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Type 2 diabetes information


Type 2 diabetes
Other namesDiabetes mellitus type 2;
adult-onset diabetes;[1]
noninsulin-dependent diabetes mellitus (NIDDM)
A blue circle is the universal symbol of diabetes.[2]
Pronunciation
  • /dəbtəs/
SpecialtyEndocrinology
SymptomsIncreased thirst, frequent urination, unexplained weight loss, increased hunger[3]
ComplicationsHyperosmolar hyperglycemic state, diabetic ketoacidosis, heart disease, strokes, diabetic retinopathy, kidney failure, amputations[1][4][5]
Usual onsetMiddle or older age[6]
DurationLong term[6]
CausesObesity, lack of exercise, genetics[1][6]
Diagnostic methodBlood test[3]
PreventionMaintaining normal weight, exercising, healthy diet[1]
TreatmentDietary changes, metformin, insulin, bariatric surgery[1][7][8][9]
Prognosis10 year shorter life expectancy[10]
Frequency392 million (2015)[11]

Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, fatigue and unexplained weight loss.[3] Symptoms may also include increased hunger, having a sensation of pins and needles, and sores (wounds) that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5]

Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are genetically more at risk than others.[6]

Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to type 1 diabetes and gestational diabetes.[1] In type 1 diabetes there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3]

Type 2 diabetes is largely preventable by staying at a normal weight, exercising regularly, and eating a healthy diet (high in fruits and vegetables and low in sugar and saturated fats).[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels (such as through a continuous glucose monitor) is advised; however, this may not be needed in those who are not on insulin therapy.[15] Bariatric surgery often improves diabetes in those who are obese.[8][16]

Rates of type 2 diabetes have increased markedly since 1960 in parallel with obesity.[17] As of 2015 there were approximately 392 million people diagnosed with the disease compared to around 30 million in 1985.[11][18] Typically it begins in middle or older age,[6] although rates of type 2 diabetes are increasing in young people.[19][20] Type 2 diabetes is associated with a ten-year-shorter life expectancy.[10] Diabetes was one of the first diseases ever described, dating back to an Egyptian manuscript from c. 1500 BCE.[21] The importance of insulin in the disease was determined in the 1920s.[22]

