Type 2 diabetes mellitus

Aging: As the body ages, cells often respond less to insulin. This makes it easier for blood sugar to rise and increases the chance of Type 2 diabetes mellitus.

Abdominal fat: Extra fat around the waist sends chemical signals that make insulin work less well. This insulin resistance raises the risk of Type 2 diabetes mellitus.

Prediabetes: Higher-than-normal blood sugar means the body is already struggling with insulin. Without treatment, this often progresses to Type 2 diabetes mellitus.

Gestational diabetes: Diabetes first noticed during pregnancy shows the body is vulnerable to insulin problems. After delivery, this raises the long-term risk of Type 2 diabetes mellitus.

Polycystic ovary syndrome: Hormone imbalances and higher insulin levels often go together in PCOS. This combination increases the chance of Type 2 diabetes mellitus.

Sleep apnea: Repeated drops in oxygen during sleep trigger stress hormones and inflammation. Over time this can lead to insulin resistance and higher blood sugars.

Fatty liver disease: Fat build-up in the liver interferes with how the body handles sugar and fats. This strongly links with insulin resistance and worsening blood sugar control.

Menopause changes: Shifts in estrogen and body fat distribution after menopause can raise fasting glucose. This makes high blood sugar more likely over time.

Air pollution: Breathing tiny particles in dirty air can inflame the body and reduce insulin sensitivity. Living in highly polluted areas has been linked with higher rates of Type 2 diabetes mellitus.

Hormone-disrupting chemicals: Contact with substances like BPA and phthalates can alter how the body controls sugar. Regular exposure has been associated with higher diabetes risk.

Heavy metals: Arsenic and cadmium in water or soil can harm insulin-producing cells. Long-term exposure is linked with problems handling blood sugar.

Certain medications: Long-term use of corticosteroids and some antipsychotics can raise blood sugar. In some people, these medicines tip the balance toward Type 2 diabetes mellitus.

Shift work: Night shifts and rotating schedules disrupt body clocks and hormones that regulate sugar. This circadian disruption is tied to a higher risk of abnormal glucose levels.

Chronic stress: Ongoing stress keeps cortisol and adrenaline elevated, which can raise blood sugar. Over months or years, this can contribute to insulin resistance.

Sugary beverages: Frequent intake of soda, sweet teas, and energy drinks causes sharp glucose spikes. Regular consumption increases insulin resistance and total calorie load.

Refined carbohydrates: White bread, pastries, and many breakfast cereals rapidly raise blood sugar. Repeated high glycemic loads strain insulin-producing cells over time.

Ultra-processed foods: Highly processed snacks and ready-to-eat meals are energy-dense and easy to overeat. They often worsen glucose control compared with minimally processed options.

Large portion sizes: Consistently oversized meals promote weight gain that heightens insulin resistance. Smaller, balanced portions help moderate post-meal glucose rises.

Low fiber intake: Not eating enough vegetables, legumes, whole grains, and nuts leads to faster glucose surges. Higher fiber slows carbohydrate absorption and improves satiety.

Physical inactivity: Limited daily movement reduces muscle glucose uptake. Regular activity enhances insulin sensitivity and helps prevent progression from prediabetes.

Prolonged sitting: Long uninterrupted sitting worsens post-meal glucose and insulin levels even in exercisers. Short movement breaks improve glucose handling across the day.

Lack of resistance training: Too little muscle-building activity lowers muscle mass, a key site for glucose disposal. Strength training improves insulin sensitivity and basal metabolic rate.

Short or poor sleep: Sleeping less than 7 hours or fragmented sleep increases insulin resistance. A consistent sleep schedule supports stable appetite hormones and glucose control.

Chronic stress: Ongoing stress elevates cortisol, which raises blood sugar and appetite for high-calorie foods. Stress-reduction practices can improve day-to-day glucose patterns.

Smoking: Tobacco use increases insulin resistance and central fat accumulation. Quitting smoking can improve insulin action and cardiovascular risk.

Excess alcohol: Heavy drinking promotes fatty liver and impairs glucose regulation. If you drink, keeping intake moderate reduces these risks.

Irregular meal timing: Skipping meals and late-night eating can worsen insulin response and next-day hunger. Consistent meal timing helps stabilize glucose throughout the day.

Weight cycling: Repeated loss and regain of weight may worsen insulin resistance. Steady, sustainable weight management is more protective than rapid swings.

Low aerobic fitness: Poor cardiorespiratory fitness is linked to higher fasting glucose and insulin levels. Regular brisk walking or similar exercise improves glucose uptake.

Balanced meals: Choose mostly vegetables, beans, whole grains, lean proteins, nuts, and unsweetened dairy. Cut back on refined carbs and ultra-processed foods to steady blood sugar.

