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Does Diabetes Always Progress

Natural Progression Of Type 2 Diabetes

Natural Progression Of Type 2 Diabetes

Type 2 diabetes is not a stable disease—it is progressive in nature. In fact, by the time someone is diagnosed with type 2 diabetes, many changes may have already occurred in the body, including the start of heart disease. These changes continue over the years, potentially making the complications of diabetes more difficult to control. For this reason, you need to know what changes to expect when you have type 2 diabetes. This article will help you and your health care provider manage your diabetes every step of the way. A LONG TIME COMING Experts today believe that people who are diagnosed with type 2 diabetes have had blood glucose levels that were high enough to diagnose diabetes, on average, seven to 10 years earlier. That’s bad news because high blood glucose levels for so long can cause damage to the heart, kidneys, eyes and nerves. So in reality, people with “newly” diagnosed type 2 diabetes may already have diabetes-related problems. But what happens during this period leading up to a diagnosis of diabetes? Initially, the pancreas produces the correct amount of insulin the body needs to keep blood glucose levels where they ought to be. However, at some point, cells begin to resist this naturally occurring insulin. This is referred to as “insulin resistance,” meaning the cells have a hard time using the insulin the body produces. The pancreas, in turn, receives a message that even more insulin is needed, and it begins to produce more than before to overcome this resistance. At some point, the pancreas is not able to keep up and blood glucose levels begin to increase. This is what’s known as pre-diabetes. Pre-diabetes means that blood glucose levels are higher than normal, but not high enough to be classified as diabetes. It is in this stage that 10 Continue reading >>

Type 2 Diabetes

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 >>

Type 2 Diabetes Faqs

Type 2 Diabetes Faqs

Common questions about type 2 diabetes: How do you treat type 2 diabetes? When you have type 2 diabetes, you first need to eat a healthy diet, stay physically active and lose any extra weight. If these lifestyle changes cannot control your blood sugar, you also may need to take pills and other injected medication, including insulin. Eating a healthy diet, being physically active, and losing any extra weight is the first line of therapy. “Diet and exercise“ is the foundation of all diabetes management because it makes your body’s cells respond better to insulin (in other words, it decreases insulin resistance) and lowers blood sugar levels. If you cannot normalize or control the blood sugars with diet, weight loss and exercise, the next treatment phase is taking medicine either orally or by injection. Diabetes pills work in different ways – some lower insulin resistance, others slow the digestion of food or increase insulin levels in the blood stream. The non-insulin injected medications for type 2 diabetes have a complicated action but basically lower blood glucose after eating. Insulin therapy simply increases insulin in the circulation. Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy. Many people with type 2 diabetes have elevated blood fats (high triglycerides and cholesterol) and blood pressure, so you may be given medications for these problem Continue reading >>

Diabetes Type 2 A Progressive Illness??

Diabetes Type 2 A Progressive Illness??

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Well, what is your opinion is it progressive. NHS employees of all kind appear to think it is just a matter of time before we type 2s have to progress to insulin taking and that the disease just progresses whatever you do. Is that so? or just another NHS myth!! I am hoping not if sugar levels are controlled does it get worse as time goes on? Well, what is your opinion is it progressive. NHS employees of all kind appear to think it is just a matter of time before we type 2s have to progress to insulin taking and that the disease just progresses whatever you do. Is that so? or just another NHS myth!! I am hoping not if sugar levels are controlled does it get worse as time goes on? Well, it's a self fulfilling prophecy isn't it? If you control your T2 diabetes the way that the NHS want you to, then it will be a progressive illness, and you probably will end up on insulin (not that that's necessarily a very bad thing). I think that there is enough anecdotal evidence (on this forum and other places) that well controlled diabetics don't always (or indeed often) progress onto insulin or worse. Hi. I agree with Borofergie. I've not come across any statistics to demonstrate that it is always progressive and in what way. I suspect some of the progressive T2s are in fact undiagnosed T1 LADA etc where the pancreas islet cells do gradually get destroyed. For many insulin resistant, overweight T2s I suspect many will have an extended period without insulin if they follow the exercise and diet guidelines on this forum as their islet cells appear to be funtioning OK? I fully 100% intend to die of something else. I think you have to recognise it may be progressive and Continue reading >>

