Type 2 diabetes

Type 2 diabetes is a chronic metabolic disease and the most common form of diabetes. Under normal conditions, insulin, a hormone produced by the pancreas, allows glucose (sugar) to move from the bloodstream into the body's cells, where it is used for energy. In type 2 diabetes, insulin resistance typically develops, meaning that the cells respond less effectively to insulin. As a result, glucose is not absorbed efficiently and accumulates in the bloodstream. Initially, the pancreas attempts to compensate by producing more insulin, but over time it may struggle to produce the amount required, causing blood sugar levels to rise.

Unlike type 1 diabetes, which is caused by an autoimmune response that damages the insulin-producing beta cells in the pancreas, type 2 diabetes usually develops gradually and is associated with a combination of genetic predisposition, age, overall health, and lifestyle factors. The disease also tends to progress slowly and is often discovered incidentally during a routine blood test.

Risk factors for type 2 diabetes include excess body weight, abdominal obesity, physical inactivity, and an unbalanced diet. However, the disease is not caused by a single factor and can also develop in people who are not overweight. It is therefore important to view type 2 diabetes as a complex disease influenced by a combination of biological, environmental, and behavioral factors.

When blood sugar levels remain poorly controlled over time, they can damage blood vessels and nerves, increasing the risk of complications such as cardiovascular disease, stroke, vision impairment, kidney damage, and nerve damage that may cause pain, tingling, numbness, or reduced sensation. Early diagnosis, regular medical follow-up, and effective blood sugar management, together with treatment of other risk factors such as high blood pressure and abnormal blood lipid levels, can help reduce the risk of these complications.

Treatment for type 2 diabetes is tailored to each individual's medical condition and may change over time. It typically includes a combination of a personalized diet, regular physical activity, weight loss when needed, and ongoing medical follow-up. Depending on the patient's condition, treatment may also involve oral medications, injectable therapies, or, in some cases, insulin. The goal is to maintain healthy blood sugar levels, reduce the risk of complications, and preserve the normal function of blood vessels, the heart, kidneys, eyes, and nerves.

Alongside existing treatments, researchers are exploring ways to restore pancreatic beta cells in order to address the underlying cause of the disease. At the Dangoor Center for Personalized Medicine at Bar-Ilan University, Dr. Ron Piran is investigating approaches to regenerate these cells as a foundation for the development of future diabetes therapies.

Frequently Asked Questions

1. What is type 2 diabetes?

Type 2 diabetes is a chronic disease in which the body has difficulty regulating blood sugar levels. In this condition, insulin resistance typically develops: the body continues to produce insulin, but the cells respond less effectively to it. As a result, glucose (sugar) accumulates in the bloodstream instead of being properly absorbed by the cells. It is the most common form of diabetes and usually develops gradually, most often in adulthood, although it has increasingly been diagnosed in younger people in recent years.

2. What are the risk factors for developing type 2 diabetes?

Type 2 diabetes develops as a result of a combination of genetic predisposition, age, overall health, and lifestyle factors. Known risk factors include a family history of diabetes, excess body weight, particularly abdominal obesity, physical inactivity, an unbalanced diet, high blood pressure, abnormal blood lipid levels, and a history of gestational diabetes. However, the disease is not caused by a single factor and can also develop in people who are not overweight.

3. What are the common symptoms of type 2 diabetes?

Type 2 diabetes usually develops gradually and may not cause obvious symptoms in its early stages. When blood sugar levels remain elevated over time, symptoms may include frequent urination, especially at night, increased thirst, dry mouth, fatigue, and weakness. Other symptoms can include blurred vision, recurrent infections, tingling or a pins-and-needles sensation in the feet, and slow wound healing.

4. What is the difference between type 1 and type 2 diabetes?

Both types of diabetes result in elevated blood sugar levels, but they do so for different reasons. In type 1 diabetes, the immune system attacks the insulin-producing cells of the pancreas, causing the body to produce little or no insulin. This disease is not caused by lifestyle factors, and treatment requires insulin therapy.

In type 2 diabetes, the body usually continues to produce insulin, but the cells respond less effectively to it. This form of diabetes is more closely associated with age, body weight, overall health, and lifestyle factors such as diet and physical activity. As a result, lifestyle changes can play an important role in treatment.

5. What is insulin resistance, and how is it related to diabetes?

Insulin resistance is a condition in which the body's cells, particularly those in muscle, fat, and liver tissue, respond less effectively to insulin than they normally would. Under normal circumstances, insulin helps glucose (sugar) move from the bloodstream into cells, where it is used for energy. When the body's response to insulin becomes impaired, glucose remains in the bloodstream at higher levels. Initially, the pancreas attempts to compensate by producing more insulin, but over time it may struggle to produce the amount required, causing blood sugar levels to rise.

6. Which blood tests are used to diagnose type 2 diabetes, and what is prediabetes?

Type 2 diabetes is diagnosed by a healthcare professional based on blood test results and an individual's overall medical condition. Common tests include the fasting blood sugar test and the HbA1c test, which reflects average blood sugar levels over the previous several months.

As a general guideline, fasting blood sugar levels of 100–125 mg/dL may indicate prediabetes, while a level of 126 mg/dL or higher may indicate diabetes. For the HbA1c test, values of 5.7%–6.4% may indicate prediabetes, while a value of 6.5% or higher may indicate diabetes. However, diagnosis should not be based on a single test alone, and test results should not be interpreted without medical guidance.

7. How are blood sugar levels measured and monitored?

Blood sugar levels are most commonly measured and monitored using blood tests, a glucometer that analyzes a small blood sample from a finger prick, or a continuous glucose monitoring (CGM) sensor. Alongside these established methods, researchers at the Dangoor Center at Bar-Ilan University are investigating a non-contact approach to measuring blood sugar levels using lasers, imaging technology, magnetic fields, and artificial intelligence. The goal is to develop a more convenient and less invasive method of monitoring glucose levels in the future. However, diagnosis and routine monitoring currently continue to rely on established testing methods and technologies.

8. Can type 2 diabetes be prevented or cured?

The risk of developing type 2 diabetes can be reduced, and in some cases the disease can enter remission, a state in which blood sugar levels return to the normal range without ongoing medication or with reduced treatment, as determined by a physician. This depends on several factors, including the duration of the disease, body weight, diet, physical activity, and pancreatic function. A balanced diet, regular physical activity, weight loss when needed, and ongoing medical follow-up can improve insulin sensitivity, help maintain healthy blood sugar levels, and slow disease progression.