Type 2 diabetes – what's going on in your body?

If you have type 2 diabetes, your body gradually stops making enough insulin and becomes less able to use the insulin it does make effectively. With too little insulin, your body cannot absorb glucose from the food you eat and your blood sugar levels rise and become harmful to your health.

Understanding the connection between insulin, blood glucose and your average blood glucose levels over time – also known as HbA1c – is important for controlling type 2 diabetes.

HbA1c is a measure of your blood glucose levels over the last two to three months. Your healthcare professional will perform a blood test to measure your HbA1c and use this to set a target blood glucose (sugar) range for you.

If you have type 2 diabetes, every 1% drop in HbA1c reduces your risk of complications. The HbA1c target ranges for people with prediabetes and type 2 diabetes are shown in this image.

While it is very important to stay within the target HbA1c range determined by your doctor, it is normal for your blood glucose levels to fluctuate throughout the day depending on many factors. However, it can be dangerous if your blood glucose levels go above or below the healthy range and are left untreated.

High blood sugar, known as hyperglycaemia or 'hypers', damage your blood vessels. It can reduce the supply of oxygen and nutrient-rich blood to your body's organs and nerves and, over time, cause serious health complications.

Controlling your high blood glucose levels will help you avoid complications like:

• Heart attack
• Stroke reduced eyesight or blindness
• Kidney disease
• Nerve problems
• Blocked circulation in the feet
• Gangrene leg amputations

Low blood glucose (sugar), known as hypoglycaemia or ‘hypos’, occurs when blood sugar levels fall below 4.0mmol/L.

High blood glucose is dangerous in the long-term, but low blood glucose levels can also impact your health.

You may have already experienced low blood glucose (sugar) without knowing it. People with diabetes who are on medication need to be aware of the signs and symptoms of low blood glucose (sugar). They can include:

• Shakiness or feeling weak
• Sweating, chills and clamminess
• Confusion
• Headache
• Rapid/fast heartbeat
• Light-headedness or dizziness
• Nervousness, anxiety or irritability
• Blurred or impaired vision

Low blood glucose (sugar) and its symptoms can be dangerous and you need to know what to do if they happen.

You can experience low blood sugar for many reasons, including if you:

• do unplanned exercise
• have missed or delayed a meal or snack
• take too much insulin or insulin secretagogue (insulin secretion inducers; sulfonyurea and glinides)
• drink alcohol without food
• experience stressful situations

On average, studies show that people with type 2 diabetes on insulin treatment experience 23 low blood glucose (sugar) episodes (mild or moderate) over a year.

The effects of low blood sugar can be different for everyone and hypoglycaemia symptoms can range from mild to severe.

Repeated hypoglycaemia can, over time, lead to 'hypo unawareness', where the warning symptoms of low blood glucose stop being felt, making it harder to identify and more difficult to manage.

Download the Hypoglycaemia Profiler to help recognise and track your hypos.

It is important to speak with a doctor or a nurse if you are experiencing low blood glucose (sugar). In some cases, it is a good idea to drink a fruit juice or eat 3 candies in order to get immediate relief, or eat 3 or 4 sugar tablets if you have them under the recommendation of your doctor or nurse. Your doctor can help you find the best option for you in case of hypoglycemia and may adjust the dose of your other diabetes medicines to reduce the risk of low blood glucose (sugar).

January 2024. IE23DI00227