Obesity and excess weight, particularly abdominal fat, which is strongly associated with insulin resistance where cells don't respond properly to insulin.

Other important contributing factors include:

• Sedentary lifestyle with insufficient physical activity

• Genetic predisposition and family history

• Advancing age (risk increases after 45)

• Poor diet high in refined carbohydrates and sugars

• Ethnicity (higher risk in certain populations including Black, Hispanic, Native American, and Asian American people)

• History of gestational diabetes or prediabetes

• Certain medical conditions like polycystic ovary syndrome

While genetic factors play a role in susceptibility, lifestyle factors such as diet, exercise, and maintaining a healthy weight are the most modifiable risk factors for preventing Type 2 diabetes.

A trained Lifestyle Coach leads the program. They help you change certain lifestyle habits, like eating healthier, reducing stress, and getting more physical activity. The program also includes group support from others who share your goals and struggles. It's delivered both in person and online.

This lifestyle change program is not a fad diet or an exercise class. And it's not a quick fix. It's a yearlong program focused on long-term changes and lasting results

A year might sound like a long commitment, but learning new habits, gaining new skills, and building confidence takes time. As you eat better and become more active, you'll notice changes in how you feel. You may even notice changes in how you look.

In someone who has type 2 diabetes, the pancreas is working harder to produce more insulin due to the resistance in the body's cells. Within insulin resistance, the muscle, fat, and liver cells are failing to absorb enough glucose and forces the pancreas to produce higher levels of insulin. Over time as the pancreas tries to keep up with the demand for more insulin, this can lead to beta cell dysfunction as they can become exhausted from the overproduction of insulin. As these beta cells are becoming more and more impaired, impaired insulin secretion occurs leading to persistent high blood sugar.

If you view your brain as a command center to how the body is run then blood sugar falling out of range will throw off the command center. If diabetes can damage nerves in other parts of the body, it can damage nerves in the brain as well.

Some areas where these effects has be seen is through:

• Memory Loss

  
  

• Increased Risk of Dementia of Alzheimer's

• Brain Atrophy or Brain Shrinking

• Small-Vessel Disease

  
  

• Brain Fog

  
  

• Brain Inflammation

  
  

• White Matter Damage

  
  

• Brain Activity

The contributing factors to brain damage are:

• Insulin Resistance

• Lack of Blood Sugar Control

• Stress

• Inflammatory Cytokines

Some other factors to note are smoking, not being physically active, poor weight management, and depression can effect your risks of dementia with those who also are diabetic.

A symptom of type 2 diabetes is excessive thirst which is medically known as polydipsia.

https://my.clevelandclinic.org/health/symptoms/24050-polydipsia

Polydipsia is diagnosed through a symptom assessment and by then preforming several tests. The different tests that can be preformed are fasting blood glucose test, oral glucose tolerance test, or a A1C test.

https://my.clevelandclinic.org/health/symptoms/24050-polydipsia

Having high blood sugar will cause the kidneys to work harder to filter the excess glucose, which will in turn leads to increased urination and fluid loss, which will tigger thirst. The treatment for polydipsia is balancing blood sugar levels through diet, exercise, staying well-hydrated by drinking plenty of fluids and avoiding sugary drinks, and possible use of diabetic medication if prescribed by doctor.

https://clevelandclinic.org/health/symptoms/24050-polydipsia

Though it should be noted that each person is different and there is no way to predict how high blood sugar levels have to be or for how long to cause the onset of neuropathy.

https://www.mayoclinic.org/disease-conditions/diabetic-neuropathy/syptoms-causes/syc-2071580

A common symptom of type 2 diabetes is change to one's vision or trouble seeing as someone once did.

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

A change or loss of vision as a result of type 2 diabetes is known as 'Diabetic Retinopathy'. Diabetic retinopathy can be diagnosed by seeing an eye doctor when any changes to vision are observed. Changes to vision can include new trouble reading or difficulty seeing faraway objects. It is recommended for someone who has type 2 diabetes to get their eye exams at least once a year. Changes to vision can start small and are often missed early on as symptoms are hard to differentiate from normal aging changes in vision.

