Type 2 Diabetes

What is type 2 diabetes? What are the symptoms? What are the main risk factors? How can we reduce the risk of getting it?

How serious is type 2 diabetes?

If you have type 2 diabetes you can develop other serious health problems. The risk of heart disease or having a stroke is up to five times greater if you have type 2 diabetes compared with people who don’t.

If you don’t treat diabetes properly, you may develop other complications including:

  • Nerve damage
  • Damage to your eyesight
  • Kidney disease
  • Sexual dysfunction

Around 1 in 10 people with diabetes will get a foot ulcer, which can cause a serious infection and even result in amputation. 

So, what is type 2 diabetes?

When you have type 2 diabetes your body doesn’t produce enough of a hormone called insulin or it produces the right amount of insulin, but your body can’t respond to it normally.

Insulin is produced by the pancreas. It allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy, or to store glucose for future use.

Type 2 diabetes not only affects the pancreas, but it also affects other organs such as the liver, skeletal muscle, fatty tissue, gastrointestinal tract, brain, peripheral nerves, eyes and kidneys.

What are the symptoms? 

Symptoms that suggest you might have type 2 diabetes include: 

  • feeling very thirsty and tired
  • sudden weight loss
  • urinating frequently, particularly at night
  • slow healing of cuts and wounds
  • blurred vision; and
  • itching around the genital area with frequent thrush. 

What are the main risk factors? 

If you are overweight, with a body mass index (BMI) of 25 to 30, or obese  with a BMI greater than 30, you are at increased risk of diabetes.

Other risk factors include:

  • Being over 40, or over 25 if you’re black or Asian
  • having a close family member (parent, brother or sister) who has type 2 diabetes
  • being south Asian or African-Caribbean; these ethnic groups are five times more likely to get type 2 diabetes
  • having had gestational diabetes - diabetes that lasts for the duration of a pregnancy)
  • having been told you have impaired fasting glycaemia or impaired glucose tolerance
  • eating an unhealthy diet (e.g. low intake of wholegrains, high intake of sugary drinks)
  • low levels of physical activity 

If you have any of these risk factors, you should maintain a healthy weight to ensure that your risk of diabetes doesn't increase further. 

Testosterone levels and diabetes risk

There’s a possibility that a low testosterone level could indicate you’re at increased risk. A systematic review published in 2018 suggests that men with high levels of testosterone could have a reduced risk of type 2 diabetes. 

There’s research to suggest that exercise and eating a low-calorie diet might increase testosterone levels in men who are overweight or obese, but the studies were small. Larger studies are needed to see if the research findings are the same in larger groups of men.

Statins and diabetes risk 

Statins, are widely used to help prevent cardiovascular disease. They had also been used to prevent and help treat potential complications of diabetes. However, in 2012, the United States Food and Drug Administration (FDA) amended its guidance on the use of statins. This followed research suggesting that statins might sometimes increase the risk of diabetes. Research published in 2017 supports this finding.

Diabetes risk and age 

Age is a risk factor for diabetes. Around 25% of over 65s have type 2 diabetes. As with younger and middle-aged people with diabetes there is an increased risk of illness and death. However, where people develop type 2 diabetes over the age of 65 it appears to be less severe and easier to control.  

Can you reverse diabetes? 

The good news is that type 2 diabetes can sometimes be reversed if you’re able to lose a lot of weight within four years of developing diabetes. That’s according to 2011 research from Newcastle University.  A small study published in 2017 suggests that it may be possible to reverse type 2 diabetes in four months with intensive lifestyle changes and anti-diabetic drugs.

How to reduce the risks of developing type 2 diabetes: 

There are some risks we unfortunately can’t avoid, like age and some ethnic origins. However, the good news is that a healthy lifestyle can reduce the risk whatever our age or background. 

  • Avoiding becoming overweight or obese, as this is one of the biggest risk factors.
  • Eating cereals and vegetables rich in fibre appears to reduce the risk – according to an 8-country research project over nearly 11 years, published in 2015.
  • Reducing the amount of sugar in your diet, particularly sugary drinks – as this has been found to be a risk factor in both the US and Europe.
  • Drinking coffee may help to lower your risk – that’s according to a systematic review of research findings that was published in 2018.
  • 30 minutes of physical activity a day can also help reduce the risk (as can a healthy diet) - according to a systematic review of research findings published in 2014 
  • Eating more yoghurt and other low fat fermented dairy  products can reduce the risk of type 2 diabetes by 24 – 28%. That’s according to researchers at Cambridge University, who followed 25,000 participants over 11 years.   

“At a time when we have a lot of other evidence that consuming high amounts of certain foods, such as added sugars and sugary drinks, is bad for our health, it is very reassuring to have messages about other foods like yoghurt and low-fat fermented dairy products, that could be good for our health,” said lead researcher Dr Forouhi. 

Conclusions 

  • The main risk factors for type 2 diabetes are being overweight or obese, getting older, having a family history of diabetes, being black or Asian, having some specific medical conditions (like diabetes throughout pregnancy), eating an unhealthy diet and lack of physical activity.
  • Losing a lot of weight after diagnosis may help reverse type 2 diabetes.
  • Fortunately, you can reduce the risk of getting type 2 diabetes if you:
  • maintain a healthy weight;
  • eat fibre-rich cereals and vegetables;
  • minimize your consumption of sugary food and drink
  • eat yoghurt and low fat fermented dairy products; and
  • aim for 30 minutes of physical activity a day.

Reviewed and updated by Dianne Cottle April 2018. Date of next review: April 2022

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