Type 2 Diabetes

Type 2 diabetes (T2D) is a disease that most people know something about. The media is filled with references to and articles about the disease. Diabetes has reached epidemic levels in the US and in most of the developing world. According to the National Diabetes Statistics, 2011, diabetes affects 25.8 million people of all ages or 8.3% of the U.S. population. Approximately 7 million of those are undiagnosed. In China, diabetes has emerged as a major public health issue with the International Diabetes Federation[1] (IDF) projecting a doubling of adult diabetics to 92.4 million over the past decade. In addition, an estimated 9% of the population suffers from diabetes, exceeding the North American prevalence of 10.2%. Another study by the Chinese National Diabetes and Metabolic Disorders Study indicated a prevalence of nearly 10% with approximately 60% of Chinese diabetics undiagnosed.
T2D is the most common form of diabetes. It is a lifelong chronic disease where the patient has high glucose levels in the blood. The disease results from problems in the way the body makes and/or uses insulin. Insulin stimulates cells to take up glucose where it is stored and used to produce energy. In patients with T2D, fat, liver, and muscle cells become resistant to the effects of insulin and glucose accumulates in the blood. T2D develops over time. As people gain weight and become obese, the fat cells and fat that accumulates in other cells inhibit the cellular response to insulin. Low activity level, poor diet and excess body fat increase the risk of developing the disease.
Early symptoms of T2D include frequent bladder, kidney, skin or other infections that heal slowly, fatigue, hunger, increased thirst, increased urination, blurred vision, erectile dysfunction and pain or numbness in the extremities. If left untreated, or as the disease progresses, more serious complications can occur including eye problems (blindness or light sensitivity), sores that won’t heal and are prone to infection, cardiovascular complications including increases in blood pressure and cholesterol that can lead to heart attack and stroke, nerve damage, digestive problems, and kidney damage or failure.
Clinical tests to confirm a T2D diagnosis include:
· Fasting blood glucose level -- two times above 126 mg/dL
· Hemoglobin A1c test – pre-diabetes: 5.7% - 6.4%; diabetics: 6.5% or greater.
· Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours
The first recommended treatment is a change in diet (weight control) and exercise. Metformin is the first line therapy for T2D.
After many years, diabetes can lead to serious problems with patient’s eyes, kidneys, nerves, heart, blood vessels, or other areas of the body. People with diabetes have a risk of a heart attack that is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. They may not even have the normal signs of a heart attack. If blood sugar and blood pressure, are controlled, the risk of death, stroke, heart failure, and other diabetes problems can be reduced. Some people with T2D no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar levels.
[1] Whiting, D., March 2010, “The implications of the new Chinese prevalence study,” International Diabetes Federation, Diabetes Voice, Vol.55:1.
T2D is the most common form of diabetes. It is a lifelong chronic disease where the patient has high glucose levels in the blood. The disease results from problems in the way the body makes and/or uses insulin. Insulin stimulates cells to take up glucose where it is stored and used to produce energy. In patients with T2D, fat, liver, and muscle cells become resistant to the effects of insulin and glucose accumulates in the blood. T2D develops over time. As people gain weight and become obese, the fat cells and fat that accumulates in other cells inhibit the cellular response to insulin. Low activity level, poor diet and excess body fat increase the risk of developing the disease.
Early symptoms of T2D include frequent bladder, kidney, skin or other infections that heal slowly, fatigue, hunger, increased thirst, increased urination, blurred vision, erectile dysfunction and pain or numbness in the extremities. If left untreated, or as the disease progresses, more serious complications can occur including eye problems (blindness or light sensitivity), sores that won’t heal and are prone to infection, cardiovascular complications including increases in blood pressure and cholesterol that can lead to heart attack and stroke, nerve damage, digestive problems, and kidney damage or failure.
Clinical tests to confirm a T2D diagnosis include:
· Fasting blood glucose level -- two times above 126 mg/dL
· Hemoglobin A1c test – pre-diabetes: 5.7% - 6.4%; diabetics: 6.5% or greater.
· Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours
The first recommended treatment is a change in diet (weight control) and exercise. Metformin is the first line therapy for T2D.
After many years, diabetes can lead to serious problems with patient’s eyes, kidneys, nerves, heart, blood vessels, or other areas of the body. People with diabetes have a risk of a heart attack that is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. They may not even have the normal signs of a heart attack. If blood sugar and blood pressure, are controlled, the risk of death, stroke, heart failure, and other diabetes problems can be reduced. Some people with T2D no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar levels.
[1] Whiting, D., March 2010, “The implications of the new Chinese prevalence study,” International Diabetes Federation, Diabetes Voice, Vol.55:1.