Most recent discussions about public health center around the COVID-19 pandemic, but another pandemic is also threatening lives: the pandemic of type 2 diabetes.

According to a March 2020 report published in the Journal of Epidemiology and Global Health, 462 million people — or 6.28 percent of the world’s population — had type 2 diabetes in 2017. More than 1 million deaths worldwide result from type 2 diabetes each year, the report said, making it the ninth leading cause of mortality.

Edward Nicklas, MD, an endocrinologist with Memorial Hermann Medical Group (MHMG), says that while one in three American adults is at risk for developing type 2 diabetes, that risk can be reduced by understanding the disease and making lifestyle changes.

What Is type 2 diabetes?
Dr. Nicklas explains that type 2 diabetes results when glucose levels in the blood are high. Increased glucose, also known as blood sugar, occurs when insulin — a hormone produced by the pancreas to keep glucose in check — cannot keep up with the body’s demand. This can happen when the pancreas fails to produce enough insulin, the insulin it produces is less effective against regulating glucose, or both.

Symptoms of type 2 diabetes
When the body cannot regulate the amount of blood sugar circulating within its blood vessels, especially over long periods of time, people may develop unusual symptoms that indicate a problem. Dr. Nicklas says the most common symptoms he sees in people with high blood sugar include:

• Increased frequency of urination
• Sensation of being thirsty
• Feeling unusually tired or weak
• Blurred vision
• Unexplained weight loss

He notes that people experiencing these symptoms should alert their primary care physician to find the cause.

When toxic levels of glucose build up in the body, the pancreas can reduce insulin production to dangerously low levels. Extended high blood sugar can result in increased acid in the blood, known as diabetic ketoacidosis, or a diabetic coma, where the mental status of the person is affected. Both conditions require immediate medical attention in a hospital, Dr. Nicklas explains.

Risk factors for type 2 diabetes
“The key risk factors for developing type 2 diabetes are genetics and environment,” Dr. Nicklas says. “We especially see an increased risk in individuals whose parents and siblings have type 2 diabetes.”

He also notes that individuals who are overweight or obese or those who do not engage in daily physical activity may also be at increased risk for developing type 2 diabetes. Both groups, he says, can reduce their risk by making important lifestyle changes.

Reducing the risk of type 2 diabetes
“We can’t change our genetics or family history,” Dr. Nicklas admits, “but if patients are at risk for developing type 2 diabetes because of their genes, we encourage them to act to lower their risk.”

Dr. Nicklas advises people at risk for type 2 diabetes to:

• Reduce the portions of food at each meal, as Americans tend to overestimate appropriate portion sizes.
• Choose plant-based foods, such as fruits, vegetables, nuts, seeds, and whole grains, which provide vitamins and other nutrients.
• Increase fiber intake to help regulate blood sugar.
• Avoid processed or packaged foods, which are often sold in the center aisles of the supermarket.
• Engage more in regular physical activity and exercise to avoid being too sedentary, which contributes to being overweight and obese.

Importance of managing type 2 diabetes
Once type 2 diabetes develops, it’s important to manage it, Dr. Nicklas says. Left unmanaged, it can lead to other health problems and disabilities. These include kidney disease requiring dialysis, neuropathy that causes numbness or pain in the hands and feet, vision problems or blindness, heart disease, heart attack, and stroke.

In addition to the lifestyle changes noted above, Dr. Nicklas points to effective therapies that help lower blood sugar. These include prescription-strength pills, injectable medications, and insulin therapy.

Once blood sugar levels return to and stay within a normal range, Dr. Nicklas says, type 2 diabetes is controlled. But, he warns, it and its complications can return without proper management. He advises people with diabetes or risk factors to pay attention to their health and manage those risk factors.

“Recognizing your risks, acting to reduce those risks and paying attention to unusual symptoms can go a long way to curb this pandemic,” he says.

Looking for a primary care physician to start a discussion about diabetes and your health? Memorial Hermann can help.