More than 37 million people in the United States have diabetes, and 90-95 percent of them have type 2 diabetes, according to the Centers for Disease Control and Prevention. Type 2 diabetes occurs when your cells don’t respond normally to insulin, a hormone created by your pancreas that regulates blood sugar in your body for energy.
While the incidence of type 2 diabetes is rising, you can prevent or delay the disease with active lifestyle changes.
David Lam, MD, Associate Professor of Endocrinology, Diabetes and Bone disease at the Icahn School of Medicine at Mount Sinai, explains what is behind the rising number of people with type 2 diabetes and how we can actively treat and prevent this disease.
Why is type 2 diabetes so prevalent?
Type 2 diabetes has been increasing in prevalence all over the world over the last few decades, and the biggest driver is likely the rising incidence of obesity. Though it is still being studied, the prevailing thought is that obesity leads to a state of inflammation in the body caused by fat cells releasing inflammatory chemicals. When that happens, insulin, a hormone your body produces to regulate blood sugar levels, doesn’t work as well, and your body becomes more resistant to insulin. This is ultimately the pathway that leads to type 2 diabetes.
What is the impact of type 2 diabetes on a person’s life?
Type 2 diabetes can affect you in many ways—the actual disease, the monitoring recommendations that clinicians provide, and even the treatments we prescribe—can all affect your life.
From a disease perspective, symptoms of high or low blood sugar can affect how you feel. Complications that arise from long-term or not-well-controlled diabetes can include neuropathy—a type of nerve damage that can cause numbness or weakness—and kidney or eye disease. Some of the medications we prescribe can have side effects and need to be taken multiple times a day.
What are a few steps the average type 2 diabetes patient can do to remain healthy?
The first step is to receive regular care and follow-ups with your health care team—not just with your clinician, but with a nurse educator, a nutritionist, an ophthalmologist, or any other specialists that’s involved in your health care. This ensures you are on the right track to take steps to improve your overall health. It is also important to take medications as prescribed, and talk with your health care team if there are any issues. The second step is to get regular physical activity. And the final step is to be mindful of carbohydrate intake, such as limiting things like soda, refined grains such as white bread, and many snack foods.
Who is most at risk for developing type 2 diabetes?
You are most at risk for developing type 2 diabetes if you are a person with obesity; have a history of prediabetes, or a history of gestational diabetes; if you have a sedentary lifestyle and/or a family history of diabetes.
How can I support my family members with type 2 diabetes?
Be present and open to hearing what they need and understand what they are going through. Listen to what they say, avoid giving them unsolicited advice, and be sensitive to their needs. For example, if they say, “It’s really hard when I go to parties or family events, and all there is to eat is carbs,” be sensitive to that. Talk to friends and family members about why it’s important to have healthy foods at parties and gatherings. The diet we recommend for patients living with diabetes is a diet everyone can benefit from.
If societal factors are to blame, what can Mount Sinai and other health care organizations do to help reduce the prevalence of the disease?
The first is ensuring individuals have access to health care. It really takes a village to treat someone living with diabetes. You might need dieticians, primary care physicians, endocrinologists, ophthalmologists, pharmacists; it takes a big multidisciplinary team.
We have to make sure patients have access to these specialists, especially those who are at the most at risk. The medications we frequently prescribe can be very expensive. There are programs that can help reduce the cost of the medications, and patients might need the help from us in navigating these programs. Lastly, larger organizations can really help support prevention programs. There are established, research-proven diabetes prevention programs that really focus on weight loss, and they have been shown to help reduce the progression from prediabetes to diabetes. Larger organizations can help support these programs to make an impact on those who are at risk.