How Type 2 Diabetes Can Change Over Time

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 >>

Retinopathy Progression And Sudden Lowering Of Hba1c , Etc

Retinopathy Progression And Sudden Lowering Of Hba1c , Etc

Generally retinopathy progresses according to the parameters below. There are very few exceptions. Once background retinopathy develops, unless diabetic control is improved as below, the retinopathy will deteriorate, laser will be needed, and even with laser sight may be affected. glucose level/HbA1c, linear relationship with retinopathy progression blood pressure, linear relationship lipid level, probably a near linear relationship smoking, probable linear relationship (some work suggests 20 cigarettes a day triples/quadruples retinopathy, others less so) pregnancy may cause a rapid deterioration sudden improvement (lowering to normal) of glucose levels in a person whose diabetes has been poorly controlled for sometime see and here . Certain clinical situations are recognised: Some people never seem to develop retinopathy: a suggestion has been made that these patients have ultra-low blood pressures, and this is what protects them. There are genes controlling retinopathy progression, and these may act through blood pressure effects. Retinopathy may run in families; there is certainly a genetic contribution All of a sudden a patient's retinopathy may start to get much worse: this may be because of a relatively sudden rise in blood pressure, which is quite common. Sometimes this seems to occur as renal function decreases. Some people's retinopathy never seems to get worse. I am not convinced this situation exists, but if it does it could be explained: a person whose diabetes was reasonably, but not well, controlled, perhaps an HbA1c of 8% with a low blood pressure, develops retinopathy, but then starts to control their diabetes and blood pressure really well, achieving an HbA1c of 7%, then the retinopathy does not progress. When a patient with poorly controlled type 2 di Continue reading >>

“reversing” Type 2 Diabetes

“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 >>

How Fast Does Type 2 Progress?

How Fast Does Type 2 Progress?

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Something I was curious about is how fast does Type 2 progress? I am a 31 year old guy. The last I was tested was in 2006 and my fasting number was 99. Then recently I was tested through an employer program and my fasting glucose was 260! In a space of 4/5 years I went from normal to very high glucose. I had assumed diabetes is a lifestyle disease that creeps up on you gradually over the years. How do I reduce my fasting numbers -- what is the best strategy. Is my condition reversible? I went and bought a blood glucose meter, and have been testing post-prandial numbers. I've been avoiding carbs completely for the past few days, and 1 hour after a meal my numbers have increased by 20 points or so, no huge spikes. But my baseline / fasting number itself is so high, I have no idea how I will get it down to below 100. I can understand one can control post-prandial numbers by being careful about what one eats. But the high fasting numbers means the liver is pumping more glucose than it should (based on low insulin signals), and so there is not a direct way to prevent that from happening? I mean, however little or differently I eat, the liver will have enough glucose to pump, if it chooses to, to make my fasting numbers high. Is that true? Something I was curious about is how fast does Type 2 progress? It depends on the individual, on your lifestyle/habits, on how far it had progressed before you started making positive changes, on how well you control your gluocose levels... The last I was tested was in 2006 and my fasting number was 99. Then recently I was tested through an employer program and m Continue reading >>

Why Doctors Believe This Toxic Myth

Why Doctors Believe This Toxic Myth

The single most dangerous idea you are likely to encounter after getting a diabetes diagnosis is the belief that science has proven, beyond a doubt, that no matter what you do, your Type 2 Diabetes will get worse. Your doctors probably believe this. Though they may give lip service to the idea that you can control your disease through diet, exercise, and drugs, most family doctors actually believe that nothing you can do will make much difference in your long-term outcome. This is why they are not likely to urge you to take an aggressive approach to managing your disease but merely write prescriptions for drugs that, if they do anything at all, do a mediocre job of controlling your blood sugars. They've Seen Poor Outcomes Among Their Own Patients Doctors will tell you that they've treated lots of patients with type 2 diabetes and that few, if any, of their patients can control their diabetes with diet. They'll say that their patients cannot lose weight, and that even with good control they end up with complications. What they don't understand is that the diet they have been recommending, thanks to the American Diabetes Association's partnership with so many national and state health authorities, is a high carbohydrate, low fat diet that contains so much sugar and starch it would raise the blood sugar of most normal people. Bananas and whole wheat bread won't control diabetes, but a diet that lowers your intake of starches and sugars often will--no matter how much fat it contains. They Think the UKPDS Study "Proved" People with Good Control Deteriorate Doctors will also tell you that a large-scale study, the UKPDS (United Kingdom Prospective Diabetes Study) proved that even with good control patients with Type 2 diabetes inevitably deteriorated over time. The UKPDS, they Continue reading >>

Defining And Characterizing The Progression Of Type 2 Diabetes

Defining And Characterizing The Progression Of Type 2 Diabetes

Defining and Characterizing the Progression of Type 2 Diabetes We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Defining and Characterizing the Progression of Type 2 Diabetes Type 2 diabetes is a progressive disease in which the risks of myocardial infarction, stroke, microvascular events, and mortality are all strongly associated with hyperglycemia ( 1 ). The disease course is primarily characterized by a decline in -cell function and worsening of insulin resistance. The process is manifested clinically by deteriorations in multiple parameters, including A1C, fasting plasma glucose (FPG), and postprandial glucose levels. In this review, we will evaluate our current understanding of the role played by deteriorating -cell function and other abnormalities linked with the progression of type 2 diabetes. An improved understanding of these abnormalities may provide the scientific groundwork for novel therapies that may help achieve and maintain good glycemic control. 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 Continue reading >>

