Type 2 diabetes
Formerly called adult-onset or non-insulin-dependent diabetes, this is the most common form of diabetes. People can develop type 2 diabetes at any age — even during childhood. In type 2 diabetes, the body either doesn’t make enough insulin or the body can’t properly use the insulin it does make; this condition is called insulin resistance. Being overweight increases your chances of developing type 2 diabetes. Treatment includes using diabetes medications and sometimes insulin, making wise food choices, exercising regularly, and controlling blood pressure and cholesterol.
There is a genetic component to developing type 2 diabetes; however, environmental factors such as diet and exercise can influence whether genes express and diabetes develops. If you have several family members with the disease, you should be checked for the disease regularly by your healthcare provider. Age, inactivity, and having obesity are risk factors for type 2 diabetes.
Exercising, maintaining a healthy weight, and eating a healthy diet such as the Whole Foods Weight Loss Eating Plan can delay or prevent the onset of type 2 diabetes.
Watch out for these signs and symptoms:
Extreme thirst
Frequent urination
Extreme hunger or unusual tiredness
Unexplained weight loss
Frequent irritability
Blurry vision
Cuts or sores that heal slowly
Unexplained loss of feeling or tingling in your feet or hands
Frequent skin, gum, or bladder infections
Frequent yeast infections
According to the 2020 CDC report 34.2 million Americans of all ages have diabetes. That’s just a little more than 1 in 10 people or 10.5 percent of the U.S. population. Most of them have type 2 diabetes, the most common form of the disease. It’s estimated that nearly one third of these people aren’t even aware they have the disease. One reason is that for a long time, you may not have any warning signs or symptoms. Sometimes the diagnosis may be made only after a serious complication occurs.
If you have one sign or symptom, that doesn’t mean you have diabetes. But you should start to be concerned if you have several symptoms. A checkup with your healthcare provider now can start you on treatment to help prevent or reduce the heart, eye, kidney, nerve, and other serious complications diabetes can cause.
Gestational diabetes
Some women develop gestational diabetes in the late stages of pregnancy. This form of diabetes usually goes away after the baby is born. However, a woman who has had gestational diabetes has a greater chance of developing type 2 diabetes later in life.
Recognizing the silent syndrome
A key development in the treatment of diabetes has been an improved understanding by the medical community of one of its major underlying causes: insulin resistance, also called metabolic syndrome. This increased understanding of insulin resistance has resulted in more appropriate medical treatment options.
Insulin resistance occurs when the body fails to respond properly to the insulin it already produces. It is an underlying cluster of symptoms that often precedes the diagnosis of type 2 diabetes. Many people at risk for diabetes do not know what insulin resistance is or even realize that they have signs of diabetes development.
A family history of diabetes, being overweight or obese, and physical inactivity increase your chances of developing insulin resistance. Certain ethnic groups, such as Latinos, Blacks, and Native Americans, are twice as likely as Caucasians to develop insulin resistance and diabetes. Insulin resistance is associated with an increased risk of heart disease and stroke.
Unfortunately, there’s no simple test for insulin resistance. It’s usually marked by a cluster of characteristics. The presence of three or more characteristics can result in a diagnosis of insulin resistance or metabolic syndrome. The characteristics of insulin resistance syndrome are as follows:
Abdominal obesity (a waist measuring more than 35 inches in women or more than 40 inches in men)
Fasting glucose level of 110 mg/dl or greater
Triglycerides of 150 mg/dl or greater
HDL cholesterol less than 50 mg/dl in women or less than 40 mg/dl in men
Blood pressure of 130/85 or greater
Understanding lipids
Lipid is another name for fat, so blood lipids are fats in your blood. Your doctor can create a profile (a breakdown of the different types of fat in your blood) of your lipids to help determine the type of heart disease you’re at risk for (if any) and also to help determine the dietary approach to best lower your lipids.
When your healthcare provider checks your lipids, you’re likely to get a list of numbers in each of the following categories:
Total cholesterol: This is a measurement of your total blood fats. This includes the sum of the HDL, LDL, and VLDL cholesterol components.
High-density lipoprotein (HDL) cholesterol: This is commonly called “good” cholesterol because it carries excess cholesterol back to the liver, which processes and excretes the cholesterol. You want this number to be greater than 40 mg/dl.
Low-density lipoprotein (LDL) cholesterol: This is commonly called “bad” cholesterol because high levels are linked to increased risk for heart disease. Ideally, you want this number to be below 100 mg/dl.
Very-low-density lipoprotein (VLDL) cholesterol: This number is determined by dividing the triglyceride number by 5. VLDL cholesterol can be converted to LDL or “bad” cholesterol.
Triglycerides: Triglycerides are a blood fat that is not only affected by the fat in your diet but is also increased by excess calories in the diet and by excess carbohydrate in the diet. Triglycerides normally increase after eating a meal, and they usually fall back to normal in two to three hours. Chronically high triglycerides have recently been linked to heart disease. You want this number to be below 150 mg/dl.
Check out Table 4-2 for guidance on what blood lipid levels you should be shooting for.
TABLE 4-2 Blood Lipid Levels
| Type of Cholesterol | Desirable | Borderline | Unacceptable |
|---|---|---|---|
| Total cholesterol | Less than 200 | 200 to 239 | 240 or above |
| HDL cholesterol | 60 or above | 40 to 59 | Less than 40 |
| LDL cholesterol |