Type 2 diabetes

Your body gets energy by making glucose from foods like bread, potatoes, rice, pasta, milk and fruit. To use this glucose, your body needs insulin. Insulin is a hormone that helps your body control the level of glucose (sugar) in your blood. Type 2 diabetes is a disease in which your pancreas does not produce enough insulin, or your body does not properly use the insulin it makes.

If you have type 2 diabetes, glucose builds up in your blood instead of being used for energy.

Of the 20.8 million Americans with diabetes, 90 percent to 95 percent have type 2 diabetes. Of these, half are unaware they have the disease.

People with type 2 diabetes often develop the disease after age 45, but are not aware they have diabetes until severe symptoms occur, or they are treated for one of its serious complications.

Type 2 diabetes is more prevalent among African American, Hispanic/Latino American, and Native Americans.

Type 2 diabetes is nearing epidemic proportions, due to an increased number of older Americans, and a greater prevalence of obesity and a sedentary lifestyle.

Sources: National Institute for Diabetes and Digestive and Kidney Disorders, and the American Diabetes Association

What is type 2 diabetes?

Type 2 diabetes is a metabolic disorder resulting from the body's inability to make enough, or to properly use, insulin. It used to be called non-insulin-dependent diabetes mellitus (NIDDM).

Without adequate production or utilization of insulin, the body cannot move blood sugar into the cells. It is a chronic disease that has no known cure. It is the most common type of diabetes.

What is prediabetes?

In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases. Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.

What causes type 2 diabetes?

The exact cause of type 2 diabetes is unknown. However, there does appear to be a genetic factor which causes it to run in families. And, although a person can inherit a tendency to develop type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease.

Prevention or delay of onset of type 2 diabetes:

Type 2 diabetes may be prevented or delayed by following a program to eliminate or reduce risk factors - particularly losing weight and increasing exercise. Information gathered by the Diabetes Prevention Program, sponsored by the National Institutes of Health and the American Diabetes Association, continues to study this possibility.

What are the symptoms of type 2 diabetes?

The following are the most common symptoms of type 2 diabetes. However, each individual may experience symptoms differently. Symptoms may include:

• frequent infections that are not easily healed
• high levels of sugar in the blood when tested
• high levels of sugar in the urine when tested
• unusual thirst
• frequent urination
• extreme hunger but loss of weight
• blurred vision
• nausea and vomiting
• extreme weakness and fatigue
• irritability and mood changes
• dry, itchy skin
• tingling or loss of feeling in the hands or feet

Some people who have type 2 diabetes exhibit no symptoms. Symptoms may be mild and almost unnoticeable, or easy to confuse with signs of aging. Half of all Americans who have diabetes do not know it.

The symptoms of type 2 diabetes may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

What are the risk factors for type 2 diabetes?

Risk factors for type 2 diabetes include the following:

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.

Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors.

But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

• age
  People over the age of 45 are at higher risk for diabetes.
• family history of diabetes
• being overweight
• not exercising regularly
• race and ethnicity
  Being a member of certain racial and ethnic groups, such as African-Americans, Hispanic Americans, and Native Americans increases the risk for type 2 diabetes.
• history of gestational diabetes, or giving birth to a baby that weighed more than 9 pounds
• a low level HDL (high-density lipoprotein - the "good cholesterol")
• a high triglyceride level

Treatment for type 2 diabetes:

Specific treatment for type 2 diabetes will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

The goal of treatment is to keep blood sugar levels as close to normal as possible.

Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare. Treatment of diabetes is an ongoing process of management and education that includes not only the person with diabetes, but also healthcare professionals and family members.

Often, type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone. However, in some cases, these measures are not enough and either oral medications and/or insulin must be used. Treatment often includes:

• proper diet
• weight control
• an appropriate exercise program
• regular foot inspections
• oral medications, other medications, and/or insulin replacement therapy, as directed by your physician
  There are various types of medications that may be used to treat type 2 diabetes when lifestyle changes such as diet, exercise, and weight loss are not effective. Oral medications of several different types are available, with each type working in a different manner to lower blood sugar. One medication may be combined with another one to improve blood sugar control. When oral medications are no longer effective, insulin may be required.
  
  New medications for treating diabetes are in development. GLP-1 agonists are one of the new types of medications. GLP-1 agonists work by stimulating insulin production by the pancreas, slowing the emptying of food from the stomach, and inhibiting the production of glucagon in the pancreas (glucagon is a hormone produced by the pancreas that stimulates release of glucose by the liver). Byetta®, a GLP-1 agonist approved by the FDA in 2005, is given by injection.
• regular monitoring of the hemoglobin A1c levels
  The hemoglobin A1c test (also called HbA1c test) shows the average amount of sugar in the blood over the last three months. The result will indicate if the blood sugar level is under control. The frequency of HbA1c testing will be determined by your physician. It is recommended that testing occur at least twice a year if the blood sugar level is in the target range and stable, and more frequently if the blood sugar level is unstable.

Untreated or inappropriately-treated diabetes can cause problems with the kidneys, legs, feet, eyes, heart, nerves, and blood flow, which could lead to kidney failure, gangrene, amputation, blindness, or stroke. For these reasons, it is important to follow a strict treatment plan.