On The Path To Diabetes

On The Path To Diabetes

People diagnosed as pre-diabetic -- there are millions -- can use lifestyle changes to head off the full-blown disease. September 08, 2008 |Valerie Ulene | Special to The Times Diagnosing disease is not always a black-and-white undertaking. There is often a gray zone between sickness and health -- a time when, technically speaking, people can't be classified as either diseased or well. Diabetes serves as a perfect example -- so much so that the gray zone has earned its own name: pre-diabetes. As its name implies, pre-diabetes is essentially a precursor to diabetes. People with pre-diabetes have blood glucose levels above those considered normal but not yet high enough to qualify as diabetic. According to the Centers for Disease Control and Prevention, nearly 57 million Americans 21 and older have the condition, roughly twice as many as have diabetes itself. Pre-diabetes is not only more common but also more treatable. If it's diagnosed early, its ill effects can often be averted. In some cases, the condition can be cured. Pre-diabetics have problems responding to insulin, the hormone that processes glucose in the body, causing the rise in blood sugar levels -- in medical terms, this is known as insulin resistance. "As resistance goes up, more and more insulin is needed to handle the same amount of glucose," says Dr. Yehuda Handelsman, co-chairman of the American College of Endocrinology's task force on the management of pre-diabetes. Mild elevations in glucose levels cause no obvious symptoms but carry significant consequences: A persistent buildup of glucose in the body damages blood vessels and other tissues throughout the body. "It's clear that the risks of high blood glucose levels occur earlier than those at which diabetes is currently defined," Handelsman says. M Continue reading >>

Diabetes Update: The Untold Story Of Disease Progression

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 >>

Type 2 Diabetes Guide

Type 2 Diabetes Guide

When your doctor tells you that you have prediabetes, you might think there's no reason to take action just yet. Or you might assume that you're definitely going to get diabetes. Not so! You do need to take prediabetes seriously, but there's still time to turn things around -- if you start now. The goal is to get your blood sugar level out of the prediabetes range, and keep it that way. What you do every day makes a big difference. Making lifestyle changes may be even more powerful than just taking medication. That's what happened in a large study called the Diabetes Prevention Program: People with prediabetes who lost a small amount of weight through diet and exercise cut their odds of getting type 2 diabetes by 58%, compared to 31% for people who only took the prescription drug metformin. Start by making these three changes. If you're overweight, slimming down is the key to turning the odds in your favor. Research shows that shedding just 5% to 10% of your body weight is often enough to get blood sugar levels back into the normal range and avoid diabetes or at least delay its onset. To reach your goal, limit portion sizes; cut calories; and eat fewer foods that are high in fat (especially saturated fat), sugar, and carbohydrates. You should also eat a wide variety of fruits, vegetables, lean protein, and whole grains. Leading an active life is a must. Aim for 30 minutes of aerobic activity (something that raises your heart rate, like walking, biking, or swimming) 5 days a week (150 minutes per week). Plus, do some strength-training exercise, like lifting weights or using resistance bands, at least twice a week. Strength work builds muscle, which helps lower your blood sugar level, helps your body respond better to insulin (which controls blood sugar), and burns calori Continue reading >>

Does Prediabetes Lead To Diabetes?

Does Prediabetes Lead To Diabetes?

In every issue of WebMD the Magazine, we ask our experts to answer readers' questions about a wide range of topics. In our January-February 2011 issue, we asked WebMD's diabetes expert, Michael Dansinger, MD, to answer a question about the link between prediabetes and diabetes. Q: At my last checkup, my doctor told me I have prediabetes. Does that mean I'll ultimately develop diabetes? A: Almost everyone who develops type 2 diabetes develops prediabetes first. But not everyone who has prediabetes -- defined as having levels of glucose (a type of sugar in the blood) that are higher than normal but not yet diabetic -- ends up with diabetes. In fact, changing your lifestyle can significantly delay or even prevent type 2 diabetes. Those changes can include losing a moderate amount of weight (5% to 10% of your body weight -- about 8 to 16 pounds for a 160-pound woman), getting regular exercise (about 30 minutes daily), and eating healthy meals. There are lots of good eating plans for delaying or preventing diabetes -- most emphasize a variety of vegetables, fruits, fish, lean chicken, beans, low-fat dairy, egg whites, soy, and whole grains. Quitting smoking, drinking alcohol only moderately (if you drink already), and reducing stress all help keep your blood glucose levels under control. You should also know that prediabetes puts you at risk for other conditions, such as heart disease and stroke. In fact, prediabetes is now considered one of America's most serious health problems (one in four adults has it). Knowing how to keep it in check can prevent diabetes from developing in the future. Continue reading >>

Type 2 Diabetes

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 >>

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