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For our project, our group decided to pick Type 2 Diabetes.

We chose this illness to help raise awareness of this condition. By doing so, we will provide ample information and statistics on Type 2 Diabetes and promote early detection and lifestyle changes. In return, our audience will gain knowledge about prevention and management tactics to improve their health outcomes.

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Type 2 Diabetes can occur in people of all ages, but the risk for developing it increases significantly with old age. According to the CDC, Type 2 Diabetes commonly develops in individuals over the age of 45. It is important to note that in recent years, more and more children, teens, and young adults are developing this condition.

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Type 2 diabetes is caused when the body’s cells stop responding properly to insulin, leading to higher blood sugar levels over time. This disease is largely preventable and strongly related to lifestyle, although genetics and family history also play a role. Some of the main contributing factors include physical inactivity, being overweight or obese, poor sleep, and chronic stress. Other factors that increase the likelihood of developing Type 2 diabetes include being over the age of 45 and having certain health conditions such as PCOS, high blood pressure, and high cholesterol.

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Your ethnicity and family history can also be risk factors for developing Type 2 Diabetes. According to the CDC, the prevalence of those diagnosed with diabetes is higher among individuals of African American, Hispanic, and Asian descent. Not only that, but those with a close relative who is diagnosed with this condition are more likely to develop it themselves, compared to those who don’t have a family history.

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Gestational diabetes can occur in women during pregnancy, even if they haven’t had previous history of diabetes. This can happen due to hormonal changes, physical inactivity, obesity, and even unhealthy food choices. Developing gestational diabetes makes women more likely to develop Type 2 Diabetes later in life. These risks not only affect the mother, but they also put the child's health at risk. Gestational diabetes increases the babies risk of becoming obese and developing Type 2 Diabetes in the future.

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Insulin is a hormone made by the pancreas that allows blood sugar to enter cells for energy. In type 2 Diabetes, the body’s cells do not respond normally to insulin. This is known as insulin resistance. Insulin resistance causes high blood sugar levels in the body because glucose is not properly absorbed by the cells.

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Because of insulin resistance, the body's cells do not respond to insulin the way they should. To make up for this, the pancreas attempts to produce even more insulin to get the body's cells to respond. Over time, this causes damage to the pancreas cells. Then, the pancreas can no longer keep up and fails to make enough insulin to maintain a healthy range of blood sugar levels. This further contributes to consistently high levels of sugar in the blood.

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More Negative Feedback: The Incretin Response

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More Negative Feedback: The Incretin Response

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The incretin response is the body’s natural hormonal reaction to food intake, especially glucose. After a meal, incretin hormones like GLP-1 (glucagon-like peptide-1) are released from the gut, which stimulate the pancreas to release more insulin and help regulate blood sugar levels. This process supports homeostasis by ensuring that glucose from food is quickly and efficiently moved into the body’s cells. However, in type 2 diabetes, the incretin response is severely impaired or nearly absent. This means the body loses a crucial mechanism for boosting insulin after meals, causing blood sugar levels to remain elevated. Over time, this contributes to a vicious cycle: higher blood sugar leads to more insulin resistance, increased fat storage, and additional metabolic strain. Instead of maintaining balance, the body falls further out of regulation, making the condition progressively worse.

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The Hypothalamus: A Central Puzzle Piece

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The Hypothalamus: A Central Puzzle Piece

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While type 2 diabetes is often viewed as a peripheral disease involving insulin resistance in muscle, fat, and the liver, recent research shows that the hypothalamus, a brain region responsible for energy and glucose regulation, also plays a key role. Inflammation and insulin resistance in the hypothalamus can impair hunger signaling, worsen glucose regulation, and promote further weight gain. This central dysfunction helps explain why lifestyle changes alone can be difficult to sustain and why T2D is such a complex, whole-body disease.

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In type 2 diabetes the body may have a hard time in regulating the break down and storage of fats. This can lead to increased free fatty acids in the blood stream which can further contribute to insulin resistance.

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The hemoglobin A1c test is a blood test commonly used to diagnose Type 2 Diabetes. This test measures an individual's average blood sugar levels over the past 2-3 months by examining the percentage of blood sugar attached to the hemoglobin. Results of 6.5% or higher on two separate tests indicate diabetes.

