Bolus insulin, on the other hand, is considered a fast- or rapid-acting form of insulin. Its effects don’t last as long as those of basal insulin.
Bariatric surgery is another treatment option if you’re managing type 2 diabetes. Although it comes with some risks, research suggests it may help put type 2 diabetes in remission.
While there’s no such thing as a “diabetes diet,” food choices can play a key role in your blood sugar control.
When you have diabetes, it’s important to avoid eating many packaged, processed snacks such as cookies, chips, cake, granola bars, and the like, in lieu of fresh, whole foods, like fiber-rich fruits, veggies, and whole grains. Eating foods high in fiber can help keep blood sugar levels steady and fill you up, potentially promoting weight loss and improving insulin sensitivity.
Monitoring your caloric intake may be helpful if you’re overweight, but everyone with type 2 diabetes should track how many carbs they’re taking in. That can be tricky because carbs are in many of the common foods you may already eat, but there are both good and bad sources of carbs. Fruits and vegetables, for example, are good sources, while pretzels and cookies are bad sources.
When you eat is just as important as what you eat when managing diabetes. Sticking to regular mealtimes can help keep your blood sugar steady.
Also, know that being diagnosed with diabetes doesn’t mean you can’t eat the foods you love. A diabetes diet is essentially a healthy diet for everyone! You can work with a registered dietitian to come up with a personalized meal plan, and be sure to track your blood sugar if you introduce new foods to your diet.
Preventing High Blood Sugar (Hyperglycemia) and Low Blood Sugar (Hypoglycemia) When You Have Type 2 Diabetes
If you have type 2 diabetes, you’re at risk for high blood sugar and low blood sugar. Preventing these episodes requires knowing the signs, causes, and treatment options to get your blood sugar back in a healthy range.
Understanding High Blood Sugar in Type 2 Diabetes
Between meals, the concentration of blood sugar for people without diabetes ranges from about 70 to 100 mg/dl. After meals, it may reach 120 to 130 mg/dl but rarely goes higher than 140 mg/dl. (30)
Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. If you have a fasting blood sugar level of fewer than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes.
A1C and fasting glucose are common tests used to diagnose diabetes, but if you’re pregnant or have a hemoglobin variant, your doctor may use another method, such as:
Oral glucose tolerance test
If you’ve been diagnosed with type 2 diabetes, you may be prescribed the oral medication Glucophage (metformin), which can help lower your blood sugar levels.
But metformin is not the only diabetes medication at your disposal. Other treatments for type 2 diabetes include:
Sulfonylureas and meglitinides This type of drug works by stimulating the pancreas to produce more insulin
Alpha-glucosidase inhibitors These drugs can help slow digestion of certain carbs, to help prevent blood sugar spikes after you eat.
Thiazolidinediones (TZDs) This group of drugs helps increase insulin sensitivity, in turn stabilizing your blood sugar levels.
The Top Diabetes Treatment Options for Better Blood Sugar Control
DPP-4 inhibitors These drugs block an enzyme called dipeptidyl peptidase 4 from being produced, allowing the body to crank out more insulin.
GLP1 antagonists This class of drugs helps increase insulin secretion from the pancreas and slows glucose from being absorbed in the gut.
Apart from these medications, treating diabetes effectively means taking a well-rounded approach: You’ll need to eat well, exercise, and manage stress because all these factors can affect your blood sugar levels. Staying healthy with diabetes also requires caring for yourself — like protecting your feet, practicing oral hygiene, and tending to your mental health.
Do You Need Basal or Bolus Insulin to Manage Type 2 Diabetes?
If you’re unable to control your blood sugar with medication, diet, and lifestyle, you may need to add basal or bolus insulin to your treatment regimen.
Basal insulin can help control your blood sugar when you’re between meals or at night when you’re asleep. Bolus insulin, on the other hand, is considered a fast- or rapid-acting form of insulin. Its effects don’t last as long as those of basal insulin.
Bariatric surgery is another treatment option if you’re managing type 2 diabetes. Although it comes with some risks, research suggests it may help put type 2 diabetes in remission.
While there’s no such thing as a “diabetes diet,” food choices can play a key role in your blood sugar control.
