Diabetes is a group of diseases in which the body cannot use food for energy correctly. There are two main types of diabetes, called Type 1 and Type 2. Type 2 diabetes is by far the more common condition. Over 90% of people with diabetes have Type 2. People with Type 2 diabetes gradually lose the ability to control the level of sugar in their blood. This is important because sugar (glucose) in the blood is the fuel that keeps us going, much like a car runs on gas.
Our bodies use glucose (a form of sugar) from the food we eat to produce energy. The body needs insulin to move sugar from the bloodstream into body cells. That is where the sugar is used. A gland called the pancreas makes insulin. Insulin does not work as it should in people who have Type 2 diabetes. They are resistant to its action. In addition, their ability to make insulin gradually decreases as time goes by. Without enough insulin working to allow glucose to enter the cells, sugar stays in the blood. Blood sugar levels rise above normal. This is diabetes.
Natural Progression of Type 2 Diabetes
Although there is considerable variability from person to person in how long this process takes, Type 2 diabetes is a disease that generally develops over a period of years. Many people who will eventually develop this disease are insulin resistant several years before their blood sugars become abnormal. Their bodies try to make up for the higher insulin needs created by insulin resistance by producing more insulin. But in people who go on to develop Type 2 diabetes, the strain of producing abnormally high levels of insulin over the years eventually begins to have a negative effect. The pancreas gradually begins to lose its ability to produce the extra insulin needed to overcome insulin resistance. As body insulin levels fall, blood sugars begin to rise.
Type 2 diabetes and the insulin resistance that causes it have a strong genetic basis and are made worse by environmental factors, including inactivity, weight gain, and stress. Most people are overweight at the time their Type 2 diabetes is discovered. Being more active or losing weight may help control diabetes once you have it. It may even help prevent or delay the development of diabetes in the first place. Type 2 diabetes was once called "Adult-onset Diabetes" but this term is no longer used because it is inaccurate. Type 2 diabetes is on the increase in all age groups, even among children of high school and grade school age. See Type 2 Diabetes in Children for more information.
Type 2 diabetes is often without symptoms in its early stages. That is the reason that as many as 40% of people with Type 2 diabetes are unaware of their disease. When there are symptoms, they may come on gradually and be very subtle. If present, they may include:
- feeling tired
- being unusually thirsty
- passing large volumes of urine, especially during the night
- having frequent infections
- having blurred eyesight
Who Gets Type 2 Diabetes?
Getting diabetes, either Type 1 or Type 2, is not your fault. But many people with Type 2 diabetes are led to feel that they are to blame for their own disease. This viewpoint is inconsistent with what we know about this disease. It's is not caused by eating too much sugar or by being heavy. After all, not everyone who does those things gets diabetes. The tendency to develop diabetes is inherited (the genes that cause it have been present since birth). This is true of both Type 1 and Type 2 diabetes. It's not possible to tell people who have inherited the tendency toward to Type 1 diabetes by just looking at or talking to them. But there are some easily observed things associated with a higher risk for developing Type 2 diabetes.
Type 2 diabetes is more likely to develop in people who:
- Have a parent, grandparent, brother or sister with diabetes
- Are over 40 years of age
- Are overweight
- Have high blood pressure
- Had diabetes during a pregnancy
- Had a baby that weighed more than 9 pounds at birth
- Are African-American, Hispanic/Latino, or Native American
- Have the stress of an illness or injury
People who have these characteristics should take a risk test. Depending on the outcome of the paper and pencil risk test, a blood test may be indicated.
Research is being conducted to learn if there are ways to prevent the development of Type 2 diabetes in people who inherited the tendency toward this disease. There is already some evidence that regular exercise and staying lean may prevent or delay some cases of Type 2 diabetes.
Because there are several defects in the body's chemistry that develop as Type 2 diabetes changes over time, there are many tools used to treat it. In its earliest stages, Type 2 diabetes can often be controlled effectively by becoming more active and by managing food to reduce the body's need for insulin. This may involve promoting a modest amount of weight loss, controlling and distributing carbohydrate intake through the day, or both. When the disease has progressed to the point where blood sugars are not controlled by activity and food management alone, several types of oral medications (pills) and/or insulin may be used singly or in combination to regain blood glucose control. Their effectiveness is judged by testing the blood sugar periodically throughout the day.
For More Information
- What You Need to Know about Type 2 Diabetes in Children
- The Prevention or Delay of Type 2 Diabetes
- Classification and Diagnosis of Diabetes
- Oral Agents in the Management of Type 2 Diabetes Mellitus
- Information for people with Type 2 diabetes
- Diabetes Registry: Type 2
- What is Type 2 Diabetes? from the ADA
- Diabetes in African Americans from the ADA
- Awakening the Spirit: Pathways to Diabetes Prevention and Control (Diabetes in Native Americans)
- Get Fit Get Right offers help in preventing childhood obesity
Last Updated: Monday October 22, 2007 17:36:24
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