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Dangers Of Diabetes Type 2

Glycemic Control And Vascular Complications In Type 2 Diabetes Mellitus

Glycemic Control And Vascular Complications In Type 2 Diabetes Mellitus

INTRODUCTION The importance of tight glycemic control for protection against microvascular and cardiovascular disease (CVD) in diabetes was established in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study for type 1 diabetes [1,2]. Although the role of glycemic control on microvascular disease in type 2 diabetes was documented in the United Kingdom Prospective Diabetes Study (UKPDS), its role in reducing cardiovascular risk has not been established as clearly for type 2 diabetes. The effects of glycemic control on microvascular and macrovascular complications in type 2 diabetes will be reviewed here. Glycemic control and vascular complications in type 1 diabetes, the mechanism by which hyperglycemia might cause these complications, and an overview of the treatment of diabetes are discussed separately. (See "Glycemic control and vascular complications in type 1 diabetes mellitus" and "Overview of medical care in adults with diabetes mellitus".) MICROVASCULAR DISEASE Hyperglycemia is an important risk factor for the development of microvascular disease in patients with type 2 diabetes, as it is in patients with type 1 diabetes. This has been shown in several observational studies [3,4]. In addition, improving glycemic control improves microvascular outcomes, as illustrated by the findings of a meta-analysis of randomized trials (34,912 participants) [5]. There was a reduction in the risk of microvascular complications (a composite outcome including progression of nephropathy, manifestation and progression of retinopathy, and retinal photocoagulation) in the intensive compared with standard glycemic control group (relative risk [RR] 0.88, 95% CI 0.82-0.95). There were significant reductions in risk for Continue reading >>

Dangers Of Not Taking Insulin Or Other Diabetes Medication

Dangers Of Not Taking Insulin Or Other Diabetes Medication

As water wears down a shoreline, even a rocky one, high blood sugar wears down the health of people with diabetes. Unless an individual can control their blood sugar through lifestyle, diet and exercise, prescription medications are the only option for preventing acute life-threatening conditions and avoiding or slowing the onset of diabetes complications. Short-Term Dangers The short-term dangers of not taking prescribed medication are symptoms of weakness, fatigue, mental confusion and the life-threatening condition of hyperosmolar syndrome. Hyperosmolar syndrome is diagnosed in people with type 2 diabetes whose blood glucose and sodium levels are extremely high because of dehydration. Symptoms of weakness, increased thirst and urination, nausea, confusion and fatigue can develop gradually over days or weeks. Eventually, convulsions and coma may set in. This condition usually requires hospitalization and aggressive treatment using IV fluids and insulin. Though symptoms are often relieved within hours, hyperosmolar syndrome can cause death, even with proper treatment. If people fall into a coma before seeking help, there is a 50 percent chance they will die from the disease. Although the condition called ketoacidosis is uncommon with type 2 diabetes, it may occur. When the body cannot process glucose for energy, it breaks down fat for fuel. As fat is metabolized, it produces ketones. Too many ketones cause increased urination and thirst, dry mouth, cool skin, nausea and vomiting. Eventually, there may be a drop in blood pressure, loss of consciousness, coma or death. Treatment involves hospitalization, IV fluids and insulin. Ketoacidosis is a more common occurrence with type 1 diabetes. Long-Term Dangers A slow erosion of health is the silent, insidious danger of not t Continue reading >>

Why Diabetes Is So Dangerous

Why Diabetes Is So Dangerous

There’s a common saying in the diabetes community that diabetes won’t kill you, but it’s complications will. Still, according to the American Diabetes Association, diabetes was the 7th leading cause of death in the United States in 2010, with over 69,000 death certificates listing it as the underlying cause of death. [1] Add to that the common complications, like cardiovascular disease, kidney disease, and infection, and you can multiply that number by 10! Yet despite these eye-opening statistics, I still see far too many people not taking diabetes seriously. They approach it as something that’s a nuisance rather than something that can and does cause major health complications, and yes even death, if uncontrolled. “Sometimes I pretend I’m not diabetic, but that’s a dangerous game.” – Unknown Diabetes is more dangerous than most people assume, and so it becomes easy for many people with diabetes to get lax in their efforts to manage the dysfunction. A 2012 GAPP2 (Global Attitude of Patients and Physicians 2) survey found that 22% of insulin-using diabetic patients missed a basal insulin dose during a 30-day period. [2] There are very real dangers diabetes poses if left unchecked or mismanaged, and one of my goals today is to motivate you into taking better care of yourself or helping a loved one manage the disease better. Why is diabetes so dangerous? Because if not managed correctly, it can wreak havoc on just about every system and organ in the body. Let’s take a look at some of the biggest risks diabetic complications pose: Diabetic Ketoacidosis Diabetic Ketoacidosis is a very dangerous condition that can occur when patients neglect to take their insulin and have uncontrolled blood sugar. Since insulin is necessary to break down glucose as a sourc Continue reading >>

Type 2 Diabetes: What's Next After Metformin?