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People with Type 2 Diabetes face a significantly higher risk of cardiovascular complications such as heart attacks and heart failure due to prolonged exposure to high blood glucose levels. High blood sugar levels can lead to blood clots that damage blood vessels over time and cause plaque buildup within the heart's arteries. This ultimately restricts or completely blocks the flow of oxygen-rich blood to the heart. Even when glucose levels are managed, related conditions such as high blood pressure and high cholesterol increase strain on the heart and further contribute to hardening of the arteries. These factors make heart disease one of the most serious complications of Type 2 Diabetes, as it is the leading cause of death within this population. Managing blood sugar levels, blood pressure, and cholesterol is a key aspect of long-term care for this condition.

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High blood glucose levels overwhelm the kidneys' ability to reabsorb glucose during filtration. As a result, excess glucose spills into the urine, drawing more water with it through osmosis. This leads to increased urine production and frequent trips to the bathroom, especially noticeable at night.

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Frequent urination causes the body to lose a significant amount of fluids, leading to dehydration. In response, the brain's thirst center is activated, prompting the person to drink more water to compensate for the fluid loss. Despite drinking more, the cycle continues unless blood glucose levels are controlled.

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In type 2 diabetes, insulin resistance prevents glucose from entering cells efficiently. Even though there is plenty of glucose in the blood, the body’s cells are “starving” for energy. This energy shortage triggers the brain to signal hunger, leading to excessive eating in an attempt to get more fuel to the cells.

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About 1 in 3 people with Type 2 Diabetes develop kidney disease, also known as diabetic nephropathy. Diabetic nephropathy is a serious and progressive disease caused by long-term high blood sugar levels damaging the small blood vessels within the kidneys. Damage to the kidney’s blood vessels reduces the kidney's ability to filter waste properly and may lead to protein leaking into the urine. This condition gradually progresses across five stages, and within each stage, kidney function declines. Symptoms such as foamy urine and fatigue are common in earlier stages, but in later stages, symptoms such as confusion, swelling in arms, feet, and legs, trouble sleeping, and even chest pain are common. As kidney function declines, complications such as heart disease increase. Kidney disease can significantly worsen an individual's overall health and lead to life-threatening complications, so proper management of blood sugar is crucial in Type 2 Diabetes.

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High blood sugar levels impair blood circulation and also weaken the immune system. The reduced blood flow means that there is less oxygen and nutrients that are reaching the wound which delays the body's regular healing process. The increase in glucose also damages the white blood cells, which play a vital role in fighting off infections that we are exposed to, which in turn can further delay the healing process of our body.

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A treatment for people with type 2 diabetes is lifestyle changes. This means making an eating plan that includes Whole Foods, vegetables, fruits, and lean protein. They should avoid sugary drinks, processed food and consuming too much saturated and trans fat. Exercising regularly can also help because it improves insulin sensitivity and helps manage the body's glucose levels since the body uses glucose for energy when you exercise, which can lead to lower blood sugar levels.

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High blood sugar levels damage the small blood vessels in the retina which can potentially lead to loss in vision and blindness. When a person has high blood sugar levels for an extended period of time the high blood sugar begins to weaken and damage the small blood vessels that supple the retina. As the blood vessels begin to get damaged fluid, blood, and other substances begin to leak into the retina causing it to swell. In an attempt to compensate for damaged blood vessels the eye will try to grow new blood vessels, however these new blood vessels can be fragile and break easily. If they are not maintained it can lead to serious vision problems, including blindness. This matters in the long term management of type 2 diabetes because it affects the quality of life for an individual and it is also the leading cause of vision loss in adults with diabetes.

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The fasting blood glucose test is a blood test that is taken after an individual has fasted for 8-12 hours. This test measures the amount of sugar in the blood when it should be at its lowest. Diabetes is diagnosed if fasting blood glucose is greater than or equal to 126mg/dL

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Metformin is commonly prescribed to those with Type 2 Diabetes. It is a first-line medication that manages high blood sugar levels by reducing glucose absorption/production and improving insulin sensitivity. This medication works best when paired with lifestyle changes such as healthy eating and exercise.