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

Diabetic retinopathy is caused by high blood sugar due to type 2 diabetes. Damage to nerves occurs across the entire body, but this specifically damages the nerves in one's retinas and causes blocked blood vessels. Diagnosing diabetic retinopathy can be done by a simple dilated eye exam performed by an eye doctor. Treatments include medicines and injections to help lower the swelling of blood vessels behind they eye, and in worse cases surgery may be needed to reduce swelling or clear blockages/scars in one's eyes. Unfortunately, if enough damage has been done, people can lose their vision in one or both eyes. Once an excess of bleeding occurs in one's eyes, irreversible damage can occur with dark spots beginning to appear and eventual blockage in the eyes.

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

Long-term Consequences of Not Seeking Treatment

1. Uncontrolled Blood Sugar Levels:

   • Without medication, blood glucose levels may remain chronically elevated, leading to hyperglycemia and worsening diabetes management.

2. Increased Risk of Complications:

   • Cardiovascular Issues: Higher risks of heart disease and stroke.

   • Neuropathy: Development of nerve damage, which can lead to pain, tingling, or loss of sensation in extremities.

   • Retinopathy: Potential for vision problems and blindness due to damage to the retina.

   • Kidney Damage: Progression to diabetic nephropathy, potentially leading to kidney failure.

3. Quality of Life Impact:

   • Chronic symptoms like fatigue, excessive thirst, frequent urination, and blurred vision can severely affect daily life and productivity.

4. Higher Long-term Costs:

   • Emergency Healthcare Costs: Untreated diabetes may lead to acute complications requiring hospitalization, resulting in high medical bills.

   • Long-term Care Needs: Increased risk for serious health issues might necessitate long-term care, rehabilitation, or more intensive treatments, leading to greater financial burden.

5. Increased Mortality Risk:

   • Studies indicate that poorly controlled diabetes is associated with a higher risk of premature death due to complications.

Conclusion

Insurance coverage for oral medications is generally good, but individuals should verify their specific plan details. Choosing not to seek treatment due to cost can lead to severe long-term health consequences, both in terms of individual well-being and financial ramifications.

References/Sources

• American Diabetes Association. (2023). "Standards of Medical Care in Diabetes—2023." Diabetes Care.

• Centers for Disease Control and Prevention (CDC). "Economic Costs of Diabetes in the U.S. in 2017." CDC.

Description of Treatment: Health coaching for diabetes focuses on empowering individuals with the tools and strategies needed to effectively manage their condition through personalized guidance on diet, exercise, and self-monitoring, while also fostering behavioral changes that support long-term health.

Effects of the Condition It Addresses: This coaching addresses both short-term effects, such as difficulty in adhering to dietary restrictions and exercise routines, and long-term effects like the increased risk of complications from poorly managed blood sugar levels, ultimately aiming to improve metabolic control and quality of life.

Type of Professional Required: A certified diabetes educator (CDE) or a registered dietitian nutritionist (RDN) with expertise in diabetes management and behavior change techniques would be best suited to deliver this specialized health coaching. Resource: American Diabetes Association (ADA)

• Website: American Diabetes Association

• Description: The ADA provides guidelines and resources for diabetes management, including the role of health coaching and self-management education.

Description of Treatment:
Exercise therapy involves structured exercise programs tailored to individual capabilities, including aerobic activities (like walking or cycling), strength training (using weights or resistance bands), and flexibility exercises (such as stretching or yoga). The programs are designed to enhance physical fitness while considering the individual’s medical condition and goals.

Short or Long-term Effects Treated:
This therapy primarily addresses both short-term effects, such as immediate improvements in blood glucose control and physical fitness, as well as long-term effects including improved cardiovascular health, increased insulin sensitivity, and weight management, which are crucial for preventing diabetes-related complications.

