
Type 2 Diabetes
Whether you have type 2 diabetes, are a caregiver or loved one of a person with type 2 diabetes, or just want to learn more, the following page provides an overview of type 2 diabetes. New to type 2 diabetes? Check out “Starting Point: Type 2 Diabetes Basics” below, which answers some of the basic questions about type 2 diabetes: what is type 2 diabetes, what are its symptoms, how is it treated, and many more! Want to learn a bit more? See our “Helpful Links” page below, which provides links to diaTribe articles focused on type 2 diabetes. These pages provide helpful tips for living with type 2 diabetes, drug and device overviews, information about diabetes complications, nutrition and food resources, and some extra pages we hope you’ll find useful! Starting Point: Type 2 Diabetes Basics Who is at risk of developing type 2 diabetes? What is the risk of developing type 2 diabetes if it runs in the family? What is type 2 diabetes and prediabetes? Behind type 2 diabetes is a disease where the body’s cells have trouble responding to insulin – this is called insulin resistance. Insulin is a hormone needed to store the energy found in food into the body’s cells. In prediabetes, insulin resistance starts growing and the beta cells in the pancreas that release insulin will try to make even more insulin to make up for the body’s insensitivity. This can go on for a long time without any symptoms. Over time, though, the beta cells in the pancreas will fatigue and will no longer be able to produce enough insulin – this is called “beta burnout.” Once there is not enough insulin, blood sugars will start to rise above normal. Prediabetes causes people to have higher-than-normal blood sugars (and an increased risk for heart disease and stroke). Left unnoticed or Continue reading >>

Symptoms At Diagnosis May Predict Progression Of Type 2 Diabetes
Researchers followed patients who were newly diagnosed with type 2 diabetes for 18 months to classify their disease progression based on 20 baseline symptoms. With Caroline A. Brorsson, PhD, and Michael Gonzalez-Campoy, MD, PhD Three major subgroups of newly diagnosed patients with type 2 diabetes (T2D) experienced different rates of disease progression over 18 months,1 according to data presented at the 53rd annual meeting of the European Association for the Study of Diabetes in Lisbon, Portugal. The research was part of the Diabetes Research on Patient Stratification project (DIRECT) within the European Union Framework 7 Innovative Medicines Initiative. Patients with type 2 diabetes are likely to present with varying degrees of insulin resistance and beta cell failure.1 Understanding the heterogeneity of a T2D presentation may lead to more effective treatment strategies for these patients. An underlying difference in pathophysiology may be indicative of a patient’s responsiveness to a prescribed treatment and have an anticipated effect on disease progression.1 Evaluating Differences in Diabetes Progression Caroline Brorsson, PhD, a postdoctoral researcher at the Technical University of Denmark and colleagues used the detailed clinical phenotyping from the Diabetes Remission Clinical Trial (DIRECT) to identify and cluster subgroups of patients who were newly diagnosed with T2D.1,2 In the DIRECT study, detailed metabolic data were collected on patients newly diagnosed with either prediabetes or type 2 diabetes.2 “Using a very detailed clinical phenotyping methodology, we wanted to systematically capture disease heterogeneity in newly diagnosed diabetes patients using a data-driven approach to be able to investigate the effect of different patient subgroups on diseas Continue reading >>

New Insights Into The Progression Of Type 1 Diabetes
If you have Type 1 diabetes or know someone who does, you’re likely aware that this type of diabetes is an autoimmune disorder that results in the destruction of the beta cells (the cells that make insulin) in the pancreas. Having Type 1 diabetes means having to take lifelong insulin injections, and people who are diagnosed with this condition must start on insulin right away. Type 1 diabetes progresses Type 2 diabetes, the “other” type of diabetes, is a whole different ball of wax. This type of diabetes partly stems from insulin resistance, meaning that the pancreas produces insulin but the body has a hard time using it. Type 2 diabetes is often described as being “progressive”: caught in the early stages, for example, it’s possible to manage it through healthy eating, weight loss (if necessary), and physical activity. But over time, many people require the help of medication, often in the form of diabetes pills, and then, perhaps, noninsulin injectable meds. Eventually, insulin injections may be needed. In the case of Type 1 diabetes, researchers now believe that this disease also progresses at predictable rates and stages before a person develops signs and symptoms. The discovery of these stages is a big deal, as it will enable researchers to find ways to intervene to delay and hopefully prevent progression to the onset of symptoms and lifelong insulin dependence. Stages of Type 1 diabetes The discovery of the various stages leading up to symptomatic Type 1 diabetes are outlined in the October 2015 issue of the journal Diabetes Care. The paper is entitled “Staging Presymptomatic Type 1 Diabetes: A Scientific Statement of JDRF, the Endocrine Society, and the American Diabetes Association.” Here’s a closer look at the crux of this paper. Stage 1: Auto Continue reading >>

