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Progression Of Diabetes Type 2

What Is Type 2 Diabetes?

What Is Type 2 Diabetes?

Type 2 diabetes is the most common form of diabetes. You have Type 2 diabetes if your tissues are resistant to insulin, and if you lack enough insulin to overcome this resistance. You have Type 2 diabetes if your tissues are resistant to insulin, and if you lack enough insulin to overcome this resistance. Type 2 diabetes is the most common form of diabetes of diabetes worldwide and accounts for 90-95% of cases. Risk Factors Your risk of type 2 diabetes typically increases when you are: Other risk factors are: Family history of diabetes in close relatives Being of African, Asian, Native American, Latino, or Pacific Islander ancestry High blood pressure High blood levels of fats, known as triglycerides, coupled with low levels of high-density lipoprotein, known as HDL, in the blood stream Prior diagnosis of pre-diabetes such as glucose intolerance or elevated blood sugar In women, a history of giving birth to large babies (over 9 lbs) and/or diabetes during pregnancy Type 2 diabetes is strongly inherited These are some of the statistics: 80-90% of people with Type 2 diabetes have other family members with diabetes. 10-15% of children of a diabetic parent will develop diabetes. If one identical twin has type 2 diabetes, there is up to a 75% chance that the other will also be diabetic. There are many genetic or molecular causes of type 2 diabetes, all of which result in a high blood sugar. As yet, there is no single genetic test to determine who is at risk for type 2 diabetes. To develop type 2 diabetes, you must be born with the genetic traits for diabetes. Because there is a wide range of genetic causes, there is also a wide range in how you will respond to treatment. You may be easily treated with just a change in diet or you may need multiple types of medication. The ha Continue reading >>

Late Stage Complications Of Diabetes And Insulin Resistance

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 >>

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 >>

The Early Treatment Of Type 2 Diabetes

The Early Treatment Of Type 2 Diabetes

Jump to Section Abstract The growing epidemic of type 2 diabetes is one of the leading causes of premature morbidity and mortality worldwide, mainly due to the micro- and macrovascular complications associated with the disease. A growing body of evidence suggests that although the risk of developing complications is greater with glucose levels beyond the established threshold for diagnosis – increasing in parallel with rising hyperglycemia—individuals with glucose levels in the prediabetic range are already at increased risk. Early intervention, ideally as soon as abnormalities in glucose homeostasis are detected, is of great importance to minimize the burden of the disease. However, as the early stages of the disease are asymptomatic, diagnosing prediabetes and early overt type 2 diabetes is challenging. The aim of this article is to discuss these challenges, the benefits of early intervention—with emphasis on the prevention trials showing that progression to type 2 diabetes can be delayed by addressing prediabetes—and the existing evidence-based guidelines that have been drawn to optimize the standards of care at the prediabetes and overt type 2 diabetes stages. 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 >>

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 >>

Progression Of Type 2 Diabetes

Progression Of Type 2 Diabetes

For most people, type 2 diabetes is not a stable disease -- its a progressive one. It often changes over time, and your treatment also needs to change. The longer you have diabetes, the more likely it is that cells in your pancreas are unable to release the insulin your body needs. This important hormone helps regulate your blood sugar levels. Your cells can often produce more insulin at first, but they cant keep up year after year, and they eventually stop making insulin. When youre first diagnosed, you may be able to control your blood sugar levels by exercising and changing your diet. Over time, however, your cells cant keep producing enough insulin. You may need oral medications to help, and these may eventually not be enough to keep your blood sugar at a healthy level. Because the disease is progressive, you and your doctor may need to adjust your treatment. Its unlikely that the same treatment that worked when you were first diagnosed will continue to be effective enough year after year. If you find that your blood sugar levels arent as well controlled as in the past, it doesnt mean youre doing anything wrong. It just means that your body has become less able to produce the insulin your body needs to effectively control your blood sugar. You will probably have to change and adjust your medications to make up for this reduced amount of insulin. Many people eventually have to take insulin to control their blood sugar levels. Youll give yourself one or more injections (shots) each day to make sure your body has the insulin it needs. Your doctor will help determine the dosage you need. This too, may change over time as your diabetes progresses. By taking your medicine as directed by your doctor, you can help keep your blood sugar levels under control. The following w Continue reading >>

The Natural History Of Type 2 Diabetes: Practical Points To Consider In Developing Prevention And Treatment Strategies

The Natural History Of Type 2 Diabetes: Practical Points To Consider In Developing Prevention And Treatment Strategies

