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How is it treated? There is no uniform therapy for type 2 diabetes treatment, which depends on the individual person and his or her stage of type 2 diabetes. To learn more about individualization of therapy, please read our patient guide. That said, the ADA and EASD have created treatment recommendation guidelines for type 2 diabetes progression. In all cases, healthy eating, exercise, and weight management are key to effective type 2 diabetes management. As type 2 diabetes progresses, patients may need to add one or more drugs to their treatment regimen.
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.
Diabetes mellitus, or as it's more commonly known diabetes, is a disease characterized by an excess of blood glucose, or blood sugar, which builds up in the bloodstream when your body isn't able to adequately process the sugar in food. High blood sugar is an abnormal state for the body and creates specific symptoms and possible long-term health problems if blood sugar is not managed well.
Most cases of diabetes involve many genes, with each being a small contributor to an increased probability of becoming a type 2 diabetic.[10] If one identical twin has diabetes, the chance of the other developing diabetes within his lifetime is greater than 90%, while the rate for nonidentical siblings is 25–50%.[13] As of 2011, more than 36 genes had been found that contribute to the risk of type 2 diabetes.[37] All of these genes together still only account for 10% of the total heritable component of the disease.[37] The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5 times and is the greatest risk of the common genetic variants.[13] Most of the genes linked to diabetes are involved in beta cell functions.[13]

Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) belongs to a class of drugs called biguanides. Metformin is first-line therapy for most type 2 diabetics. It works to stop the liver from making excess glucose, and has a low risk of hypoglycemia. Hypoglycemia, or very low blood sugar can cause symptoms such as sweating, nervousness, heart palpitations, weakness, intense hunger, trembling, and problems speaking. Many patients lose some weight taking metformin, which is also helpful for blood sugar control.
The woman’s weight may also play a role. Changing hormone levels and weight gain are part of a healthy pregnancy, but both changes make it more difficult for the body to keep up with its need for insulin. This may lead to gestational diabetes. As pregnancy progresses, the placenta also produces insulin-blocking hormones, which might result in a woman’s blood-glucose levels becoming elevated if there isn’t enough insulin to counter this effect.
The WHO estimates that diabetes mellitus resulted in 1.5 million deaths in 2012, making it the 8th leading cause of death.[9][101] However another 2.2 million deaths worldwide were attributable to high blood glucose and the increased risks of cardiovascular disease and other associated complications (e.g. kidney failure), which often lead to premature death and are often listed as the underlying cause on death certificates rather than diabetes.[101][104] For example, in 2014, the International Diabetes Federation (IDF) estimated that diabetes resulted in 4.9 million deaths worldwide,[19] using modeling to estimate the total number of deaths that could be directly or indirectly attributed to diabetes.[20]
And go easy on yourself: Sometimes you can be doing everything perfectly and your blood sugars start to creep up. Because diabetes is a progressive disease, your body slowly stops making insulin over time. If you've had diabetes for a very long time, try not to be discouraged if your doctor has to increase your medication or discusses insulin with you. Continue to do what you can to improve your health.
^ Jump up to: a b Petzold A, Solimena M, Knoch KP (October 2015). "Mechanisms of Beta Cell Dysfunction Associated With Viral Infection". Current Diabetes Reports (Review). 15 (10): 73. doi:10.1007/s11892-015-0654-x. PMC 4539350. PMID 26280364. So far, none of the hypotheses accounting for virus-induced beta cell autoimmunity has been supported by stringent evidence in humans, and the involvement of several mechanisms rather than just one is also plausible.
Diabetes mellitus is not a single disorder but a heterogeneous group of disorders. All forms are characterized by hyperglycemia and disturbances of carbohydrate, fat, and protein metabolism which are associated with absolute or relative deficiencies of insulin action and/or insulin secretion. The World Health Organization (WHO) developed a now widely accepted classification of the disorder, largely based on clinical characteristics (see Table 1, WHO, 1985).