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 >>

Late Stage Complications Of Diabetes And Insulin Resistance
1Department of Microbiology, Chaitanya Postgraduate College, Kakatiya University, Warangal, India 2Department of Biotechnology, Presidency College, Bangalore University, India *Corresponding Author: Department Of Microbiology, Chaitanya Postgraduate College affiliated to Kakatiya University, Warangal, India E-mail: [email protected] Citation: Soumya D, Srilatha B (2011) Late Stage Complications of Diabetes and Insulin Resistance. J Diabetes Metab 2:167. doi:10.4172/2155-6156.1000167 Copyright: © 2011 Soumya D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes mellitus is considered one of the main threats to human health in the 21st century. Diabetes is a metabolic disorder or a chronic condition where the sugar levels in blood are high. Diabetes is associated with long-term complications that affect almost every part of the body and often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Also it is associated with significantly accelerated rates of several debilitating microvascular complications such as nephropathy, retinopathy, and neuropathy, and macrovascular complications such as atherosclerosis and stroke. In the present article it has been discussed about the resistance of insulin and its consequences in diabetic patients. Insulin resistance results in various disorders. Metabolic syndrome is predicted to become a major public health problem in many developed, as well as developing countries. Keywords Diabetes; Complications Continue reading >>
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“reversing” Type 2 Diabetes
Can It Be Done? Health professionals usually call Type 2 diabetes a chronic, progressive illness. “Chronic” means you’ll always have it. “Progressive” means you will almost certainly get worse. The best you can hope for is to slow its progression through your diet, exercise, and oral medicine or insulin. The diagnosis of a chronic, progressive condition can feel like having a curse put on you. If you have to get worse, if you can’t avoid complications and premature death, then why struggle with your diet and managing your diabetes? In the words of Jenny Ruhl, a blogger with LADA (latent autoimmune diabetes of adults, sometimes called “Type 1.5” diabetes), “If there is nothing you can do, it is rational behavior to shift your energy elsewhere and enjoy life – including the foods you love – while you can.” Although experts have called both Type 1 and Type 2 diabetes “chronic” and “progressive” for decades, some people with diabetes disagree. A Diabetes Self-Management Blog reader named Dennis wrote, “Last November I weighed 288 [pounds] with an [HbA1c level] of 7.1%. Diabetic complications had set in. Today, with a very low-carbohydrate diet, my [HbA1c level] is 5.6%. I’ve lost 35 pounds, my sugars are under control, and all my symptoms are gone!” (The HbA1c test gives an indication of average blood glucose level over the past 2–3 months. The American Diabetes Association advises most people with diabetes to aim for an HbA1c level below 7% to prevent complications.) On the same note, a reader named Bob wrote, “By limiting carbs, my [HbA1c level] dropped from an 8.6% to a most recent reading of 4.9%.” And Terri posted, “I am a diabetic who eats a low-carb vegan diet. I am far healthier now at 53 than ever before and maintain pe Continue reading >>

Type 2 Diabetes Overview
What Is It? When you have this disease, your body does a poor job turning the carbohydrates in food into energy. This causes sugar to build up in your blood. Over time it raises your risk for heart disease, blindness, nerve and organ damage, and other serious conditions. It strikes people of all ages, and early symptoms are mild. About 1 out of 3 people with type 2 diabetes don't know they have it. People with type 2 diabetes often have no symptoms. When they do appear, one of the first may be being thirsty a lot. Others include dry mouth, bigger appetite, peeing a lot -- sometimes as often as every hour -- and unusual weight loss or gain. In many cases, type 2 diabetes isn't discovered until it takes a serious toll on your health. Some red flags include: Cuts or sores that are slow to heal Frequent yeast infections or urinary tract infections Itchy skin, especially in the groin area Diabetes can damage blood vessels and nerves in your genitals. This could lead to a loss of feeling and make it hard to have an orgasm. Women are also prone to vaginal dryness. About 1 in 3 who have diabetes will have some form of sexual trouble. Between 35% and 70% of men who have the disease will have at least some degree of impotence in their lifetime. Some health habits and medical conditions related to your lifestyle can raise your odds of having type 2 diabetes, including: Being overweight, especially at the waist A couch potato lifestyle Smoking Eating a lot of red meat, processed meat, high-fat dairy products, and sweets Unhealthy cholesterol and triglyceride levels Other risk factors are out of your control, including: Race or ethnicity: Hispanics, African-Americans, Native Americans, and Asians are more likely to get it Family history of diabetes: Having a parent or sibling with d Continue reading >>

