More than 37 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.
What Causes Type 2 Diabetes?
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells don’t respond normally to insulin; this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
Symptoms and Risk Factors
Type 2 diabetes symptoms often develop over several years and can go on for a long time without being noticed (sometimes there aren’t any noticeable symptoms at all). Because symptoms can be hard to spot, it’s important to know the risk factors and to see your doctor to get your blood sugar tested if you have any of them
Testing for Type 2 Diabetes
A simple blood test will let you know if you have diabetes. If you’ve gotten your blood sugar tested at a health fair or pharmacy, follow up at a clinic or doctor’s office to make sure the results are accurate.
Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, and other important people in your life. Managing diabetes can be challenging, but everything you do to improve your health is worth it!
You may be able to manage your diabetes with healthy eating and being active, or your doctor may prescribe insulin, other injectable medications, or oral diabetes medicines to help manage your blood sugar and avoid complications. You’ll still need to eat healthy and be active if you take insulin or other medicines. It’s also important to keep your blood pressure and cholesterol close to the targets your doctor sets for you and get necessary screening tests.
You’ll need to check your blood sugar regularly. Ask your doctor how often you should check it and what your target blood sugar levels should be. Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related complications.
Stress is a part of life, but it can make managing diabetes harder, including managing your blood sugar levels and dealing with daily diabetes care. Regular physical activity, getting enough sleep, and relaxation exercises can help. Talk to your doctor and diabetes educator about these and other ways you can manage stress.
Make regular appointments with your health care team to be sure you’re on track with your treatment plan and to get help with new ideas and strategies if needed.
Whether you were just diagnosed with diabetes or have had it for some time, meeting with a diabetes educator is a great way to get support and guidance, including how to:
Develop a healthy eating and activity plan
Test your blood sugar and keep a record of the results
Recognize the signs of high or low blood sugar and what to do about it
If needed, give yourself insulin by syringe, pen, or pump
Monitor your feet, skin, and eyes to catch problems early
Buy diabetes supplies and store them properly
Manage stress and deal with daily diabetes care
Ask your doctor about diabetes self-management education and support services and to recommend a diabetes educator, or search the Association of Diabetes Care & Education Specialists’ (ADCES) nationwide directoryexternal icon for a list of programs in your community.
Type 2 Diabetes in Children and Teens
Childhood obesity rates are rising, and so are the rates of type 2 diabetes in youth. More than 75% of children with type 2 diabetes have a close relative who has it, too. But it’s not always because family members are related; it can also be because they share certain habits that can increase their risk. Parents can help prevent or delay type 2 diabetes by developing a plan for the whole family:
Drinking more water and fewer sugary drinks
Eating more fruits and vegetables
Making favorite foods healthier
Making physical activity more fun
Healthy changes become habits more easily when everyone makes them together. Find out how to take charge family style with these healthy tips.
Green Tara (Jetsun Drolma) statue from the Gyantse Kumbum Pagoda, Pelkor Chode Monastery, Gyantse, Tibet
H.E. Tangtong Gyalpo Bodhisattva (1361-1485)
It is through the understanding and practice of the Buddha-dharma that one becomes a holy person–a living jewel. Sainthood in Buddhism has a somewhat different meaning than that held in Christianity although both refer to people who live an exceptionally holy life, are very compassionate, and can demonstrate certain “miracles.” In Buddhism it also means one who has become enlightened—been liberated from the cycle of reincarnation and all its related suffering. The Christian saint aspires to be born in the Christian heaven, but this is not the goal of a Buddhist. A Buddhist saint is one who has escaped samsara or existence all together and gone beyond what is possible in the heavenly realms. A Buddhist saint would live in the Dharma realms or wherever he choses to be to help living beings. A saint in Buddhism is one who, like the Buddha, has become enlightened and realized his or her original nature, possessing the skills and wisdom of a Buddha. They have gained control over life and death and are thus liberated from the cycle of reincarnation. This is true happiness!
“Painting of Monk Jigong” by Master Wan Ko Yee.
In Buddhism saints may not lead what is normally thought of as a “conventional” life. There are many examples of Buddhist saints who exhibited most unorthodox (“deliberate“) behavior. Examples of these kinds of happy, crazy saints are Han-shan and Shih-te, eccentric Ch’an (Zen) hermit-monks from Tang Dynasty, as well as Monk Ji-gong and Birdnest Roshi, but there are many others including the crazy yogis of Tibet like Padmasambhava, Virupa, Manjusrimitra, Tsang Nyon Heruka, and Tangtong Gyalpo. Saints can manifest in innumerable forms and may appear as humans or animals or live in other dimensions.