Type of Professional Required:
A certified exercise physiologist, physical therapist, or a diabetes educator with expertise in fitness and exercise programming would typically deliver this treatment to ensure safe and effective implementation. Reference:

• Colberg, S. R., et al. (2016). "Exercise and diabetes: A position statement of the American Diabetes Association." Diabetes Care, 39(11), 2065-2079.

  • Link: American Diabetes Association

1. Speech Therapy

Description of Treatment:
Speech therapy involves individualized sessions with a speech-language pathologist (SLP) who provides exercises and strategies to improve articulation, clarity of speech, and overall communication skills. The therapy may include articulation drills, breath control exercises, and techniques to strengthen the muscles used in speech.

Short or Long-term Effects Treated:
This treatment aims to address short-term effects such as difficulty in pronouncing words clearly and improve overall communication effectiveness over the long term. By enhancing speech clarity, individuals can maintain social interactions and improve their quality of life.

Type of Professional Required:
A licensed Speech-Language Pathologist (SLP) is required to deliver this treatment. The SLP assesses speech difficulties and tailors the intervention to the individual’s specific needs.

Reference:

• American Speech-Language-Hearing Association. (2020). "Speech-Language Pathologists."

  • Link: ASHA

When thinking of type of treatment and approximate cost involved in lifestyle modifications for type 2 diabetes it would include a possible gym membership, coaching, working with dietician, buying healthy food options, and possible therapist. While it would be challenging to determine an exact cost since some treatments could be optional and may only last for a season, like working with a dietitian and therapist, until you acquired the skills needed to be successful. Costs of living are also vast around the country. An estimated cost would average probably around an extra couple hundred dollars a month to cover grocery shopping for healthy food choices, a gym membership, and working with professionals who can better help the condition you're facing with support.

Some insurance plans will cover the use of a dietician. Different employers do often offer gym memberships through the company or reimbursement of monthly memberships to join a gym. The use of a therapist may also be covered by insurance, but if not therapist offer sliding scale for payment of their services to make things more affordable.

The long-term consequences if treatment in these areas is not preferred would be masking the issue. Even if medication is used if no lifestyle changes occur the end result will be loss of quality of life.

The long term effects of type 2 diabetes can impact motor coordination, making daily activities and work tasks more of a challenge.

Physical therapist are able to assist with balance and coordination deficits often seen in those who have type 2 diabetes.

Source: https://research.aota.org/ajot/artical-abstract/77/6/7706205100/24997/Habit-Formation-Intervention-to-improve-Type-2?redirectedFrom=fulltext

CBT can have long-term effects on individuals with type 2 diabetes by helping to improve glycemic control, symptoms of depression around the disease, anxiety, and quality of life.

A licensed mental health professional such as psychologist, psychiatrists, and social workers can deliver this type of treatment.

Source: http://pmc.ncbi.nlm.nih.gov/articals/PMC10165773

In individuals with type 2 diabetes, short-term cognitive rehabilitation can improve memory and attention.

Psychologist, psychiatrists, mental health nurse, and social workers can provide therapy for cognitive issues around type 2 diabetes.

Source:

http://pmc.ncbi.nlm.nih.gov/articals/PMC10184896/#:~:text=Diabetes%20is%20related%20to%20acclerated,potentially%2C%20diabetes%20self%2Dmanagement

https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring

Difficulty Scale:
On a scale of 1-10, the difficulty of making this lifestyle change might be around a 6, as adjusting long-standing eating habits can be challenging, especially in the face of cravings, social situations, and the availability of unhealthy food options.

Professional Support:
A registered dietitian nutritionist (RDN) would be the ideal professional to guide and support a patient in making healthy eating changes, providing personalized meal plans, education on nutritional choices, and strategies for maintaining healthy habits.

Why it Matters:

This change matters because healthy eating can significantly improve blood sugar control, reduce the risk of diabetes-related complications, and promote overall well-being. By maintaining stable blood glucose levels and supporting cardiovascular health, individuals can enhance their quality of life, increase energy levels, and reduce the likelihood of chronic conditions associated with diabetes, ultimately leading to better long-term health outcomes.