Can type 2 diabetes be cured? In the early stages of type 2 diabetes, it is possible to manage the diabetes to a level where symptoms go away and A1c reaches a normal level – this effectively “reverses” the progression of type 2 diabetes. According to research from Newcastle University, major weight loss can return insulin secretion to normal in people who had type 2 diabetes for four years or less. Indeed, it is commonly believed that significant weight loss and building muscle mass is the best way to reverse type 2 diabetes progression. However, it is important to note that reversing diabetes progression is not the same as curing type 2 diabetes – people still need to monitor their weight, diet, and exercise to ensure that type 2 diabetes does not progress. For many people who have had type 2 diabetes for a longer time, the damage to the beta cells progresses to the point at which it will never again be possible to make enough insulin to correctly control blood glucose, even with dramatic weight loss. But even in these people, weight loss is likely the best way to reduce the threat of complications.
There are a number of medications and other health problems that can predispose to diabetes.[39] Some of the medications include: glucocorticoids, thiazides, beta blockers, atypical antipsychotics,[40] and statins.[41] Those who have previously had gestational diabetes are at a higher risk of developing type 2 diabetes.[23] Other health problems that are associated include: acromegaly, Cushing's syndrome, hyperthyroidism, pheochromocytoma, and certain cancers such as glucagonomas.[39] Testosterone deficiency is also associated with type 2 diabetes.[42][43]

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.
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:
^ Jump up to: a b c Simpson, Terry C.; Weldon, Jo C.; Worthington, Helen V.; Needleman, Ian; Wild, Sarah H.; Moles, David R.; Stevenson, Brian; Furness, Susan; Iheozor-Ejiofor, Zipporah (2015-11-06). "Treatment of periodontal disease for glycaemic control in people with diabetes mellitus". Cochrane Database of Systematic Reviews (11): CD004714. doi:10.1002/14651858.CD004714.pub3. ISSN 1469-493X. PMID 26545069.
Talking to a counselor or therapist may help you cope with the lifestyle changes that come with a type 2 diabetes diagnosis. You may find encouragement and understanding in a type 2 diabetes support group. Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you're interested, your doctor may be able to recommend a group in your area.
A healthy meal plan for people with diabetes is generally the same as healthy eating for anyone – low in saturated fat, moderate in salt and sugar, with meals based on lean protein, non-starchy vegetables, whole grains, healthy fats, and fruit. Foods that say they are healthier for people with diabetes generally offer no special benefit. Most of them still raise blood glucose levels, are more expensive, and can also have a laxative effect if they contain sugar alcohols.
Diabetic ketoacidosis (DKA) is much less common than hypoglycemia but is potentially far more serious, creating a life-threatening medical emergency. [13] Ketosis usually does not occur when insulin is present. In the absence of insulin, however, severe hyperglycemia, dehydration, and ketone production contribute to the development of DKA. The most serious complication of DKA is the development of cerebral edema, which increases the risk of death and long-term morbidity. Very young children at the time of first diagnosis are most likely to develop cerebral edema.
Get Educated: The American Diabetes Association advises that all persons with diabetes receive diabetes self-management education (DSME) at diagnosis and thereafter. A certified diabetes educator or other qualified health professional can give you the tools you need to understand and take care of your diabetes. In addition, these individuals are trained to create a customized plan that works for you. Diabetes self-management education is a patient-centered approach that enables patients to get involved in their care.
Jump up ^ Attridge, Madeleine; Creamer, John; Ramsden, Michael; Cannings-John, Rebecca; Hawthorne, Kamila (2014-09-04). "Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus". Cochrane Database of Systematic Reviews (9): CD006424. doi:10.1002/14651858.CD006424.pub3. ISSN 1469-493X. PMID 25188210.
[1] Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet Diabetes & Endocrinology. 2015;3(11):866‒875. You can find more information about this study on the Diabetes Prevention Program Outcomes Study website.
