Type 2 Diabetes Mellitus

What is Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a long-term (chronic) disease. It may be caused by one or both of these problems:

  • Your pancreas does not make enough of a hormone called insulin.
  • Your body does not react in a normal way to insulin that it makes.

Insulin lets sugars (glucose) go into cells in your body. This gives you energy. If you have type 2 diabetes, sugars cannot get into cells. This causes high blood sugar (hyperglycemia).

Type 2 Diabetes Mellitus, Diagnosis

Your doctor will set treatment goals for you. Generally, you should have these blood sugar levels:

  • Before meals (preprandial): 80–130 mg/dL (4.4–7.2 mmol/L).
  • After meals (postprandial): below 180 mg/dL (10 mmol/L).
  • A1c (hemoglobin A1c) level: less than 7%.

Follow these instructions at home:

Questions to ask your doctor

  • You may want to ask these questions:
    • Do I need to meet with a diabetes educator?
    • Where can I find a support group for people with diabetes?
    • What equipment will I need to care for myself at home?
    • What diabetes medicines do I need? When should I take them?
    • How often do I need to check my blood sugar?
    • What number can I call if I have questions?
    • When is my next doctor’s visit?

General instructions

  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

  • Your blood sugar is at or above 240 mg/dL (13.3 mmol/L) for 2 days in a row.
  • You have been sick for 2 days or more, and you are not getting better.
  • You have had a fever for 2 days or more, and you are not getting better.
  • You have any of these problems for more than 6 hours:
    • You cannot eat or drink.
    • You feel sick to your stomach (nauseous).
    • You throw up (vomit).
    • You have watery poop (diarrhea).

Get help right away if:

  • Your blood sugar is lower than 54 mg/dL (3 mmol/L).
  • You get confused.
  • You have trouble:
    • Thinking clearly.
    • Breathing.
  • You have moderate or large ketone levels in your pee (urine).

Summary

  • Type 2 diabetes is a long-term (chronic) disease. Your pancreas may not make enough of a hormone called insulin, or your body may not react normally to insulin that it makes.
  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Keep all follow-up visits as told by your doctor. This is important.

Type 2 Diabetes Mellitus, Self Care

When you have type 2 diabetes (type 2 diabetes mellitus), you must make sure your blood sugar (glucose) stays in a healthy range. You can do this with:

  • Nutrition.
  • Exercise.
  • Lifestyle changes.
  • Medicines or insulin, if needed.
  • Support from your doctors and others.

How to stay aware of blood sugar

  • Check your blood sugar level every day, as often as told.
  • Have your A1c (hemoglobin A1c) level checked two or more times a year. Have it checked more often if your doctor tells you to.

Your doctor will set personal treatment goals for you. Generally, you should have these blood sugar levels:

  • Before meals (preprandial): 80–130 mg/dL (4.4–7.2 mmol/L).
  • After meals (postprandial): below 180 mg/dL (10 mmol/L).
  • A1c level: less than 7%.

How to manage high and low blood sugar

Signs of high blood sugar

High blood sugar is called hyperglycemia. Know the signs of high blood sugar. Signs may include:

  • Feeling:
    • Thirsty.
    • Hungry.
    • Very tired.
  • Needing to pee (urinate) more than usual.
  • Blurry vision.

Signs of low blood sugar

Low blood sugar is called hypoglycemia. This is when blood sugar is at or below 70 mg/dL (3.9 mmol/L). Signs may include:

  • Feeling:
    • Hungry.
    • Worried or nervous (anxious).
    • Sweaty and clammy.
    • Confused.
    • Dizzy.
    • Sleepy.
    • Sick to your stomach (nauseous).
  • Having:
    • A fast heartbeat.
    • A headache.
    • A change in your vision.
    • Jerky movements that you cannot control (seizure).
    • Tingling or no feeling (numbness) around your mouth, lips, or tongue.
  • Having trouble with:
    • Moving (coordination).
    • Sleeping.
    • Passing out (fainting).
    • Getting upset easily (irritability).

