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 >>
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 >>
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 >>
Will Diabetes Progress Regardless
We know that Type 2 is also known as "adult onset" diabetes. Many, like my doctor, feel that as we age our diabetic condition continues to deteriorate - a condition often referred to as progressive. On the subject, I found this I think it depends who you are talking about. My husband has had diabetes for 19 years and his HbA1 c is 5.9. I eat lower carb than he does and mine is 6.6. He is a,so 20 pounds overweight and I am thin. I don't think my diabetes is deteriorating but as I age I have to work harder to control it. 115 pounds, Breast Cancer dx'd 6/16, 6 months of chemo and 6 weeks of radiation 2000 metformin ER, 100 mg Januvia,Glimperide, Prolia, Gabapentin, Meloxicam, Probiotic with a Prebiotic, , Lisinopril, B-12, B-6, Tumeric, Magnesium, Calcium, Vit D, and Occuvite mostly vegan diet, low fat and around 125 carbs a day, walk 5-6 miles every other day and 1 hour of yoga and light weights. D.D. Family Getting much harder to control I know two type 2 on dlife that is no longer active, in fact last I was there they had forums closed. Both were at 70 or above one used exercise only when the other used exercise and extreme low carb. They both had normal normal readings and no meds, so is it progressive well for some yes, mine is the same as its been over the last 33 yrs so can not go by me but actually mine is much better. Maybe its me know what to do, years ago the so called experts wow I tell you. My doctor reminded me a couple of weeks ago that T2D is progressive, but I've been working hard for nearly three and a half years to minimise my insulin stocks and requirements, to limit both the wear and tear on my pancreas, and the effort required by my endocrine system to manage the necessary processes. I agree with the article that the statistics are mostly derived fro Continue reading >>
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Is It Possible For Type 2 Diabetes To Turn Into Type 1?
Type 2 diabetes can’t turn into type 1 diabetes, since the two conditions have different causes. Type 1 diabetes is an autoimmune disease. It occurs when the insulin-producing islet cells in the pancreas are completely destroyed, so the body can’t produce any insulin. In Type 2 diabetes, the islet cells are still working. However, the body is resistant to insulin. In other words, the body no longer uses insulin efficiently. Type 1 diabetes is far less common than type 2. It used to be called juvenile diabetes because the condition is typically diagnosed in early childhood. Type 2 diabetes is more commonly diagnosed in adults, though we’re now seeing more and more children being diagnosed with this disease. It’s more commonly seen in those who are overweight or obese. It’s possible for someone with type 2 diabetes to be misdiagnosed. They may have many of the symptoms of type 2 diabetes, but actually have another condition that may be more closely related to type 1 diabetes. This condition is called latent autoimmune diabetes in adults (LADA). Researchers estimate that between 4 and 14 percent of people diagnosed with type 2 diabetes might actually have LADA. Many physicians are still unfamiliar with the condition and will assume a person has type 2 diabetes because of their age and symptoms. In general, a misdiagnosis is possible because: both LADA and type 2 diabetes typically develop in adults the initial symptoms of LADA — such as excessive thirst, blurred vision, and high blood sugar — mimic those of type 2 diabetes doctors don’t typically run tests for LADA when diagnosing diabetes initially, the pancreas in people with LADA still produces some insulin diet, exercise, and oral drugs usually used to treat type 2 diabetes work well in people with LADA Continue reading >>
How Does Type 2 Diabetes Progress? Just Curious
How does Type 2 diabetes progress? Just curious 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. How does Type 2 diabetes progress? Just curious Just curious, does Type 2 Diabetes progress by failure of Phase I insulin response first then later Phase II insulin response? Do Type 2s ever go through a honeymoon period? Just wondering. I've had Type 2 for about 3 1/2 years and I think my disease has progressed. I started off on 500 of metformin and now take 2550 mg of metformin. I think fairly soon I will add a second drug. I have also had to lower my carb allowance at meals and really watch what I eat and how much I exercise. I have lost the weight I needed to and then some. My doctor says I am no longer insulin resistant but probably insulin insufficient now. Since I eat very low carb I can controll the spikes at meals to about 20 points but my problem is with long periods of fasting. The dreaded DP Monster is still haunting me and has seemed to get worse lately. Type 2 is heterogeneous so there are a lot of variations. If you are at the insulin insufficiency end of the spectrum then it's progressive, if you are at the insulin resistant end then maybe it isn't. Most people are somewhere between and it is progressive to a greater or lesser extent. The difficult thing is that you don't really know where you are until it progresses. I've had Type 2 for about 3 1/2 years and I think my disease has progressed. I started off on 500 of metformin and now take 2550 mg of metformin. I think fairly soon I will add a second drug. I have also had to lower my carb allowance at meals and really watch what I eat and how much I exercise. I have lost the weig Continue reading >>
“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 >>
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 >>
