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Tuesday, September 14, 2010

Type 2 Diabetes

Diabetes is a disease where your blood glucose (sugar) levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that the body produces that helps the glucose get into the cells in your body to give them energy. In Type I Diabetes, your body does not make insulin at all. These are the diabetics that must take insulin injections or receive insulin through a pump for the rest of their lives. In Type 2 Diabetes, the most common kind, your body doesn’t make or use insulin well so the glucose stays in your blood.

Having too much glucose in your blood can cause many problems over time. Over time, you can develop problems with your eyes, kidneys, and nerves. Diabetes can lead to blindness, kidney problems that necessitate dialysis, nerve problems with the limbs in your body that may get bad enough that they need to be amputated. Diabetes can also lead to heart disease and stroke.

Some of the risk factors for type 2 diabetes are older age, obesity, a family history of diabetes, lack of physical activity, and certain ethnicities. About 80% of the people with diabetes type 2 are overweight. Type 2 diabetes is increasingly being diagnosed in children and adolescents, especially among African American, Mexican American, and Pacific Islander youth.

Symptoms of type 2 diabetes include excessive thirst, fatigue, weight loss, vision problems, and frequent urination. Some people may not have any symptoms, which can lead to a delay in the diagnosis of the disease.

A fasting blood glucose test, preferably done in the morning, is the most accurate way to diagnose diabetes. However, the following tests results can also be used to diagnose diabetes:

- A blood glucose level of 126 milligrams per deciliter (mg/dL) or higher after an 8-hour fast. This test is called the fasting blood glucose test.
- A blood glucose level of 200 mg/dL or higher 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
- A random—taken at any time of day—blood glucose level of 200 mg/dL or higher, along with the presence of diabetes symptoms.

These test results should be confirmed by retesting on a different day.


Pre-diabetes is a condition where the blood glucose is higher than normal, but not high enough to be considered diabetes.

Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.

- IFG is a condition in which the blood glucose level is high—100 to 125 mg/dL—after an overnight fast, but is not high enough to be classified as diabetes. The former definition of IFG was 110 mg/dL to 125 mg/dL.
- IGT is a condition in which the blood glucose level is high—140 to 199 mg/dL—after a 2-hour OGTT, but is not high enough to be classified as diabetes.

(Above information on test results is from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health)

Treatment options for type 2 diabetes include insulin, metformin, and a number of other drugs. Along with the medicines, it is important to develop a meal plan and stick to it, get enough exercise and control your weight. The more you change your lifestyle, the more effective your treatment will be.

For more information on treatment options for diabetes, the National Institute of Diabetes and Digestive and Kidney Diseases, has a great resource called What I Need to Know about Diabetes Medicines. This resource provides detailed information on the types of insulin and other medicines that your doctor might prescribe.

Consumer Reports has a two-page supplement to their Best Buy Drugs publication that lists all the different medicines. Besides the effectiveness and safety information, they provide very useful information on the costs of the different medicines so you can compare prices for each one. Here is the publication: The Oral Diabetes Drugs: Comparing Effectiveness, Safety, and Price

Other links to check out:

Diabetes Overview from The National Institute of Diabetes and Digestive and Kidney Diseases

Take Steps to Prevent Type 2 Diabetes from the Office of Disease Prevention and Health Promotion

For those interested in alternative therapies:

Diabetes and CAM: A Focus on Dietary Supplements

Complementary and Alternative Medical Therapies for Diabetes

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