Type 2 diabetes (formerly named non-insulin-dependent) which results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well.
Some people with type 2 diabetes are treated with insulin. Insulin is either injected with a syringe several times per day, or delivered via an insulin pump. The goal of insulin therapy is to mimic the way the pancreas would produce and distribute its own insulin, if it were able to manufacture it. Taking insulin does not mean you have done a bad job of trying to control your blood glucose—instead it simply means that your body doesn’t produce or use enough of it on its own to cover the foods you eat.
While it's conceivable that scientists will isolate a single factor as causing type 1 and type 2, the much more likely outcome is that there is more than one cause. Each person seems to take a unique path in developing diabetes. Someday, doctors may be able to assess an individual's genetic risk for diabetes, allowing him or her to dodge the particular environmental factors that would trigger the disease. And perhaps if the baffling question of why a person gets diabetes can be put to rest, the answer will also offer a cure for the disease.
a broadly applied term used to denote a complex group of syndromes that have in common a disturbance in the oxidation and utilization of glucose, which is secondary to a malfunction of the beta cells of the pancreas, whose function is the production and release of insulin. Because insulin is involved in the metabolism of carbohydrates, proteins and fats, diabetes is not limited to a disturbance of glucose homeostasis alone.
Another area of pathologic changes associated with diabetes mellitus is the nervous system (diabetic neuropathy), particularly in the peripheral nerves of the lower extremities. The patient typically experiences a “stocking-type” anesthesia beginning about 10 years after the onset of the disease. There may eventually be almost total anesthesia of the affected part with the potential for serious injury to the part without the patient being aware of it. In contrast, some patients experience debilitating pain and hyperesthesia, with loss of deep tendon reflexes.
Type 2 DM is primarily due to lifestyle factors and genetics. A number of lifestyle factors are known to be important to the development of type 2 DM, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization. Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders. Even those who are not obese often have a high waist–hip ratio.
People with glucose levels between normal and diabetic have impaired glucose tolerance (IGT) or insulin resistance. People with impaired glucose tolerance do not have diabetes, but are at high risk for progressing to diabetes. Each year, 1% to 5% of people whose test results show impaired glucose tolerance actually eventually develop diabetes. Weight loss and exercise may help people with impaired glucose tolerance return their glucose levels to normal. In addition, some physicians advocate the use of medications, such as metformin (Glucophage), to help prevent/delay the onset of overt diabetes.
Watch for thirst or a very dry mouth, frequent urination, vomiting, shortness of breath, fatigue and fruity-smelling breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes but can sometimes occur in people with type 2 diabetes.
Type 2 diabetes used to be called adult-onset diabetes or non-insulin dependent diabetes because it was diagnosed mainly in adults who did not require insulin to manage their condition. However, because more children are starting to be diagnosed with T2D, and insulin is used more frequently to help manage type 2 diabetes, referring to the condition as “adult-onset” or “non-insulin dependent” is no longer accurate.
Individuals with diabetes have two times the likelihood of getting a urinary tract infection compared to individuals without the disease. If you find yourself getting up every couple of hours in the middle of the night, and you seem to be expelling a lot more urine than you used to, talk to your doctor and find out whether or not you have diabetes.
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Type 2 diabetes is one of the major degenerative diseases in the Western world today. It happens when your body can’t use insulin properly, or can’t make enough insulin. Insulin is a hormone the assists the body’s cells in utilizing glucose. It also helps the body store extra sugar in fat, liver, and muscle cells. If you don’t have insulin, your body can’t use the sugar in the bloodstream.
It isn't always easy to start an exercise regimen, but once you get into a groove, you may be surprised at how much you enjoy it. Find a way to fit activity into your daily routine. Even a few minutes a day goes a long way. The American Diabetes Association recommends that adults with diabetes should perform at least 150 minutes of moderate-intensity aerobic physical activity per week (spread over at least three days with no more than two consecutive days without exercise). You don't have to start with this right away, though. Start with five to 10 minutes per day and go from there. To stay motivated, find a buddy, get a fitness tracker, or use another measurement tool that can help you see your progress.
Insulin, a hormone released from the pancreas (an organ behind the stomach that also produces digestive enzymes), controls the amount of glucose in the blood. Glucose in the bloodstream stimulates the pancreas to produce insulin. Insulin helps glucose to move from the blood into the cells. Once inside the cells, glucose is converted to energy, which is used immediately, or the glucose is stored as fat or glycogen until it is needed.