  1. ^ a b c d e f g h i j Cite error: The named reference WHO2015 was invoked but never defined (see the help page).
  2. ^ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17 March 2006. Archived from the original on 5 August 2007.
  3. ^ a b c d e "Diagnosis of Diabetes and Prediabetes". National Institute of Diabetes and Digestive and Kidney Diseases. June 2014. Archived from the original on 6 March 2016. Retrieved 10 February 2016.
  4. ^ a b Pasquel FJ, Umpierrez GE (November 2014). "Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment". Diabetes Care. 37 (11): 3124–31. doi:10.2337/dc14-0984. PMC 4207202. PMID 25342831.
  5. ^ a b Fasanmade OA, Odeniyi IA, Ogbera AO (June 2008). "Diabetic ketoacidosis: diagnosis and management". African Journal of Medicine and Medical Sciences. 37 (2): 99–105. PMID 18939392.
  6. ^ a b c d e f g "Causes of Diabetes". National Institute of Diabetes and Digestive and Kidney Diseases. June 2014. Archived from the original on 2 February 2016. Retrieved 10 February 2016.
  7. ^ a b Maruthur NM, Tseng E, Hutfless S, Wilson LM, Suarez-Cuervo C, Berger Z, et al. (June 2016). "Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 164 (11): 740–51. doi:10.7326/M15-2650. PMID 27088241. S2CID 32016657.
  8. ^ a b Cetinkunar S, Erdem H, Aktimur R, Sozen S (June 2015). "Effect of bariatric surgery on humoral control of metabolic derangements in obese patients with type 2 diabetes mellitus: How it works". World Journal of Clinical Cases. 3 (6): 504–9. doi:10.12998/wjcc.v3.i6.504. PMC 4468896. PMID 26090370.
  9. ^ a b Krentz AJ, Bailey CJ (February 2005). "Oral antidiabetic agents: current role in type 2 diabetes mellitus". Drugs. 65 (3): 385–411. doi:10.2165/00003495-200565030-00005. PMID 15669880. S2CID 29670619.
  10. ^ a b Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. (2011). Williams textbook of endocrinology (12th ed.). Philadelphia: Elsevier/Saunders. pp. 1371–1435. ISBN 978-1-4377-0324-5.
  11. ^ a b Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  12. ^ MacKay I, Rose N, eds. (2014). The Autoimmune Diseases. Academic Press. p. 575. ISBN 978-0-12-384929-8. OCLC 965646175.
  13. ^ Gardner DG, Shoback D, eds. (2011). "Chapter 17: Pancreatic hormones & diabetes mellitus". Greenspan's basic & clinical endocrinology (9th ed.). New York: McGraw-Hill Medical. ISBN 978-0-07-162243-1. OCLC 613429053.
  14. ^ Saenz A, Fernandez-Esteban I, Mataix A, Ausejo M, Roque M, Moher D (July 2005). Saenz A (ed.). "Metformin monotherapy for type 2 diabetes mellitus". The Cochrane Database of Systematic Reviews (3): CD002966. doi:10.1002/14651858.CD002966.pub3. PMID 16034881. (Retracted)
  15. ^ Malanda UL, Welschen LM, Riphagen II, Dekker JM, Nijpels G, Bot SD (January 2012). "Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin". The Cochrane Database of Systematic Reviews. 1: CD005060. doi:10.1002/14651858.CD005060.pub3. hdl:1871/48558. PMID 22258959. S2CID 205176936.
  16. ^ Ganguly S, Tan HC, Lee PC, Tham KW (April 2015). "Metabolic bariatric surgery and type 2 diabetes mellitus: an endocrinologist's perspective". Journal of Biomedical Research. 29 (2): 105–11. doi:10.7555/JBR.29.20140127. PMC 4389109. PMID 25859264.
  17. ^ Moscou S (2013). "Getting the word out: advocacy, social marketing, and policy development and enforcement". In Truglio-Londrigan M, Lewenson SB (eds.). Public health nursing: practicing population-based care (2nd ed.). Burlington, MA: Jones & Bartlett Learning. p. 317. ISBN 978-1-4496-4660-8. OCLC 758391750.
  18. ^ Smyth S, Heron A (January 2006). "Diabetes and obesity: the twin epidemics". Nature Medicine. 12 (1): 75–80. doi:10.1038/nm0106-75. PMID 16397575. S2CID 1042625.
  19. ^ Tfayli H, Arslanian S (March 2009). "Pathophysiology of type 2 diabetes mellitus in youth: the evolving chameleon". Arquivos Brasileiros de Endocrinologia e Metabologia. 53 (2): 165–74. doi:10.1590/s0004-27302009000200008. PMC 2846552. PMID 19466209.
  20. ^ Imperatore G, Boyle JP, Thompson TJ, Case D, Dabelea D, Hamman RF, et al. (December 2012). "Projections of type 1 and type 2 diabetes burden in the U.S. population aged <20 years through 2050: dynamic modeling of incidence, mortality, and population growth". Diabetes Care. 35 (12): 2515–20. doi:10.2337/dc12-0669. PMC 3507562. PMID 23173134.
  21. ^ Leutholtz BC, Ripoll I (2011). "Diabetes". Exercise and disease management (2nd ed.). Boca Raton: CRC Press. p. 25. ISBN 978-1-4398-2759-8. OCLC 725919496.
  22. ^ Zaccardi F, Webb DR, Yates T, Davies MJ (February 2016). "Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective". Postgraduate Medical Journal. 92 (1084): 63–9. doi:10.1136/postgradmedj-2015-133281. PMID 26621825. S2CID 28169759.

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