HEALTH TALK: What Type 2 diabetes does to your health

Dr. Victor Emanuel MD


Type 2 diabetes strikes people of all ages, and early symptoms can be subtle. In fact, about one out of three people with Type 2 diabetes don’t know they have it. This chronic condition thwarts the body’s ability to use the carbohydrates in food for energy. The result is elevated blood sugar. Over time, this excess sugar raises the risk for heart disease, loss of vision, nerve and organ damage, and other serious conditions.


People with Type 2 diabetes frequently have no symptoms. When those symptoms do appear, one of the first may be an increase in thirst. This is often accompanied by additional problems, including dry mouth, increased appetite, frequent urination, sometimes as often as every hour – and unusual weight loss or gain.


As blood sugar level become more abnormal, additional symptoms may include headaches, blurred vision, and fatigue.


In most cases, Type 2 diabetes is not discovered until it takes a noticeable toll on health. One red flag is troubling infections, such as:

•    Cuts or sores that are slow to heal
•    Frequent yeast infections or urinary tract infections
•    Itchy skin, especially in the groin area


Sexual dysfunction is common among people with diabetes. Diabetes can cause damage to blood vessels and nerve endings in the genitals, leading to a loss of feeling and making orgasm difficult. Other complications can include vaginal dryness and impotence in men. It is estimated that between 35% and 70% of men with diabetes will have at least some degree of impotence in their lifetime. And about one in three women with diabetes will experience some form of sexual dysfunction.


Some health habits and medical conditions related to your lifestyle can increase the odds of developing type 2 diabetes, including:

•    Being overweight, especially at the waist
•    A sedentary lifestyle
•    Smoking
•    A diet high in red meat, processed meat, high-fat dairy products, and sweets
•    Abnormal cholesterol and blood fats, such as HDL “good” cholesterol lower than 35 mg/dl or a triglyceride level over 250 mg/dl.


Some risk factors are out of your control, including:

•    Race or ethnicity: Hispanics, African Americans, Native Americans, and Asians have a higher than average risk.
•    Family history of diabetes: Having a parent or sibling with diabetes boosts your risk.
•    Age: being 45 and older increases your risk of type 2 diabetes,
•    The more risk factors you have, the greater your odds or developing type 2 diabetes.


Having gestational diabetes when you’re pregnant puts you at higher risk for developing type 2 diabetes later on. Women who give birth to a baby weighing over nine pounds are also at risk. Having a history of polycystic ovarian syndrome (PCOS) can also cause insulin resistance that can lead to diabetes.


In a healthy person, insulin helps turno food into energy – in an efficient manner. The stomach breaks down carbohydrates from food into sugars, including glucose. Glucose then enters the bloodstream which stimulates the pancreas to release insulin in just the right amount. Insulin, a hormone, allows glucose to enter cells throughout the body, where it is used as fuel. Excess glucose is stored in the liver.


In type 2 diabetes, the cells cannot absorb glucose properly. That means glucose levels in the blood become elevated. It you’ve developed a condition called insulin resistance, the body makes excess insulin, but the muscle, liver, and fat cells to not use or respond properly to the insulin. With long-standing uncontrolled type 2 diabetes, the pancreas will reduce the amount of insulin it produces.


A simple blood test can diagnose diabetes. The A1C (HbA1c) test gives a snapshot of your average blood glucose level over the past 2 – 3 months (technically 4 months). An A1c level of 6.5% or higher may indicate diabetes. With a fasting plasma glucose test, a result above a certain range is considered diabetes. Your doctor may order an oral glucose challenge test with a two-hour blood test. In people with classic symptoms of diabetes, a random blood glucose of greater than 200 can help diagnose diabetes.


Fortunately, controlling blood sugar levels by changing diet can also cut your risk of complications. People with type 2 diabetes should carefully monitor carbohydrate consumption, as well as total fat and protein intake, and reduce calories. Ask your doctor for a referral to a registered dietitian/nutritionist to help you with healthy choices and an eating plan that will work for you.


Routine exercise, such as strength training or walking, improves the body’s use of insulin and can lower blood sugar levels in people with type 2 diabetes. Being active also helps reduce body fat, lower blood pressure, and protect against heart disease. People with type 2 diabetes should try to get 30 minutes of moderate exercise on most days of the week.


Stress can cause blood pressure to rise. It can also increase glucose levels in your blood as part of your “fight or flight” response. Or you may turn to food to cope with stress. All are bad when living with diabetes. Instead of letting stress take its toll, try practicing relaxation techniques such as deep breathing, meditation, or visualization. Sometimes talking to a friend, family member, counselor, or member of the clergy can help. If you’re still battling stress, reach out to doc.


When people with type 2 diabetes are unable to control blood sugar sufficiently with diet and exercise, medication may be added. There are many types of diabetes pills available, and they are often used in combination. Some may work by stimulating the pancreas to make more insulin, and others improve the effectiveness of insulin, or block the digestion of starches.


Your doc may prescribe insulin early on in your treatment and in combination with pills. Insulin is also used in people with type2 diabetes who develop “beta-cell failure.” This means the cells in the pancreas no longer produce insulin in response to high blood sugar levels. In this case, insulin therapy – injections or an insulin pump – must become part of the daily routine.


New drugs are available for people with type 2 diabetes. Pramlintide (Symlin), exenatide (Byetta), and liraglutide (Victoza) are non-insulin injectable drugs. Whereas insulin pulls glucose into the cells, these medications cause the body to release insulin to control blood sugar levels.