Previously, CGMs required frequent calibration with fingerstick glucose testing. Also their results were not accurate enough so that people always had to do a fingerstick to verify a reading on their CGM before calculating a dose of insulin (for example before meals or to correct a high blood sugar). However, recent technological advances have improved CGMs. One professional CGM can be worn for up to 14 days without calibration. Another personal CGM can be used to guide insulin dosing without confirmation by fingerstick glucose. Finally, there are now systems in which the CGM device communicates with insulin pumps to either stop delivery of insulin when blood glucose is dropping (threshold suspend), or to give daily insulin (hybrid closed loop system).
The beta cells may be another place where gene-environment interactions come into play, as suggested by the previously mentioned studies that link beta cell genes with type 2. "Only a fraction of people with insulin resistance go on to develop type 2 diabetes," says Shulman. If beta cells can produce enough insulin to overcome insulin resistance, a factor that may be genetically predetermined, then a person can stay free of diabetes. But if the beta cells don't have good genes propping them up, then diabetes is the more likely outcome in a person with substantial insulin resistance.
Get to Know Your Medications: If you have diabetes, it is important to know and understand what your medications do. This can help to keep blood sugars controlled and prevent low and high blood sugars. Certain medicines need to be taken with food, or they will cause your blood sugar will drop. There are so many diabetes medications out there. Being your own advocate can help you. Make sure to tell your doctor if your medications are too expensive or if they are causing any side effects. If your medication regimen is not working for you, odds are your doctor can find a new medicine that might work better.
In people with type 1 diabetes, the symptoms often begin abruptly and dramatically. A serious condition called diabetic ketoacidosis, a complication in which the body produces excess acid, may quickly develop. In addition to the usual diabetes symptoms of excessive thirst and urination, the initial symptoms of diabetic ketoacidosis also include nausea, vomiting, fatigue, and—particularly in children—abdominal pain. Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity (see Acidosis), and the breath smells fruity and like nail polish remover. Without treatment, diabetic ketoacidosis can progress to coma and death, sometimes very quickly.
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 AD with type 1 associated with youth and type 2 with being overweight. The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus which is also associated with frequent urination. Effective treatment was not developed until the early part of the 20th century when the Canadians Frederick Banting and Charles Best discovered insulin in 1921 and 1922. This was followed by the development of the long acting NPH insulin in the 1940s.
There is evidence that certain emotions can promote type 2 diabetes. A recent study found that depression seems to predispose people to diabetes. Other research has tied emotional stress to diabetes, though the link hasn't been proved. Researchers speculate that the emotional connection may have to do with the hormone cortisol, which floods the body during periods of stress. Cortisol sends glucose to the blood, where it can fuel a fight-or-flight response, but overuse of this system may lead to dysfunction.
Many studies have shown that awareness about the diabetes and its complications is poor among the general population specially in the rural areas6,7. There is an urgent need to create awareness among the population regarding diabetes and about the serious consequences of this chronic disorder. Epidemiological data from India have shown the presence of a number of risk factors which can be easily identified by simple non-invasive risk scores8,9. The major risk factors are listed in Box 1.
To measure blood glucose levels, a blood sample is usually taken after people have fasted overnight. However, it is possible to take blood samples after people have eaten. Some elevation of blood glucose levels after eating is normal, but even after a meal the levels should not be very high. Fasting blood glucose levels should never be higher than 125 mg/dL. Even after eating, blood glucose levels should not be higher than 199 mg/dL.
Elevated homocysteine levels in the blood called hyperhomocysteinemia, is a sign that the body isn't producing enough of the amino acid homocysteine. is a rare and serious condition that may be inherited (genetic). People with homocystinuria die at an early age. Symptoms of hyperhomocysteinemia include developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities.
High blood glucose sets up a domino effect of sorts within your body. High blood sugar leads to increased production of urine and the need to urinate more often. Frequent urination causes you to lose a lot of fluid and become dehydrated. Consequently, you develop a dry mouth and feel thirsty more often. If you notice that you are drinking more than usual, or that your mouth often feels dry and you feel thirsty more often, these could be signs of type 2 diabetes.