When you have diabetes, it’s important to avoid eating many packaged, processed snacks such as cookies, chips, cake, granola bars, and the like, in lieu of fresh, whole foods, like fiber-rich fruits, veggies, and whole grains. Eating foods high in fiber can help keep blood sugar levels steady and fill you up, potentially promoting weight loss and improving insulin sensitivity.
Monitoring your caloric intake may be helpful if you’re overweight, but everyone with type 2 diabetes should track how many carbs they’re taking in. That can be tricky because carbs are in many of the common foods you may already eat, but there are both good and bad sources of carbs. Fruits and vegetables, for example, are good sources, while pretzels and cookies are bad sources.
When you eat is just as important as what you eat when managing diabetes. Sticking to regular mealtimes can help keep your blood sugar steady.
Also, know that being diagnosed with diabetes doesn’t mean you can’t eat the foods you love. A diabetes diet is essentially a healthy diet for everyone! You can work with a registered dietitian to come up with a personalized meal plan, and be sure to track your blood sugar if you introduce new foods to your diet.
Preventing High Blood Sugar (Hyperglycemia) and Low Blood Sugar (Hypoglycemia) When You Have Type 2 Diabetes
If you have type 2 diabetes, you’re at risk for high blood sugar and low blood sugar. Preventing these episodes requires knowing the signs, causes, and treatment options to get your blood sugar back in a healthy range.
Understanding High Blood Sugar in Type 2 Diabetes
Between meals, the concentration of blood sugar for people without diabetes ranges from about 70 to 100 mg/dl. After meals, it may reach 120 to 130 mg/dl but rarely goes higher than 140 mg/dl. (30)
Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. If you have a fasting blood sugar level of fewer than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes.
A1C and fasting glucose are common tests used to diagnose diabetes, but if you’re pregnant or have a hemoglobin variant, your doctor may use another method, such as:
Oral glucose tolerance test
Random blood sugar test
Monitoring your caloric intake may be helpful if you’re overweight, but everyone with type 2 diabetes should track how many carbs they’re taking in. That can be tricky because carbs are in many of the common foods you may already eat, but there are both good and bad sources of carbs. Fruits and vegetables, for example, are good sources, while pretzels and cookies are bad sources. (29)
Understanding Low Blood Sugar in Type 2 Diabetes
Although low blood sugar is more common in people with type 1 diabetes, people with type 2 diabetes can also develop this condition, especially if they are using insulin.
For people with diabetes, low blood sugar is typically a drop in blood sugar below 70 mg/dl, although the exact level may vary from person to person.
Low blood sugar can happen if:
Your body's supply of glucose is used up too quickly. Glucose is released into your bloodstream too slowly. There's too much insulin in your bloodstream.
Although no two people will have the exact same symptoms of low blood sugar, there are some common signs to watch out for:
Sudden, intense hungerDizziness or light-headednessExcessive sweating (often sudden and without regard to temperature)Shaking or tremorsSudden feelings of anxiety irritability, mood swings, and sudden emotional outbursts that aren't part of your normal behaviorConfusion or inability to concentrateWeakness or drowsinessBlurry visionSlurred speechSleep disturbances, including night sweats, nightmares, waking suddenly and crying out, or feelings of confusion upon waking hypoglycemia isn't treated right away, low blood sugar may result in life-threatening complications such as seizure or coma, or even death.
People with diabetes may become hypoglycemic when they:
Take their insulin or oral diabetes medication but then skip a meal, delay eating, or eat very little Develop it as a side effect of other diabetes medication
Exercise strenuously without adequate food intake
Drink too much alcohol
10 Warning Signs of Low Blood Sugar
If you have type 2 diabetes, you've probably had a conversation with your doctor about how to treat yourself for low blood sugar.
If you feel your blood sugar dropping, quickly consume 15 to 20 grams (g) of simple carbohydrates.
Recheck your blood glucose level after 15 minutes. If it's still low, eat another 15 to 20 g of simple carbohydrates.