Type 2 Diabetes - What Happens
When you have type 2 diabetes, your body still makes insulin. But as time goes on, your pancreas may make less and less insulin, which will make it harder to keep your blood sugar in your target range. If your blood sugar gets too high and stays too high for too long, your risk for other health problems increases. Over time, high blood sugar can damage many parts of your body . High blood sugar levels may cause temporary blurred vision. Blurry vision, floaters, or flashes of light may be a sign of diabetic retinopathy, which can cause severe vision loss. To learn more, see the topic Diabetic Retinopathy. You may have less feeling in your feet, which means that you can injure your feet and not know it. Blisters, ingrown toenails, small cuts, or other problems that may seem minor can quickly become more serious. If you develop serious infections or bone and joint deformities, you may need surgery (even amputation) to treat those problems. Common infections can quickly become more serious when you have diabetes. High blood sugar damages the lining of blood vessels. This can lead to stroke, heart attack, or peripheral arterial disease. Erection problems can be an early warning sign of blood vessel disease and may mean a higher risk of heart disease. High blood sugar levels can damage nerves throughout your body. This damage is called diabetic neuropathy. There are three kinds of diabetic neuropathy: Diabetic peripheral neuropathyDiabetic peripheral neuropathy. This is damage to the nerves that sense pain, touch, hot, and cold. This type of nerve damage can lead to a deformity called Charcot foot . It can also lead to other problems that may require amputation. Autonomic neuropathyAutonomic neuropathy. This is damage to nerves that control things like your heartbeat, blood p Continue reading >>
Is Type 2 Diabetes Reversible?
Type 2 diabetes is a serious, long-term medical condition. It develops mostly in adults but is becoming more common in children as obesity rates rise across all age groups. Several factors contribute to type 2 diabetes. Being overweight or obese is the biggest risk factor. Type 2 diabetes can be life-threatening. But if treated carefully, it can be managed or even reversed. Your pancreas makes a hormone called insulin. When your blood sugar (glucose) levels rise, the pancreas releases insulin. This causes sugar to move from your blood to your cells, where it can be used as an energy source. As glucose levels in your blood go back down, your pancreas stops releasing insulin. Type 2 diabetes impacts how you metabolize sugar. Either your pancreas doesn’t produce enough insulin or your body has become resistant to its effects. This causes glucose to build up in the blood. This is called hyperglycemia. There are several symptoms of untreated type 2 diabetes, including: excessive thirst and urination fatigue increased hunger weight loss, in spite of eating more infections that heal slowly blurry vision dark patches on the skin Treatment for type 2 diabetes includes monitoring your blood sugar levels and using medications or insulin when needed. Doctors also recommend losing weight through diet and exercise. Some diabetes medications have weight loss as a side effect, which can also help reverse diabetes. If you start eating healthier, get more exercise, and lose weight, you can reduce your symptoms. Research shows that these lifestyle changes, especially physical activity, can even reverse the course of the condition. Studies that show the reversal of type 2 diabetes include participants who have lived with the condition for only a few years. Weight loss is the primary fact 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 >>
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 >>
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 >>
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 >>
How Quickly Can T-2 Progress?
D.D. Family T2 since May 2007, started Byetta Jan 2008 I know that D is progressive, but how quickly? How long after diagnosis have you experienced loss of bg control, etc. D.D. Family Type 2 since 1995, Invokana, Trulicity I know that D is progressive, but how quickly? How long after diagnosis have you experienced loss of bg control, etc. It depends how old you are. I'm close to being in control. Several members here are in control. For some of us it will be our life time. I've been a type II for over ten years and I'm still very healthy for my age. A lot will depend on you Becky and how much you're willing to work to get in control. It's a totally new life style. Let us help you thru it. D.D. Family T2 for 24 years, pumping 3/07/07,no complications I'm 57, had T2 for more than 13 years, and my A1c is 5.5 I have progressed to the point where I need insulin, but I am very much in control. You have to work at it though. I am 72 years old, T-2, never since diagnosis above 5.5. For my age the M.D.s say that I am doing very well. The carb counting has become a habit. I began using insulin when first diagnosed three years ago, or so. It is not my doctor's health that is at risk! Do I want toes or pizza? A1c 5.4. And, yes I am a HAM. That is a HAM Radio Operator. KL1XT. like it has been already said, it does depend on how much you take care of yourself. up till November 2006 my hba1c was 6.2. Then this year i have not been careful and guess what - in July my hba1c was 10.7. and now it seems i cannot get control of it. i am looking of starting on insulin only after just over 2 years after diagnoses. D.D. Family T1 since May 2006 Metformin, Humalog and Lantus I started Insulin 10 months after diagnosis,my last A1C was 6.8,up on the last one that was 6.4 I have better control s Continue reading >>