Over the last decade, new cases of Type 2 diabetes have decreased – except in one important age group. Among people younger than 20 years old, Type 2 diabetes has risen significantly. All told, more than 37 million Americans have diabetes. The majority (about 95 percent) have Type 2 diabetes.

With Type 2 diabetes, the body doesn’t use insulin the way it should to control blood sugar (blood glucose) levels. This is known as insulin resistance. At first, the pancreas produces extra insulin to make up for the body’s poor use. Over time, the pancreas can no longer keep up. It can’t create enough to maintain normal blood glucose levels.

High blood sugar increases inflammation in your arteries. When this happens, your organs don’t get the blood they need to stay healthy and function properly. With diabetes you have a greater risk for stroke, heart attack, kidney failure, blindness and advanced memory loss.

An unhealthy lifestyle can trigger the onset of the disease, but genetics play a role, too. Some groups of people have a higher risk for Type 2 diabetes than others. The disease is more common in African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders.

Living Well with Type 2 Diabetes

While there isn’t a cure for diabetes, a lot can be done to control blood sugar levels so individuals can live well with the disease. Lifestyle changes, oral medications and insulin are all important tools that help.

Some people with Type 2 diabetes can control their blood glucose with healthy eating and regular physical activity. Still, for many, oral medications or insulin may be needed.

Dangerously Unaware

Sadly, millions of people are in the dark about their diabetes.  About one in five people don’t even know they have the disease. Signs and symptoms of Type 2 diabetes often develop slowly and aren’t always clear. In fact, you can have Type 2 diabetes for years and not know it. It’s important to recognize the symptoms.

Watch for these warning signs:

• Greater thirst, frequent urination. Excess sugar builds up in your bloodstream and causes fluid to be pulled from tissues throughout your body. When you feel dehydrated, you may drink – and urinate – more than usual.
• Increased hunger. Without enough insulin to carry sugar into your cells, your muscles and organs don’t get the fuel they need and are deprived of energy. This triggers intense hunger.
• Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses fuel stored in muscle and fat. Calories are lost as excess glucose is flushed out of the body in urine.
• Fatigue. If your cells are deprived of sugar, you may become tired and irritable.
• Blurry vision. When your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus clearly.
• Infections and slow-healing sores. Type 2 diabetes affects your ability to fight off infections and heal.
• Skin damage. Some people with Type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies – usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance.

If you have any of these symptoms and are concerned about Type 2 diabetes, talk with your doctor. They may order a blood glucose test to check for prediabetes or diabetes.

Sources: National Diabetes Statistics Report 2022,  Centers for Disease Control and Prevention, 2022; Type 2 Diabetes,  Mayo Clinic, 2021; The Facts, Stats, and Impacts of Diabetes,  Centers for Disease Control and Prevention, 2022; Blood Sugar and Insulin at Work,  Diabetes, American Diabetes Association, 2022

Originally published 3/4/2016; Revised 2021, 2023