Type 2 Diabetes
Type 2 diabetes is a chronic condition in which the body does not use insulin effectively, causing blood sugar to remain elevated. Sustained hyperglycemia damages blood vessels and nerves over years, raising the risk of heart disease, kidney failure, and neuropathy. Early and consistent management dramatically reduces complication risk.
Symptoms
Increased thirst and urination, unexplained fatigue, blurred vision, slow-healing cuts or bruises, tingling in hands or feet, frequent infections, and darkened skin in body folds (acanthosis nigricans). Many people have few or no symptoms in early stages.
Causes and risk
Insulin resistance develops when cells stop responding normally to insulin, prompting the pancreas to overproduce it until it can no longer keep up. Key risk factors include excess body weight especially visceral fat, physical inactivity, family history, prediabetes, prior gestational diabetes, PCOS, and age over 45.
How it is evaluated
Diagnosis requires a fasting glucose ≥126 mg/dL, a random glucose ≥200 mg/dL with symptoms, or an A1C ≥6.5% confirmed on a second test. We assess kidney function (eGFR, urine albumin), lipid panel, liver enzymes, thyroid (TSH), and foot and eye referral needs.
Treatment
Lifestyle modification -- structured nutrition, weight loss, and regular exercise -- is foundational. Metformin remains the first-line medication for most patients. GLP-1 receptor agonists and SGLT-2 inhibitors provide A1C lowering plus cardiovascular and kidney protective benefits. Insulin is added when A1C targets are not met. CGM can improve glucose awareness and outcomes.