About Type 2 Diabetes

Type 2 diabetes is also referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult onset diabetes mellitus (AODM).

Type 2 diabetes is characterized by high levels of blood sugar, caused by the body's inability to utilize insulin to move blood sugar into the cells for energy. In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin.

A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells). In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. High plasma levels of insulin and glucose due to insulin resistance often lead to metabolic syndrome and type 2 diabetes, including its complications.

Diabetes is a major cause of heart disease and stroke, as well as the most common cause of blindness, kidney failure and amputations in U.S. adults. 

Statistics

Type 2 diabetes affects nearly 21 million in the United States and nearly 200 million people worldwide.

Diabetes is a major cause of heart disease and stroke, as well as the most common cause of blindness, kidney failure and amputations in U.S. adults.

Total Prevalence of Diabetes Among People Aged 20 Years or Older, United States, 2005

• Age 20 years or older: 20.6 million; 9.6 percent of all people in this age group have diabetes .
• Age 60 years or older: 10.3 million; 20.9 percent of all people in this age group have diabetes .
• Men: 10.9 million; 10.5 percent of all men aged 20 years or older have diabetes .
• Women: 9.7 million; 8.8 percent of all women aged 20 years or older have diabetes. 

Risk Factors
For the first time in the history of humans, type 2 diabetes is now more common than type 1 diabetes in childhood.  Here are the common risk factors:

Genetics

Several studies have been conducted in recent years taking a comprehensive look at genetic risk factors for type 2 diabetes. To date 16 genetic variants associated with increased risk of diabetes has been confirmed.

Obesity

While there is a strong genetic component to developing this form of diabetes, there are other risk factors - the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true in children as well as adults. It is estimated that the chance to develop diabetes doubles for every 20% increase over desirable body weight.

Lack of exercise

Inactivity promotes type 2 diabetes. Every two hours you spend watching TV instead of pursuing something more active increases the changes of developing diabetes by 14% (source: Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity

and type 2 diabetes mellitus in women. JAMA 2003; 289:1785-91.). Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose. This puts less stress on your insulin-making cells. Studies suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30%. (source: Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999; 282:1433-9.). The amount of exercise has a variety of other benefits as well. Even greater cardiovascular and other benefits can be attained by more, and more intense, exercise.

Age

While it is said that type 2 diabetes occurs mostly in individuals over 30 years old and the incidence increases with age, there happens to be an increasing number of teens contracting the disease as a direct result of: poor eating habits, higher body weight and lack of exercise.

Data also shows that for each decade after 40 years of age regardless of weight there is an increase in incidence of diabetes. The prevalence of diabetes in persons 65 to 74 years of age is nearly 20%.

Ethnicity

Type 2 diabetes is also more common in certain ethnic groups.

Total Prevalence of Diabetes by Race/Ethnicity Among People Aged 20 Years or Older, United States, 2005

• Non-Hispanic whites: 13.1 million; 8.7 percent of all non-Hispanic whites aged 20 years or older have diabetes.
• Non-Hispanic blacks: 3.2 million; 13.3 percent of all non-Hispanic blacks aged 20 years or older have diabetes. After adjusting for population age differences, non-Hispanic blacks are 1.8 times as likely to have diabetes as non-Hispanic whites of similar age.
• Hispanic/Latino Americans: After adjusting for population age differences, Mexican Americans, the largest Hispanic/Latino subgroup, are 1.7 times as likely to have diabetes as non-Hispanic whites. If the prevalence of diabetes among Mexican Americans was applied to the total Hispanic/Latino population, about 2.5 million (9.5 percent) Hispanic/Latino Americans aged 20 years or older would have diabetes. Sufficient data are not available to derive estimates of the total prevalence of diabetes (both diagnosed and undiagnosed diabetes) for other Hispanic/Latino groups. However, residents of Puerto Rico are 1.8 times as likely to have diagnosed diabetes as non-Hispanic whites in the United Sates.
• American Indians and Alaska Natives who receive care from the Indian Health Service (IHS): 99,500; 12.8 percent of American Indians and Alaska Natives aged 20 years or older who received care from the Indian Health Service (IHS) in 2003 had diagnosed diabetes. Applying the rate of undiagnosed diabetes in the total U.S. population to the American Indians and Alaska Natives who receive care from IHS gives an estimate of 118,000 (15.1 percent) American Indians and Alaska Natives aged 20 years or older with diabetes (both diagnosed and undiagnosed diabetes). After adjusting for population age differences, the total prevalence of diabetes in this group is lowest among Alaska Natives (8.1 percent) and highest among American Indians in the southern United States (26.7 percent) and in southern Arizona (27.6 percent). Taking into account population age differences, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites.
• Asian Americans and Native Hawaiian or other Pacific Islanders: The total prevalence of diabetes (both diagnosed and undiagnosed diabetes) is not available for Asian Americans or Pacific Islanders. In Hawaii, however, Asians, Native Hawaiians, and other Pacific Islanders aged 20 years or older are more than 2 times as likely to have diagnosed diabetes as whites after adjusting for population age differences. Similarly in California, Asians were 1.5 times as likely to have diagnosed diabetes as non-Hispanic whites. Other groups within these populations also have increased risk for diabetes.

Gender

Diabetes occurs much more frequently in women with a prior history of diabetes that develops during pregnancy.

Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 25-50% of women with gestational diabetes will eventually develop Type 2 diabetes later in life, especially in those who require insulin during pregnancy and those who remain overweight after their delivery.

Prevention
The good news is that type 2 diabetes is largely preventable. About 9 cases in 10 could be avoided by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet , and not smoking. 

Exercise

Studies suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30%. (source: Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999; 282:1433-9.).