Good sources of simple carbohydrates (e.g. they are digested and absorbed quickly) to treat hypoglycemia include:
Glucose tablets
Glucose Gel
Juice or regular soda (not diet)
Sugar, honey, or corn syrup
Raisins
Hard candies, jelly beans, or gumdrops
Family members, co-workers, and other people you're in close contact with should be taught how to administer a glucagon injection in case you have a severe hypoglycemic event and can't do it yourself.
Ketosis, Diabetic Ketoacidosis, and the Ketogenic Diet: Understanding the Basics if You Have Type 2 Diabetes
One of the most common ways people with type 2 diabetes attempt to lower their blood sugar is by drastically reducing their intake of carbs. The ADA agrees that carbohydrate counting is essential if you have diabetes, but extreme diets like the ketogenic diet, which reduces carb intake to as little as 5 percent of your daily calories, can be risky for some people with diabetes.
The ketogenic, or keto, diet calls for dramatically increasing your fat intake and consuming a moderate amount of protein and a very low amount of carbs, with the aim of kicking your body into a natural metabolic state called ketosis, in which it relies on burning fat rather than carbs for energy. Ketosis is different from diabetic ketoacidosis, a health emergency that occurs when insulin levels are low in conjunction with high levels of ketones. (37) Ketones are by-products of metabolism that are released into the blood when carb intake is low.
While research suggests the ketogenic diet may result in quick weight loss and potentially even help put diabetes in remission, it’s important to work with your doctor to make sure your nutritional needs are being met. Having this conversation is especially important if you’re on diabetes medication.
Some risks of the keto diet include low blood sugar, negative medication interactions, and nutrient deficiencies. (People who should avoid the keto diet include those with kidney damage or disease, women who are pregnant or breastfeeding, and those with or at a heightened risk for heart disease due to high blood pressure, high cholesterol, or family history.
What Are the Potential Health Complications of Type 2 Diabetes, and How Can You Age Well With the Disease?
If you have been diagnosed with type 2 diabetes, you may have anxiety or concerns about the prospect of future health complications, such as amputations, heart disease, and vision loss. But living with this disease doesn’t destine you for these unpleasant outcomes.
The National Institutes of Health points out that long-term complications of type 2 diabetes can be prevented and, in some cases, reversed or slowed by a combination of:
Blood sugar control
10 Warning Signs of Low Blood Sugar
If you have type 2 diabetes, you've probably had a conversation with your doctor about how to treat yourself for low blood sugar.
If you feel your blood sugar dropping, quickly consume 15 to 20 grams (g) of simple carbohydrates.
Recheck your blood glucose level after 15 minutes. If it's still low, eat another 15 to 20 g of simple carbohydrates.
Good sources of simple carbohydrates (e.g. they are digested and absorbed quickly) to treat hypoglycemia include:
Glucose tablets
Glucose Gel
Juice or regular soda (not diet)
Sugar, honey, or corn syrup
Raisins
Hard candies, jelly beans, or gumdrops
Family members, co-workers, and other people you're in close contact with should be taught how to administer a glucagon injection in case you have a severe hypoglycemic event and can't do it yourself.
Ketosis, Diabetic Ketoacidosis, and the Ketogenic Diet: Understanding the Basics if You Have Type 2 Diabetes
One of the most common ways people with type 2 diabetes attempt to lower their blood sugar is by drastically reducing their intake of carbs. The ADA agrees that carbohydrate counting is essential if you have diabetes, but extreme diets like the ketogenic diet, which reduces carb intake to as little as 5 percent of your daily calories, can be risky for some people with diabetes.
The ketogenic, or keto, diet calls for dramatically increasing your fat intake and consuming a moderate amount of protein and a very low amount of carbs, with the aim of kicking your body into a natural metabolic state called ketosis, in which it relies on burning fat rather than carbs for energy. Ketosis is different from diabetic ketoacidosis, a health emergency that occurs when insulin levels are low in conjunction with high levels of ketones. (37) Ketones are by-products of metabolism that are released into the blood when carb intake is low.
While research suggests the ketogenic diet may result in quick weight loss and potentially even help put diabetes in remission, it’s important to work with your doctor to make sure your nutritional needs are being met. Having this conversation is especially important if you’re on diabetes medication.