Type 2 Diabetes: What's Next After Metformin?

Empagliflozin indications extended Empagliflozin is now TGA-approved for reducing cardiovascular deaths in patients with type 2 diabetes with established cardiovascular disease. What is the evidence, and what does this mean in clinical practice? MedicineWise News: Type 2 diabetes – when metformin is not enough NPS RADAR: Pharmacological therapies in Australia for type 2 diabetes Metabolic syndrome and diabetes: how much blame does sugar deserve? Australian Prescriber: Encouraging adherence to long‑term medication Tim Usherwood Aust Prescr 2017;40:147-501 Patients should be asked about adherence at every consultation. Learn more about: using a collaborative communication style using the patient’s own expressions and responding to their cues how to normalise non-adherence using open questions and more specific probes. Episode 6 – Encouraging adherence to long-term medication, with Prof Tim Usherwood Dr Janine Rowse interviews Professor Tim Usherwood about the different types of medication non-adherence and his practical recommendations for better identification in the primary care setting. CPD options Consolidate your knowledge about COPD, brush up on current guidelines and practices and earn CPD points through our learning activities. For GPs: Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Type 2 diabetes is a progressive condition in which the body becomes resistant to the normal effects of insulin and/or gradually loses the capacity to produce enough insulin in the pancreas. We do not know what causes type 2 diabetes. Type 2 diabetes is associated with modifiable lifestyle risk factors. Type 2 diabetes also has strong genetic and family related risk factors. Type 2 diabetes: Is diagnosed when the pancreas does not produce enough insulin (reduced insulin production) and/or the insulin does not work effectively and/or the cells of the body do not respond to insulin effectively (known as insulin resistance) Represents 85–90 per cent of all cases of diabetes Usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups including children, adolescents and young adults Is more likely in people with a family history of type 2 diabetes or from particular ethnic backgrounds For some the first sign may be a complication of diabetes such as a heart attack, vision problems or a foot ulcer Is managed with a combination of regular physical activity, healthy eating and weight reduction. As type 2 diabetes is often progressive, most people will need oral medications and/or insulin injections in addition to lifestyle changes over time. Type 2 diabetes develops over a long period of time (years). During this period of time insulin resistance starts, this is where the insulin is increasingly ineffective at managing the blood glucose levels. As a result of this insulin resistance, the pancreas responds by producing greater and greater amounts of insulin, to try and achieve some degree of management of the blood glucose levels. As insulin overproduction occurs over a very long period of time, the insulin producing cells in the pan Continue reading >>

Complications Of Diabetes Mellitus

Complications Of Diabetes Mellitus

The complications of diabetes mellitus are far less common and less severe in people who have well-controlled blood sugar levels. Acute complications include hypoglycemia and hyperglycemia, diabetic coma and nonketotic hyperosmolar coma. Chronic complications occur due to a mix of microangiopathy, macrovascular disease and immune dysfunction in the form of autoimmune disease or poor immune response, most of which are difficult to manage. Microangiopathy can affect all vital organs, kidneys, heart and brain, as well as eyes, nerves, lungs and locally gums and feet. Macrovascular problems can lead to cardiovascular disease including erectile dysfunction. Female infertility may be due to endocrine dysfunction with impaired signalling on a molecular level. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise which are accessible to management as they are modifiable. Non-modifiable risk factors of diabetic complications are type of diabetes, age of onset, and genetic factors, both protective and predisposing have been found. Overview[edit] Complications of diabetes mellitus are acute and chronic. Risk factors for them can be modifiable or not modifiable. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels.[1][2][3] However, (non-modifiable) risk factors such as age at diabetes onset, type of diabetes, gender and genetics play a role. Some genes appear to provide protection against diabetic complications, as seen in a subset of long-term diabetes type 1 survivors without complications .[4][5] Statistics[edit] As of 2010, there were about 675,000 diabetes-related emergency department (ED) visits in the Continue reading >>

