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Type 2 Diabetes

Once known as non-insulin dependent diabetes, type 2 diabetes, is the most commonly occurring form of diabetes. Find out about insulin resistance, the causes of diabetes, symptoms you shouldn’t ignore, and tips for managing type 2 diabetes.


People with type 2 diabetes are still able to make insulin - a hormone critical to getting sugars into the body’s cells. The problem is that they either do not make enough insulin, or their body is not able to properly use the insulin that it produces. In either case, the body cannot manage its sugar, so it builds up in the bloodstream. Historically, type 2 diabetes was mainly an adult disease. Currently, though, the disease is becoming more and more common in children. Although the cause of this phenomenon has not been definitively identified, it is likely a result of more sedentary lifestyles and changes in eating habits, leading to an increase in childhood obesity. If you or your child is at risk of developing type 2 diabetes, it is critical to familiarize yourself with the disease and learn important self-care tips to help avoid developing the sickness (WebMD, 2013).


Inability to Break Dow Sugar leads to Insulin Resistance


Type 2 diabetes is a syndrome with a diverse collection of causes and symptoms. Regardless of what leads to the disease, it is characterized by abnormalities in the way that your body is able to break down sugars and fats. While some of the causes are genetic, others are a result of the way that you live your life. One thing that does appear to be a commonality is that, a majority of people with type 2 diabetes are obese. Although previously the linkage was not recognized, within the past several years, many have hypothesized that extra fat affects the production of chemicals in the body that are used to provide communication between various organs and parts of the body. Changes in these chemicals have been implicated in the resistance of the body to insulin and/or its ability to produce an adequate supply of insulin, leading to type 2 diabetes. Therefore, insulin resistance leads to this condition (Scheen, 2003).


Poverty, Obesity, and Physical Inactivity put you at Risk for Diabetes


Although researchers are not totally clear on what puts you at risk for getting type 2 diabetes, diabetes researchers Riste and associates (2001) may have found the answer. They set out to compare the prevalence of type 2 diabetes in people of white, European, African-Caribbean and Pakistani descent.  Their random sample included 1,318 people residing in in Manchester, the third most impoverished area in Britain.  If a subject had not been previously diagnosed with diabetes, they underwent a 2 hour glucose tolerance test according to the guidelines laid out by the World Health Organization. Of the subjects screened, greater than 60% were considered impoverished, and they did not get enough physical activity on a regular basis. Also, for these participants, the frequency of obesity was high.


The investigators found that the overall prevalence of diabetes observed in over 20% of the study participants.  Broken down by ethnicity, 20% of Europeans, 22% of African-Caribbeans and 33% of Pakistanis were diabetic. Further analyses showed high blood sugar levels in subjects with:  greater waist girth, lower height, older age and less physical activity.  The investigators concluded that family history, poverty, obesity and physical inactivity are likely contributors to the occurrence of type 2 diabetes (Riste et al., 2001).


Two Conditions that Lead to Type 2 Diabetes


The Mayo Clinic describes two additional conditions that can often lead to eventual type 2 diabetes: pre-diabetes and gestational diabetes.


• Pre-diabetes: This occurs when your blood sugar is elevated to some extent, but you do not yet meet the criteria for diabetes. If this condition is left untreated, pre-diabetes can often progress to type 2 diabetes.


• Gestational diabetes:  This form of the disease develops during pregnancy. While many women revert to normal sugar levels after their baby is born, the risk of ultimately developing type 2 diabetes is increased. Additionally, women who give birth to babies in excess of 9 pounds are at increased risk of developing type 2 diabetes.
(Mayo Clinic, 2013)


Diabetes Symptoms are Often Easy to Ignore


Many times, there are no obvious symptoms of type 2 diabetes. As such, even when they do occur, they are often subtle and easy to ignore. Some symptoms that may occur include the following:


• Greater thirst and appetite
• Frequent urination
• Unexplained weight gain or loss
• Unexplained fatigue
• Blurry vision
• Frequent vaginal infections
• Yeast infections (men and women)
• Dry mouth
• Sores or cuts that take longer than usual to heal

(WebMD, 2013)

Diabetes Can Lead to Serious Complications


The complications associated with type 2 diabetes are many, and often, these are serious.  According to a 2011 Centers for Disease Control diabetes fact sheet, the complications of type 2 diabetes include:


• Heart disease and stroke
• High blood pressure
• Blindness
• Kidney disease
• Nervous system disease- to include dulled sense of sensation or pain in their feet and hands, impaired digestion, carpal tunnel syndrome, erectile dysfunction or other nerve problems.
• Amputations (more than half of non-traumatic amputations occur in people with type 2 diabetes)
• Periodontal disease

Tips for Treating your Type 2 Diabetes


Diabetes investigators Inzucchi and colleagues reported, in a 2012 comprehensive review article, some key points to keep in mind when treating type 2 diabetes. These include:


• Individualized Treatment:  It is essential that blood sugar targets and therapies be individualized.
• Lifestyle and Diet:  You need to get plenty of exercise and eat right to avoid diabetes.
• Metformin:  Unless there is a very good reason not to, the first line drug should be metformin.
• Insulin:  At the end of the day, many may require insulin, either alone or with pills.
• Joint Collaboration: It is critical that treatment decisions be made between you and your doctor.
• Reduce Heart Disease:  Since heart disease occurs with diabetes, the reduction of other cardiovascular risks also needs to be a focus of therapy.


Insulin Pumps


Although more common in the treatment of type 1 diabetes, many people with type 2 diabetes are finding it advantageous to use an insulin pump. Insulin pumps replace periodic injections of insulin with continuous injections of rapid-acting insulin. The use of such pumps may allow you to more closely match your insulin needs to your lifestyle, rather than changing your life to accommodate your insulin injections. Speak to your doctor to see if an insulin pump may be useful in your individual plan to treat type 2 diabetes (American Diabetes Association, 2013).


References


CDC (2011). Diabetes fact sheet. Retrieved from:  http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
Diabetes.org (2013). Living with diabetes. Retrieved from:                                                                                                                 http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-pumps.html


Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). 2012; 35:1364–1379.


Mayo Clinic (2013). Type 2 diabetes. Retrieved from:                                                                                    http://www.mayoclinic.com/health/type-2-diabetes/DS00585/DSECTION=risk-factors


Riste L, Khan F, Cruickshank K.  High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city. Diabetes Care. 2001; 24:1377-1383.


Scheen  AJ. Pathophysiology of type 2 diabetes. Acta Clinica Belgica, 2003; 58-66.
WebMD (2013). Type 2 diabetes. Retrieved from:  http://diabetes.webmd.com/guide/type-2-diabetes

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