Treating low blood sugar

To treat low blood sugar, eat or drink something sugary right away. If you can think clearly and swallow safely, follow the 15:15 rule:

  • Take 15 grams of a fast-acting carb (carbohydrate). Some fast-acting carbs are:
    • 1 tube of glucose gel.
    • 3 sugar tablets (glucose pills).
    • 6–8 pieces of hard candy.
    • 4 oz (120 mL) of fruit juice.
    • 4 oz (120 mL) regular (not diet) soda.
  • Check your blood sugar 15 minutes after you take the carb.
  • If your blood sugar is still at or below 70 mg/dL (3.9 mmol/L), take 15 grams of a carb again.
  • If your blood sugar does not go above 70 mg/dL (3.9 mmol/L) after 3 tries, get help right away.
  • After your blood sugar goes back to normal, eat a meal or a snack within 1 hour.

Treating very low blood sugar

If your blood sugar is at or below 54 mg/dL (3 mmol/L), you have very low blood sugar (severe hypoglycemia). This is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

If you have very low blood sugar and you cannot eat or drink, you may need a glucagon shot (injection). A family member or friend should learn how to check your blood sugar and how to give you a glucagon shot. Ask your doctor if you need to have a glucagon shot kit at home.

Follow these instructions at home:

Medicine

  • Take insulin and diabetes medicines as told.
  • If your doctor says you should take more or less insulin and medicines, do this exactly as told.
  • Do not run out of insulin or medicines.

Having diabetes can raise your risk for other long-term conditions. These include heart disease and kidney disease. Your doctor may prescribe medicines to help you not have these problems.

Food

  • Make healthy food choices. These include:
    • Chicken, fish, egg whites, and beans.
    • Oats, whole wheat, bulgur, brown rice, quinoa, and millet.
    • Fresh fruits and vegetables.
    • Low-fat dairy products.
    • Nuts, avocado, olive oil, and canola oil.
  • Meet with a food specialist (dietitian). He or she can help you make an eating plan that is right for you.
  • Follow instructions from your doctor about what you cannot eat or drink.
  • Drink enough fluid to keep your pee (urine) pale yellow.
  • Keep track of carbs that you eat. Do this by reading food labels and learning food serving sizes.
  • Follow your sick day plan when you cannot eat or drink normally. Make this plan with your doctor so it is ready to use.

Activity

  • Exercise 3 or more times a week.
  • Do not go more than 2 days without exercising.
  • Talk with your doctor before you start a new exercise. Your doctor may need to tell you to change:
    • How much insulin or medicines you take.
    • How much food you eat.

Lifestyle

  • Do not use any tobacco products. These include cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your doctor.
  • Ask your doctor how much alcohol is safe for you.
  • Learn to deal with stress. If you need help with this, ask your doctor.

Body care

  • Stay up to date with your shots (immunizations).
  • Have your eyes and feet checked by a doctor as often as told.
  • Check your skin and feet every day. Check for cuts, bruises, redness, blisters, or sores.
  • Brush your teeth and gums two times a day. Floss one or more times a day.
  • Go to the dentist one or more times every 6 months.
  • Stay at a healthy weight.

General instructions

  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Share your diabetes care plan with:
    • Your work or school.
    • People you live with.
  • Carry a card or wear jewelry that says you have diabetes.
  • Keep all follow-up visits as told by your doctor. This is important.

Questions to ask your doctor

  • Do I need to meet with a diabetes educator?
  • Where can I find a support group for people with diabetes?

Where to find more information

To learn more about diabetes, visit:

Summary

  • When you have type 2 diabetes, you must make sure your blood sugar (glucose) stays in a healthy range.
  • Check your blood sugar every day, as often as told.
  • Having diabetes can raise your risk for other conditions. Your doctor may prescribe medicines to help you not have these problems.
  • Keep all follow-up visits as told by your doctor. This is important.
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