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Slideshow: Type 2 diabetes overview

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Type 2 diabetes: What is it?

Diabetes is a chronic condition that affects the body's ability to convert sugar into energy. This allows sugar levels to build up in the blood, which can lead to heart disease, blindness and other serious complications. Type 2 diabetes can affect people of all ages and early symptoms are subtle. Diabetes UK estimates that around 850,000 people with type 2 diabetes don't know they have it. Learn to spot the warning signs in this slideshow.

Warning sign: Thirst

One of the first symptoms of type 2 diabetes may be an increase in thirst. This is often accompanied by additional problems, including dry mouth, increased appetite, frequent urination – sometimes as often as every hour -- and unusual weight loss or gain.

Warning sign: Blurred vision

As blood sugar levels become more abnormal, additional symptoms may include headaches, blurred vision and fatigue.

Warning sign: Infections

In most cases, type 2 diabetes is not discovered until it takes a noticeable toll on health. Look out for troubling infections, such as:

Cuts or sores that are slow to heal
Frequent yeast infections
Itchy skin, especially in the groin area

Diabetes warning sign: Sexual dysfunction

Sexual dysfunction is common among people with diabetes. Diabetes can cause damage to blood vessels and nerve endings in the genitals, leading to a loss of feeling and making orgasm difficult. Other complications can include vaginal dryness in women and erection problems in men.

Risk factors you can control

Your habits and lifestyle can affect your odds of developing type 2 diabetes. Factors that boost your risk include:

Being overweight, defined as a body mass index (BMI) over 25
Sedentary lifestyle

Risk factors you can't control

Other risk factors are out of your control, including:

Race or ethnicity: South Asian and African Caribbean people have a higher than average risk
Family history of diabetes: having a parent or brother or sister with diabetes increases your risk
Age: being 45 and older increases your risk of type 2 diabetes

The more risk factors you have, the greater your chances of developing type 2 diabetes.

Risk factors for women

Having gestational diabetes when you’re pregnant puts you at seven times higher risk of developing type 2 diabetes later on. Women who've given birth to a large baby weighing more than 4.5kg (9.9 pounds) before are more likely to develop gestational diabetes in future pregnancies. Having a history of polycystic ovary syndrome (PCOS) can also cause insulin resistance that can lead to diabetes.

Type 2 diabetes in children

Although older people have a higher risk of getting type 2 diabetes, the condition is affecting more young people. Diabetes UK estimates as many as 1,400 children in the UK have the condition. The leading risk factor for children is being overweight, often connected with an unhealthy diet and lack of physical activity. Once children are overweight, their chances of developing type 2 diabetes more than doubles.

Diagnosing type 2 diabetes

There's no need for guesswork in diagnosing type 2 diabetes. A urine test is usually carried out first, and if it contains glucose, a simple blood test, called a fasting plasma glucose test, will be done to confirm the diagnosis. The test measures the level of sugar in your blood after you have been fasting for at least eight hours. If the level is 7.0 mmol/L or higher, type 2 diabetes is diagnosed.

How does insulin work?

In healthy people, after a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use the hormone insulin, made in the pancreas, to help them process blood glucose into energy. People develop type 2 diabetes because the cells in the muscles, liver and fat do not use insulin properly.

Type 2 Diabetes: Metabolism mishaps

In type 2 diabetes, the cells cannot absorb glucose properly. That means glucose levels in the blood become elevated. If you've developed a condition called insulin resistance, the body makes insulin, but the muscle, liver and fat cells do not use or respond properly to the insulin. With long-standing, uncontrolled type 2 diabetes, the pancreas will reduce the amount of insulin it produces.

Managing diabetes: Diet

Fortunately, people with type 2 diabetes can significantly reduce the risk of damage to the heart, kidneys, eyes and feet. The key is controlling blood sugar levels by changing diet. People with type 2 diabetes should carefully monitor carbohydrate consumption, as well as total fat and protein intake and reduce calories.

Managing diabetes: Exercise

Moderate exercise, such as strength training or walking, improves the body's use of insulin and can lower blood sugar levels in people with type 2 diabetes. Being active also helps reduce body fat, lower blood pressure and protect against heart disease. Try to do at least 150 minutes of exercise a week, with some on most days of the week.

Managing diabetes: Stress reduction

Stress can cause blood pressure to rise. It can also increase glucose levels in your blood as part of your "fight or flight" response. Or you may turn to food to cope with stress. All are bad when living with diabetes. Instead of letting stress take its toll, try relaxation techniques such as deep breathing, meditation or just talking to a friend or relative. If these don't work for you, seek medical advice.

Managing diabetes: Medication

When people with type 2 diabetes are unable to control blood sugar sufficiently with diet and exercise, medication can help. There are many types of diabetes tablets available and they are often used in combination. Some work by stimulating the pancreas to make more insulin, and while others improve the effectiveness of insulin or block the digestion of starches.

Managing diabetes: Insulin

Many people with type 2 diabetes eventually develop 'beta-cell failure'. This means the cells in the pancreas no longer produce insulin in response to high blood sugar levels. In this case, insulin therapy – injections or an insulin pump – must become part of the daily routine.

Non-Insulin Injectables

New drugs are available for people with type 2 diabetes. Exenatide and liraglutide are non-insulin injectable drugs. Whereas insulin pulls glucose into the cells, these medications cause the body to release insulin to control blood sugar levels.

Glucose testing

Testing your blood glucose level will let you know how controlled your blood sugars are and if you need to take actions to change your treatment plan. How often and when you test will be based on how controlled your diabetes is, the type of therapy used to control your diabetes and whether you are experiencing symptoms of fluctuating sugars. Your diabetes team will suggest how often you should use a glucose meter to check your blood sugar. Common testing times are first thing in the morning, before and after meals and exercise and before bedtime.

Long-term damage: Arteries

Over time, untreated type 2 diabetes can damage many of the body's systems. Two out of three people with diabetes die of heart disease. Having diabetes also puts you at risk of stroke. People with diabetes are likely to develop plaque in their arteries, which reduces blood flow and increases the risk of clots. This raises the risk of heart attack and stroke. Around two out of three people with diabetes die of heart disease.

Long-term damage: Kidneys

The longer you have untreated diabetes, the greater the risk of developing kidney disease or kidney failure. Patients with kidney failure must get a kidney transplant or rely on dialysis to survive.

Long-term damage: Eyes

High blood sugar can damage the tiny blood vessels that bring oxygen and nutrients to the retina, a critical part of the eye. This is known as diabetic retinopathy and it can cause progressive, irreversible vision loss. It is the leading cause of blindness in people between the ages of 20 and 60. Pools of blood, or haemorrhages, on the retina of an eye are visible in this image.

Long-Term Damage: Nerve Pain

Over time, uncontrolled diabetes and elevated blood sugars create a very real risk for nerve damage. Symptoms can include tingling, numbness, pain and a pins and needles sensation -- often in the fingers, hands, toes or feet. The damage is not reversible, but treatments can help with the pain and numbness. Controlling your diabetes can help prevent further damage.

Long-term damage: Feet

People with diabetes often experience nerve damage that can make it more difficult to feel their feet. At the same time, narrowing of the arteries results in poor blood flow to the feet. Foot sores and gangrene can occur. In severe cases, the foot or leg must be amputated.

Preventing type 2 diabetes

One of the most astonishing things about type 2 diabetes is that such a life-altering condition is often preventable. To lower your risk, follow the same guidelines for warding off heart disease: