Type 2 Diabetes

by Karen Schroeder Kassel, MS, RD, MEd

Type 2 diabetes is primarily a disorder in which the cells in the body are not responding to the high levels of insulin (insulin resistance). In end-stage type 2 diabetes, the beta cells of the pancreas are not producing enough insulin.

Insulin is a hormone normally produced by the pancreas. This hormone helps your body convert food into energy. Without insulin, glucose (sugar) from the food you eat cannot enter cells, and glucose builds up in the blood. Your body tissues become starved for energy.

The Pancreas

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Type 2 diabetes, which was formerly called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. Of the nearly 23 million Americans with diabetes, 70%-95% have type 2 diabetes. People usually develop type 2 diabetes after age 45, but it can occur at any age—even during childhood.

In recent years, there has been an increase in the number of cases of type 2 diabetes diagnosed in children and adolescents. This has been blamed, in part, on the increase in childhood overweight problems and obesity, resulting from poor eating habits and sedentary lifestyles.

Type 2 diabetes occurs because either one or both of the following conditions exist:

• The beta cells in the pancreas do not make enough insulin relative to the demands of the body.
• The fat, muscle, or liver cells do not respond to the high levels of insulin (called insulin resistance).

Being overweight or obese, especially in the abdominal area (central obesity), is the primary cause of insulin resistance and increases the chance of developing type 2 diabetes.

The key to minimizing complications is keeping your blood sugar level within a healthy range. When your blood sugar level is not within the ideal range, you can experience the following problems:

In the short-term:

• High blood sugar, called hyperglycemia
• Low blood sugar, called hypoglycemia

In the long-term:

• Blindness
• Kidney disease
• Heart disease
• Stroke
• Nerve disease, which can cause numbness, pain, or altered sensation such as a burning feeling in the legs and feet
• Loss of limbs, when amputations are needed because of infection, poor circulation, or nerve disease
• Impotence

REFERENCES:

American Diabetes Association website. Available at: http://www.diabetes.org . Accessed February 8, 2006.

National diabetes statistics, 2007. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/DM/PUBS/statistics/ . Published June 2008. Accessed June 12, 2009.

National Institute of Diabetes and Digestive and Kidney Diseases. National Institutes of Health website. Available at: http://www.niddk.nih.gov/ . Accessed February 8, 2006.

Rosenbloom aL, Silverstein JH, Amemiya S et al: ISPAD Clinical Practice Consensus Guideline 2006-2007. Type 2 diabetes mellitus in the child and adolescent. Pediatr Diabeetes. 2008;9:512-26.

Rosenzweig JL, Ferrannini E, Grundy SM et al: Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93:3671-89

Skyler JS, Bergenstal R, Bonow RO et al: Intensive glycemic control and the prevention of cardiovascular events: Implications of the ACCORD, ADVANCE and VA diabetes trials: a position statement of the American Diabetes association and a scientific statement of the American College of Cardiology Foundation and the American Heart Assocaition. Circulation. 2009;119:351-7.

U.S. Preventive Services Task Force: Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services tAsk Force recommendation statement. Ann Intern Med. 2008;148:846-54.

Last reviewed February 2009 by David Juan, MD
Last Updated: 6/12/2009