Type 2 Diabetes In Children & Adolescents

Type 2 Diabetes In Children & Adolescents

Type 2 diabetes was previously seen only in middle age or older adults. However, with the rise of obesity in children, it is now being increasingly diagnosed in young people, particularly Aboriginal and Torres Strait Islander youth and children with non- European backgrounds. Type 2 diabetes is serious and can cause long-term complications such as heart and kidney disease, which, with more young people developing type 2 diabetes, are likely to occur at a younger age. Proper treatment is therefore essential to preventing these long-term health problems. Sometimes a young person with type 2 diabetes will be initially mistaken as having type 1 diabetes, until a complete assessment can be done. Type 2 Although there is a stronger inherited tendency to developing type 2 diabetes compared to type 1, type 2 diabetes in young people is largely due to lifestyle habits. Type 1 The development of type 1 diabetes is not usually related to lifestyle habits, obesity or insulin resistance, but to a problem with immunity. Children and adolescents most at risk of developing type 2 diabetes are those who are: overweight or obese AND have any two of the following: blood relatives with type 2 diabetes an Aboriginal or Pacific Islander background or other high risk ethnic groups signs of insulin resistance diagnosed by the doctor. Type 2 diabetes in young people is thought to result from insulin resistance, which means insulin does not work properly. The hormone insulin is made in our bodies by an organ called the pancreas and has an important role in regulating blood glucose levels. Young people with insulin resistance need to make more insulin than is ‘normally’ required to regulate their blood glucose levels. Overweight and obese young people are most likely to have insulin resistanc Continue reading >>

Complications Of Untreated Type 2 Diabetes

Complications Of Untreated Type 2 Diabetes

Untreated type 2 diabetes can lead to severe complications resulting in reduced quality of life or even death.Type 2 diabetes is a serious disease that is normally developed during adulthood, as opposed to type 1, or juvenile, diabetes. Type 2 diabetes affects the body’s absorption and processing of glucose, or sugar. Insulin is a hormone the body produces to regulate glucose metabolism. An individual with type 2 diabetes is either resistant to the effects of insulin or does not produce the amount of insulin needed to regulate glucose levels in the body. Video of the Day Type 2 diabetes is often asymptomatic for years before it is diagnosed, usually due to a complication. According to the American Diabetes Association, about 5.7 million people each year live with undiagnosed diabetes. (See References 1) One of the most frequent complications is heart disease. Uncontrolled glucose damages blood vessels and nerves in the body. About 75 percent of people with diabetes die of heart disease. (See References 2) Most cases of kidney failure in the United States are cause by diabetes. (See References 1) Normally, the kidneys filter waste from the body. Over time, high blood sugar can clog the tiny blood vessels in the kidneys or cause problems in the urinary tract that can also damage the kidneys. Each year about 43 percent of diabetic nephropathy cases, or kidney failures, are due to diabetes. (See References 2) Diabetes causes wounds to heal very slowly or sometimes not at all. Nerve damage can cause vascular damage leading to poor circulation to the extremities, especially the feet. In cases of uncontrolled type 2 diabetes, a patient can develop an infection in an unhealed wound. The infection can spread, causing ulceration and sometimes necessitating the amputation of a t Continue reading >>

Complications Of Diabetes

Complications Of Diabetes

Over time persistent high blood glucose levels (BGLs) can damage the body's organs. This damage is referred to as 'diabetes-related complications'. While these complications are serious and can be life-threatening, with appropriate lifestyle changes and attention to blood glucose control, people with diabetes can greatly reduce the risk of these complications. Heart disease and stroke People with diabetes are at increased risk of heart disease and stroke due to raised BGLs, in association with high blood pressure and cholesterol. You should discuss your individual risk factors and how to reduce them with your doctor or diabetes educator. In general terms, the risk of heart disease in diabetes can be reduced by: losing weight if you are overweight managing blood fats managing high blood pressure taking medication as prescribed. For more information speak to your doctor or specialist or contact the Australian Diabetes Council Customer Care Line on 1300 DIABETES or 1300 342 238 and ask to speak to a Diabetes Educator. High Blood Pressure As well as being a risk factor for developing diabetes, high blood pressure can also be a complication of diabetes. Diabetes changes the body chemistry to increase the risk of high blood pressure. As having high blood pressure in diabetes further increases the risk of other complications of diabetes, it is important that it is adequately monitored and, if necessary, controlled. You should get your blood pressure checked every time you go to the doctor, and at least: every 6 months for people with normal blood pressure 3 months for people with high blood pressure every 4-8 weeks if your blood pressure medication is being changed. Skin Damage to the small blood vessels and nerves common in people with diabetes can cause very dry skin. This c Continue reading >>

