Individuals with type 2 diabetes have normal, increased, or decreased insulin levels due to abnormal beta cell function. The need for exogenous insulin in type 2 diabetes is variable. Individuals with type 2 diabetes may be able to control their blood glucose levels with medical nutrition therapy (MNT) and exercise only, with the aid of antidiabetic medication, and/or insulin injections.
The result of type 2 diabetes is hyperglycemia, insulin resistance, and/or hyperinsulinemia. Like type 1 diabetes, individuals with type 2 diabetes can be diagnosed at any age but typically after the age of 30. The number of adolescents with type 2 diabetes is on the rise, particularly in the African American, Native American, and Hispanic population groups. Most importantly, type 2 diabetes can be delayed or prevented with lifestyle modifications, such as awareness of appropriate dietary intake, physical activity, and weight control.
Since many individuals with type 2 diabetes can be asymptomatic, it may be years before a diagnosis is uncovered. The time difference between the initial hyperglycemia and diagnosis averages around 6.5 years, therefore, it is common for individuals to have characteristics of long-term complications prior to diagnosis.7 In addition to asking about symptoms related to hyper- or hypoglycemia, the medical history should include questions regarding indications of the long-term complications.
Dental professionals should be aware of hyperosmolar hyperglycemic state (HHS). It is a life-threatening medical emergency associated with type 2 diabetes in which blood glucose values are typically greater than 600 mg/dL. Signs and symptoms include dehydration and neurologic dysfunction.