Type 2 diabetes is a health battle that starts when your body struggles to process sugar, or glucose, as fuel. This results in too much sugar floating around in your bloodstream, which can cause a whole host of problems with your immune, nervous, and circulatory systems over time.
The root of the problem lies in two main areas: your pancreas not producing enough insulin, a hormone that regulates sugar absorption, and your cells not responding well to insulin and absorbing less sugar than they should.
Once thought of as a condition that only struck adults, both kids and grown-ups can now be affected by type 2 diabetes. It's more common in older adults, but the rise in childhood obesity has led to more young people developing type 2 diabetes too.

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Blood sugar, or blood glucose, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.
If you have diabetes, your blood glucose target is the range you try to reach as much as possible.

The typical targets are:
Before a meal: 80 to 130 mg/dL

• Two hours after the start of a meal: Less than 180 mg/dL

Your blood glucose targets may be different, depending on your age, any additional health problems you have, and other factors. Talk with your health care team about the best target range for you.
The most common way to check your blood glucose level at home is with a blood glucose meter. A blood glucose meter measures the amount of glucose in a small sample of blood, usually from your fingertip. Continuous glucose monitoring (CGM) is another way to check your glucose levels. Most CGM systems use a tiny sensor that is inserted under your skin. The sensor measures your glucose level every few minutes. It can show changes in your glucose level throughout the day and night. A CGM system is especially useful for people who take insulin and have problems with low blood glucose.
Your provider will also check your blood glucose with a blood test called an A1C. It checks your average blood glucose level over the past three months. People with diabetes usually have an A1C test at least twice a year. But you may need the test more often if you aren't meeting your diabetes treatment goals.

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Symptoms

Type 2 diabetes symptoms may develop slowly and without being noticed. But when they do occur, they can include:

• Increased thirst
• Frequent urination
• Increased hunger
• Unintended weight loss
• Fatigue
• Blurred vision
• Slow-healing sores
• Frequent infections
• Numbness or tingling in the hands or feet
• Darkened skin in certain areas, such as the armpits and neck.

When to see a doctor
Don't ignore the warning signs of type 2 diabetes. Schedule a check-up with your healthcare provider.

Causes

Type 2 diabetes is mainly the result of two problems:

• Cells in muscle, fat and the liver become resistant to insulin As a result, the cells don't take in enough sugar.
• The pancreas can't make enough insulin to keep blood sugar levels within a healthy range.

Exactly why this happens is not known. Being overweight and inactive are key contributing factors.
Type 2 diabetes is like a two-headed monster, with two major culprits behind it:

• The first troublemaker is the insulin resistance that sneaks up on your muscle, fat, and liver cells. These cells develop a stubborn streak and refuse to let sugar in, causing a buildup of sugar in your blood.
• The second culprit is a pancreas that can't keep up with the sugar rush. It can't make enough insulin to keep your blood sugar levels from skyrocketing.

The mystery is why this all happens. But, our health sleuths have found some clues. Lifestyle choices like being a couch potato and carrying extra weight are the prime suspects.

Risk Factors

Factors that may increase the risk of type 2 diabetes include:

• Weight. ​Being overweight or obese is a main risk.
• Fat distribution. Storing those extra pounds on your tummy instead of your thighs and buttocks can spell trouble. 
• Inactivity. Get those muscles pumping! The more active you are, the better your chances at keeping the risk of health issues at bay. Exercise not only helps maintain a healthy weight but also uses glucose as fuel and amps up your cells' sensitivity to insulin.
• Family history. An individual's risk of type 2 diabetes increases if a parent or sibling has type 2 diabetes.
• Race and ethnicity. The reason is not entirely clear, however, individuals belonging to specific races and ethnicities, such as Black, Hispanic, Native American, Asian, and Pacific Islander populations, have a higher propensity to develop type 2 diabetes in comparison to white people.
• Blood lipid levels. Your risk of danger skyrockets when that "good" cholesterol (HDL) takes a nosedive, and triglycerides soar.
• Age. The risk of type 2 diabetes increases with age, especially after age 35.
• Prediabetes. Prediabetes is like a sneak attack from the sugar monster, where your blood sugar is higher than normal but not yet in the diabetes danger zone. But if you don't give it the attention it needs, it could very well upgrade to type 2 diabetes.
• Pregnancy-related risks. Individuals who experienced gestational diabetes during pregnancy or gave birth to a baby weighing over nine pounds (four kilograms) are at a higher risk of developing type 2 diabetes.
• Polycystic ovary syndrome. Polycystic Ovary Syndrome (PCOS), which is marked by irregular menstrual cycles, excessive hair growth, and obesity, raises the risk of developing diabetes.