The Causes And Progression Of Type 2 Diabetes
Many people are born with a genetic predisposition to developing diabetes at some point in life – though this does not necessarily mean that they are destined to develop diabetes. We explore why and how type 2 diabetes develops in some people, and not others. First comes love…then comes marriage…then comes a baby - wait. That's not the progression we are talking about. We're talking about the progression of a disease. A very deadly disease at that, with type 2 diabetes being the 7th leading cause of death, according to the Centers for Disease Control and Prevention. How does Type 2 Diabetes Develop? Many people are born with a genetic predisposition to developing diabetes at some point in life - though this does not necessarily mean that they are destined to develop diabetes. It does, however mean that you they are more likely to develop diabetes than someone who is not genetically predisposed. Even if you don't have diabetes running in your family - you can certainly still develop it. After conception, your genes are all planned out and locked in for life, you might say. After this point, lifestyle takes over and plays the biggest role in whether you will develop type 2 diabetes in your lifetime. It's the classic nature vs. nurture argument, and we must consider both genetics and environment to explain how you get type 2 diabetes. As you grow and develop as toddler, how you eat can begin to influence the progression of type 2 diabetes. If you consume lots of sugary drinks and fruit juices, candy, and simple carbohydrates like crackers, cookies, and chips, then you are already increasing your risk, as a child, for type 2 diabetes. These kinds of foods cause your pancreas to begin working overtime to produce insulin in order to process all that sugar. So when you c Continue reading >>

Articles Ontype 2 Diabetes
Diabetes is a life-long disease that affects the way your body handles glucose, a kind of sugar, in your blood. Most people with the condition have type 2. There are about 27 million people in the U.S. with it. Another 86 million have prediabetes: Their blood glucose is not normal, but not high enough to be diabetes yet. Your pancreas makes a hormone called insulin. It's what lets your cells turn glucose from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don't use it as well as they should. Doctors call this insulin resistance. At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can't keep up, and the sugar builds up in your blood instead. Usually a combination of things cause type 2 diabetes, including: Genes. Scientists have found different bits of DNA that affect how your body makes insulin. Extra weight. Being overweight or obese can cause insulin resistance, especially if you carry your extra pounds around the middle. Now type 2 diabetes affects kids and teens as well as adults, mainly because of childhood obesity. Metabolic syndrome. People with insulin resistance often have a group of conditions including high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides. Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and usually the liver will slow down and store its glucose for later. But some people's livers don't. They keep cranking out sugar. Bad communication between cells. Sometimes cells send the wrong signals or don't pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reac Continue reading >>
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Stages Of T1d
Type 1 diabetes can now be most accurately understood as a disease that progresses in three distinct stages. TrialNet screening looks for five diabetes-related autoantibodies that signal an increased risk of T1D. The JDRF, ADA and Endocrine Society now classify having two or more of these autoantibodies as early stage T1D. Finding T1D in its earliest stage allows for prompt intervention aiming to change the course of the disease. T1D starts with a genetic predisposition—gene(s) that put you at higher risk. Risk for people in the general population is about 1 in 300. If you have a family member with T1D, your risk is 1 in 20. There are three distinct stages of T1D. The first two stages can be identified by TrialNet screening prior to symptoms. Our goal is to identify the disease in its earliest stage and stop disease progression by preserving beta cell production. Stages of T1D Continue reading >>

Type 2 Diabetes
Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide. How serious is type 2 diabetes? Type 2 diabetes is a serious medical condition that often requires the use of anti-diabetic medication, or insulin to keep blood sugar levels under control. However, the development of type 2 diabetes and its side effects (complications) can be prevented if detected and treated at an early stage. In recent years, it has become apparent that many people with type 2 diabetes are able to reverse diabetes through methods including low-carb diets, very-low-calorie diets and exercise. For guidance on healthy eating to improve blood glucose levels and weight and to fight back against ins Continue reading >>