Alternatively, if you hit it really hard for 20 minutes or so, you may never enter the fat burning phase of exercise. Consequently, your body becomes more efficient at storing sugar (in the form of glycogen) in your liver and muscles, where it is needed, as glycogen is the muscles’ primary fuel source. If your body is efficient at storing and using of glycogen, it means that it is not storing fat.
nephrogenic diabetes insipidus a rare form caused by failure of the renal tubules to reabsorb water; there is excessive production of antidiuretic hormone but the tubules fail to respond to it. Characteristics include polyuria, extreme thirst, growth retardation, and developmental delay. The condition does not respond to exogenous vasopressin. It may be inherited as an X-linked trait or be acquired as a result of drug therapy or systemic disease.

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.
Clinical Manifestations. Diabetes mellitus can present a wide variety of symptoms, from none at all to profound ketosis and coma. If the disease manifests itself late in life, patients may not know they have it until it is discovered during a routine examination, or when the symptoms of chronic vascular disease, insidious renal failure, or impaired vision cause them to seek medical help. 

Jump up ^ Farmer, AJ; Perera, R; Ward, A; Heneghan, C; Oke, J; Barnett, AH; Davidson, MB; Guerci, B; Coates, V; Schwedes, U; O'Malley, S (27 February 2012). "Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes". The BMJ. 344: e486. doi:10.1136/bmj.e486. PMID 22371867.
While there is a strong genetic component to developing this form of diabetes, there are other risk factors - the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true in children as well as adults. It is estimated that the chance to develop diabetes doubles for every 20% increase over desirable body weight.
Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin.
A number of studies have looked for relationships between sugar and diabetes risk. A 2017 meta-analysis, based on nine reports of 15 cohort studies including 251,261 participants, found no significant effect of total sugars on the risk of developing type 2 diabetes.7 Those consuming the most sugar actually had a 9 percent lower risk of developing diabetes, compared with those consuming the least sugar, although the difference was not statistically significant (meaning that it could have been a chance result). Similarly, fructose was not significantly associated with diabetes risk. Sucrose appeared to have a significant protective association. Those consuming the most sucrose had 11 percent less risk of developing type 2 diabetes, compared with those consuming the least.
As of 2016, 422 million people have diabetes worldwide,[101] up from an estimated 382 million people in 2013[17] and from 108 million in 1980.[101] Accounting for the shifting age structure of the global population, the prevalence of diabetes is 8.5% among adults, nearly double the rate of 4.7% in 1980.[101] Type 2 makes up about 90% of the cases.[16][18] Some data indicate rates are roughly equal in women and men,[18] but male excess in diabetes has been found in many populations with higher type 2 incidence, possibly due to sex-related differences in insulin sensitivity, consequences of obesity and regional body fat deposition, and other contributing factors such as high blood pressure, tobacco smoking, and alcohol intake.[102][103]
Insulin Therapy. Exogenous insulin is given to patients with diabetes mellitus as a supplement to the insufficient amount of endogenous insulin that they produce. In some cases, this must make up for an absolute lack of insulin from the pancreas. Exogenous insulin is available in various types. It must be given by injection, usually subcutaneously, and because it is a potent drug, the dosage must be measured meticulously. Commonly, regular insulin, which is a fast-acting insulin with a short span of action, is mixed with one of the longer-acting insulins and both types are administered in one injection.
People who are obese -- more than 20% over their ideal body weight for their height -- are at particularly high risk of developing type 2 diabetes and its related medical problems. Obese people have insulin resistance. With insulin resistance, the pancreas has to work overly hard to produce more insulin. But even then, there is not enough insulin to keep sugars normal.
Type 1 diabetes is always treated with insulin, a life-saving treatment. Patients will need to take insulin several times a day for the rest of their lives. They will usually learn how to self-administer this. Insulin is usually given through injections under the skin, normally two to four times a day. An increasing number of patients with type 1 diabetes are being treated with ‘insulin pumps’, which provide a continuous supply of insulin. 
Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.[93] Additionally it is associated with increased rates of heart disease and death.[94] Angiotensin-converting enzyme inhibitors (ACEIs) prevent kidney disease and improve outcomes in those with diabetes.[95][96] The similar medications angiotensin receptor blockers (ARBs) do not.[96] A 2016 review recommended treating to a systolic blood pressure of 140 to 150 mmHg.[97]
Infections. Poorly controlled diabetes can lead to a variety of tissue infections. The most commonly encountered is a yeast infection (Candida) and the presence of dry mouth further increases one’s risk (see PATIENT INFORMATION SHEET – Oral Yeast Infections). Typically, affected areas appear redder than the surrounding tissue and commonly affected sites include the tongue, palate, cheeks, gums, or corners of the mouth (see Right). There is conflicting data regarding cavity risk in the diabetic patient, but those who have dry mouth are clearly at increased risk for developing cavities.
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.

About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. This hormone was isolated by Frederic Banting and Charles Best in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable.


Jump up ^ Haw, JS; Galaviz, KI; Straus, AN; Kowalski, AJ; Magee, MJ; Weber, MB; Wei, J; Narayan, KMV; Ali, MK (6 November 2017). "Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials". JAMA Internal Medicine. 177 (12): 1808–17. doi:10.1001/jamainternmed.2017.6040. PMID 29114778.
a complex disorder of carbohydrate, fat, and protein metabolism that is primarily a result of a deficiency or complete lack of insulin secretion by the beta cells of the pancreas or resistance to insulin. The disease is often familial but may be acquired, as in Cushing's syndrome, as a result of the administration of excessive glucocorticoid. The various forms of diabetes have been organized into categories developed by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus of the American Diabetes Association. Type 1 diabetes mellitus in this classification scheme includes patients with diabetes caused by an autoimmune process, dependent on insulin to prevent ketosis. This group was previously called type I, insulin-dependent diabetes mellitus, juvenile-onset diabetes, brittle diabetes, or ketosis-prone diabetes. Patients with type 2 diabetes mellitus are those previously designated as having type II, non-insulin-dependent diabetes mellitus, maturity-onset diabetes, adult-onset diabetes, ketosis-resistant diabetes, or stable diabetes. Those with gestational diabetes mellitus are women in whom glucose intolerance develops during pregnancy. Other types of diabetes are associated with a pancreatic disease, hormonal changes, adverse effects of drugs, or genetic or other anomalies. A fourth subclass, the impaired glucose tolerance group, also called prediabetes, includes persons whose blood glucose levels are abnormal although not sufficiently above the normal range to be diagnosed as having diabetes. Approximately 95% of the 18 million diabetes patients in the United States are classified as type 2, and more than 70% of those patients are obese. About 1.3 million new cases of diabetes mellitus are diagnosed in the United States each year. Contributing factors to the development of diabetes are heredity; obesity; sedentary life-style; high-fat, low-fiber diets; hypertension; and aging. See also impaired glucose tolerance, potential abnormality of glucose tolerance, previous abnormality of glucose tolerance.