Testing your blood glucose level will let you know how controlled your blood sugars are and if you need to take actions to change your treatment plan. How often and when you test will be based on how controlled your diabetes is, the type of therapy used to control your diabetes, and whether you re experiencing symptoms of fluctuating sugars. Talk with your doc to find out how often you should use a glucometer to check your blood sugar. Some common testing times may be when waking up, before and after meals and exercise, and at bedtime. Continuous glucose monitor (CGM) may be useful to those with type 1 diabetes to help lower their blood glucose.


Over time, untreated type2 diabetes can damage many of the body’s systems. About two out of three people with diabetes die of heart disease. Having diabetes also puts you at two to four times higher risk for stroke. People with diabetes are likely to develop plaque in their arteries, reducing blood flow and increasing risk of clots.  This hardening of the arteries (atherosclerosis) raises the risk of heart attack and stroke.


The longer you have diabetes, the greater the risk of developing chronic kidney disease. Diabetes is the leading cause of kidney failure, accounting for the majority of cases on renal dialysis. Controlling risk factors such as uncontrolled diabetes, high blood pressure, and high cholesterol reduces your risk of developing this complication. Annual screening for kidney disease and medications, which slow the development and progression of kidney disease, are used to reduce your risk of kidney failure.


High blood sugar can damage the tiny blood vessels that bring oxygen and nutrients to the retina, the part of the eye where an image is formed. This is known as diabetic retinopathy, and it can cause progressive, irreversible vision loss. It’s the leading cause of new cases of blindness in people between the ages of 20 and 74. Pools of blood, or hemorrhages, on the retina are visible to the doc examining the eye.


Over time, uncontrolled diabetes and elevated blood sugars create a very real risk for nerve damage. Symptoms can include numbness, pain, and a pins and needles sensation – often in the fingers, hands, toes, or feet. The damage is not reversible, but treatments can help with the pain and numbness. And controlling your diabetes can help prevent further damage.


Diabetic nerve damage can make it difficult to feel your feet and detect injury. At the same time, hardening of the arteries results in poor blood flow to the feet. Foot sores and gangrene can occur, even from small injury. In severe cases, infections can go unchecked and result in an amputation.


One of the most interesting things about type 2 diabetes is that such a life-altering condition is often preventable. To lower your risk, follow the same guidelines for warding off heart disease:

•    Eat a healthy diet
•    Exercise for 30 minutes, five days a week, at least.
•    Maintain healthy weight
•    Talk to your doctor about being screened for prediabetes

In people with prediabetes, lifestyle changes and medication can help prevent the progression to typoe2 diabetes.

See you next week.

People of the north, Dr. Victor Emanuel will be in Portsmouth on Fridays from 8 am to  3 pm at Bayside Medical Center across from the police station.

Copyright 2012 Dominica News Online, DURAVISION INC. All Rights Reserved. This material may not be published, broadcast, rewritten or distributed.

Disclaimer: The comments on this page do not necessarily reflect the views of Inc. All comments are approved by before they are posted. We never censor based on political or ideological points of view, but we do try to maintain a sensible balance between free speech and responsible moderating.

We will delete comments that:

  • violate or infringe the rights of any person, are defamatory or harassing or include personal attacks
  • a reasonable person would consider abusive or profane
  • contain material which violates or encourages others to violate any applicable law
  • promote hatred of any kind
  • refer to people arrested or charged with a crime as though they had been found guilty
  • contain links to "chain letters", pornographic or obscene movies or graphic images
  • are excessively long and off-topic

See our full comment/user policy/agreement.


  1. speaking logic
    August 9, 2012

    ALOES is also a master and eat more breadfruit…put a piece of aloes on tissue and place on eyes for at least half reduces pressure and other illness of the eyes…drink the water.. swallow pieces..all these helps. and cut down on sugary stuff…

  2. anonymous2
    August 8, 2012

    Good article.

  3. Mr B
    August 8, 2012

    Very informative writing. The information has been most useful. Keep up the good gesture Doc.

  4. tect nee cal lity
    August 8, 2012

    present doc.i honor you for you highly informative work,you are the best source of information on this site to me.
    once again thank you.God’s willing,iwill be waiting for you next week.

  5. Freethinker
    August 8, 2012

    You see, THIS is a science column. Not that natural healing garbage. I’m not hatin’–the truth is the truth. This is factual material, whereas the other column is mystical pseudoscientific hyper-religious nonsense.

  6. August 8, 2012

    Thanks Doc for the info. This topic is so close to home. Thanks a million.

  7. Anonymous
    August 8, 2012

    my mum is a type 2 diabetic they just found a pool of blood at the back of the retina

  8. virgo
    August 8, 2012

    THANKS! Doc, once more until next week if GOD, permit.

  9. life
    August 8, 2012

    hi am so thankful for your post and would like 2 get your info on where can i contact you i would really like to pay u a visit…

    August 8, 2012

    Tumaric Powder, Garlic, Ginger… learn more and you could help prevent the advancement, treat it and even eliminate this horror. STOP with the junk foods.. just STOP!

Post a Comment

Your email address will not be published. Required fields are marked *

:) :-D :wink: :( 8-O :lol: :-| :cry: 8) :-? :-P :-x :?: :oops: :twisted: :mrgreen: more »

 characters available