Some risks of the keto diet include low blood sugar, negative medication interactions, and nutrient deficiencies. (People who should avoid the keto diet include those with kidney damage or disease, women who are pregnant or breastfeeding, and those with or at a heightened risk for heart disease due to high blood pressure, high cholesterol, or family history.
What Are the Potential Health Complications of Type 2 Diabetes, and How Can You Age Well With the Disease?
If you have been diagnosed with type 2 diabetes, you may have anxiety or concerns about the prospect of future health complications, such as amputations, heart disease, and vision loss. But living with this disease doesn’t destine you for these unpleasant outcomes.
The National Institutes of Health points out that long-term complications of type 2 diabetes can be prevented and, in some cases, reversed or slowed by a combination of:
Blood sugar control
Blood pressure control
Blood cholesterol control
You should discuss your level of control (and how to maintain or improve it) with your doctor at every doctor’s appointment.
If you have been living with diabetes for several years or are older, knowing your A1C goal and levels is particularly important because you are at a greater risk of developing type 2 diabetes complications.
Possible Health Complications Linked With Poorly Controlled Type 2 Diabetes
If your blood sugar is frequently imbalanced, you may be at a greater risk for the following type 2 diabetes complications:
Cardiovascular disease Compared with people without diabetes, people with the diabetes are at a greater risk for heart disease, statistically get heart disease at a younger age, and have more severe forms of heart disease. People with diabetes are also about twice as likely as people without diabetes to die of heart disease.
Lowering your risk for cardiovascular disease — or treating it, if you have it — involves a combination of lifestyle changes and may or may not include medication.
Diabetic retinopathy In diabetic retinopathy, high blood sugar weakens the capillaries (the tiny blood vessels) that supply the retina, the light-sensitive layer of tissue at the back of the inner eye.
The capillaries then swell, become blocked, or leak blood into the center of the eye, blurring vision. In advanced stages, abnormal new blood vessels grow.
When these new vessels leak blood, the result can be severe vision loss or blindness.
Diabetic neuropathy Neuropathy, or nerve damage, can affect any nerve in your body. Most commonly, it affects the nerves in the feet, legs, hands, and arms; this condition is called peripheral neuropathy.
Peripheral neuropathy can cause tingling, burning, pain, or numbness in the affected areas.
The pain of peripheral neuropathy is difficult to control, though some find topical products that contain capsaicin to be helpful.
Prescription products that may help alleviate the pain caused by peripheral neuropathy include a variety of antidepressants and anticonvulsants.
Diabetic nephropathy (kidney disease) In diabetic nephropathy, the nephrons (or filtering units) in the kidneys become damaged from chronic high blood sugar.
High blood pressure compounds the problem, and high cholesterol appears to contribute to it as well.
In the early stages of diabetic nephropathy, you may not notice any symptoms, but standard blood and urine tests can detect early signs of dysfunction, and early treatment can stop or slow its progression.
As many as 40 percents of people with diabetes may develop kidney disease.
Diabetic ulcer People with diabetes have an increased risk of developing foot ulcers (open sores).
A diabetic ulcer is often painless, and people may not even know they have them at first.
More in Type 2 Diabetes
These foot ulcers can take several weeks to heal and are a primary reason for hospital stays among people with diabetes.
If you have diabetes, examining your feet and legs regularly is key for identifying diabetic ulcers and getting prompt treatment.
If you have diabetes, you may also deal with sexual issues, gum disease, sleep apnea, and red or brown lesions (diabetic dermopathy).
How to Age Well When You Are Living With Type 2 Diabetes
Unfortunately, aging itself is a risk factor for type 2 diabetes, so getting older with the disease can increase your risk of complications.
Following tips like these can help you stay healthy and keep your blood sugar control:
Lean on your medical team, which should consist of a podiatrist, an endocrinologist, a registered dietitian, and other specialty health professionals.
Stick to your medication regimen, and be open to potential medication adjustments.
Take insulin if your doctor says you need it.
Don’t smoke.
Eat diabetes-friendly foods and practice portion control.
Exercise regularly.
Regularly check your blood sugar.
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