Japanese hanging scroll by Hashimoto Gaho of Han-shan and Shih-te (Kanzan and Fittoku), eccentric Ch’an (Zen) hermit-monks from Tang Dynasty, whose poetry is popular in the west.
It is important to know that one cannot fully understand what takes place on higher levels of the path. For example, those on the first Bodhisattva stage do not know about what takes place on the second Bodhisattva stage and so on up the path. Those on the second Bodhisattva stage see those on the first Bodhisattva stage as having impurities. Even those on the tenth Bodhisattva stage see those on the ninth Bodhisattva stage as having certain impurities. It is natural that the impurities and obscurations of those on the lower levels would be greater than those at the higher levels. Nevertheless, those who are kind and benefit others can guide and transform living beings no matter where they are on the path. However, ordinary beings and those at the lower levels of the path cannot possibly understand the behavior of true holy beings.
The key features of the various paths to becoming a holy being are summarized in the chart “The Way to Become a Holy Being or Saint.” It is useful to think of these paths as stages on the way to becoming a Buddha. It is interesting to note that the other world religions are also included as initial stages on the way to buddhahood in as much as they teach compassion, loving kindness, some aspects of morality, and discourage evil. Some also teach various forms of training the mind in meditation. Bodhisattvas do not only incarnate as Buddhists to help living being. The three pure precepts of Buddhism—cease evil, do good, and help others—can be practiced in many forms.
You must remember that ALL sentient beings are evolving toward the perfection of being a Buddha, whether they know it or not, and whether at the moment they may be very confused and behaving in foolish or even evil ways. This includes the minions of Mara and the demons of hell as well as the devas or gods in heaven.
One of the deities most frequently seen on altars in China’s temples is Quan Yin (also spelled Kwan Yin, Kuanyin; in pinyin, Guanyin). In Sanskrit, her name is Padma-pâni, or “Born of the Lotus.” Quan Yin, alone among Buddhist gods, is loved rather than feared and is the model of Chinese beauty. Regarded by the Chinese as the goddess of mercy, she was originally male until the early part of the 12th century and has evolved since that time from her prototype, Avalokiteshvara, “the merciful lord of utter enlightment,” an Indian bodhisattva who chose to remain on earth to bring relief to the suffering rather than enjoy for himself the ecstasies of Nirvana. One of the several stories surrounding Quan Yin is that she was a Buddhist who through great love and sacrifice during life, had earned the right to enter Nirvana after death. However, like Avlokiteshvara, while standing before the gates of Paradise she heard a cry of anguish from the earth below. Turning back to earth, she renounced her reward of bliss eternal but in its place found immortality in the hearts of the suffering. In China she has many names and is also known as “great mercy, great pity; salvation from misery, salvation from woe; self-existent; thousand arms and thousand eyes,” etc. In addition she is often referred to as the Goddess of the Southern Sea — or Indian Archipelago — and has been compared to the Virgin Mary. She is one of the San Ta Shih, or the Three Great Beings, renowned for their power over the animal kingdom or the forces of nature. These three Bodhisattvas or P’u Sa as they are know in China, are namely Manjusri (Skt.) or Wên Shu, Samantabhadra or P’u Hsien, and Avalokitesvara or Quan Yin.
Quan Yin is a shortened form of a name that means One Who Sees and Hears the Cry from the Human World. Her Chinese title signifies, “She who always observes or pays attention to sounds,” i.e., she who hears prayers. Sometimes possessing eleven heads, she is surnamed Sung-Tzu-Niang-Niang, “lady who brings children.” She is goddess of fecundity as well as of mercy. Worshiped especially by women, this goddess comforts the troubled, the sick, the lost, the senile and the unfortunate. Her popularity has grown such through the centuries that she is now also regarded as the protector of seafarers, farmers and travelers. She cares for souls in the underworld, and is invoked during post-burial rituals to free the soul of the deceased from the torments of purgatory. There are temples all over China dedicated to this goddess, and she is worshiped by women in South China more than in the North, on the 19th day of the 2nd, 6th and 9th moons. (For example, it is a prevalent birth custom in Foochow that when a family has a daughter married since the 15th day of the previous year, who has not yet given birth to a male infant, a present of several articles is sent to her by her relatives on a lucky day between the 5th and 14th of the first month. The articles sent are as follows: a paper lantern bearing a picture of the Goddess of Mercy, Quan Yin, with a child in her arms, and the inscription, “May Quan Yin present you with a son”; oysters in an earthenware vessel; rice-cakes; oranges; and garlic.) Worshipers ask for sons, wealth, and protection.
