Type 2 Diabetes 101: Symptoms, Causes, Stages & Treatment

Type 2 diabetes is one of the most common chronic health conditions affecting Australians. It is a complex illness that impacts your body’s ability to effectively balance your insulin and glucose levels. There are three main types of diabetes, and all types of diabetes are serious, and understanding your diagnosis gives you the best chance of effectively managing your condition and leading a fulfilling life. Read on to find out more about type 2 diabetes, including its causes, symptoms, stages and options for treatment.

What is Type 2 Diabetes?

Type 2 diabetes is one of the main types of diabetes mellitus. Diabetes is a collection of three types of diseases that change the way your body maintains healthy levels of blood glucose (sugar). Type 2 diabetes is the most common type of diabetes, affecting around 85 to 90% of all people with diabetes diagnoses. Type 2 diabetes affects around 1 million Australians. This equates to around 5.3% of the Australian population aged 18 years and over having a type 2 diabetes diagnosis.

Type 2 diabetes is most common among adults aged over 40 years. However, diagnosis of type 2 diabetes in younger adults, children and adolescents is becoming more common. Some population groups, such as people of Aboriginal and Torres Strait Islander origin, are at an elevated risk of having type 2 diabetes and gestational diabetes. 

What Is the Difference Between Type 1, Type 2, and Gestational Diabetes?

The three types of diabetes are distinct from one another in their symptoms, treatment and who they are most likely to affect. All types of diabetes are increasing in prevalence, indicating an urgent need for greater intervention to protect the health, well-being and longevity of Australians. Type 2 diabetes is increasing at the fastest rate, and many are starting to experience symptoms of diabetes without yet receiving a formal diagnosis.

Type 1 Diabetes

Type 1 diabetes is a condition in which your body does not produce its own insulin. People with type 1 diabetes have an autoimmune condition, meaning your immune cells attack the cells which are responsible for producing insulin. Without insulin, your body cannot manage your blood glucose. People with type 1 diabetes need to take insulin injections to manage their blood glucose and lead healthy life. Type 1 diabetes usually has a genetic factor, and most often appears during childhood or adolescence. However, adults can develop type 1 diabetes.

Type 2 Diabetes

Type 2 diabetes is a condition in which your body does not respond to insulin normally. This is known as insulin resistance. People with type 2 diabetes do not produce enough insulin from the pancreas to manage blood glucose levels. A sustained poor supply of insulin causes glucose levels to build up to dangerous levels in the blood instead of being transported to the cells for energy. Having consistently high blood glucose levels over a significant period can damage other parts of your body. This damage is known as diabetes complications.

Gestational Diabetes

Gestational diabetes is a third type of diabetes that primarily affects pregnant women. Most women will no longer have gestational diabetes after they give birth. However, women with gestational diabetes may continue to have elevated blood glucose and have a higher risk of developing type 2 diabetes later in life. 

5 Stages of Type 2 Diabetes

Diabetes is often progressive, meaning it can worsen over time, especially if left untreated. Diabetes can be categorised into five stages, which indicate how far the disease has progressed and how much damage it has done to tissues and organs throughout your body. Doctors and members of your medical team use your current stage to decide on the best treatment pathways to control your symptoms and allow a good quality of life. The stages of type 2 diabetes are

Stage 1 Type 2 Diabetes: Insulin Resistance

It is often called the insulin resistance stage. In stage 1, the cells in your fat tissue, muscles and liver have started resisting your insulin and are struggling to bring glucose into your cells to use for energy. In stage 1 type 2 diabetes, your blood glucose levels remain normal thanks to your pancreas creating more insulin to compensate for the resistance.

Stage 2 Type 2 Diabetes: Pre-Diabetes

In this stage, your cells have become even more insulin resistant. In stage 2, your blood glucose levels will become elevated. This is because the extra insulin your pancreas produces is no longer enough to bring your blood glucose down to within a normal range. In stage 2, your blood glucose levels will be high, but not high enough to receive a full diagnosis of type 2 diabetes. Some people in stage 2 also experience dysfunction of their beta cells.

