Blog
Type 2 Diabetes
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Type 2 diabetes is a multifactorial disorder of insulin resistance and progressive beta‑cell dysfunction causing chronic hyperglycemia. It underlies cardiovascular, renal, hepatic, and neurovascular disease burden worldwide. Effective management combines lifestyle, pharmacotherapy, and technology to prevent complications and potentially achieve remission in early stages.
Symptoms
Many patients are asymptomatic. Classic symptoms—polyuria, polydipsia, blurred vision, fatigue—often appear late. Recurrent skin infections, slow wound healing, and acanthosis nigricans may precede diagnosis. Complications such as myocardial infarction or stroke sometimes reveal underlying diabetes.
Causes
Obesity, high‑caloric diets, physical inactivity, genetics, aging, sleep deprivation, and chronic stress generate insulin resistance. Lipotoxicity, glucotoxicity, and inflammatory cytokines erode beta‑cell mass, closing the pathophysiologic loop.
Risk Factors
Risk factors include BMI >25 kg/m² (23 in Asian ancestry), family history, gestational diabetes, PCOS, hypertension, dyslipidemia, ethnicity (African‑American, Hispanic, Native American, South Asian), and history of cardiovascular disease.
Diagnosis
Diagnosis: fasting glucose ≥126 mg/dL, HbA1c ≥6.5 %, 2‑hour OGTT ≥200 mg/dL, or random ≥200 mg/dL with symptoms. Annual screening for adults over 35 or earlier if overweight with risk factors. Confirm with repeat testing unless unequivocally symptomatic.
Treatments
Lifestyle change remains first‑line: moderate‑carbohydrate Mediterranean‑style diet, 150 minutes weekly exercise, weight loss of 5–10 %. Medications: metformin, GLP‑1 RAs, SGLT2 inhibitors, DPP‑4 inhibitors, TZDs, sulfonylureas, basal or prandial insulin. Devices: CGM, smart pens, decision‑support apps.
Prevention
Weight maintenance, active living, balanced diet, regular sleep, and periodic glucose screening prevent or delay onset. Diabetes Prevention Program showed lifestyle can cut incidence by 58 %. Metformin prophylaxis aids high‑risk younger adults with BMI >35 kg/m².
Our Take
Covenant applies precision medicine—matching drug choice to cardiovascular, renal, and weight profiles, while leveraging CGM data to fine‑tune meal and exercise timing.
Type 2 diabetes is preventable and, when diagnosed, manageable. Covenant empowers patients with personalized plans crossing nutrition, exercise, pharmacology, and digital monitoring.
