Type 2 diabetes

Symptoms of type 2 diabetes

Type 2 diabetes develops over time and initially causes minimal symptoms. If you live with the condition for a long time before being diagnosed, you will probably feel tired and exhausted, and you may also experience weight loss and perhaps feel unusually thirsty.  

As people with type 2 diabetes often have no symptoms, doctors need to look for other factors that increase the risk of type 2 diabetes. These include: 

• Being overweight or obese  
• Large waistline (over 94 cm for men and 80 cm for women)  
• Low levels of physical activity (less than 30 minutes of physical activity per day)  
• A diet high in meat, saturated fat and processed foods, high consumption of foods and drinks with high sugar content and/or little fibre, wholegrain, fruits and vegetables  
• Hereditary factors (if your parents or siblings have type 2 diabetes, you will be at greater risk of developing it)  
• Ethnicity (people from Asia and Africa are at a higher risk of developing type 2 diabetes)  
• Age (insulin works less effectively as you get older)  
• Use of corticosteroids (such as prednisolone) and some anti-psychotic drugs (such as clozapine and olanzapine)  
• Smoking 
• History of gestational diabetes 

Many people with type 2 diabetes also have: 

• Polycystic ovary syndrome (PCOS) (in Norwegian)
• High blood pressure (in Norwegian) 
• Cardiovascular disease (in Norwegian) 
• Obstructive sleep apnoea (stopping of breathing during sleep) (in Norwegian) 

Investigation and diagnosis

Type 2 diabetes is diagnosed using a blood test that measures your average blood sugar level (HbA1c). The blood sample will reflect the average blood sugar level in your body over the last two to three months.  

You have diabetes if your average blood sugar level in two samples taken on different days is greater than or equal to 48 mmol/mol. If the results are between 42 and 46 mmol/mol, you are at a high risk of developing type 2 diabetes. In this case, you should consult your doctor to find out what you can do to reduce your risk of developing the condition, and you should also measure your average blood sugar level every year. 

What happens to your body when you have type 2 diabetes?

In the case of type 2 diabetes, glucose circulating in the blood after a meal will not be absorbed as well by the cells in your body. The reason why the cells do not absorb enough glucose is a combination of insulin not working as well as it should and/or your body being unable to produce enough insulin. 

Insulin is a hormone produced in the pancreas that ensures that the glucose from the carbohydrates in the food you eat enters the cells in your body, where it can be used for energy. Having too much glucose in your blood over time can damage many of the organs in your body.

Education and self-care

Physical activity (in Norwegian) and a healthy diet (in Norwegian) can reduce your risk of developing type 2 diabetes. They also form the cornerstones for the treatment of people who have been diagnosed with type 2 diabetes. 

Lifestyle changes reduce the risk of late-onset injuries and the need for medication. Some people can even reverse the condition by making major lifestyle changes. This will usually apply to people who are overweight or obese and lose a lot of weight. Weight loss of at least 5-15% will usually be necessary. This is called remission and means that your blood sugar levels remain normal as a result of the lifestyle and weight changes you have made, but the condition can return. If this is not your goal, smaller lifestyle changes can also have a positive impact on your health. 

Making changes to your lifestyle and good self-care require both effort and knowledge. You can get guidance and support from your GP, hospital or other services in the municipality, such as the Healthy Lifestyle Centre. Information courses on the practical aspects of type 2 diabetes are available at your local hospital. 

Preventing late-onset injuries

The treatment of diabetes aims not only to lower your blood sugar level, but also to reduce the risk of cardiovascular disease (in Norwegian) and other late-onset injuries resulting from diabetes (such as impaired vision, reduced sensation in the feet, kidney damage and erectile dysfunction).  

The following factors affect the risk of late-onset injuries resulting from diabetes and should therefore be discussed with your doctor:  

• physical activity (in Norwegian) 
• diet 
• weight loss (if you are overweight) 
• stopping smoking (if applicable)
• blood glucose management and average blood sugar level (HbA1c) 
• blood pressure 
• the level of fats in the blood (especially LDL cholesterol) 

Smoking habits

Smoking is particularly dangerous for people with diabetes. If you smoke, talk to your doctor about it. Smoking increases the risk of the most serious and common diabetes complications, such as heart attack, stroke and kidney failure. Smoking also increases the risk of developing many other conditions that are also associated with a higher risk for those diagnosed with diabetes. These conditions include reduced blood circulation in the legs, foot ulcers, heart failure, erectile dysfunction, gingivitis, cataracts, cancer and dementia. One of the most important things you can do to preserve your health and live a long and healthy life with diabetes is therefore not to smoke. 

There are many effective tools to help you quit smoking in the form of advice, mobile apps (in Norwegian), courses (in Norwegian) and drugs (in Norwegian), and your doctor can also help you to successfully stop smoking. 

Blood sugar-lowering tablets and insulin 

If lifestyle changes are not enough, you may need to take blood sugar-lowering drugs and/or insulin (and perhaps other drugs too) to reduce the risk of developing late-onset injuries from diabetes. If you experience side effects from a drug, you may find that it helps to switch to another drug. Talk to your doctor about your choices and let them know if you experience any side effects from the medication you are taking. 

Diabetes and dental health 

It is particularly important to keep your teeth and gums clean if you have diabetes (pdf) (in Norwegian). The best way to do this is to make sure you brush your teeth twice a day with a fluoride toothpaste and floss or use an interdental brush daily. 

Diabetes can weaken your immune system and lead to increased mouth dryness. This allows bacteria to multiply and cause gingivitis. Gingivitis can worsen blood sugar management and even lead to teeth coming loose.  

If you develop severe gingivitis, your dentist can assess whether you are entitled to social security benefits.

Management and check-ups for type 2 diabetes

Most people with type 2 diabetes have check-ups with their GP (diabetes.no) (in Norwegian), but some have check-ups at a hospital. How often you have diabetes check-ups will depend on your needs.  

Over the course of a year, you should be checked for various risk markers for diabetes complications. Making sure that each of these risk markers is kept under control will significantly reduce the risk of complications. This is often known as an “annual check-up”, but it can be split across several doctor’s appointments.