Stage 3 Type 2 Diabetes: Formal Diagnosis

In stage 3, your blood glucose remains above the healthy range. Stage 3 type 2 diabetics have high enough blood glucose to receive a formal type 2 diabetes diagnosis. In stage 3 there is often significant insulin resistance and beta-cell malfunctioning. The blood glucose level seen in stage 3 is enough to cause significant damage to your body if left untreated.

Stage 4 Type 2 Diabetes: Complications Begin

In stage 4, complications start to arise due to your elevated blood glucose. People with stage 4 type 2 diabetes often start to experience vascular complications due to sustained high blood sugar. These complications can include:

• Albuminuria (excess albumin in your urine)
• Chronic kidney disease
• Coronary artery disease
• Heart failure
• Peripheral neuropathy (damage to the nerves outside of the brain and spinal cord)
• Stroke.

End-Stage Type 2 Diabetes: Advanced Diabetes Complications

End-stage diabetes, also known as Advanced Diabetes Complications usually means you have lived with type 2 diabetes for many years. In end-stage type 2 diabetes, you may experience more severe or advanced complications such as advanced kidney disease. People with end-stage diabetes often have many symptoms and may experience a reduced quality of life.

Signs and Symptoms of Type 2 Diabetes

Some people with type 2 diabetes have few symptoms, especially in the earlier stages. Over time, sustained high blood sugar levels can lead to symptoms including:

• Increased urination frequency 
• Increased thirst
• Fatigue and lethargy
• Wounds healing more slowly than normal
• Infections that are slow to heal or recurring
• Eyesight problems such as blurry vision.

Diabetes can also lead to a range of secondary health complications if poorly managed. Long-term health complications from diabetes can include:

• Eye complications
• Heart disease
• Stroke
• Kidney disease
• Foot problems
• Nerve problems.

Risk Factors of Type 2 Diabetes

Type 2 diabetes is increasing in prevalence in Australia and many other countries around the world. The increasing rates of diabetes are thought to be a result of combined genetic, environmental and behavioural lifestyle factors. 

Diabetes is influenced by our environments, such as increasingly sedentary work schedules, reduced physical activity and the availability of hyper-palatable, highly processed foods. Diabetes also often has a genetic component. Some populations are at a greater risk of developing type 2 diabetes due to their ethnic background.

People at the greatest risk of developing type 2 diabetes are:

• People with pre-diabetes
• Aboriginal and Torres Strait Islander individuals
• People of certain ethnicities including Pacific Islanders, Maori, Asian (including the Indian subcontinent, or of Chinese origin) Middle Eastern, North African or Southern European
• Overweight or obese individuals over the age of 40
• People diagnosed with hypertension (high blood pressure)
• People who have a parent, sibling or child who has type 2 diabetes
• People with existing cardiovascular diseases such as a history of stroke, angina, heart attack or atherosclerosis (narrowed blood vessels)
• Overweight or obese women diagnosed with the polycystic ovarian syndrome (PCOS)
• Women who have previously had gestational diabetes
• Women who had a baby with a birth weight of over 4.5kg
• People taking some types of medications, including antipsychotics and corticosteroids
• Older people.

Some risk factors for type 2 diabetes, like genetic predisposition, cannot be changed. However, there are additional lifestyle or behavioural risk factors for type 2 diabetes. Making changes in these areas may help to reduce your risk of being diagnosed with type 2 diabetes or developing early-stage insulin resistance. Lifestyle risk factors for type 2 diabetes include:

• Excess body weight or body fat (especially around the waist)
• Low physical activity levels
• Sedentary lifestyle (e.g. watching more than 2 hours of television daily)
• Smoking cigarettes
• High blood pressure (hypertension)
• High cholesterol
• Dietary factors, including regularly consuming foods high in fat, sugar, and/or salt
• Low intake of dietary fibre.

How is Type 2 Diabetes Diagnosed?

It is important to diagnose any type of diabetes as early as possible. The earlier diabetes is detected, the sooner you can start taking steps to manage your symptoms and treat your diabetes.

If you or your doctor suspect that you may have type 2 diabetes, the first step is usually to take some blood tests. The blood tests will be used to determine your current blood glucose level. The main 4 types of blood tests used to diagnose type 2 diabetes are as follows.

