Type 2 Diabetes

The two major forms of diabetes are type 1 and type 2. Both diabetes type 1 and 2 share one central feature: elevated blood sugar levels due to absolute or relative insufficiencies of insulin, a hormone produced by the pancreas. Insulin is a key regulator of the body's metabolism. Here is the process that usually works: during and immediately after a meal, the process of digestion breaks carbohydrates down into sugar molecules, and proteins into amino acids. Right after the meal, glucose and amino acids are absorbed directly into the bloodstream, and blood glucose levels rise sharply. The rise in blood glucose levels signals important cells in the pancreas, called beta cells, to secrete insulin, which pours into the bloodstream. Within ten minutes after a meal insulin rises to its peak level. Insulin then enables glucose and amino acids to enter cells in the body, particularly muscle and liver cells. Here, insulin and other hormones direct whether these nutrients will be burned for energy or stored for future use. When insulin levels are high, the liver stops producing glucose and stores it in other forms until the body needs it again. As blood glucose levels reach their peak, the pancreas reduces the production of insulin. About two to four hours after a meal both blood glucose and insulin are at low levels, with insulin being slightly higher. The blood glucose levels are then referred to as fasting blood glucose concentrations.

Type 2 diabetes, formerly called adult-onset or noninsulin-dependent, is most common form of diabetes. An estimated 16 million Americans have type 2 diabetes and half are unaware they have it. The first stage in type 2 diabetes is the condition called insulin resistance; although insulin can attach normally to receptors on liver and muscle cells, certain mechanisms prevent insulin from moving glucose into these cells where it can be used. Most type 2 diabetics produce variable, even normal or high amounts of insulin, and in the beginning this amount is usually sufficient to overcome such resistance. Over time, the pancreas becomes unable to produce enough insulin to overcome resistance. In type 2 diabetes the initial effect of this stage is usually an abnormal rise in blood sugar right after a meal. This effect is now believed to be damaging to the body.

Type 2 diabetes is caused by a complicated interplay of genes, environment, insulin abnormalities, increased glucose production in the liver, increased fat breakdown, and possibly defective hormonal secretions in the intestine. The recent dramatic increase indicates that lifestyle factors may be strong in releasing the genetic elements that cause this type of diabetes. The characteristic feature of diabetes type 2 is the body's resistance to the actions of insulin. In many people, before diabetes develops, normal or even excessive levels of insulin compensate for this resistance. Over time however, insulin production often drops and resistance worsens.

Diabetes type 2 affects at least 16 million Americans, and the incidence is sharply rising. Here are some factors that have to do with who is as risk. Low birth weight, research now indicates that low birth weight is a risk factor for type 2 diabetes. Some research indicates that malnutrition in the pregnant woman may be responsible for causing metabolic abnormalities in the developing fetus that eventually lead to diabetes. In a 2001 study, obesity was the number one risk factor for diabetes type 2. Excess body fat appears to play a strong role in insulin resistance, but the way the fat is distributed is also significant. Weight concentrated around the abdomen and in the upper part of the body is associated with insulin resistance and diabetes, heart disease, high blood pressure, stroke, and unhealthy cholesterol levels. Fat that settles in a "pear shape" around the hips and flank appears to have a lower association with these conditions. Between 25% to 33% of all type 2 patients have family members with diabetes. Having a first-degree relative with the disease poses a 40% risk of developing diabetes. The risk for type 2 diabetes varies among population groups. Diabetes also seems to pose a higher of lower risks for specific complications among ethnic groups. Genetic, socioeconomic factors, or both seem to be involved in ethnic differences. An estimated 5% of pregnant women develop a form of type 2 diabetes, usually temporary, in their third trimester called gestational diabetes. Gestational diabetes is a diabetic condition that develops during the third trimester. After delivery, blood glucose levels generally return to normal, although between one-third and one-half of these women develop type 2 diabetes within 10 years.

Type 2 diabetes usually begins gradually and progresses slowly. Symptoms in adults include the following: Excessive Thirst, Increased urination, Fatigue, Blurred vision, Weight loss, In women, vaginal yeast infections or fungal infections under the breast or in the groin, Severe gum problems, and Itching. In men it may cause Impotence, and unusual sensations, such as tingling or burning, in the extremities. Symptoms in children are often different: Most children are obese or overweight, Increased urination is mild or even absent, and many develop a skin problem called acanthosis, which is characterized by velvety, dark colored patches of skin. People with diabetes who need the intensively control glucose levels are at risk for hypoglycemia. This condition develops if blood sugar levels fall below normal and may also be caused by insufficient intake of food, excess exercise, or alcohol intake. Usually the condition is manageable, but occasionally, it can be severe or even life threatening, particularly if the person fails to recognize the symptoms. Mild hypoglycemia is common among people with type 2 diabetes, but severe episodes