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Diabetescare is a site where you can find advice for people with diabetes. Diabetescare is intended for people interested in diabetes and the illnesses it causes. You can also find diets, tips, explanations of concepts, and scientific developments relevant to people with diabetes. Type 2 diabetes is diagnosed when the pancreas does not produce enough insulin (reduced insulin production), and/or insulin does not work effectively, and/or the body's cells do not respond effectively to insulin (known as insulin resistance). It accounts for 85–90 percent of all diabetes cases. It usually develops in adults over 45, but is increasingly occurring in younger groups, including children, adolescents, and young adults. It is more likely in people with a family history of type 2 diabetes or particular ethnic backgrounds. For some, the first sign may be a complication of diabetes, such as a heart attack, vision problems, or a foot ulcer. Type 2 diabetes care includes a combination of regular physical activity, healthy eating, and weight reduction. Because type 2 diabetes is often progressive, most people will need oral medication and/or insulin injections in addition to lifestyle changes over time. How does type 2 diabetes develop? Type 2 diabetes develops over a long period of time (years). During this time, insulin resistance begins, meaning that insulin becomes increasingly ineffective at managing blood glucose levels. In response to this insulin resistance, the pancreas produces increasing amounts of insulin to try to achieve some degree of blood glucose control. As insulin overproduction continues over a very long period, the insulin-producing cells in the pancreas wear out, so that by the time someone is diagnosed with type 2 diabetes, they have lost 50 to 70% of their insulin-producing cells. This means that type 2 diabetes is a combination of ineffective insulin and insufficient insulin. When people refer to type 2 diabetes as a progressive disease, they mean the continuing destruction of insulin-producing cells in the pancreas. Initially, type 2 diabetes can often be managed with healthy eating and regular physical activity. Over time, most people with type 2 diabetes will also need tablets, and many will need insulin. It is important to note that this is the natural progression of the condition, and taking tablets or insulin as soon as they are needed may lead to fewer long-term complications. What causes type 2 diabetes? Genetic factors can predispose people to type 2 diabetes. If you have a relative with diabetes, you have a genetic predisposition to the condition. Although people may have a strong genetic predisposition to type 2 diabetes, the risk increases greatly if they have a number of modifiable lifestyle factors, such as high blood pressure, overweight or obesity, insufficient physical activity, poor diet, and the classic 'apple-shaped' body, where extra weight is carried around the waist. Risk factors for developing type 2 diabetes Having a family history of diabetes Being over 45 years of age. The risk increases as we age Being over 45 and overweight Being over 45 and having high blood pressure Being over 35 and of Hispanic, Black, yellow, or Asian origin, including Indian origin. Being a woman who has given birth to a child weighing more than 4.5 kg (9 lb), had gestational diabetes during pregnancy, or had a condition known as polycystic ovary syndrome. Symptoms of type 2 diabetes Many people with type 2 diabetes have no symptoms. Because type 2 diabetes is commonly diagnosed (though not always) later in life, signs are sometimes dismissed as part of 'getting older'. In some cases, diabetes complications may already be present when type 2 diabetes is diagnosed. Symptoms include: Excessive thirst Excessive urination Feeling tired and lethargic Always feeling hungry Cuts that heal slowly Itching, skin infections Blurred vision Gradual weight gain Mood swings Headaches Feeling dizzy Leg cramps