Diabetes mellitus (DM) is a strong predictor of cardiovascular morbidity and mortality and is associated with both micro- and macrovascular complications.1 Cardiovascular disease (CVD) causes up to 70% of all deaths in people with DM. The epidemic of DM will thus be followed by a burden of diabetes-related vascular diseases. The number of DM patients increases with aging of the population, in part because of the increasing prevalence of obesity and sedentary lifestyle. Although the mortality from coronary artery disease (CAD) in patients without DM has declined since the 1990s, the mortality in men with type 2 diabetes (T2DM) has not changed significantly.2 Moreover, DM is an independent risk factor for heart failure. Heart failure is closely related to diabetic cardiomyopathy: changes in the structure and function of the myocardium are not directly linked to CAD or hypertension. Diabetic cardiomyopathy is clinically characterized by an initial increase in left ventricular stiffness and subclinical diastolic dysfunction, gradually compromising left ventricular systolic function with loss of contractile function and progress into overt congestive heart failure. DM accounts for a significant percentage of patients with a diagnosis of heart failure in epidemiologic studies such as the Framingham Study and the UK Prospective Diabetes Study (UKPDS).2 A 1% increase in glycated hemoglobin (HbA1c) correlates to an increment of 8% in heart failure.3 The prevalence of heart failure in elderly diabetic patients is up to 30%.3

Diabetes mellitus occurs throughout the world but is more common (especially type 2) in more developed countries. The greatest increase in rates has however been seen in low- and middle-income countries,[101] where more than 80% of diabetic deaths occur.[105] The fastest prevalence increase is expected to occur in Asia and Africa, where most people with diabetes will probably live in 2030.[106] The increase in rates in developing countries follows the trend of urbanization and lifestyle changes, including increasingly sedentary lifestyles, less physically demanding work and the global nutrition transition, marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats, sometimes referred to as the "Western-style" diet).[101][106] The global prevalence of diabetes might increase by 55% between 2013 and 2035.[101]
Before you find yourself shocked by a diabetes diagnosis, make sure you know these 20 diabetes signs you shouldn’t ignore. If you identify with any of these warning signs on the list, be sure to visit your doctor ASAP to get your blood sugar tested. And if you want to reduce your risk of becoming diabetic in the first place, start with the 40 Tips That Double Weight Loss!

Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue.
Keeping track of the number of calories provided by different foods can become complicated, so patients usually are advised to consult a nutritionist or dietitian. An individualized, easy to manage diet plan can be set up for each patient. Both the American Diabetes Association and the American Dietetic Association recommend diets based on the use of food exchange lists. Each food exchange contains a known amount of calories in the form of protein, fat, or carbohydrate. A patient's diet plan will consist of a certain number of exchanges from each food category (meat or protein, fruits, breads and starches, vegetables, and fats) to be eaten at meal times and as snacks. Patients have flexibility in choosing which foods they eat as long as they stick with the number of exchanges prescribed.
The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body.[60] Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.[60]
Jump up ^ Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H. "Diagnosis, Prognosis, and Treatment of Impaired Glucose Tolerance and Impaired Fasting Glucose". Summary of Evidence Report/Technology Assessment, No. 128. Agency for Healthcare Research and Quality. Archived from the original on 16 September 2008. Retrieved 20 July 2008.
Our bodies break down the foods we eat into glucose and other nutrients we need, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can't make or can't respond to insulin properly.

Treatment of high blood pressure and high cholesterol levels, which can contribute to circulation problems, can help prevent some of the complications of diabetes as well. A low dose of aspirin taken daily is recommended in people with risk factors for heart disease. All people with diabetes who are between 40 and 75 years are given a statin (a drug to decrease cholesterol levels) regardless of cholesterol levels. Younger people with an elevated risk of heart disease should also take a statin .


Excessive thirst typically goes hand-in-hand with increased urination. As your body pulls water out of the tissues to dilute your blood and to rid your body of sugar through the urine, the urge to drink increases. Many people describe this thirst as an unquenchable one. To stay hydrated, you drink excessive amounts of liquids. And if those liquids contain simple sugars (soda, sweet iced tea, lemonade, or juice, for example) your sugars will skyrocket even higher.
While there are competing explanations of the link between obesity and type 2 diabetes, Gerald Shulman, MD, PhD, a professor of internal medicine and physiology at Yale University, believes the key is figuring out insulin resistance. He has studied the causes of insulin resistance for 25 years and thinks he may have the answer to the weight-diabetes link.
Different environmental effects on type 1 diabetes mellitus development complicate the influence of race, but racial differences are evident. Whites have the highest reported incidence, whereas Chinese individuals have the lowest. Type 1 diabetes mellitus is 1.5 times more likely to develop in American whites than in American blacks or Hispanics. Current evidence suggests that when immigrants from an area with low incidence move to an area with higher incidence, their rates of type 1 diabetes mellitus tend to increase toward the higher level.