Control your weight. Excess weight is the single most important cause of type 2 diabetes. Being overweight increases the chances of developing type 2 diabetes seven-fold. Being obese makes you 20 to 40 times more likely to develop diabetes than someone with a healthy weight. Losing weight can help if your weight is above the healthy-weight range. Losing 7-10% of your current weight can cut in half your chances of developing type 2 diabetes. 

Eat Healthy

Choose whole grains and whole-grain products over highly processed (high glycemic) carbohydrates. White bread, white rice, mashed potatoes, donuts, bagels, and many breakfast cereals are high glycemic carbohydrates . This means that they cause sustained spikes in blood sugar and insulin levels. A proper diet would include fibrous carbohydrates and other carbohydrates that are low glycemic. Low glycemic carbs aren't as easily digested and cause lower, slower increases in blood sugar and insulin. As a result, low glycemic carbs cause less stress on the body's insulin-making machinery and help prevent type 2 diabetes. Low glycemic foods include whole wheat, brown rice, other whole grains, most beans and nuts, and whole grain breakfast cereals.

Avoid Bad Fats.

Bad fats (trans fats) are found in many margarines, packaged baked goods, fried foods in most fast-food restaurants, and any product that lists "partially hydrogenated vegetable oil" on the label. 

Choose good fats instead of bad fats.

The types of fats in your diet can also affect the development of diabetes. Good fats, such as the polyunsaturated fats found in tuna, salmon, liquid vegetable oils, and many nuts, can help ward off type 2 diabetes. 

If you smoke, try to quit.

Smokers are 50% to 90% more likely to develop diabetes than nonsmokers.
 

Watch the Alcohol

The key is to keep alcohol consumption in the moderate range. 

Consider Supplements

There are natural supplements that may aid in controlling your blood sugar. These include alpha-lipoic acid, chromium, magnesium, cinnamon, as well the following herbs: gymnema, and fenugreek.

Alpha-Lipoic Acid

Above normal levels of blood glucose are one cause of oxidative stress. It is believed that alpha-lipoic acid should be beneficial due to its antioxidant abilities. There have been some small studies in animals and in people showing some beneficial results. The concern to understand is that someone with diabetes needs to be aware that an alpha-lipoic acid supplement could lower blood sugar a great deal. So you'd want to pay careful attention to your blood sugar level. Alpha-lipoic acid might also reduce blood concentrations of some minerals (iron) and can interfere with some medicines (such as antacids), and due to its antioxidant capabilities it might diminish the effectiveness of some anticancer drugs.

Chromium

Chromium is often sold in the form of chromium picolinate, and chromium polynicotinate. Chromium can add to insulin and have lowering effects on blood sugar.

Magnesium

Popular  of this mineral include Calcium-Magnesium-Zinc tablets and liquid forms of magnesium. Magnesium is involved in muscle function and helps the heart, nerves, and making proteins. Those with diabetes commonly have reduced levels of magnesium. Low magnesium levels might make glucose control worse in type II diabetes and might contribute to further complications. There is some evidence that magnesium supplementation might be helpful for insulin resistance.

Cinnamon.

Of all the spices, cinnamon is one of the richest sources of antioxidants. Studies that have tested cinnamon on people with type 2 diabetes have found that as little as 1/4 teaspoon of cinnamon a day can help lower the risk of factors associated with metabolic syndrome - high blood cholesterol, triglyceride and glucose levels - by as much as 10 to 30 percent. Having metabolic syndrome puts you at increased risk for type 2 diabetes and heart disease. A recent lab study by Richard Anderson, a scientist with the USDA in Beltsville, Md. found that the antioxidants in cinnamon increase the amounts of three key proteins that are important in insulin signaling, glucose transport and inflammatory response.

Gymnema

Reduces the effect on the pancreases cells, Raises insulin levels in the body. In some cases decreasing insulin needs. Known to lower blood sugar levels, (triglycerides). Well known as the destroyer of sugar cravings, effective for up to 3 hours. In type 2 diabetes, helps improve insulin effect.

Fenugreek

Fenugreek has shown to reduce blood sugar levels. Blood sugar levels tend to remain more stable and improves glucose tolerance and excretion of glucose in the urine.  

Prevention of Diabetes Complications

Diabetes can affect many parts of the body and can lead to serious complications such as blindness, kidney damage, and lower-limb amputations. If you already have diabetes there are things that can be to reduce the occurrence of diabetes complications. Examples include:

Glucose control

Studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results (e.g., from 8 to 7 percent) reduces the risk of microvascular complications (eye, kidney, and nerve disease) is reduced by 40 percent.

Blood pressure control

Blood pressure control reduces the risk of cardiovascular disease (heart disease or stroke) among persons with diabetes by 33 to 50 percent, and the risk of microvascular complications (eye, kidney, and nerve disease) by about 33 percent. In general, for every 10 mm Hg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12  percent.

Control of blood lipids

Improved control of cholesterol or blood lipids (for example, HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20 to 50 percent.

Preventive care practices for eyes, kidneys, and feet

Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent, while comprehensive foot care programs can reduce amputation rates by 45 to 85 percent. Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30 to 70 percent. Treatment with ACE inhibitors and angiotensin receptor blockers (ARBs) are more effective in reducing the decline in kidney function than other blood pressure-lowering drugs.

The Bottom line

They key to preventing type 2 diabetes and the complications to your health that it can cause is very simple: stay lean and stay active and live a healthy life.

Author Disclaimer: The information contained herein s not intended to replace medical advice. It is ideal to see your doctor for any medical questions or concerns you may have regarding your health, especially if you are taking prescription medications and are considering any alternative remedies.