She can bring children (generally sons, but if the mother asks for a daughter she will be beautiful), protect in sorrow, guide seamen and fishermen (thus we see her “crossing the waves” in many poses), and render harmless the spears of an enemy in battle. Her principal temple on the island of Putuoshan, in the Chusan Archipelago off the Zhejiang coast near Ningbo, is a major pilgrimage site sacred to the Buddhists, the worship of Quan Yin being its most prominent feature on account of the fact that the Goddess is said to have resided there for nine years, reigning as the Queen of the Southern Seas. The full name of the island is P’u t’o lo ka, from Mount Pataloka, whence the Goddess, in her transformation as Avalokiteshvara, looks down upon mankind. Miao Feng Shan (Mount of the Wondrous Peak) attracts large numbers of pilgrims, who use rattles and fireworks to emphasize their prayers and attract her attention. In 847, the first temple of Quan Yin was built on this island. By 1702, P’u Tuo had four hundred temples and three thousand monks, and was the destination of countless pilgrims. (By 1949, however, P’u Tuo was home to only 140 monasteries and temples.)
No other figure in the Chinese pantheon appears in a greater variety of images, of which there are said to be thousands of different incarnations or manifestations. Quan Yin is usually depicted as a barefoot, gracious woman dressed in beautiful, white flowing robes, with a white hood gracefully draped over the top of the head and carrying a small upturned vase of holy dew. (However, in the Lamaistic form, common in bronze from eighteenth-century China and Tibet, she is often entirely naked.) She stands tall and slender, a figure of infinite grace, her gently composed features conveying the sublime selflessness and compassion that have made her the favorite of all deities. She may be seated on an elephant, standing on a fish, nursing a baby, holding a basket, having six arms or a thousand, and one head or eight, one atop the next, and four, eighteen, or forty hands, which which she strives to alleviate the sufferings of the unhappy. She is frequently depicted as riding a mythological animal known as the Hou, which somewhat resembles a Buddhist lion, and symbolizes the divine supremacy exercised by Quan Yin over the forces of nature. Her bare feet are the consistent quality. On public altars, Quan Yin is frequently flanked by two acolytes, to her right a barefoot, shirtless youth with his hands clasped in prayer known as Shan-ts’ai (Golden Youth), and on her left a maid demurely holding her hands together inside her sleeves known as Lung-nü (Jade Maiden). Her principal feast occurs yearly on the nineteenth day of the second lunar month. However, she is fortunate in having three birthdays, the nineteenth of the second, sixth and ninth months. There are many metamorphoses of this goddess. She is the model of Chinese beauty, and to say a lady or a little girl is a Kwan Yin is the highest compliment that can be paid to grace and loveliness.
According to one ancient legend her name was Miao Shan, and she was the daughter of an Indian Prince. Youthful and serene, she chose to follow a path of self-sacrifice and virtue, and became a pious follower of Buddha, herself attaining the right to buddhahood but remaining on earth to help mankind. In order to convert her blind father, she visited him transfigured as a stranger, and informed him that were he to swallow an eyeball of one of his children, his sight would be restored. His children would not consent to the necessary sacrifice, whereupon the future goddess created an eye which her parent swallowed and he regained his sight. She then persuaded her father to join the Buddhist priesthood by pointing out the folly and vanity of a world in which children would not even sacrifice an eye for the sake of a parent.
Another Miao Shan legend was that the son of the dragon king had taken the form of a carp and was caught by a fisherman and displayed for sale in the market place. Miao Shan sent her servant to buy the fish and released it.
As related in yet another legend Quan Yin was said to be the daughter of a sovereign of the Chou dynasty, who strenuously opposed her wish to be a nun, and was so irritated by her refusal to marry that he put her to humiliating tasks in the convent. This means of coercion failed, and her father then ordered her to be executed for disobedience to his wishes. But the executioner, a man of tender heart and some forethought, brought it about that the sword which was to descend upon her should break into a thousand pieces. Her father thereupon ordered her to be stifled. As the story goes, she forthwith went to Hell, but on her arrival the flames were quenched and flowers burst into bloom. Yama, the presiding officer, looked on in dismay at what seemed to be the summary abolition of his post, and in order to keep his position he sent her back to life again. Carried in the fragrant heart of a lotus flower she went to the island of Putuo, near Ningbo. One day her father fell ill and according to a Chinese custom, she cut the flesh from her arms that it might be made into medicine. A cure was effected, and in his gratitude her father ordered her statue to be made “with completely-formed arms and eyes.” Owing to a misunderstanding of the orders the sculptor carved the statue with many heads and many arms, and so it remains to this day.