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This test examines Blood Glucose levels 2 hours after drinking a glucose rich beverage.

Diabetes threshold:>200 mg/dl (11.1 mole/L) after 2 hours

Pre Diabetes: 140-199mg/dL (7.8-11.0 mole/L)

Repeating testing is usually recommended to confirm diagnosis.

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Managing your blood pressure control as well as your Cholesterol Management. Taking aspirin for certain high risk cardiovascular patients. Also having to monitor for kidney, eye and foot care. Having a plan for everything to help yourself control your levels.

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You can start to have peripheral neuropathy, numbness, tingling, or pain in the feet and hands. This can also affect digestion, bladder, your heart rate and blood pressure.

You can also start to get foot ulcers, infections, and start to have amputions done if you don’t maintain your Type 2 diabetes. Other disorders can start with bone and joints, increased infections and trigger your mental health if you try to stay on Top of your symptons.

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People with Type 2 Diabetes are two times more likely to develop hearing loss compared to people of the same age who don’t suffer from this condition. This is because prolonged exposure to high blood sugar causes damage to the small vessels and nerves within the inner ear. Annual hearing tests performed by an audiologist are an important step in detecting complications early on and protecting long-term hearing health. Relevant treatments include the use of hearing aids and cochlear implants. Hearing aids are small devices worn in or behind the ear that amplify sound to improve hearing. A cochlear implant is a device used in those with severe hearing loss. It sits under the skin in the inner ear and provides a sense of sound. An audiologist is able to diagnose the level of hearing loss and may work alongside a hearing instrument specialist to provide and fit hearing aids.

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Physical therapy is a great long-term treatment option that can improve the overall health outcomes and quality of life for those living with Type 2 Diabetes. Physical therapy that focuses on resistance training has been shown to improve muscle strength, insulin sensitivity, and can even promote better blood sugar management. A physical therapist (PT) can tailor resistance training exercises to each individual's needs. They can also determine the proper intensity and frequency while ensuring that the exercises are done safely and effectively.

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Lifestyle medicine focuses on reversing or managing Type 2 Diabetes through sustained dietary changes, regular physical activity (150+ minutes per week), stress management, adequate sleep, and weight loss, without relying solely on medication. For structured programs (e.g., the National DPP), costs can range from $200 to $800, though many community-based options are low-cost or free. This treatment is frequently covered by private insurance and Medicare Part B. Avoiding this approach increases the risk of uncontrolled blood sugar, weight gain, and insulin resistance, which can lead to higher long-term medical expenses and serious complications such as heart disease, neuropathy, kidney failure, and vision loss.

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Diabetes Self-Management Education and Supports (DSMES)

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Diabetes Self-Management Education and Supports (DSMES)

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DSMES teaches patients how to manage their condition through skills such as monitoring blood glucose, reading food labels, using medications correctly, coping with stress, and solving everyday problems related to diabetes care. The cost can range from $200 to $1,600, depending on the length and format (group vs. individual). This treatment is typically covered by Medicare, Medicaid, and most private insurance plans. Avoiding treatment can result in a poor understanding of diabetes management, leading to more frequent ER visits and hospitalizations. It may also increase the risk of serious complications due to missed warning signs, incorrect medication use, or unhealthy lifestyle choices that worsen the condition.

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Though many medications are prescribed for Type 2 Diabetes, Metformin is one of the most widely used oral medications. It lowers glucose production in the liver and improves insulin sensitivity. It is often the first-line treatment for managing Type 2 Diabetes. The cost typically ranges from $4 to $30 per month (about $50 to $360 per year). Metformin is almost always covered with a minimal copay under Medicare Part D and most private insurance plans. If treatment is avoided, elevated blood glucose levels can persist, leading to irreversible organ and nerve damage. This can result in the need for more expensive and invasive treatments in the future, such as insulin injections and hospitalizations.