Limit sugary drinks: Replace soda, energy drinks, and sweet teas with water, sparkling water, or unsweetened options. Sugary beverages spike blood sugar and make weight control harder.

Regular movement: Aim for frequent activity most days, like brisk walking or cycling, plus strength work a couple of times a week. Muscle helps your body use insulin more efficiently.

Sit less: Break up long sitting with short movement breaks. Even a few minutes of walking or stretching each hour can improve blood sugar control.

Weight management: If you live with overweight, even a modest weight loss can meaningfully reduce risk. Focus on realistic goals and habits you can keep.

Fiber focus: Add more fiber from vegetables, fruit, legumes, and whole grains. Fiber slows how fast sugar enters the blood and helps you feel full longer.

Healthy fats: Choose olive oil, nuts, seeds, and fatty fish over butter, sausage, and fried foods. Better fats can improve cholesterol and reduce insulin resistance.

Sleep routine: Aim for consistent, good-quality sleep. Short or poor sleep can raise hunger hormones and make blood sugar harder to manage.

Stress management: Try daily stress-relief like walking, breathing exercises, stretching, or time outdoors. Lower stress hormones can support healthy blood sugar and choices.

Avoid smoking: Smoking raises the risk of type 2 diabetes and heart disease. Quitting improves insulin sensitivity and overall health.

Alcohol limits: If you drink, keep it moderate and avoid sugary mixers. Too much alcohol can affect weight, liver health, and blood sugar swings.

Know warning signs: Learn early symptoms of type 2 diabetes, like more thirst, frequent urination, fatigue, or blurred vision. If these show up, ask for a glucose check.

Regular screening: If you have risk factors—such as family history, previous gestational diabetes, or higher weight—get periodic blood sugar testing. Early detection allows quicker action.

Medicine for high risk: Some people with prediabetes may benefit from medication like metformin. Your doctor can advise if this makes sense for your risk profile.

Gestational diabetes follow-up: After a pregnancy affected by gestational diabetes, arrange regular glucose checks and continue healthy habits. This lowers the chance of later type 2 diabetes.

Cholesterol and blood pressure: Keep these in a healthy range through lifestyle and medicines if needed. Heart health support also lowers overall diabetes complications.

Community support: Involve family or friends in meals, walks, or quit-smoking plans. Shared routines make healthy changes easier to stick with.

Heart and vessels: Type 2 diabetes raises the risk of heart attack, stroke, and heart failure. Damage builds quietly over time as arteries stiffen or clog.

Kidney disease: High glucose can scar the kidneys, leading to protein in the urine and gradually reduced filtering. Without treatment, this can progress to advanced kidney disease.

Eye changes: Tiny blood vessels in the retina can weaken and leak, causing blurry vision or vision loss over time. Cataracts and glaucoma also become more likely.

Nerve damage: Long-term high glucose can injure nerves, leading to numbness, burning pain, or tingling in the feet and hands. Autonomic nerves can also be affected, changing heart rate, sweating, or blood pressure.

Foot problems: Reduced feeling and poor circulation raise the risk of ulcers and slow-healing wounds. Severe ulcers can lead to infection and, in some cases, amputation.

Sexual health: Nerve and vessel changes can cause erectile difficulties in men and reduced arousal or discomfort in women. Vaginal dryness and recurrent genital infections may also occur.

Mental health: Living with Type 2 diabetes can add stress and raise the risk of depression or anxiety. These can make day-to-day self-care feel harder and affect blood sugar patterns.

Digestive issues: Damage to stomach nerves can slow emptying, causing nausea, fullness, or bloating after small meals. Bowel or bladder habits may also change with autonomic nerve involvement.

Infections and skin: High glucose can lower the body’s defenses, making bacterial or fungal infections more common. Skin may be dry, itchy, or prone to cracking and slow healing.

Dental disease: Type 2 diabetes increases the risk of gum disease, tooth loss, and dry mouth. Treating gum inflammation can also help improve glucose control.

Hearing loss: Over time, damage to small vessels and nerves in the inner ear can reduce hearing. People may notice trouble following conversations, especially in noisy spaces.

Cognitive changes: There is a higher risk of memory and thinking problems later in life. Good control of cardiovascular risks may help protect brain health.

Liver disease: Fat can build up in the liver, sometimes leading to inflammation and scarring. This fatty liver condition is more common in people with Type 2 diabetes.

Healthy eating plan: A dietitian can help you choose balanced carbs, fiber-rich foods, and satisfying portions. This reduces glucose spikes and supports steady energy. People with Type 2 diabetes often find flexible meal plans easier to follow long term.

Physical activity: Regular movement improves insulin sensitivity and lowers blood glucose. Aim for a mix of brisk walking and simple strength exercises most days. Start small and build up as your fitness improves.