Complications

Type 2 diabetes affects many major organs, including the heart, blood vessels, nerves, eyes and kidneys. Also, factors that increase the risk of diabetes are risk factors for other serious diseases. Managing diabetes and controlling blood sugar can lower the risk for these complications and other medical conditions, including:

• Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels, a condition called atherosclerosis.
• Nerve damage in limbs. This condition is called neuropathy. High blood sugar over time can damage or destroy nerves. That may result in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
• Other nerve damage. Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. Nerve damage also may cause erectile dysfunction.
• Kidney disease. Diabetes may lead to chronic kidney disease or end-stage kidney disease that can't be reversed. That may require dialysis or a kidney transplant.
• Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
• Skin conditions. Diabetes may raise the risk of some skin problems, including bacterial and fungal infections.
• Slow healing. The Importance of Treating Cuts and Blisters
  If left untreated, cuts and blisters can lead to severe infections, which can result in poor healing. In extreme cases, amputation of the toe, foot, or leg may be necessary.
• Hearing impairment. Hearing problems are more common in people with diabetes.
• Sleep apnea. Obstructive sleep apnea is prevalent among individuals with type 2 diabetes, and obesity seems to be the primary factor contributing to both conditions.
• Dementia. The Connection Between Type 2 Diabetes and Dementia
  Type 2 diabetes is strongly associated with Alzheimer's disease and other forms of dementia. If blood sugar levels are not properly regulated, it can lead to a more rapid deterioration of cognitive function, including memory and other thinking abilities.

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How insulin works
Meet insulin, the body's very own sugar sheriff, produced in the pancreas (a gland behind your stomach). Insulin makes sure sugar gets used correctly by doing the following:

• When sugar senses trouble in the bloodstream, the pancreas springs into action and releases insulin.
• Insulin cruises through your body, escorting sugar into cells.
• Sugar levels in the bloodstream now drop.
• This dip signals the pancreas to release less insulin. 

So, thanks to insulin, our bodies can keep sugar in check!
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The role of glucose
Picture glucose as a VIP guest, bringing the energy that fires up our muscles and tissues. This special visitor has two ways of arriving at the party: from food or made by the liver. Once glucose arrives, insulin escorts it into the cells where it can work its magic.
The liver is like a glucose warehouse, keeping some for later or making some when needed. When glucose levels dip, the liver springs into action, breaking down stored glycogen into glucose to keep things balanced.
But, in type 2 diabetes, the guest list gets out of hand. Glucose can't get into the cells, and starts causing traffic jams in the bloodstream. The poor pancreas is left in charge of crowd control, releasing more and more insulin. Over time, the pancreas' insulin-making team gets tired and throws in the towel. Suddenly, the party is over and all that's left is a mess to clean up.
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​Healthy lifestyle choices can help prevent type 2 diabetes. If you've received a diagnosis of prediabetes, lifestyle changes may slow or stop the progression to diabetes.
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A healthy lifestyle includes:
Let's get serious about diabetes prevention with these four power moves:

• Chow down on healthy eats that are low in fat and calories, but bursting with fiber. Think fruits, veggies, and whole grains.
• Get that blood pumping with moderate to vigorous aerobic activity for 150 minutes or more per week. Ready, set, go: brisk walking, cycling, running, or swimming.
• Shedding those extra pounds could be a game-changer. Even a modest loss can help delay prediabetes from becoming full-blown diabetes. And if you already have prediabetes, dropping 7% to 10% of your weight can slash your risk of the D-word.
• Sitting down is the new smoking! Long periods of inactivity can spike your type 2 diabetes odds. So, set a timer and break up those stretches of sitting every 30 minutes with a few minutes of movement. It's time to get up and groove!

Metformin (Fortamet, Glumetza, others), a diabetes medication, may be given to individuals with prediabetes to minimize the risk of developing type 2 diabetes. Typically, it is recommended for older adults who struggle with obesity and are unable to achieve healthy blood sugar levels through lifestyle changes.

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