Type Two Diabetes Mellitus (T2DM)

by | Aug 13, 2024 | Metabolic Health

Graphic showing a person checking blood sugar with a glucometer, surrounded by icons for healthy food, exercise, weight loss, and medical care—representing T2DM prevention and management.

Understanding Type 2 Diabetes: Risk, Symptoms, and Prevention

Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic conditions in the United States and is rising rapidly worldwide. According to the CDC, 2021 data show that 38.4 million people (11.6% of the population) have diabetes, and 8.7 million adults are unaware they even have it.

Prediabetes is even more common: 98 million American adults—more than 1 in 3 people—have prediabetes, and over 80% do not know it. Prediabetes significantly increases the risk of developing T2DM, heart disease, and stroke.

The Cost and Impact of T2DM

Diabetes carries a major health and financial burden:

  • $413 billion is spent annually on direct and indirect costs of diabetes.

  • It is the 8th leading cause of death in the U.S.

  • It is the leading cause of blindness in adults ages 18–64.

  • It dramatically increases risk for:

    • Cardiovascular disease (heart attack, stroke)

    • Chronic kidney disease (CKD), including end-stage renal disease (ESRD) requiring dialysis

    • Blindness and neuropathy

T2DM, Metabolic Syndrome, and Insulin Resistance

The rise of T2DM parallels the increase in obesity and abnormal cholesterol levels. Together, these form metabolic syndrome (also called insulin resistance or syndrome X).

Diagnostic Criteria for Metabolic Syndrome

A person is diagnosed with metabolic syndrome if three or more of the following are present:

  • Waist circumference > 35 inches (women) or > 40 inches (men)

  • Fasting blood sugar > 100 mg/dL

  • Triglycerides > 150 mg/dL

  • HDL cholesterol < 50 mg/dL (women) or < 40 mg/dL (men)

  • Blood pressure > 130/85 mmHg

Metabolic syndrome, like T2DM, is strongly linked to Western lifestyle factors such as poor diet, physical inactivity, and excess body weight.

Causes of Type 2 Diabetes

T2DM develops when cells become insulin resistant, meaning they no longer respond properly to insulin. This causes glucose to build up in the blood, eventually leading to diabetes.

Modifiable Risk Factors

  • Overweight or obesity

  • Poor diet and high sugar intake

  • Sedentary lifestyle

  • Abnormal cholesterol or triglycerides

  • Prediabetes

  • History of gestational diabetes

  • Family habits (poor dietary patterns)

Most risk factors are modifiable, meaning you can make changes to prevent or even reverse the condition.

Common Symptoms of T2DM

Some people have no symptoms, but common signs include:

  • Frequent urination

  • Increased thirst and hunger

  • Fatigue

  • Poor wound healing

  • Numbness or tingling in hands or feet

Diagnosis of Diabetes

Diabetes is diagnosed when:

  • Fasting blood glucose ≥ 126 mg/dL on two occasions

  • A1c ≥ 6.5%

Prediabetes is diagnosed when:

  • Fasting glucose is 100–125 mg/dL

  • A1c is 5.7–6.4%

I also measure fasting insulin levels to better evaluate diabetes risk. Research shows a fasting insulin > 7 is linked to higher risk of T2DM and metabolic syndrome.

Treatment and Management

Several medication classes may be used to manage T2DM, including:

  • Metformin (biguanide)

  • Januvia (DPP-4 inhibitors)

  • Ozempic (GLP-1 receptor agonists)

  • Jardiance (SGLT2 inhibitors)

  • Amaryl (sulfonylureas)

  • Avandia/Actos (TZDs)

  • Insulin therapy

However, lifestyle changes remain the foundation for prevention and management.

Lifestyle Changes to Prevent and Reverse T2DM

Nutrition

  • Choose whole, unprocessed foods

  • Increase non-starchy vegetables, in-season fruits, quality proteins, and healthy fats

  • Reduce processed sugars and refined carbohydrates

Time-Restricted Eating

  • Eat within a defined window (e.g., 8 hours per day) to promote autophagy and improve insulin sensitivity

  • Work with a clinician if you are on insulin or other glucose-lowering medications

Exercise

  • Aim for consistent physical activity — it can lower T2DM risk by up to 50%

  • Include both resistance training and cardio

Supplements and Support

  • Consider B vitamins, magnesium, zinc, chromium, berberine, and soluble fiber to support glucose control

Lifestyle Habits

  • Manage stress

  • Get 7–8 hours of quality sleep

  • Address hormone imbalances

  • Support gut health

Final Thoughts

Type 2 diabetes is not a life sentence. With the right lifestyle changes, monitoring, and support, you can lower your blood sugar, improve insulin sensitivity, and prevent complications.

Call or text 813-669-3084 to schedule a consultation with Stasha-Gae Roberts, Nurse Practitioner and get a personalized, integrative plan for diabetes prevention and management.

Nursing your journey to lasting wellness.

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