Type 2 diabetes

Type 2 diabetes can cause symptoms that may not be immediately obvious at first. You might recognise the condition through signs such as:

• Excessive thirst and frequent urination 
• Eye problems, such as blurred vision, burning sensations in the eyes, or double vision  
• Wounds that are slow to heal  
• Fatigue  
• Frequent recurring infections  

Anyone can develop type 2 diabetes, but certain individuals are at a higher risk. The following factors, among others, increase the likelihood of developing type 2 diabetes:

• Overweight;  
• Lack of physical activity;  
• Smoking;  
• Older age;  
• Genetic predisposition;  
• Medications;  
• Unhealthy diet.  

The more risk factors you have, the greater your chances of developing the condition.

The progression of the disease differs for each individual. A tailored treatment approach is required on a daily basis. In some cases, making adjustments to your lifestyle may suffice. If not, medical intervention will be necessary. By monitoring your blood sugar levels independently while using insulin, you can gain valuable insights into how your body reacts to food, drink, and physical activity.

For individuals with type 2 diabetes, oral blood glucose-lowering medications in tablet form are often prescribed. These medications either stimulate the pancreas to produce more insulin or enhance the sensitivity of the organs to the effects of insulin. Both mechanisms help to reduce blood sugar levels. Examples of blood glucose-lowering medications include:

• Metformin (also referred to as Biguanides)  
• Sulfonylurea derivatives (such as gliclazide)  
• DPP-4 inhibitors (such as sitagliptin)  
• SGLT2 inhibitors (such as dapagliflozin)  
• GLP-1 receptor agonists are typically used prior to initiating insulin therapy.  

In some instances, individuals with type 2 diabetes may also require insulin injections.  

Medications for type 2 diabetes may cause side effects, which vary depending on the specific drug. Common side effects include nausea, vomiting, and diarrhoea. In cases of under- or overdosing, the following risks or side effects may arise:

• An overdose can result in low blood glucose levels (hypoglycaemia). This may also occur due to intense physical activity, eating too little, eating too late, or injecting insulin into a different area of the body. It is particularly common with the use of insulin or medications such as gliclazide. Possible symptoms include headache, trembling, sweating, hunger, irritability, paleness, fatigue, and dizziness. If a hypo is not treated promptly, it may lead to fainting.
• An underdose can cause high blood glucose levels (hyperglycaemia). Symptoms of this include frequent urination, excessive thirst, and fatigue. If hyperglycaemia persists for too long, it can lead to vascular and nerve damage.
• In some cases, individuals may be allergic to insulin or other components of their medication.
• Injection site reactions may also occur, such as hard spots or lumps on the skin. Avoid injecting into these areas again, as the insulin may be absorbed too quickly, leading to fluctuating blood glucose levels. These spots usually disappear on their own, although this can sometimes take up to a year.
• During the first few months of treatment, you may experience reduced vision. This occurs as the eyes adjust to the altered blood sugar levels and typically resolves on its own.

A healthy lifestyle can help to prevent type 2 diabetes, although not in all cases. In some instances, hereditary factors are the root cause. Type 2 diabetes is becoming increasingly prevalent, and certain lifestyle choices can contribute to its onset.

You can take the following steps:

• Quitting smoking: the risk of developing type 2 diabetes is approximately 30–40% higher for smokers. Smoking causes blood sugar levels to rise more rapidly and reduces the body’s sensitivity to insulin.  
• Eating a healthy diet: include fruits, vegetables, wholegrain products, and reduce your sugar intake.  
• Engaging in regular physical activity (at least 30 minutes a day): walking, cycling, or taking the stairs.  
• Losing weight if overweight: being overweight decreases the body’s responsiveness to insulin. Even a modest amount of weight loss can make a significant difference.  
• Managing or preventing stress: stress has a direct impact on blood glucose levels, so managing it is highly beneficial.  
• Getting sufficient sleep: poor sleep reduces the body’s sensitivity to insulin.  

These recommendations are also advantageous for individuals already diagnosed with type 2 diabetes, as they help to stabilise blood sugar levels. Adopting these measures can significantly reduce the risk.  

A low-carbohydrate diet, regular exercise, and maintaining a generally healthy lifestyle can lower the likelihood of side effects and complications. Furthermore, the need for medication may decrease, though this should always be done in consultation with a doctor and/or dietitian.  

You can lower the risk of developing type 2 diabetes by adhering to the previously mentioned advice, such as losing weight if you are overweight and stopping smoking. The amount of glucose rises when you consume carbohydrates, such as biscuits and pastries, potatoes, and pasta. However, other factors, such as certain strong emotions and physical activity, can also cause an increase in glucose levels. Try to consider this in your lifestyle.

https://www.diabetesfonds.nl/over-diabetes/dagelijks-leven/medicijnen-bij-diabetes

https://www.diabetes.nl/diabetes-type-2/over-diabetes-type-2/wat-is-diabetes-type-2

https://www.dvn.nl/diabetes/behandelingen/behandeling-diabetes-type-2/medicatie-diabetes-type-2