The image of this divinity is generally placed on a special altar at the back of the great Shakyamuni Buddha behind a screen, and facing the north door, in the second half of the Buddhist monastery. Quan Yin is also worshiped by the Taoists, and they imitate the Buddhists in their descriptions of this deity, speaking in the same manner of her various metamorphoses, her disposition to save the lost, her purity, wisdom, and marvel-working power.
From early Ch’ing times to the present, many thousands of statues of Quan Yin have been carved in jade. The Maternal Goddess, the Protectress of Children, the Observer of All Sounds, Quan Yin is a favorite figure in domestic shrines. As well, her image is carved on small jades which Chinese women offer faithfully at the temples dedicated to her. She also is the single most important figure crafted in blanc de Chine ware, with approximately nine out of every ten figures from Dehua representing that divinity in one or other of her manifestations. (The Quan Yins often were described to European purchasers as “white Santa Marias,” so as to make them more desirable to a Christian market.)
Heart attacks are often stereotyped as something that happens to older men, not women. But heart disease is the leading cause of death for women in the United States.1 Yet only about half (56%) of women know this.1
Plus, the way women experience a heart attack can feel different from men. While both men and women may have chest pain during a heart attack, women tend to have symptoms in addition to chest pain.
Researchers found that when women have a heart attack, they’re more likely to experience 3 or more related symptoms compared to men.2 These symptoms may include jaw pain, neck pain, back pain, and shortness of breath, and can make it hard for women to tell if they’re having a heart attack.
Women are also more likely than men to think their heart attack symptoms are caused by anxiety and stress.2 Oftentimes, this misunderstanding — combined with a wider range of symptoms — can cause women to wait longer to get treated.
“Several studies have shown that women wait longer to get treatment for a heart attack than men,” says Mingsum Lee, MD, a clinical cardiologist at Kaiser Permanente’s Los Angeles Medical Center.
So, it’s important to learn these symptoms of a heart attack and know when to seek care.
Heart attack warning signs for women
1. Chest pain
The most common heart attack symptom for women (and men) is chest pain. “About 90% of women and men have chest pain when they’re having a heart attack,” says Dr. Lee.
This chest pain and discomfort usually happens after stress — the stress can either be physical, like exercise, or emotional stress. The pain is usually strong, comes on gradually, and increases in intensity over several minutes.
“Typically, the pain feels very deep and it’s hard to localize or pinpoint,” says Dr. Lee. “People generally use terms like ‘pressure,’ ‘squeezing,’ ‘heaviness,’ or ‘tightness’ to describe the sensation in their chest.”
2. Arm, back, neck, or jaw pain
“Sometimes chest pain can radiate or travel through your arm, neck, jaw, or your back,” says Dr. Lee. The pain may gradually get more intense over several minutes.
Since most people expect pain to be in their chest during a heart attack, these symptoms can be very confusing. This is especially true because it may be difficult to pinpoint where the pain started.
3. Stomach pain
Nausea and stomach pain may also be heart attack warning signs for women. “Sometimes people come in late for care because they think they’re having heartburn or acid reflux,” says Dr. Lee. Heartburn or reflux comes from inflammation in the esophagus, which is right next to the heart. This can make it hard to tell if it’s discomfort from eating certain foods or a heart attack. “Generally speaking, heartburn can be triggered by certain spicy food, citrus, and alcohol,” she explains. And acid reflux feels worse when you lie down.
4. Shortness of breath
You might be having a heart attack if you suddenly have shortness of breath for no apparent reason. It may feel like you have to stop and catch your breath while doing an ordinary task. “For example, if you can normally do grocery shopping with no problem, but suddenly you can’t catch your breath while you’re walking down the grocery aisle and you have to stop to rest, that’s a warning sign,” says Dr. Lee.
Sudden sweating plus chest pain is another related heart attack symptom for women. You may feel like you’re having a cold sweat or feel clammy while also feeling some chest pain.
Similarly, chest pain with sudden fatigue and exhaustion may be a sign that you’re having a heart attack. You may feel overly tired for no reason — and the fatigue comes out of nowhere. Your regular activities suddenly become too difficult because you’re extremely tired.
Don’t hesitate to call 911
You might not have all of these heart attack warning signs. But if you’re having any of these symptoms, call 911 immediately. Don’t wait.
In her work, Dr. Lee has seen both younger and older women put off going to the doctor — even when they’re feeling heart attack symptoms. “Young women are often focused on being the caretaker for their children or elderly parents, and they don’t come into the hospital because there’s no one else to take care of their children or parents,” she says.