Complications Of Type 2 Diabetes

Complications Of Type 2 Diabetes

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren's contracture when a "cord" can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18. Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®. Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®: hives swollen face breathing trouble chest pain low blood pressure dizziness or fainting Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not be right for you. Before receiving XIAFLEX®, tell you Continue reading >>

Preventing And Managing Diabetes Complications

Preventing And Managing Diabetes Complications

Fast Facts There are three main types of diabetes: type 1, when the body does not make insulin and people need to take insulin every day to live; type 2, the most common type of diabetes, in which the body does not make or use insulin well (people with type 2 may need to take pills or insulin to manage their diabetes) and gestational diabetes, diagnosed in some women during pregnancy. Most of the time, it goes away after the baby is born, but even if it goes away, these women and their children have a greater chance of getting type 2 diabetes later in life. Diabetes can lead to problems with the heart, kidneys, eyes, skin, legs and feet, nerves, and teeth and gums. Good management can cut this risk in half. 23.6 million Americans have diabetes—7.8 percent of the U.S. population. Nearly 1 in 4 of those don't know they have it. About 79 million adults aged 20 years and older have prediabetes. This is a condition where blood glucose (sugar) levels are higher than normal but not high enough to be called diabetes. Prediabetes puts you at risk for type 2 diabetes and cardiovascular disease, but you can lower this risk. People with diabetes have seen greater success in managing the complications of their disease. Between 1997 and 2006, death rates for people with diabetes dropped substantially, especially deaths related to heart disease and stroke, according to the Centers for Disease Control and Prevention (CDC) and NIH researchers. Diabetes means your blood glucose, or blood sugar, is too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to provide energy. Without insulin, too much glucose stays in your blood. Over time, this can cause problems with your heart, kidneys, Continue reading >>

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Global Aetiology And Epidemiology Of Type 2 Diabetes Mellitus And Its Complications

Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications. Continue reading >>

Cardiovascular Disease & Diabetes

Cardiovascular Disease & Diabetes

The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. Why are people with diabetes at increased risk for CVD? Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly type 2 diabetes, may have the following conditions that contribute to their risk for developing cardiovascular disease. High blood pressure (hypertension) High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. Abnormal cholesterol and high triglycerides Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity Obesity is a major risk factor for cardiovascular disease Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Causes Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy. When sugar cannot enter cells, a high level of sugar builds up in the blood. This is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 2 diabetes. Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way. Type 2 diabetes can also develop in people who are thin. This is more common in older adults. Family history and genes play a role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your chance of getting the disease. Over the past several years, our collective diets have grown unhealthier, and our waistlines have expanded as a result. Doing so, we're putting ourselves at risk for a number of diseases, including type 2 diabetes. Diabetes is serious stuff, if it's not treated, it can lead to some pretty dangerous complications, including nerve and kidney damage. The good news is you can often avoid type 2 diabetes and its complications. You need sugar, or glucose, to keep your body running. Normally when you eat, your pancreas releases a hormone called insulin, which moves the sugar from food out of your blood and into your cells, where it can either be u Continue reading >>

Sugars And Type 2 Diabetes

Sugars And Type 2 Diabetes

What is type 2 diabetes? Diabetes is a lifelong condition that causes a person’s blood sugar to be too high. There are two forms of diabetes: type 1 and type 2 [1]. Insulin is a hormone that is key in regulating blood glucose levels. Type 2 diabetes can occur either as a result of insulin receptors becoming desensitised and as a result no longer responding to insulin; or, due to the beta cells of the pancreas no longer producing insulin. Often it is a combination of these two factors that leads to this condition known as type 2 diabetes. Type 2 diabetes is by far the most common type – of all the adults who have diabetes, 90% of them have type 2. Diabetes is an increasing health problem in the UK with 3.2million people diagnosed with diabetes and a further 850,000 estimated to be undiagnosed [1]. Diabetes is a growing health burden and it is estimated that by 2025, 5 million people will have been diagnosed in the UK [2]. Diabetes is the leading cause of blindness in the UK and the disease’s complications cause more than 100 amputations to take place each week. Each year, 24 000 people die early from diabetes-associated complications [3]. Its total cost is estimated at £13.8billion each year [4]. It is predicted that the annual NHS cost of the direct treatment of diabetes in the UK will increase to £16.9 billion over the next 25 years, which is 17 per cent of the NHS budget [5], believed to potentially bankrupt the NHS What are the causes of Type 2 diabetes? There is a complex combination of genetic and environmental risk factors that play a part in the development of diabetes – it tends to cluster in families, but there is also a strong link to environmental risk factors. Ethnicity also plays a major role in its development, with people of South Asian descent Continue reading >>

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