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Many people suffering from Type 2 Diabetes often report symptoms of anxiety and depression. These specific psychological challenges can be damaging to the individual's health, as these symptoms are associated with poor self-care, low levels of productivity, and even reduced medication adherence. Cognitive Behavioral Therapy (CBT) can be used to help manage these symptoms. CBT is a structured and goal-oriented talk therapy that challenges negative thought patterns and reshapes responses to unsettling situations. CBT for Type 2 Diabetes can improve self-care behavior, physical activity, glycemic control, and medication adherence. Licensed mental health professionals, such as psychologists, counselors, therapists, and mental health clinicians, can provide Cognitive Behavioral Therapy.

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Integrated Behavioral Health Consulting (IBHC)

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Integrated Behavioral Health Consulting (IBHC)

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IBHC is a team-based approach in which behavioral health specialists work alongside primary care providers to address both the physical and psychological aspects of Type 2 Diabetes. This model integrates mental health support directly into medical visits, making it easier for patients to receive comprehensive care.

Targeted symptoms include depression, anxiety, diabetes-related distress, low motivation or poor self-care, difficulty with lifestyle changes, and stress that affects blood sugar management.

Healthcare professionals who can deliver this approach include Licensed Clinical Social Workers (LCSWs), Licensed Professional Counselors (LPCs), Psychologists, Behavioral Health Consultants, and members of integrated care teams.

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Motivational Interviewing and Problem Solving Therapy

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Motivational Interviewing and Problem Solving Therapy

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Motivational Interviewing(MI) and Problem Solving Therapy (PST) are effective approaches to manage type 2 diabetes when they are used simultaneously. MI focuses on and enhancing an individual's motivation to change, while PST provides the person with the skills that they need to to be able to identify and solve problems that allow them to manage their diabetes which in turn can improve the person's overall well being. The people who typically provide this Motivational and Problem-Solving Therapy are Doctors, nurses, Certified Diabetes Educators(CDEs), and Pharmacists.

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One of the many things that Occupational Therapists help patients with type 2 Diabetes is lifestyle modification. This involves things such as helping them develop and maintain healthy habits like regular physical activity, balanced nutrition, and making sure that they follow through with taking their medications regularly. This type of rehabilitation can treat both short and long term effects of type 2 diabetes.

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Occupational Therapy lifestyle modification type 2 diabetes

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The cost of diabetes treatment depends on your location. In the United States, the average annual cost of treatment is about $16,750, with about $9,600 of that attributable to diabetes care. On average, people with this condition pay 2.3 times more in medical expenses than those without this condition. Other countries like Canada have provincial healthcare coverage, which reduces the financial cost. Out-of-pocket expenses for Type 2 Diabetes care in Canada typically range from $1,000 to $2,000 per year. In the United Kingdom, most diabetes care is free.

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Quitting/Limiting Bad Habits: Smoking and Drinking 

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Quitting/Limiting Bad Habits: Smoking and Drinking 

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Smoking increases the risk of developing Type 2 Diabetes by 30-40%. Nicotine in cigarettes and chemicals in other tobacco products trigger inflammation. This impairs blood sugar regulation and makes diabetes management that much harder. Smokers often need larger dosages of insulin to maintain healthy blood glucose levels. Nicotine is a highly addictive substance, which makes it very challenging to quit. The difficulty level for this lifestyle change sits at an 8/10.

Excessive alcohol consumption causes chronic inflammation in the pancreas, impairing its ability to secrete insulin. Certain alcohols are also high in calories in carbohydrates, contributing to weight gain and high blood sugar. Limiting alcohol consumption can be challenging, especially when using it as a stress relief. This makes the difficulty level for this lifestyle change sit around a 6/10.

Substance use counselors can help create realistic plans to reduce and/or quit both smoking and drinking.

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According to the CDC, those who have low incomes are more likely to develop Type 2 Diabetes. This population is at higher risk due to higher levels of stress from financial burdens and living in unsafe/polluted environments. These factors can cause an inflammatory response in the body, which interferes with insulin sensitivity. Challenges while getting care for this population include a lack of regular medical care, reduced access to healthy food options, and less education surrounding diabetes. Financial barriers can prevent this population from getting the necessary treatment/medications.

