
Type 2 diabetes mellitus (DM) is the most common form of diabetes and in simple terms, means your body is not using insulin properly. More often than not, type 2 DM evolves from some state of insulin resistance, where cells are desensitized to the effects of insulin. This resistance causes the body a lot of difficulty when trying to regulate blood glucose and eventually leads into prediabetes and eventually type 2 DM.
The World Health Organization estimated that 422million people have diabetes. The Centers for Disease Control Prevention estimates 37million Americans have diabetes and approximately 90-95% with type2 DM. Diabetes is also the seventh leading cause of death in the United States.
Insulin resistance is the earliest indicator of progressing type 2 DM. With insulin resistance, tissues inappropriately respond to insulin. When cells no longer produce enough insulin, glucose rises and leads to prediabetes. On the other end of the spectrum, another sign of type 2 DM is hyperinsulinemia. Hyperinsulinemia is a condition where the amount of insulin your blood is higher than what’s considered normal. The combination of insulin resistance and hyperinsulinemia results in the “metabolic syndrome”, a cluster of abnormalities including obesity, hypertension, dyslipidemia, type2 DM, and cardiovascular diseases.
Insulin resistance has no signs or symptoms that can be difficult to diagnose. However, certain signs include:
Treating Insulin Resistance
The National Diabetes Prevention Program certifies lifestyle-change programs including eating healthy, increasing physical activity, and setting goals to stay motivated that prevent insulin resistance. Southwest Family Physicians’ Oregon Medical Weight Loss Program offers a team of board-certified and specially trained providers who will partner with you to establish a lifestyle that is sustainable and successful!
American Diabetes Association recommends people without risk factors to start screening for prediabetes/diabetes when they reach 45 years old. You should obviously see your PCP sooner if you believe you are at risk prior to turning 45 years old. If you are overweight or obese while showing no symptoms, the ADA recommends screening if you have one or more of the below risk factors:
Diagnosis of DM and prediabetes based on laboratory test results:
Knowledge of DM and risk factors are ways to meet glucose management. Prevention and DM management programs increase adherence to treatments and decrease the chance to develop DM. Please reach out to your PCP for lab testing if you feel you are at risk. Southwest Family Physicians’ Oregon Medical Weight Loss is also a resource for anyone in the Portland area to join and have support throughout their lifelong health journey.
Sources: Insulin Resistance and the Evolution of Type 2 Diabetes
Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers