5 Type 2 Diabetes

Valerie Cagle

Diabetes is a common chronic condition that either does not allow for the proper use of insulin or does not create insulin to begin with. There are two types of diabetes: Type 1 diabetes occurs when the body does not produce insulin. Type 2 diabetes occurs when the body produces some insulin but cannot keep blood sugar levels regulated due to the ineffective use of insulin in the body (CDC, 2022). Type 2 diabetes is more common and is strongly related to behavioral factors such as diet or exercise habits, which makes it more preventable. Around 37 million people, 11.3% of Americans, have some form of diabetes; of those cases, 90% are type 2 diabetes (ADA). Diabetes is a disease that can lead to additional health issues, such as cardiovascular disease. It may be life-threatening if not taken seriously and treated correctly. The ratio between men and women with diabetes is similar, but men are almost twice as likely to develop type 2 diabetes.
This image shows diabetes prevalence worldwide in 2021. A darker color represents a higher prevalence.

“Diabetes Prevalence, 2021” by Our World in Data is licensed under CC BY 4.0

What is Type 2 Diabetes?

Type 2 diabetes occurs when the body’s insulin receptors do not respond appropriately to insulin and create insulin resistance and the body is not properly managing glucose (Mayo Clinic, 2021). Glucose is the body’s primary source of energy and is also known as blood sugar. Insulin is a hormone that carries this glucose out of the blood and to various locations in the body. Insulin is a key that allows glucose to enter the cell. When insulin resistance occurs, the key does not open the door to let the sugar in the cell. Because of this, the pancreas will continue to produce insulin with the hope that cells will respond. When this resistance continues, the pancreas is forced to work harder than it can handle. This extra workload causes a rise in blood sugar levels, and these elevated levels can be harmful to the body (CDC, 2022).

 

Risk Factors

Many factors can raise the risk of developing type 2 diabetes. Some of these risk factors are controllable while others are not, and there are also risk factors seen explicitly in men. According to the Centers for Disease Control and Prevention (CDC), risk factors for developing type 2 diabetes include being overweight, age of 45 and older, having a relative with the condition, and being physically inactive. Some ethnicities, such as African American, Hispanic or Latino, and American Indian , or Alaska Native populations experience higher risk (CDC, 2022). In men specifically, low testosterone can contribute to a higher risk of developing diabetes. This is due to the increased body fat levels it causes (Diabetes.co.uk, 2019).
Because there are various risk factors, it is essential to understand them to prevent type 2 diabetes from developing. Age, family history, and ethnicity are examples of uncontrollable factors associated with increased risk of developing type 2 diabetes. Although these factors are not something an individual has control over, knowing the increased risk associated with these uncontrollable factors is an advantage for making decisions that may affect health in the long run. On the other hand, exercise and diet are two controllable factors that contributing heavily to diabetes prevalence due to their effect on blood sugar regulation.
On top of these risk factors, many symptoms can be associated with type 2 diabetes. These symptoms may take time to develop, are not noticeable, or can be hard to spot (CDC, 2022). Specific to men, erectile dysfunction, overactive bladder, urinary tract infections, and retrograde ejaculation may result from type 2 diabetes (CDC, 2022). Because these symptoms are often not noticeable right away, it is vital to be aware of the signs to act quickly when they do appear.

Treatment Methods

Preventing Type 2 diabetes is not always possible. When this is the case, setting up a time to test your blood sugar is essential. Once diagnosed with this condition, the individual will begin to monitor their blood sugar. Diabetes medication and insulin therapy are also options for treatment. Insulin therapy is a treatment that helps to keep blood sugar levels within the desired range (Mayo Clinic, 2021). If blood sugar is consistently outside this range, complications can arise. The other side of type 2 diabetes treatment focuses on behavioral and lifestyle changes. This includes steps such as healthy eating and exercising regularly. These changes help to regulate your blood sugar and can slow down or even prevent complications.

This image shows one way to monitor blood sugar through a finger prick blood collection.

 “Diabetes Glucose monitoring” by Blausen.com staff is licensed under CC BY 3.0

 

Getting screened regularly by your doctor, especially if you have some risk factors, is another way to get ahead of treating and managing your diabetes. Healthcare professionals recommend that all patients begin screenings at the age of 45, and earlier if multiple risk factors are present (WebMD, n.d.). Finally, medications can be taken if other methods, such as diet and exercise, are insufficient to manage blood sugar levels (Mayo Clinic, 2021). Medication is typically not prescribed until after trying lifestyle changes but is effective when needed. Overall, taking care of your body before a diagnosis can reduce diabetes prevalence and may prevent the development of serious complications as well.

Socioeconomic status and Diabetes

Because type 2 diabetes connects to behavioral factors so closely, socioeconomic status can significantly impact development and prevalence. The socioeconomic status of an individual can impact their healthcare in multiple ways. One significant way this population is affected is through less access to care. Those living in areas with a low socioeconomic status are less likely to use and have access to general healthcare, specifically preventative care for diabetes (Saydah et al., 2012). This affects diabetes care because individuals may be unable to make necessary lifestyle changes before being diagnosed if preventative care and screenings are unavailable. Wealth also has an impact on access to care. Those with a lower socioeconomic status have an additional challenge when it comes to accessing care. High healthcare costs contribute to the difficulty seen when accessing care, as individuals within this socioeconomic status are sometimes not offered the same care as those at a higher status (McMaughan et al., 2020). According to the CDC, men are much less likely to visit the doctor and to schedule visits for annual exams or preventative care compared to women (CDC, 2006). Men are also less likely to have insurance, which may be another barrier to seeking care. Because socioeconomic status already creates a challenge to healthcare, the data surrounding men’s health causes a larger concern in this population specifically.

Another critical factor that can be affected by socioeconomic status is nutritional access. There are multiple different aspects to lacking proper access to nutrition. One factor included in this is not having access to nutritional services and resources (Endevelt et al., 2009). This occurs when patients are uninformed about what resources are available, how to utilize them, and how to access them. A second factor to consider when living in lower socioeconomic areas is accessing foods with proper nutrition. Male-headed households are less likely to struggle with household food insecurity, but that does not take away the barrier (Alkerwi & Joy, 2013).  Part of this issue is monetary and comes from residents purchasing foods with a lower nutritional value and less diversity because they are more affordable (Alkerwi et al., 2019). The other side comes from habits. Many people continue to eat the foods they grew up with and are familiar with. If an individual grows up with a low socioeconomic status, they may continue those eating habits, especially if they are still in that socioeconomic status. Additionally, adult males are more likely to eat fast food with young adults being the most likely to display these habits (CDC, 2018). Because an increased prevalence of type 2 diabetes is being seen in young adults, habits such as this may be influencing this rise.

Relationship Status and Social Support

Relational and marital status can positively influence patients dealing with several medical conditions. A support system is crucial for managing stress and maintaining a general feeling of well-being (Fisher, 2020). Having an effective social support system can improve mental health, reduce substance abuse, and generally promote positive health behaviors in men (Liu et al., 2015). For diabetes, a sound social support system is linked to two key components. The first is coping with the disease itself. Coping can modify or reduce the amount of stress related to the stressor. This decreases the emotional distress men may experience connected to their diabetes, and those with high social support also show more favorable overall well-being levels. The second component of a helpful support system is a higher level of adherence to treatment (Ramkisson et al., 2017). Many people require help when it comes to their treatments. Diet, exercise, and taking medications are all areas in which individuals need assistance. Being able to rely on others to help in those areas increases the ability of some men to be consistent with their treatments.

Marital status is considered a prominent aspect of social support. There is not necessarily a direct correlation between marital status and diabetes in men, but this relational position could have an effect in other ways. Positive and negative impacts are both seen from this aspect of social support, but it often depends on the individual situation. Lifestyle factors can be affected by whether someone is married or not; one example is weight. Being married is often associated with weight gain, being overweight, and exercising less, while a divorce is more associated with weight loss (Cornelis et al., 2014). One correlation that may lead to positive impacts is having a spouse that plays a role in reminding their husband to receive medical care regularly and that help with maintenance after a diagnosis. This applies for general checkups, which usually includes diabetes screenings, and treatment and maintenance care as well (Liu et al., 2016).  Men typically experience more emotional support and health behavior regulation benefits than women do in their marriages, which can positively affect men living with diabetes. Because weight, regular checkups, prevention, and care management are vital contributors to type 2 diabetes, marital status may impact type 2 diabetes prevalence in men despite seeing conflicting data.

Call to Action

Type 2 diabetes prevalence has continually increased for the past two decades and was the eighth leading cause of death in the United States in 2020. One of the main aspects that are crucial to reducing diabetes is education. That being said, there are many challenges to this, and one of those is that there are no national offices for men’s health specifically. Seven of these offices exist for women. The Office on Women’s Health (OASH) is one of these offices. They work with various federal agencies to educate the public and health professionals on multiple women’s health topics (Office on Women’s Health, n.d.). Implementing just one office to focus specifically on men’s health is a step that needs to be made to see improvements in issues that affect men. Making this change will allow educational materials to be distributed more efficiently and for more men to access this information.

Another platform that could be improved to benefit men’s health more is Healthy People. Healthy People is a national initiative from the U.S. Department of Health and Human Services that provides national health goals for each decade. These goals aim to improve the nation’s overall health, including many objectives specific to diabetes (Healthy People 2030, n.d.). Healthy People 2030 covers objectives to reduce the number of cases diagnosed annually, the mortality rate, increase the amount of formal diabetes education, and more. Both diabetes and men’s health generally have goals, but there are no goals that combine these two, which would be helpful for those looking for goals specific to those components (Diabetes, n.d.). Overall, many organizations in the U.S. positively impact Americans’ health, but changes need to be made to offer support and education on men’s health specifically.

Key Takeaways

  • Diabetes prevalence is similar between men and women, but men are almost twice as likely to develop type 2 diabetes.
  • Although type 2 diabetes is often associated with behavior, factors such as social support and socioeconomic status are also influential in the way men manage the disease.
  • Many organizations are present to support Americans’ health needs, but men do not have as many resources to support them in this area as compared to women.

 

Chapter Review Questions

  1. True or False: Type 2 diabetes occurs when the body does not produce insulin
    • A. True
    • B. False
  2. What risk factor for type 2 diabetes is specifically seen in men?
    • A. Low testosterone
    • B. Poor diet
    • C. Lack of exercise
    • D. Being overweight
  3. True or False: It is recommended that all individuals start getting screened for diabetes at the age of 45
    • A. True
    • B. False
  4. Which of the following is a controllable risk factor?
    • A. Ethnicity
    • B. Family History
    • C. Diet
    • D. Age

References

Alkerwi, A., Vernier, C., Sauvageot, N., Crichton, G. E., & Elias, M. F. (2015). Demographic and socioeconomic disparity in nutrition: application of a novel Correlated Component Regression approach. BMJ open, 5(5), e006814. https://doi.org/10.1136/bmjopen-2014-006814

Azétsop, J., & Joy, T. R. (2013, October 29). Access to nutritious food, socioeconomic individualism and Public Health Ethics in the USA: A common good approach. Philosophy, ethics, and humanities in medicine: PEHM. Retrieved November 20, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231366/

Centers for Disease Control and Prevention. (2022, June 21). Diabetes basics. Centers for Disease Control and Prevention. Retrieved September 23, 2022, from https://www.cdc.gov/diabetes/basics/index.html 

Centers for Disease Control and Prevention. (2022, March 15). Diabetes and men. Centers for Disease Control and Prevention. Retrieved November 20, 2022, from https://www.cdc.gov/diabetes/library/features/diabetes-and-men.html

Centers for Disease Control and Prevention. (2018, October 30). Fast Food Consumption Among Adults in the United States, 2013–2016. Centers for Disease Control and Prevention. Retrieved November 20, 2022, from https://www.cdc.gov/nchs/products/databriefs/db322.htm

Centers for Disease Control and Prevention. (2006, October 6). NCHS pressroom – 2001 news release – women visit doctor more often than men. Centers for Disease Control and Prevention. Retrieved November 20, 2022, from https://www.cdc.gov/nchs/pressroom/01news/newstudy.htm

Cornelis MC, Chiuve SE, Glymour MM, Chang S-C, Tchetgen EJT, Liang L et al. Bachelors, divorcees, and widowers: Does marriage protect men from type 2 diabetes? PLoS One. 2014;9(9):e106720 10.1371/journal.pone.0106720   Marital status-

Diabetes.co.uk. (2019, March 6). Testosterone and diabetes. Diabetes Digital Media. https://www.diabetes.co.uk/body/testosterone-and-diabetes.html#:~:text=Research%20has%20shown%20that%20low,visceral%20fat%20storage%20in%20women

Diabetes. Diabetes – Healthy People 2030. (n.d.). Retrieved November 20, 2022, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes

Endevelt, R., Baron‐Epel, O., Karpati, T., & Heymann, A. D. (2009, March 27). Does low socioeconomic status affect use of nutritional services by pre‐diabetes patients? International Journal of Health Care Quality Assurance. Retrieved September 23, 2022, from https://www.emerald.com/insight/content/doi/10.1108/09526860910944647/full/ml 

Fisher, M. (2020, June 25). Social support systems: Called to care: Johns Hopkins Bayview Medical Center in Baltimore, MD. Social Support Systems | Called to Care | Johns Hopkins Bayview Medical Center in Baltimore, MD. Retrieved October 7, 2022, from https://www.hopkinsmedicine.org/about/community_health/johns-hopkins-bayview/services/called_to_care/social_support_systems.html

Healthy People 2030 Framework. Healthy People 2030 Framework – Healthy People 2030. (n.d.). Retrieved November 20, 2022, from https://health.gov/healthypeople/about/healthy-people-2030-framework#:~:text=Healthy%20People%202030’s%20overarching%20goals,and%20well%2Dbeing%20of%20all.

Liu, J., Qu, B., Zhu, Y., & Hu, B. (2015, May 26). The influence of social support on quality of life of men who have sex with men in China: A preliminary study. PLOS ONE. Retrieved November 20, 2022, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0127644#pone.0127644.ref036

Mayo Foundation for Medical Education and Research. (2021, January 20). Type 2 diabetes. Mayo Clinic. Retrieved October 7, 2022, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

Mayo Foundation for Medical Education and Research. (2021, June 25). Diabetes prevention: 5 tips for taking control. Mayo Clinic. Retrieved November 3, 2022, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639

Mayo Foundation for Medical Education and Research. (2021, August 7). Diabetes treatment: Using insulin to manage blood sugar. Mayo Clinic. Retrieved October 7, 2022, from https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-treatment/art-20044084

McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Frontiers in public health, 8, 231. https://doi.org/10.3389/fpubh.2020.00231

Office on Women’s Health. (n.d.). What we do. What we do | Office on Women’s Health. Retrieved November 28, 2022, from https://www.womenshealth.gov/about-us/what-we-do

Ramezankhani, A., Azizi, F., & Hadaegh, F. (2019, April 22). Associations of marital status with diabetes,hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study. PloS one. Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476533/    

Ramkisson, S., Pillay, B. J., & Sibanda, W. (2017, July 31). Social Support and coping in adults with type 2 diabetes. African journal of primary health care & family medicine. Retrieved October 7, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566130/

Statistics about diabetes. Statistics About Diabetes | ADA. (n.d.). Retrieved September 23, 2022, from https://diabetes.org/about-us/statistics/about-diabetes

Liu, H., Shen, S., & Waite, L. (2016, November). Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality. Academic.oup.com. Retrieved November 20, 2022, from https://academic.oup.com/psychsocgerontology/article/71/6/1070/2194721

WebMD. (n.d.). Type 2 diabetes screening, testing, and diagnosis. WebMD. Retrieved November 3, 2022, from https://www.webmd.com/diabetes/type-2-diabetes-screening

License

Icon for the Creative Commons Attribution 4.0 International License

An Intersectional Look at Men's Health Copyright © 2022 by Abby Frank; Abigail Blanchfield; Addison Mohl; Aneri Vasoya; Anna George; Anthony Acker; Bailie Featherston; Berkeley Young; Chyna Thompson; Emma Goerl; Grace Bauman; Hailey Longstreet; Jake Baranoski; John Williams; Kaustubha Reddy; Lauren Lewis; Lena Gammel; Mac Martin; Matthew Maloney; Molly Wiggins; Riley Sutton; Robert Capps; Savannah Grewal; Valerie Cagle; and Will Blackston is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

Share This Book