Weight management: Modest, steady weight loss can improve glucose control and lower blood pressure and cholesterol. Support may include nutrition coaching, activity plans, and accountability check-ins. This is especially helpful for many living with Type 2 diabetes.

Diabetes education: Structured programs, like diabetes self-management education, can help build skills and confidence. You learn how food, activity, sleep, and stress affect your numbers. Many programs also offer ongoing support.

Glucose monitoring: Checking with a meter or a continuous glucose monitor shows how meals and activity affect your levels. You and your care team can use patterns to adjust routines. This helps prevent highs and lows in Type 2 diabetes.

Sleep routine: Getting 7–9 hours of regular, good-quality sleep supports appetite hormones and glucose balance. A steady bedtime and wake time can make a difference. Treating snoring or sleep apnea may further improve control.

Stress management: Mindfulness, breathing exercises, or counseling can lower stress hormones that raise glucose. Short daily practices can ease tension and improve focus. Supportive therapies can also help with burnout.

Smoking cessation: Quitting tobacco improves circulation and reduces heart and kidney risks. Nicotine replacement, coaching, and digital tools can boost success. Your care team can tailor a plan for you.

Alcohol moderation: If you drink, limit amounts and pair alcohol with food to reduce lows. Check glucose before bed when you’ve had alcohol. Some may need to avoid it based on medications or other health conditions.

Foot care: Daily checks, comfortable shoes, and prompt care for blisters or cuts help prevent infections. Regular foot exams can catch nerve or circulation problems early. This lowers the risk of ulcers in Type 2 diabetes.

Oral health: Brushing, flossing, and routine dental visits reduce gum disease, which can worsen glucose control. Treating gum inflammation may improve A1C. Let your dentist know you have Type 2 diabetes.

Social support: Connecting with peers, family, or community groups can make routines easier to maintain. Sharing tips and challenges keeps motivation up. Family members often play a role in supporting new routines.

Metformin: Often the first medicine used, it lowers sugar the liver releases and improves insulin use. It does not cause low blood sugar on its own and may help with modest weight loss. Stomach upset is the most common side effect and usually eases when taken with food.

GLP-1 receptor agonists: Semaglutide, liraglutide, and dulaglutide help your body release insulin when needed and slow digestion. They often lead to weight loss and can protect the heart in people at risk. Nausea is common at the start and doses are increased gradually.

Dual incretin (GIP/GLP-1): Tirzepatide helps the pancreas release insulin appropriately and reduces appetite. Many people lose weight and see strong A1C reductions. It may cause nausea or diarrhea early on.

SGLT2 inhibitors: Empagliflozin, dapagliflozin, and canagliflozin help the kidneys pass extra sugar into urine. They lower blood sugar, support weight loss, and can protect the heart and kidneys. Genital yeast infections and dehydration can occur, so staying hydrated is important.

DPP-4 inhibitors: Sitagliptin and linagliptin help raise natural insulin levels after meals without causing weight gain. They are generally well tolerated. They are less potent than GLP-1 medicines but are easy to take once daily.

Sulfonylureas: Glipizide, glimepiride, and glyburide push the pancreas to release more insulin. They lower blood sugar reliably but can cause low blood sugar and weight gain. Eating regular meals and monitoring helps reduce hypoglycemia risk.

Thiazolidinedione: Pioglitazone makes the body more sensitive to insulin. It does not trigger low blood sugar on its own but can cause weight gain and fluid retention. It may not be suitable if you have heart failure.

Basal insulin: Insulin glargine, degludec, or detemir provide steady background insulin through the day and night. They are added when tablets or injections are not enough to reach targets. Careful dose adjustment helps avoid nighttime hypoglycemia.

Mealtime insulin: Insulin lispro, aspart, or glulisine cover blood sugar rises with meals. They work quickly and can be combined with basal insulin. Counting carbohydrates and checking blood sugar help fine-tune dosing.

Meglitinides: Repaglinide and nateglinide boost insulin release around meals. They work fast and are taken with food, which offers flexibility if you skip a meal. Low blood sugar is possible, though usually shorter-lived.

Alpha-glucosidase inhibitors: Acarbose slows the breakdown of starchy foods in the gut to blunt after-meal spikes. Gas and bloating are common at first and often improve over time. It is taken with the first bite of each main meal.

Bile acid sequestrant: Colesevelam can modestly lower blood sugar and also reduce LDL cholesterol. It may cause constipation or bloating. It can interfere with absorption of other medicines, so timing matters.

Dopamine agonist: Bromocriptine-QR can help lower A1C for some people. It is taken in the morning and may cause nausea or dizziness. It is used less often when other options fit better.

Amylin analog: Pramlintide slows stomach emptying and reduces after-meal sugar surges. It is injected with mealtime insulin and can help with fullness. Low blood sugar can happen if insulin doses are not adjusted.