Fasting Glucose Blood Test

This test is the most common type of blood test to diagnose type 2 diabetes. You must have fasted for between 8 and 16 hours before your blood was taken. Your doctor may then recommend other tests, depending on your results and any symptoms you are experiencing.

Oral Glucose Tolerance Blood test (OGTT)

Oral glucose tolerance blood test is a more complex procedure than a standard fasting blood glucose test. You have to fast overnight and undertake a fasting blood glucose test. Then, you consume a drink with glucose in it and have blood glucose tests one hour and two hours afterwards. This helps determine how your body responds after glucose enters your bloodstream.

Random Blood Glucose Test

Random blood glucose tests can be done at any time of day and don’t require you to fast. This type of blood test helps understand any variances in your blood glucose levels throughout the day.

Glycosylated Haemoglobin Test (HbA1c Test)

The HbA1c tests your blood to get an average of your blood glucose levels over a 10-12 week time period. It does not require you to fast. Depending on the results of your blood tests, your doctor may or may not make a diagnosis. They may also suggest things you can do to start managing your diabetes or preventing it from developing in the future.

How Can I Prevent Type 2 Diabetes?

Type 2 diabetes can be prevented by making certain lifestyle changes. These lifestyle changes can also slow the progression of diabetes if you are already diagnosed. Type 2 diabetes is the only type of diabetes we know can be prevented if action is taken early. You can reduce your risk by

• Consuming a healthy, varied diet
• Engaging in regular physical activity
• Maintaining or achieving a healthy weight

How is Type 2 Diabetes Treated?

Type 2 diabetes is not curable, but there are lots of things you can do to effectively manage your diabetes. Some people are even able to enter a type of diabetes ‘remission’ in which their symptoms become much less severe. Diabetes treatment and management are focused on managing your symptoms, keeping you as well as possible, and keeping your blood glucose, pressure and cholesterol within healthy ranges.

You can help maintain healthy blood glucose levels by:

• Eating a healthy diet
• Losing excess body weight or body fat
• Sitting less and finding ways to move your body more
• Taking your medications (including insulin and/or glucose-lowering medication) as prescribed.

You can help keep your blood pressure and cholesterol within healthy ranges by leading a healthy lifestyle and getting regular diabetes checks for your eyes, feet, heart and kidneys. You should also get your blood pressure and cholesterol checked regularly to identify any issues that require lifestyle changes.

Getting Support to Manage Type 2 Diabetes

Learning that you or someone you love has diabetes can be a frightening and stressful experience. Don’t try to handle it all on your own. In an emergency, dial triple zero (000) and request an ambulance. Otherwise, always follow the advice of your diabetes treatment team. This team usually includes a range of professionals with different areas of expertise. This often includes:

• Doctors
• Diabetes educators
• Dieticians
• Podiatrists
• Endocrinologists
• Counsellors
• Exercise physiologists.

There is also a range of support groups and organisations that can help you and your family navigate the challenges of managing type 2 diabetes. Some of the organisations in Australia that can support you are:

• Australian Diabetes Society 
• Australian Diabetes Educators Association (ADEA)
• Australasian Paediatric Endocrine Group 
• Australasian Diabetes in Pregnancy Society (ADIPS)
• Diabetes Australia – State and Territory Directory
• Diabetes Australia Research Program 
• Juvenile Diabetes Research Foundation (JDRF).

How Homage can Help

Homage’s team of dedicated, highly trained Care Professionals are ready to help you or a loved one manage type 2 diabetes from the comfort of your own home. 

It is so important to detect diabetes early, as well as keep up to date with checkups to track how well you are managing your diabetes. If you have mobility or geographical barriers to attending medical appointments, our Patient Transport Service is a great option. 

Our incredible home nurses are trained in providing diabetes care and management and can support you in your home. Diabetes can often lead to symptoms such as fatigue, poor eyesight and the need to use the bathroom more frequently. Receiving high-quality nursing care from home can help improve your quality of life and avoid uncomfortable or embarrassing situations when out and about. 

Our Care Professionals can even help take some of the pressure off you and your family at home by assisting with personal care, light housekeeping, grocery shopping or preparing healthy meals. Contact our friendly Care Advisors today for an obligation-free discussion of how we can support you to effectively manage your diabetes and lead a fulfilling and enjoyable life.