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Continuous Glucose Monitors (CGMs) are wearable devices used to manage and treat T2D that continuously measure glucose levels in the interstitial fluid just beneath the skin. This device provides real-time data 24 hours a day. A transmitter sends the results to one’s cellular device so they can track glucose changes throughout the day. CGMs reduce the need for fingerstick tests and can improve long-term blood sugar control. Some CGMs can be connected with insulin pumps to offer automatic insulin delivery. Limitations of this device include delays in readings, potential skin irritation, and high costs that might not be covered by insurance.

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The National Diabetes Prevention Program is a public health initiative that offers an evidence-based lifestyle change program aimed at preventing/delaying Type 2 Diabetes. It is a year-long program that teaches its participants about healthy eating, physical activity, and coping skills, utilizing a CDC-approved curriculum led by a lifestyle coach. This program has been proven to reduce the risk of developing Type 2 Diabetes in adults with prediabetes by 58% and by 71% in individuals over the age of 60. This program targets the individual by shaping behavioral and lifestyle patterns. Barriers to successful implementation include low participant recruitment and retention due to eligibility requirements and insufficient funding to support program delivery costs.

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American Diabetes Association “Know Your Risk” Campaign 

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American Diabetes Association “Know Your Risk” Campaign 

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The ADA’s "Know Your Risk" Campaign is a public health initiative aimed at educating and raising awareness about the risk of Type 2 Diabetes. This campaign encourages people to asses their own risk using their “Diabetes Risk Test” which evaluates common risk factors such as family history, age, weight, gender, and activity level. This campaign targets the individual by providing tools and resources to help them understand their personal risk and to take preventative measures to reduce their likelihood of developing T2D. Barriers to this campaign include low public awareness and concerns over the accuracy of the test, which can lead to false reassurance or missed diagnoses.

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Smart insulin pens are a reusable injection pen that connects to one’s phone through an app. They calculate and track doses of insulin based on the body's current blood glucose level and carbohydrate intake. This device helps treat and manage Type 2 Diabetes by delivering accurate dosages, keeping track of the time/amount of each dose, sending notifications when insulin has expired/exceeded its temperature range, and even sending data to healthcare providers. The drawbacks and limitations of this technology include its high cost, which may not be covered by insurance, limited compatibility with certain types of insulin, a learning curve with new technology, and the risk of it being misplaced or lost.

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Type 2 Diabetes is largely influenced by everyday lifestyle choices, and one of the most significant factors is physical activity. A lack of regular movement contributes directly to weight gain, particularly the buildup of visceral fat around the abdomen, which is closely linked to insulin resistance. When the body becomes resistant to insulin, glucose cannot enter the cells efficiently, causing blood sugar levels to rise, a defining feature of Type 2 Diabetes. Regular exercise helps combat this by increasing insulin sensitivity, allowing the body to use glucose more effectively. It also helps regulate weight, reduce inflammation, and improve cardiovascular function, all of which are key to preventing or managing this disease. Even moderate physical activity, when done consistently, can significantly lower a person’s risk of developing Type 2 Diabetes.

Difficulty Level: 6/10 – Many people find this moderately difficult due to time constraints, low energy, or lack of routine.

Professional Support: A certified personal trainer, physical therapist, or primary care provider can help guide and support this change.

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Engaging in regular physical activity, such as walking, cycling, or swimming for at least 150 minutes per week, helps improve overall metabolic health. Exercise improves insulin sensitivity, reduces body fat (especially visceral fat), and helps regulate blood sugar levels, all of which significantly lower the risk of developing Type 2 Diabetes.

Common barriers include lack of time, limited access to safe or affordable exercise environments, physical limitations, or low motivation, especially in underserved or high-risk communities.

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Following a diet focused on whole foods, like vegetables, fruits, whole grains, lean proteins, and healthy fats, while limiting processed foods and added sugars.
A healthy diet helps maintain stable blood sugar levels, prevents weight gain, and reduces inflammation, all key contributors to reducing the risk of Type 2 Diabetes.

Challenges include high cost of fresh, healthy foods, limited access in food deserts, cultural food preferences, and lack of nutrition education.