Because people with type 2 diabetes produce some insulin, ketoacidosis does not usually develop even when type 2 diabetes is untreated for a long time. Rarely, the blood glucose levels become extremely high (even exceeding 1,000 mg/dL). Such high levels often happen as the result of some superimposed stress, such as an infection or drug use. When the blood glucose levels get very high, people may develop severe dehydration, which may lead to mental confusion, drowsiness, and seizures, a condition called hyperosmolar hyperglycemic state. Currently, many people with type 2 diabetes are diagnosed by routine blood glucose testing before they develop such severely high blood glucose levels.
According to the National Institutes of Health, the reported rate of gestational diabetes is between 2% to 10% of pregnancies. Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk for developing type 2 diabetes later in life. Up to 10% of women with gestational diabetes develop type 2 diabetes. It can occur anywhere from a few weeks after delivery to months or years later.
Don’t be alarmed: This is not diabetic retinopathy, where the blood vessels in the back of the eye are getting destroyed, says Dr. Cypess. In the early stages of diabetes, the eye lens is not focusing well because glucose builds up in the eye, which temporarily changes its shape. “You’re not going blind from diabetes,” Dr. Cypess says he assures patients. “In about six to eight weeks after your blood sugars are stabilized, you’re not going to feel it anymore; the eye will adjust.” Here are more surprising facts you never knew about diabetes.
The term brittle diabetes has been used to refer to people who have dramatic recurrent swings in blood glucose levels, often for no apparent reason. However, this term is no longer used. People with type 1 diabetes may have more frequent swings in blood glucose levels because insulin production is completely absent. Infection, delayed movement of food through the stomach, and other hormonal disorders may also contribute to blood glucose swings. In all people who have difficulty controlling blood glucose, doctors look for other disorders that might be causing the problem and also give people additional education on how to monitor diabetes and take their drugs.
Get Educated: The American Diabetes Association advises that all persons with diabetes receive diabetes self-management education (DSME) at diagnosis and thereafter. A certified diabetes educator or other qualified health professional can give you the tools you need to understand and take care of your diabetes. In addition, these individuals are trained to create a customized plan that works for you. Diabetes self-management education is a patient-centered approach that enables patients to get involved in their care.
American Diabetes Association Joslin Diabetes Center Mayo Clinic International Diabetes Federation Canadian Diabetes Association National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Daily American Heart Association Diabetes Forecast Diabetic Living American Association of Clinical Endocrinologists European Association for the Study of Diabetes
Persons with diabetes are prone to infection, delayed healing, and vascular disease. The ease with which poorly controlled diabetic persons develop an infection is thought to be due in part to decreased chemotaxis of leukocytes, abnormal phagocyte function, and diminished blood supply because of atherosclerotic changes in the blood vessels. An impaired blood supply means a deficit in the protective defensive cells transported in the blood. Excessive glucose allows organisms to grow out of control.
observations The onset of type 1 diabetes mellitus is sudden in children. Type 2 diabetes often begins insidiously. Characteristically the course is progressive and includes polyuria, polydipsia, weight loss, polyphagia, hyperglycemia, and glycosuria. The eyes, kidneys, nervous system, skin, and circulatory system may be affected by the long-term complications of either type of diabetes; infections are common; and atherosclerosis often develops. In type 1 diabetes mellitus, when no endogenous insulin is being secreted, ketoacidosis is a constant danger. The diagnosis is confirmed by fasting plasma glucose and history.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Reduce Your Carbohydrate Intake: One of the most important components involved in a diabetes diet is knowing how to eat a modified carbohydrate diet. Carbohydrates are the nutrient that impacts blood sugars the most. Carbohydrates are found in starches, fruit, some vegetables like potatoes, sweets, and grains. Eating the right kinds of carbohydrate in the right quantities can help you manage your weight and your blood sugars. Knowing how to identify and count carbohydrates is very important in managing diabetes. Eating a consistent carbohydrate diet is ideal because it can help you body regulate blood sugars.
