What conditions may occur alongside type 2 diabetes?

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Obesity is a common condition in the United States. It refers to when a person has excess weight or body fat that may affect their health. According to the National Heart, Lung, and Blood Institute (NHLBI), almost 3 in 4 adults in the U.S. over the age of 20 years has overweight or obesity. Obesity tends to run in families, which often have similar dietary and exercise habits.

There is a close association between obesity and T2DM. Some evidence notes that 90% of adults with T2DM have overweight or obesity.

Some research suggests that the link between obesity and T2DM may involve high lipid levels impairing the function of the pancreas, causing it to produce less insulin. Alternatively, the body may also develop insulin resistance due to the raised lipid levels. However, this relationship is complex and still requires further research.

Obesity is a modifiable risk factor, meaning a person can manage and prevent this condition. A nutritious diet and regular exercise can help reduce the risk of obesity in most people.

Dyslipidemia is the imbalance of fatty substances known as lipids. These include:

• triglycerides
• cholesterol
• low-density lipoprotein (LDL)
• high-density lipoprotein (HDL)

Specifically, dyslipidemia in T2DM typically presents with:

• increased plasma triglycerides
• low HDL
• high LDL

According to a 2021 cross-sectional study, just over 32% of individuals with T2DM had high cholesterol levels, while 57.7% of patients had high LDL levels. Dyslipidemia is also one of the main causes of cardiovascular diseases in people with T2DM.

Hypertension occurs when the blood in the body flows at a higher pressure than typical. Most people will not know they have hypertension unless a medical professional checks their blood pressure.

Insulin resistance can cause type 2 diabetes, and the resulting high blood sugars may damage the blood vessels. Due to this, resistance in the arteries increases and body fluid volume rises. This causes a rise in blood pressure to meet the demands of the body.

According to the American Diabetes Association (ADA), 2 in 3 people with diabetes will either report having raised blood pressure or will be taking medication to lower their blood pressure. Similarly, a 2019 cohort study found that 85.1% of people with T2DM had hypertension.

Click here to learn more about diabetes and hypertension.

Because T2DM can strain the blood vessels and nerves that control the heart, it may lead to heart disease over time. Fatty deposits can develop in the heart’s artery walls and result in increased blood pressure and the arteries hardening.

Approximately 30% of people with T2DM have heart disease. A person with T2DM is twice as likely to develop heart disease or have a stroke compared with someone without diabetes. Additionally, their chance of developing heart disease increases the longer they have diabetes.

According to the Centers for Disease Control and Prevention (CDC), a person with T2DM is more likely to develop heart failure. This is where the heart cannot pump blood as efficiently and can lead to other consequences, such as swelling in the legs, fluid building up in the lungs, and difficulty breathing.

Cardiovascular diseases, such as heart attacks and strokes, are also the main cause of death in people with diabetes.

The primary role of the kidneys is to filter waste products and extra water out of the body. They also aid in blood pressure regulation and release hormones.

In T2DM, high blood sugar causes damage to the kidneys’ blood vessels, impairing their function. However, most people with kidney disease do not have symptoms. According to the National Kidney Foundation, T2DM is the principal cause of kidney failure.

Click here to learn more about how to prevent kidney damage due to diabetes.

Due to the many requirements of T2DM management, such as blood sugar level monitoring, insulin dosing, and meal-planning, a person may experience mental health complications such as:

• depression
• anger
• stress
• anxiety
• suicidal ideation

According to the CDC, people with diabetes are 2–3 times more likely to experience depression compared with people without diabetes. The CDC also notes that only 25–50% of individuals who have diabetes and develop depression actually receive a diagnosis and treatment.

Click here to learn more about how diabetes can affect mental health.

Sleep disturbance affects between 42% and 76.8% of people with T2DM. Uncontrolled blood sugar levels may result in people with T2DM waking up more often and having to urinate more frequently at nighttime. Additionally, the associated depression with T2DM can also contribute to the risk of developing sleep disorders.

Common sleep disorders that a person with T2DM may experience can include:

• Restless leg syndrome: This is where a person may experience uncomfortable sensations in the leg that results in an irresistible urge to move them.
• Sleep apnea: This condition causes someone’s breathing to often stop and restart during asleep.
• Insomnia: This disorder occurs when a person has trouble falling asleep, staying asleep, or getting a good quality of sleep.

Click here to learn more about diabetes and sleep.

There is an association between T2DM and the chance of developing some cancer types, including:

• liver cancer
• pancreatic cancer
• breast cancer
• bladder cancer
• colon cancer

Researchers believe a combination of factors may increase the risk of cancer development in people with T2DM, including insulin resistance, inflammation, and overstimulated cell growth.

There are some things a person with T2DM can do to try and prevent comorbidities and manage their condition. Someone who has prediabetes could prevent or delay T2DM. An individual with T2DM can also use techniques to prevent the development of comorbidities. Prevention techniques can include:

• joining a diabetes prevention program, which may be able to reduce their risk of developing T2DM by 58% over 3 years
• taking part in more physical activity
• following a nutritious diet with a focus on whole grains, nuts, legumes, vegetables, and fruits
• stopping smoking
• losing weight

A person with T2DM should also adhere to treatment plans they discuss with their medical professional to ensure their condition is well-managed. For example, a doctor may prescribe metformin for someone with T2DM to help control their blood sugar.

The ADA has a Living with Type 2 Diabetes Program that can help people with T2DM learn more about their condition and how to manage it.

Click here to learn more about preventing complications from T2DM.

T2DM is a form of diabetes that results from the body not responding typically to insulin. This causes blood sugar levels to rise, which can affect the rest of the body. This can result in the development of another chronic condition. When a person has two or more chronic conditions, a doctor may refer to these conditions as comorbid.

A person with T2DM is more likely to develop comorbidities such as heart disease, sleep disorders, cancer, obesity, dyslipidemia, and hypertension. Someone with T2DM can reduce their likelihood of developing comorbidities through various methods, including dietary changes, partaking in more physical activity, following their treatment plan, and managing their weight.