Physical activity is vast in what can be done so, on average, I would say the level of difficulty to implement this as a helpful source would be around a 5. Walking is a wonderful way to introduce physical activity that is low impact and relatively easy for most to establish into their health routine. I give walking a 5 in difficulty because if someone were to have neuropathy which is weakness, numbness, or pain in the feet because of nerve damage related to type 2 diabetes, then even walking could pose as a challenge as a way to be active.

A personal trainer and even a physical therapist would be able to serve as a professional to help with this change.

Unique challenges they may face include limited awareness of gestational diabetes, which can result in delays in diagnosis and treatment. Additionally, managing diabetes during pregnancy can be stressful, as women must navigate dietary changes, blood sugar monitoring, and regular check-ups while also ensuring the health and well-being of their baby.

Resource: Centers for Disease Control and Prevention (CDC). (2023). "Gestational Diabetes." Available at: cdc.gov

Challenges: Unique challenges to implementing regular physical activity may include a lack of motivation, limited access to safe and convenient places for exercise, time constraints due to busy schedules, and physical limitations or health issues that can make exercise difficult.

Source: American Diabetes Association. (2023). "Physical Activity/Exercise and Diabetes." Available at: diabetes.org

Negative Aspects: Possible negative aspects of using CGMs include skin irritation or allergic reactions at the sensor site, the potential for inaccurate readings, and the need for regular calibration with fingerstick tests, which may inconvenience users. Additionally, some individuals may find the cost of CGM systems prohibitive, especially if not covered by insurance.

Source: American Diabetes Association. (2023). "Continuous Glucose Monitoring." Available at: diabetes.org

Challenges: Possible challenges to implementing the DPP include recruiting participants who are at risk, addressing barriers related to access and affordability of program resources, and ensuring long-term engagement and adherence among participants to sustain lifestyle changes.

Source: Centers for Disease Control and Prevention (CDC). (2023). "National Diabetes Prevention Program." Available at: cdc.gov

This is due to many factors including limited access to healthy food, healthcare, diabetes education, and increased financial strain from managing the condition. Individuals with low income are more likely to have higher rates of obesity and being physically inactive, which raised risk factors for type 2 diabetes as well.

Source:

https://pmc.ncbi.nlm.nih.gov/articals/PMC3476930/

There are several challenging factors for getting screened early for type 2 diabetes. These include effectiveness of screening methods in various settings, the lack of universal diagnostic criteria, and the concerns for over diagnosing and over treatment. Community screenings may also not be well-targeted and can lead to lack of valuable follow-up care.

Source:

https://pmc.ncbi.nlm.nih.gov/articals/PMC10665905/

While insulin pumps are beneficial for the control of diabetes, they can have several side effects, including diabetic ketoacidosis related to pump malfunction, hypoglycemia from over-delivery, and skin complications related in infections and irritation at the infusion site. Some individuals can experience weight gain, and there is also a risk of lipodystrophy, a change in the fat tissue at injection site.

Source:

http://londondiabetes.com/news-and-events/pros-and-cons-of-insulin-pumps/

Public health interventions face several different challenges, including insufficient funding, qualified personal, and difficulty around communicating complex information to the general public.

Source:

http://www.ncbi.nlm.nih.gov/books/NBK218227/

https://diabetes.org/living-with-diabetes/treatment-care/diabetes-technology-guide#:~:text=Whether%20it%20be%20a%20continuous,essential%20part%20of%20diabetes%20management.

https://diabetes.org/living-with-diabetes/treatment-care/diabetes-technology-guide#:~:text=Whether%20it%20be%20a%20continuous,essential%20part%20of%20diabetes%20management.

https://publichealth.berkeley.edu/news-media/research-highlights/taxes-on-sugar-sweetened-drinks-drive-decline-in-consumption

https://www.congress.gov/bill/117th-congress/senate-bill/203