Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses, a lack of insulin may also develop.[12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2]
Persons with diabetes who take insulin must be careful about indulging in unplanned exercise. Strenuous physical activity can rapidly lower their blood sugar and precipitate a hypoglycemic reaction. For a person whose blood glucose level is over 250 mg/dl, the advice would be not to exercise at all. At this range, the levels of insulin are too low and the body would have difficulty transporting glucose into exercising muscles. The result of exercise would be a rise in blood glucose levels.
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 Maruthur, NM; Tseng, E; Hutfless, S; Wilson, LM; Suarez-Cuervo, C; Berger, Z; Chu, Y; Iyoha, E; Segal, JB; Bolen, S (19 April 2016). "Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 164 (11): 740–51. doi:10.7326/M15-2650. PMID 27088241.
The blood vessels and blood are the highways that transport sugar from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Sugar cannot go into the cells by itself. The pancreas releases insulin into the blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy.
Diabetes mellitus (“diabetes”) and hypertension, which commonly coexist, are global public health issues contributing to an enormous burden of cardiovascular disease, chronic kidney disease, and premature mortality and disability. The presence of both conditions has an amplifying effect on risk for microvascular and macrovascular complications.1 The prevalence of diabetes is rising worldwide (Fig. 37.1). Both diabetes and hypertension disproportionately affect people in middle and low-income countries, and an estimated 70% of all cases of diabetes are found in these countries.2,3 In the United States alone, the total costs of care for diabetes and hypertension in the years 2012 and 2011 were 245 and 46 billion dollars, respectively.4,5 Therefore, there is a great potential for meaningful health and economic gains attached to prevention, detection, and intervention for diabetes and hypertension.

The glucose level at which symptoms develop varies greatly from individual to individual (and from time to time in the same individual), depending in part on the duration of diabetes, the frequency of hypoglycemic episodes, the rate of fall of glycemia, and overall control. (Glucose is also the sole energy source for erythrocytes and the kidney medulla.)
Type 1 DM is caused by autoimmune destruction of the insulin-secreting beta cells of the pancreas. The loss of these cells results in nearly complete insulin deficiency; without exogenous insulin, type 1 DM is rapidly fatal. Type 2 DM results partly from a decreased sensitivity of muscle cells to insulin-mediated glucose uptake and partly from a relative decrease in pancreatic insulin secretion.

You have a higher risk of type 2 diabetes if you are older, have obesity, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes.

Type 1 DM is caused by autoimmune destruction of the insulin-secreting beta cells of the pancreas. The loss of these cells results in nearly complete insulin deficiency; without exogenous insulin, type 1 DM is rapidly fatal. Type 2 DM results partly from a decreased sensitivity of muscle cells to insulin-mediated glucose uptake and partly from a relative decrease in pancreatic insulin secretion.
interventions The goal of treatment is to maintain insulin glucose homeostasis. Type 1 diabetes is controlled by insulin, meal planning, and exercise. The Diabetes Control and Complications Trial (DCCT), completed in mid-1993, demonstrated that tight control of blood glucose levels (i.e., frequent monitoring and maintenance at as close to normal as possible to the level of nondiabetics) significantly reduces complications such as eye disease, kidney disease, and nerve damage. Type 2 diabetes is controlled by meal planning; exercise; one or more oral agents, in combination with oral agents; and insulin. The results of the United Kingdom Prospective Diabetes Study, which involved more than 5000 people with newly diagnosed type 2 diabetes in the United Kingdom, were comparable to those of the DCCT where a relationship in microvascular complications. Stress of any kind may require medication adjustment in both type 1 and type 2 diabetes.
Risk factors for type 2 diabetes include obesity, high cholesterol, high blood pressure, and physical inactivity. The risk of developing type 2 diabetes also increases as people grow older. People who are over 40 and overweight are more likely to develop type 2 diabetes, although the incidence of this type of diabetes in adolescents is growing. Diabetes is more common among Native Americans, African Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Also, people who develop diabetes while pregnant (a condition called gestational diabetes) are more likely to develop type 2 diabetes later in life.
A person of Asian origin aged 35 yr or more with two or more of the above risk factors, should undergo a screening test for diabetes. An oral glucose tolerance test (OGTT) is commonly used as the screening test10. Fasting and 2 h post glucose tests can identify impaired fasting glucose (IFG) (fasting glucose >110 - <125 mg/dl), impaired glucose tolerance (IGT) (2 h glucose >140-<200 mg/dl) and presence of diabetes (fasting > 126 and 2 h glucose >200 mg/dl). If a random blood glucose value is > 150 mg/dl, further confirmation by an OGTT is warranted. Recently, glycosylated haemoglobin (HbA1c) has been recommended as the test for diagnosis of diabetes (>6.5%). Presence of pre-diabetes is indicated by HbA1c values between 5.7 - 6.4 per cent11.

The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves.[32] Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness.[32] Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that diabetics visit an eye doctor once a year.[33] Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.[32] Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes.[32] The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle atrophy and weakness.


DM is a strong independent predictor of short- and long-term recurrent ischemic events, including mortality, in acute coronary syndrome (ACS),6,7 including unstable angina and non-ST-elevation MI (NSTEMI),8 ST-elevation MI (STEMI) treated medically,9 and ACS undergoing percutaneous coronary intervention (PCI).10,11 Furthermore, the concomitant presence of cardiovascular risk factors and comorbidities that negatively affect the outcomes of ACS is higher in DM patients.12

Those dark patches on your skin could be more serious than a blotchy tan. In fact, they might be the first sign of diabetes. This darkening of the skin, which usually occurs on the hands and feet, in folds of skin, along the neck, and in a person’s groin and armpits, called acanthosis nigricans, often occurs when insulin levels are high. The high insulin levels in your blood can increase your body’s production of skin cells, many of which have increased pigmentation, giving skin a darkened appearance.


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]
Jump up ^ Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016). "Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013". BMJ. 354: i3857. doi:10.1136/bmj.i3857. PMC 4979358. PMID 27510511.
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by:
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).

But the 2015-2020 Dietary Guidelines recommend keeping added sugar below 10 percent of your overall daily caloric intake. And the American Heart Association suggests consuming no more than 9 teaspoons (tsp) — equal to 36 grams (g) or 150 calories — of added sugar if you're a man, and 6 tsp — equal to 25 g or 100 calories — if you're a woman. "Naturally occurring sugars don't count in these recommendations," notes Grieger, which means you should worry less about those sugars in fruits and veggies, for instance, than you should about those in processed fare.
High blood sugar levels (hyperglycemia) can lead to a condition called glucose toxicity. This leads to further damage to the pancreas, and the body is less able to produce insulin. Without insulin, glucose levels continue to rise to levels that can cause damage to organs such as the eyes, nerves, and kidneys. These problems are similar to the complications associated with type 1 diabetes.
Low testosterone (low-T) can be caused by conditions such as type 2 diabetes, obesity, liver or kidney disease, hormonal disorders, certain infections, and hypogonadism. Signs and symptoms that a person may have low-T include insomnia, increased body fat, weight gain, reduced muscle, infertility, decreased sex drive, depression, and worsening of congestive heart failure or sleep apnea.
Then, once you do have an injury, uncontrolled diabetes can make it harder for your body to heal. “High blood sugars provide a good environment for bacteria to grow,” she says. That's because diabetes is also often accompanied by high blood pressure and high cholesterol, and the resulting plaque buildup can narrow blood vessels, reducing blood supply and leading to slow healing.
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