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What is Type 2 Diabetes?

By Laurie Marbas, M.D. ; Updated August 14, 2017

Type 2 diabetes is also known as Type 2 diabetes mellitus. Type 2 diabetes accounts for more than 90 percent of all diabetics. It’s a metabolic disorder that hinders your body’s utilization of blood sugars. Most of the food we eat breaks down into glucose (also known as blood sugar). Every cell in the body requires glucose to function normally. However, glucose cannot enter the cell without insulin, a hormone released by the pancreas. Insulin acts like a key that unlocks the door that allows glucose to go from the blood into the cell. When there is not enough insulin or the body is not responding well to it, glucose (blood sugar) is no longer allowed into cells, thereby increasing concentrations of sugar in the blood.

Evolution of Type 2 Diabetes

Type 2 diabetes takes several years to develop and is usually diagnosed after a long, asymptomatic course. About 85 percent of diabetics are obese, and insulin resistance (when cells no longer respond to insulin) is typically present, causing high levels of insulin to circulate throughout the body. Insulin tells the body to store fat and sends signals to the brain that you are hungry.

Symptoms are usually much milder in Type 2 diabetes than in Type 1 diabetes upon presentation, but complications are common and increase in prevalence when blood sugar control is poor. Screening for complications begins at diagnosis because the disease development occurs over years, so damage may have already been done.

The Rise of Type 2 Diabetes in Children

Over the past 20 years there has been a tenfold increase in incidence of Type 2 diabetes in children because of the increase of obesity, lack of exercise and the consumption of nutrient-poor foods. About 208,000 Americans under age 20 are estimated to have diagnosed diabetes. This accounts for approximately one in four individuals of that population.

Type 2 Diabetes Is Associated With Other Medical Conditions

Type 2 diabetes is often associated with hypertension or high blood pressure and lipid abnormalities, such as an elevated total cholesterol and increased low-density lipoprotein (LDL). LDL is known as the “bad” cholesterol because it gathers on the walls of blood vessels, creating blockages and increasing risks for heart attack and strokes. Every five minutes two people die of diabetes-related causes and 14 adults are newly diagnosed.

The American Diabetes Association (ADA) Management Goals

The ADA has set management goals for Type 2 diabetics. You and your doctor should be working toward these goals and altering them if necessary to account for your personal needs and circumstances.

1) Hemoglobin A1c should be less than 7 percent. Exceptions: Goal should be less than 6.5 percent for those with a new Type 2 diabetes diagnosis and who have a long life expectancy, or less than 8 percent for longstanding diabetes, advanced complications or limited life expectancy, such as the elderly. The hemoglobin A1c should be monitored every three to six months.

2) Hypoglycemia, or very low blood sugar, should be limited. Those with a history of hypoglycemia have an increased risk of future episodes and mortality.

3) Blood pressure should be less than 140/80 mm Hg, but less than 130/80 is preferred.

4) Low-density lipoprotein, or LDL cholesterol, should be less than 100 mg/dL. In Type 2 diabetics with known cardiovascular disease, the goal should be less than 70 mg/dL. If this LDL goals cannot be met, a reduction of 30 to 40 percent should be the goal.

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