CLINICAL DIABETES VOL. 18 NO. 2 Spring 2000 PRACTICAL POINTERS Type 2 diabetes, previously referred to as adult-onset or non-insulin-dependent diabetes, progresses from an early asymptomatic stage with insulin resistance to mild postprandial hyperglycemia to frank diabetes requiring pharmacological intervention. Understanding this natural history of type 2 diabetes will guide primary care providers in formulating effective treatment regimens that reflect the pathological differences between these stages of the disease. The optimal medication regimen, when used in conjunction with dietary changes and exercise, will require modifications for each patient as the disease progresses. The term impaired glucose tolerance (IGT) or pre-diabetes was first coined in 1979 by the World Health Organization and the National Diabetes Data Group to replace the terms borderline, chemical, and asymptomatic diabetes mellitus. In 1997, an expert committee of the American Diabetes Association recommended the following criteria for IGT: a normal fasting plasma glucose (<126 mg/dl) with a postprandial plasma glucose of >140 mg/dl but <200 mg/dl 2 h after a 75-g oral glucose challenge.1 This stage of mild postprandial hyperglycemia is an extremely useful marker of patients at risk for the eventual development of type 2 diabetes. Patients with IGT may benefit from timely patient education and perhaps even more aggressive forms of intervention, such as diet, exercise, or medication. An estimated 15.7 million Americans have type 2 diabetes, representing 5.9% of the population. Only two-thirds of those affected are diagnosed and are being actively treated. Although these numbers are staggering, there are even more potential diabetic patients waiting in the wings: the prevalence of IGT is estimated Continue reading >>

Defining And Characterizing The Progression Of Type 2 Diabetes

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 β-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 β-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. CHARACTERISTICS OF DISEASE PROGRESSION 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 triglycer 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 >>

Importance Of -cell Failure In The Development And Progression Of Type 2 Diabetes | The Journal Of Clinical Endocrinology & Metabolism | Oxford Academic

Importance Of -cell Failure In The Development And Progression Of Type 2 Diabetes | The Journal Of Clinical Endocrinology & Metabolism | Oxford Academic

The pathogenesis of type 2 diabetes is complex and in most instances clearly requires defects in both -cell function and insulin sensitivity ( 1 ). Together, these abnormalities result in increased rates of glucose release by the liver and kidney as well as decreased clearance from the circulation ( 2 , 3 ). For the last decade, a great deal of attention has been directed at further understanding the role of insulin resistance as an important contributor to the development and maintenance of the hyperglycemia of type 2 diabetes. During this same period, the well described vital role of the pancreatic islet, and specifically the -cell, in this process has been largely neglected. Perhaps one of the most striking and sobering findings of the United Kingdom Prospective Diabetes Study (UKPDS) was the reaffirmation of the clinically recognized progressive nature of type 2 diabetes ( 4 ). Every day clinicians all over the world find themselves struggling to maintain good glycemic control in subjects with type 2 diabetes, and the results of this study clearly confirm that, even with the use of algorithmic approaches aimed at maintaining superb glucose control, it is very difficult to maintain individuals at the desired levels of glycemia. In fact, in the UKPDS after 9 yr only 25% of the subjects in the intensive treatment arm were achieving a HbA1c less than 7% with monotherapy alone ( 5 ). When one examines the outcome in the different groups based on their initial assignment, this goal was attained in 8% of subjects given dietary therapy, 13% receiving metformin, 24% taking sulfonylureas, and 42% of individuals using insulin. The reason(s) for the progressive deterioration in glycemic control observed in the UKPDS have been addressed using the Homeostasis Model Assessment (H Continue reading >>

Risk Factors For Type 2 Diabetes

Risk Factors For Type 2 Diabetes

US Pharm. 2007;32(10):61-63. Type 2 diabetes mellitus is a chronic and progressive syndrome characterized by several metabolic factors that eventually lead to hyperglycemia. The development and progression to type 2 diabetes significantly increases morbidity and mortality, most often due to chronic complications.1 In the United States, type 2 diabetes has reached epidemic proportions. In 2005, approximately 21 million adult Americans had diabetes, and it was estimated that an additional 1.5 million new cases would be diagnosed that same year.2 The prevalence of diabetes is only expected to rise. The financial impact of this disease state is staggering, with an estimated $132 billion directed toward the total cost of care in 2002.3 This article highlights major risk factors that are commonly associated with type 2 diabetes. The development of diabetes tends to be insidious. The presence of risk factors may precede the actual onset of the disease by several years. Many times, patients may have diabetes for several years before symptoms are apparent or a diagnosis is made. In some cases, patients have identifiable risk factors for the disease that are not addressed in a medical setting, or risk factors are addressed but not aggressively enough. Decreasing the risk of progression to diabetes may greatly lower the development of complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy. Pharmacists have the ability and obligation to educate patients and be further involved in their care when appropriate. Identifying risk factors to aid primary prevention is an important intervention needed to decrease the associated morbidity and mortality. Prediabetes Prediabetes refers to blood glucose impairment that is not yet classified as type 2 diabetes. W 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

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 >>

The Causes And Progression Of Type 2 Diabetes

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 >>

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