Overview

Type 2 diabetes is a long-term condition in which blood sugar stays too high because the body does not respond well to insulin and does not make enough of it. Prediabetes means blood sugar is higher than normal but not yet in the diabetes range. Both can go unnoticed for years, so regular testing matters.

Type 2 diabetes is common in Kuwait and the Gulf and is linked to excess weight, low activity, and family history. With healthy habits, regular checkups, and modern medicines, most people can keep blood sugar in a healthy range and lower the risk of complications. Prediabetes can often return to normal with lifestyle changes.

Symptoms

• Often no symptoms, especially in prediabetes
• Strong thirst and frequent urination, including at night
• Tiredness and blurred vision
• Slow-healing cuts or repeated skin, gum, or urine infections
• Tingling or numbness in the feet
• Dark, velvety skin on the neck or armpits
• Seek urgent care for vomiting, confusion, or fast breathing with very high sugar, or shaking, sweating, and confusion from very low sugar

Causes & Risk Factors

• Excess weight, especially around the waist
• Low physical activity and long hours of sitting
• A diet high in sugary drinks, sweets, white bread, white rice, and fried food
• A parent or sibling with diabetes
• Age 35 and older, though it now appears in younger adults and teens
• Past gestational diabetes or polycystic ovary syndrome (PCOS)
• High blood pressure, high triglycerides, or low HDL cholesterol

Complications

• Heart attack and stroke
• Kidney disease
• Eye damage (diabetic retinopathy) that can affect vision
• Nerve damage causing pain or numbness in the feet
• Foot ulcers and infections that heal slowly
• Gum disease and erectile dysfunction

Diagnosis

Diagnosis uses blood tests with American Diabetes Association (ADA) cutoffs: an HbA1c of 6.5% or higher means diabetes, and 5.7–6.4% means prediabetes. For fasting glucose, 126 mg/dL (7.0 mmol/L) or higher means diabetes, and 100–125 mg/dL (5.6–6.9 mmol/L) means prediabetes. For the 2-hour oral glucose tolerance test (OGTT), 200 mg/dL (11.1 mmol/L) or higher means diabetes, and 140–199 mg/dL (7.8–11.0 mmol/L) means prediabetes. A second test usually confirms the result unless symptoms are clear and sugar is very high.

Treatment

• Healthy eating, regular activity, and weight loss as the base of care
• Metformin, often the first medicine prescribed
• GLP-1 receptor agonists, injections or tablets that lower sugar and support weight loss
• SGLT2 inhibitors, tablets that also help protect the heart and kidneys
• Insulin or other medicines when needed
• Regular checks of HbA1c, blood pressure, cholesterol, kidneys, eyes, and feet
• Ramadan: seeing a doctor several weeks before fasting to check safety and adjust medicines

Prevention

• Losing 5–7% of body weight when overweight
• At least 150 minutes of moderate activity a week, such as brisk walking indoors or in cooler hours
• Water instead of sugary drinks and juices
• More vegetables, legumes, and whole grains, and smaller portions of rice and bread
• No smoking, including shisha
• Blood sugar testing from age 35, or earlier with excess weight and other risk factors
• During Ramadan, checking sugar often and breaking the fast if it goes too low or too high, as the doctor advises

The Internal Medicine and Laboratory departments at AlHayat Medical Center test for, diagnose, and manage type 2 diabetes and prediabetes.

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