A: There are two scenarios to consider here, pregnant patients who have diabetes and pregnant patients who have gestational diabetes. Gestational diabetes describes hyperglycemia discovered during pregnancy. This hyperglycemia often corrects itself after pregnancy, but women who experience gestational diabetes are at higher for developing type-2 diabetes later in life when compared to women who experience no hyperglycemia during pregnancy. Regardless of the type of diabetes a pregnant patient has, her physician will closely monitor her disease and its response to therapy. Proper glucose control is important not only for the health of the mother, but also her developing child.
Jump up ^ Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, Seshasai SR, McMurray JJ, Freeman DJ, Jukema JW, Macfarlane PW, Packard CJ, Stott DJ, Westendorp RG, Shepherd J, Davis BR, Pressel SL, Marchioli R, Marfisi RM, Maggioni AP, Tavazzi L, Tognoni G, Kjekshus J, Pedersen TR, Cook TJ, Gotto AM, Clearfield MB, Downs JR, Nakamura H, Ohashi Y, Mizuno K, Ray KK, Ford I (February 2010). "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials". Lancet. 375 (9716): 735–42. doi:10.1016/S0140-6736(09)61965-6. PMID 20167359.
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Oral medications are available to lower blood glucose in Type II diabetics. In 1990, 23.4 outpatient prescriptions for oral antidiabetic agents were dispensed. By 2001, the number had increased to 91.8 million prescriptions. Oral antidiabetic agents accounted for more than $5 billion dollars in worldwide retail sales per year in the early twenty-first century and were the fastest-growing segment of diabetes drugs. The drugs first prescribed for Type II diabetes are in a class of compounds called sulfonylureas and include tolbutamide, tolazamide, acetohexamide, and chlorpropamide. Newer drugs in the same class are now available and include glyburide, glimeperide, and glipizide. How these drugs work is not well understood, however, they seem to stimulate cells of the pancreas to produce more insulin. New medications that are available to treat diabetes include metformin, acarbose, and troglitizone. The choice of medication depends in part on the individual patient profile. All drugs have side effects that may make them inappropriate for particular patients. Some for example, may stimulate weight gain or cause stomach irritation, so they may not be the best treatment for someone who is already overweight or who has stomach ulcers. Others, like metformin, have been shown to have positive effects such as reduced cardiovascular mortality, but but increased risk in other situations. While these medications are an important aspect of treatment for Type II diabetes, they are not a substitute for a well planned diet and moderate exercise. Oral medications have not been shown effective for Type I diabetes, in which the patient produces little or no insulin.
Jump up ^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
Arlan L Rosenbloom, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Epidemiology, American Pediatric Society, Endocrine Society, Pediatric Endocrine Society, Society for Pediatric Research, Florida Chapter of The American Academy of Pediatrics, Florida Pediatric Society, International Society for Pediatric and Adolescent Diabetes
Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose.[67] people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.[68] The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).[69]
All children with type 1 diabetes mellitus require insulin therapy. Most require 2 or more injections of insulin daily, with doses adjusted on the basis of self-monitoring of blood glucose levels. Insulin replacement is accomplished by giving a basal insulin and a preprandial (premeal) insulin. The basal insulin is either long-acting (glargine or detemir) or intermediate-acting (NPH). The preprandial insulin is either rapid-acting (lispro, aspart, or glulisine) or short-acting (regular).
Higher levels of sugar in the urine and the vagina can become a breeding ground for the bacteria and yeast that cause these infections. Recurrent infections are particularly worrisome. “Usually when you keep getting infections, doctors will check for diabetes if you don’t already have it,” says Cypress. “Even women who go to the emergency room for urinary tract infections are often checked.” Don’t miss these other silent diabetes complications you need to know about.
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