Defining And Characterizing The Progression Of Type 2 Diabetes
Go to: Progression from pre-diabetes to overt diabetes Because glucose is a continuous variable, the use of thresholds to make a diagnosis is somewhat arbitrary. The term “pre-diabetes” has become well established and implies a risk of progression to overt diabetes. However, although such progression is well studied in prevention trials, little is known about the rate of progression and the characteristics of such progression in the population at large. Table 1 summarizes some of the factors associated with such progression. Nichols et al. (2) studied the progression of pre-diabetes to overt disease and observed that 8.1% of subjects whose initial abnormal fasting glucose was 100–109 mg/dl and 24.3% of subjects whose initial abnormal fasting glucose was 110–125 mg/dl developed diabetes over an average of 29.0 months (1.34 and 5.56% per year, respectively). A steeper rate of increasing fasting glucose; higher BMI, blood pressure, and triglycerides; and lower HDL cholesterol predicted diabetes development. The Baltimore Longitudinal Study of Aging (3) concluded that although phenotypic differences in rates of progression are partly a function of diagnostic thresholds, fasting and postchallenge hyperglycemia may represent phenotypes with distinct natural histories in the evolution of type 2 diabetes. Does hyperglycemia evolve from normoglycemia gradually over time or as a step increase? Ferrannini et al. (4) measured plasma glucose and insulin levels during oral glucose testing at baseline and after 3 and 7 years of follow-up. In subjects with normal glucose tolerance on all three occasions (nonconverters), FPG increased only slightly over 7 years. In contrast, conversion to both impaired glucose tolerance (IGT) and diabetes among normal glucose tolerance subjects Continue reading >>

How Type 2 Diabetes Can Change Over Time
You probably already know that type 2 diabetes can cause long-term damage if you don’t control it, but it’s also important to understand that even well-controlled diabetes progresses over time — meaning you may have to adjust your treatment plan more than once. The key to learning about the progression of diabetes is to understand the role of your pancreas, which produces insulin. For people with type 1 diabetes, the pancreas does not make any insulin, so they must take it through injections. With type 2, the pancreas doesn’t make enough insulin or the cells don’t respond to it adequately, according to the American Academy of Family Physicians. This means that the body has trouble moving sugar from the blood into cells to be used for energy. Diet, exercise, and medication, if prescribed, can all help those with type 2 diabetes lower their blood sugar levels and help their bodies use insulin made by the pancreas, according to the American Diabetes Association (ADA). If blood sugar levels remain high, the ADA says, you may be at risk for such diabetes complications as vision loss, heart disease, nerve damage, foot or leg amputation, and kidney disease. However, proper diabetes management can help prevent or delay the onset of these complications. How Your Diabetes Treatment Plan Might Change Over time, your medications, diet, and exercise goals may need to be adjusted. “Initially the pancreas produces extra insulin to make up for insulin resistance, but in most people, the pancreas eventually is unable to make the extra insulin to keep blood sugar levels normal,” says Marc Jaffe, MD, a San Francisco endocrinologist in practice with Kaiser Permanente in Northern California. After a type 2 diabetes diagnosis, your doctor will set blood sugar goals for you, rec Continue reading >>

Type 2 Diabetes
Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Diabetes Update: The Untold Story Of Disease Progression
CE credit is no longer available for this article. Originally posted March 2001 Pick up the paper. Turn on the radio. Diabetes is rapidly becoming a national epidemic. An estimated 18 million Americans have diabetes—and that number is growing, particularly among children. Certain ethnic groups, such as African-Americans, Hispanics, and Native Americans, have the highest incidence. Among those groups, one in four over the age of 45 will most likely develop diabetes. The Centers for Disease Control and Prevention (CDC) reports that between 1990 and 1998, the incidence of diabetes rose by 70% among people ages 30 - 39; by 40% among those 40 - 49; and by 31% among those 50 - 59. What may be even more disturbing is the percentage of people who don't even know that they have diabetes: About 33% of the population with Type 1 diabetes and up to 55% of people with Type 2 go undiagnosed. Many patients are hyperglycemic for up to six years before finding out they have diabetes. The toll diabetes takes is staggering. It is the leading cause of new cases of adult blindness, end-stage renal disease, and nontraumatic lower extremity amputations. And patients with diabetes have an incidence of cardiovascular morbidity and mortality four times that of non-diabetics. In fact, 65% of patients with Type 2 diabetes will die of a cardiovascular complication. The cost is enormous: $138 billion annually. The average per capita medical expenditure is $10,000 per diabetic patient, vs. $2,700 for the non-diabetic individual. The good news is that complications of diabetes can be limited and its progression slowed with strict control of blood sugar and new treatment protocols. New drugs provide more therapeutic options. Insulin sensitizers, insulin secretagogues, medications that alter the diges Continue reading >>