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Older adults are more likely to experience insulin resistance due to age-related changes in metabolism, decreased physical activity, and weight gain. They're also at higher risk because aging bodies process glucose less efficiently. Older adults may face challenges such as limited mobility, cognitive decline, fixed incomes, multiple chronic conditions, and difficulty managing complex treatment regimens—all of which can affect prevention, timely diagnosis, and consistent treatment.

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Focusing on Whole Foods helps emphasizes vegetables, fruits, whole grains, lean proteins, and healthy fats. Eating right and learning what is best for your body with type 2 diabetes is a great factor to learn. Choosing complex carbs with a low glycemic index can spread carb intake throughout the day. Choosing the right carbs can be very significant to your diet and knowing which carbs are bad for you. Having to choose a balanced diet which portion control can help with blood sugar as well. With learning these steps on choosing to eat right it is moderate to high if you are not use to the changing your diets. Starting small is best for this to be under control and help your diets with the different food intake. You have to work through it. Working with a dietitian can help you get there to being healthy.

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Women who are pregnant or become pregnant can develop gestational diabetes during pregnancy. This puts them at high risk of type 2 diabetes later in life. This will also cause their child to be at risk for type 2 diabetes. Up to 50% of women with GDM will see signs within 5-10 years after delivery. When a pregnant woman is diagnosed in early pregnancy, they will have to watch what to eat and be monitored closely. Women should start to eat healthy and exercise regularly. Doctor check-ups to help monitor symptoms and understand how to keep your levels under control.

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Try to aim for 7-9 hours of sleep per night. Poor sleep affects your insulin sensitivity, and your glucose stays in your bloodstream instead of being used for energy. Partial sleep deprivation can lead to higher fasting blood sugar levels. Poor sleep can also lead to weight gain, which is a risky factor in type 2 diabetes. Lack of sleep can also increase a stress hormone as well as a hunger hormone. This can lead to more sugar and carb intake, which is not good for anyone with type 2 diabetes. Trying to maintain constant sleep is a huge must, in a dark, cool, and quiet place.

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Digital health technologies, such as mobile apps, integrate data from various diabetes devices such for example CGMs, insulin pumps, and glucose meters. These devices can help one prevent type 2 diabetes by providing the person a comprehensive view of diabetes and making it easier for people to identify patterns that can alert them that they can be at risk of diabetes before they are diagnosed with it. These digital health technologies can also help them treat type 2 diabetes by providing people with a personalized recommendation of diet and exercise based on their individual data. The drawbacks of digital health technologies would be that data privacy and security risk and also that it is not accessible to everyone due to their high cost.

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Insulin Pumps are used to treat type 2 diabetes by delivering insulin continuously through a catheter that is inserted under the skin. It can be used with a CGM by adjusting insulin delivery based on the glucose readings, which can lead to better blood sugar control. Using an insulin pump allows the person to be more flexible in meal timing and lifestyle choices as compared to getting an injection multiple times a day. The drawbacks of using an Insulin Pump would be that there can be a risk of skin infection or irritation at the insertion site. There can also be a potential for diabetic ketoacidosis (DKA) of the pump malfunctions. It can also be more expensive compared to getting an injection.

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The Healthy Schools Program is a prevention initiative that promotes health and wellness in schools nationwide. By partnering with the CDC, this program educates the youth on healthy nutrition, encourages physical activity through physical education classes, and provides students with knowledge to manage chronic conditions, such as diabetes and asthma. The program also supports schools by improving their health services. The program's long-term goal is to introduce healthy habits early, which can help prevent Type 2 Diabetes. Limitations to successful implementation include the school's budget cuts, cultural barriers, cost of nutritious foods, and lack of parental involvement.

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The American Diabetes Association’s Project Power initiative is a free lifestyle change program designed for people of all ages. The program promotes healthy eating, regular physical activity, and strong social support, offering personalized coaching and tools like activity trackers to help participants stay engaged. This program targets individuals by providing education and resources that empower them to make healthy lifestyle choices. Project Power is highly accessible, with both in-person and virtual delivery options. Limitations to successful implementation include its reliance on grant funding, which may affect the program's stability, and the potential lack of access to technology among its virtual participants.