On the flip side, Dr. Lee has seen older women who are widowed and live alone not want to bother their children or friends. “These women may be having chest pain, but they don’t want to bother people. So they sit at home and hope the symptoms go away,” she says. Sometimes, they don’t drive and are too embarrassed to ask for help.
“I think a lot of times women are used to being the caregivers, so when they themselves need help they aren’t used to asking for it,” Dr. Lee says. This could be another reason why women wait so long to get care for heart attacks.
But it’s important to listen to your body and prioritize your health.
Bottom line: If you’re not sure if you’re having a heart attack, come into the hospital to get checked out. “The earlier you come in for medical care,” Dr. Lee says, “the earlier we can start therapy and the less damage there will be to the heart.”
Risk factors for heart attack in women
In addition to knowing key heart attack symptoms, it’s also important to know if you have risk factors for heart disease. “Many women aren’t aware that they’re at risk for heart attack,” explains Dr. Lee. “So when they start having symptoms, they don’t even consider that it’s a warning sign.”
Common risk factors for women include:
Certain medical conditions. Women are at higher risk for heart disease if they have diabetes, high blood pressure, or an inflammatory disease like rheumatoid arthritis or lupus.
Pregnancy complications. Women who had pregnancy complications like gestational diabetes, gestational hypertension, or preeclampsia are at higher risk for heart attack later in life.
Smoking. Research shows that smoking can increase the risk of heart attack for young people by sevenfold.3 And female smokers are 25% more likely to have heart disease than male smokers.3
Lifestyle choices. Poor diet, overuse of alcohol, and physical inactivity all increase a woman’s risk for heart attack.
Menopause. Lower levels of estrogen after menopause can increase the risk of heart attack for women.
Understanding your risk factors and knowing common heart attack symptoms are important first steps in taking care of your heart.
Small acts of kindness can have a big impact. Not only does offering support to your loved ones show you care, but you can benefit from it, too. Studies show that helping others can reduce stress, increase happiness, and even help you live longer.
Here are 7 simple ways to connect with your loved ones — and let them know that you care.
1. Respond to “bids”
According to Dr. John Gottman, our loved ones will often make “bids” for our attention throughout the day. These bids are when a loved one says something like, “Want to see what I made during art class?” or “Take a look at this cute cat video.”
One good way to respond to bids is by active listening. You can show your loved one you’re actively listening by paying close attention to what they’re saying. Let them know you’re listening by nodding, smiling, or saying “I see.”
And don’t be afraid to ask questions if you’re unsure of what was said. These seemingly small interactions can let our loved ones know we truly care about what’s important to them.
2. Practice mindfulness
It can be easy to get distracted by multiple screens and to-do lists. So when you spend time with loved ones, make a point to limit interruptions. Put down your tablet or smartphone, and focus on staying present. Show up on time, actively listen, and avoid multitasking. If you don’t have a lot of time, consider having a 5- or 10-minute phone call. Giving your undivided attention will make your loved one feel valued and appreciated.
3. Lend a hand
We all need extra help from time to time — and that’s OK. You can show someone you care by offering to help when you think they might be struggling. If, for example, your sister just had a baby and is feeling overwhelmed, offer to run her errands or make her a home-cooked meal so she can get some much-needed rest.
4. Have an attitude of gratitude
Showing appreciation can make people feel good about what they do. How you show gratitude could be as simple as sharing a kind word or as meaningful as writing a handwritten thank-you note for the influence they’ve had in your life. And expressing gratitude can remind both you and your loved one of the positive parts of your lives.
5. Celebrate success
When your loved one accomplishes a goal, be their own personal cheerleading squad. Take some time to celebrate their success and show interest in their life. No matter how you choose to celebrate — sending them a greeting card in the mail, taking them out to dinner, donating to a charity or cause that’s important to them in their name — the other person will feel empowered by your support.
6. Spend quality time together
Quality time is the moments you spend with your loved ones that make you both feel closer and more connected. It can be as simple as meeting for coffee, watching a favorite movie together, playing a board game, or even chatting on a video call. The activity itself doesn’t matter — what matters is how the time spent together makes you feel.
7. Just be there
Listen to someone vent, be a shoulder to cry on, or hold their hand if they’re going through a tough time.
Even if you don’t know the right words to say, by just being there, you let the other person know how much they matter to you. This is especially important if a loved one is struggling with a mental health issue like depression. You don’t need to be a doctor or therapist to offer support — listening with an open mind can help them feel understood. But if you ever do need guidance on what to say, we’re here to help.
So, take time to show you care. You’ll strengthen your relationships and give your loved ones — and yourself — a dose of good health.