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How to Know If You Have Type 2 Diabetes — And How to Reverse It

The initial symptoms often go unnoticed.


The Centers for Disease Control and Prevention (CDC) estimates that 32 million Americans have type 2 diabetes, a condition in which the body’s cells have become resistant to the effects of insulin. But how do you know if you have type 2 diabetes?

First off, let’s nail down what type 2 diabetes is. Since insulin is responsible for ushering glucose (released when your body breaks down carbs in the gut) into cells for fuel, the resistance to insulin leads to excess levels of glucose in the bloodstream. This elevated blood glucose leads to a wide range of health problems.

The good news: Lifestyle interventions focused on diet and exercise can reduce weight and improve diabetes management, says Brad Bale, M.D., co-author of Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes (Buy on Amazon, $14.77). Indeed, studies show up to 98 percent of people can prevent or reverse type 2 diabetes with lifestyle changes.

What are the symptoms of type 2 diabetes?

So, how do you know if you have type 2 diabetes? Because the initial symptoms of type 2 diabetes — persistent hunger, fatigue, weight loss, excessive thirst, frequent urination, dry mouth, and blurred vision — are common and sometimes mild, they often go unnoticed and unreported to healthcare providers.

This suggests that the true impact of the disease is unknown: In fact, according to CDC, 7.3 million adults have the disease but don’t know it. As the disease progresses, more dramatic symptoms that require more urgent medical treatment begin to appear.

Who is at risk for type 2 diabetes?

Researchers don’t fully understand why some people develop type 2 diabetes and others don’t, but they do know that certain factors can make you more susceptible to the condition.

One key risk factor: having prediabetes, a condition that affects another 88 million Americans. With prediabetes, which often leads to type 2 diabetes, blood sugar is only slightly elevated and may not cause any symptoms.

Being overweight, over the age of 45, or having heart and blood vessel diseases, high blood pressure, low HDL (“good”) cholesterol, or high triglycerides also raise the risk of developing diabetes, as do smoking, stress, getting little or no exercise, sleeping too much or too little, and having a family history of the condition.

Ethnicity plays a role too. According to the CDC, the risk
of diabetes is 77 percent higher among Black people than non-Hispanic white people. Diabetes researcher Judith Simcox, PhD, an assistant professor of biochemistry at the University of Wisconsin-Madison, notes, “With type 2 diabetes, if you look at the African-American population, there seems to be a lot more under-diagnosis, and that probably leads to some of the challenges with health disparities, and why there’s not the same standard of preventive care.”

Carrying extra pounds and a lack of physical activity are in large part to blame for the increase in type 2 diabetes, asserts Dr. Bale. “Obesity is rampant, and most of that weight gets carried in the middle or the belly, and that makes the body much more resistant to insulin,” he says. Countless studies show that exercise not only wards off diabetes, but can help reverse it too.

How do you get a type 2 diabetes diagnosis?

If you’re experiencing excessive hunger, fatigue, increased thirst, or any more of these vague symptoms, it’s a good idea to ask your doctor if you might have diabetes, since the condition can pose serious consequences for your health if left untreated. Diabetes impairs the kidneys’ ability to filter impurities from the blood, and high blood sugar can damage your eyes and cause blindness. Nerve damage caused by the condition can lead to numbness, create digestive problems, and diminish sexual response.

What’s more, diabetes sufferers are up to five times more likely to get heart disease or have a stroke. So read on to find out how to know if you have type 2 diabetes.

How to Know If You Have Diabetes

To determine whether you have diabetes, your doctor will order one of three tests.

  • A1C, which averages your blood glucose over the preceding three-month period. Normal blood-sugar levels are below 5.7 percent, and a result between 5.7 and 6.4 percent is considered prediabetes.
  • The fasting plasma glucose test, which measures your blood sugar on an empty stomach. A fasting blood-sugar level of 99 milligrams per deciliter or lower is normal, 100 to 125 milligrams per deciliter indicates you have prediabetes, and 126 milligrams per deciliter or higher indicates you have diabetes.
  • The oral glucose tolerance test checks your blood glucose before and two hours after consuming a sugary drink to determine how your body handles it. A blood-sugar level of 140 milligrams per deciliter or lower is considered normal, 140 to 199 milligrams per deciliter indicates you have prediabetes, and 200 milligrams per deciliter or higher indicates you have diabetes.

Your doctor will discuss the results of each of these tests with you and help you determine your next steps.

Is it possible to cure diabetes?

“With prediabetes, typically, if you take steps like changing your diet and adding exercise, you can prevent it from going into complete diabetes,” says Simcox. And even full-blown diabetes can be treated and even reversed by making some modest lifestyle changes.

Change up your plate: Cutting calories, reducing refined carbs (especially sweets), getting more fiber, and adding veggies and fruit to your diet can dramatically improve your health.

Don’t forget to include fruit, says Dr. Bale. “Fruits like blueberries, apples, and pears are superb at helping prevent diabetes.” Treats are also on the menu. “Eating a tiny piece of 85% dark chocolate before a meal reduces the post-meal sugar surge,” he explains. That can have powerful effects, report investigators in the journal BMJ, who found that people who regularly indulge in chocolate reduce their risk of developing diabetes by 31 percent.

Make time for movement: The long-term benefits of exercise on blood sugar and insulin health are unquestionable, so squeezing in physical activity is key—but a little bit can go a long way. In a 10-year government study, participants who did 30 minutes of exercise a day paired with a healthy diet reduced their risk of developing diabetes by 58 percent.

Trim excess pounds: Maintaining a healthy weight gives you more control over your blood sugar and can help reduce the amount of medication you need to manage the disease. And you don’t need to lose much! In a study at the University of Cambridge in the UK, researchers found that people with diabetes who reduced their weight by just 10 percent over five years were more than twice as likely to reverse the condition than those who didn’t lose weight.

What’s more, that small weight loss will lower your risk of other complications like high blood pressure, high LDL (“bad”) cholesterol and arterial damage that can lead to stroke or heart

What is the best medication for diabetes?

While diet and exercise alone are enough to help some people with type 2 diabetes achieve their target blood-sugar levels, many also need medications or insulin therapy to effectively manage the disease.

Which diabetes medications are best for you depends on many factors, including your blood-sugar level and other health conditions you have. The prescription drug metformin is usually the first medication used to treat type 2 diabetes. It works by lowering glucose production in the liver and improving sensitivity to insulin so that your body uses the hormone more effectively. But your doctor may also recommend a combination of drugs from different classes to help you control your blood sugar in several different ways.

This article first appeared in our print magazine, Reverse Diabetes. (Buy on Amazon, $12.99)

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