Diabetes Mellitus Type II
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Diabetes
NIH - Medical Encyclopedia Diabetes
"Type 2 diabetes is far more common than type 1 and makes up 90% or more of all cases of diabetes. It usually occurs in adulthood. Here, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise. … Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and/or oral medications. … Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity, because when their ideal weight is reached, their own insulin and a careful diet can control their blood glucose levels."
Highlighted ArticleWalking for exercise--does three times per week influence risk factors in type 2 diabetes? (Diabetes Res Clin Pract. 2006)
"Our results suggest that an increase of regular physical activity equivalent to 45 min of walking 3 days/week may suffice to improve systolic and diastolic blood pressure, lipid metabolism and BMI in patients with type 2 diabetes."
Notes
The Guidelines section will contain the 2006 and certain 2005 updated published guidelines. To view Guidelines from previous years, view year 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).
Diabetes Mellitus Type 2
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Device Therapy
Insulin pumps improve diabetes control
Drug Side-Effects and Interactions
Risk Factors of Vitamin B12 Deficiency in Patients Receiving Metformin (Arch Intern Med. 2006) "Conclusions Our results indicate an increased risk of vitamin B12 deficiency associated with current dose and duration of metformin use despite adjustment for many potential confounders. The risk factors identified have implications for planning screening or prevention strategies in metformin-treated patients."
Risk Factors of Vitamin B12 Deficiency in Patients Receiving Metformin (Arch Intern Med. 2006) "Conclusions Our results indicate an increased risk of vitamin B12 deficiency associated with current dose and duration of metformin use despite adjustment for many potential confounders. The risk factors identified have implications for planning screening or prevention strategies in metformin-treated patients."
Type 2 Diabetics Who Use Insulin at Increased Risk for Hypertension "Patients taking pharmacologic dosages of insulin 'may be repetitively exposed to high concentrations of insulin,' Dr. Tseng explains. 'This excess of insulin may exert detrimental effects on the vascular system, leading to elevated blood pressure.' "
FDA - Avandia and Diabetic Macular Edema
FDA - Rosiglitazone Linked to Macular Edema
Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: There is no evidence from prospective comparative trials or from observational cohort studies that metformin is associated with an increased risk of lactic acidosis, or with increased levels of lactate, compared to other anti-hyperglycemic treatments if prescribed under the study conditions."
Rosiglitazone Linked to New/Worsening Macular Edema ". new onset or worsening macular edema in patients receiving rosiglitazone maleate. . Rosiglitazone is currently available for use alone (Avandia) or in combination with metformin HCl (Avandamet); a recently approved formulation of rosiglitazone plus glimepiride (Avandaryl) will also be marketed in the near future. All 3 products are indicated for use as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus."
Drugs
[Oral antidiabetic therapy.] (Dtsch Med Wochenschr. 2006)
Long-term Safety of Pioglitazone versus Glyburide in Patients with Recently Diagnosed Type 2 Diabetes Mellitus (Pharmacotherapy. 2006)
Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy (NEJM 2006)
Drug unlikely to slow type 2 diabetes progression "Treating 'postprandial hyperglycemia' -- the spike in blood sugar that occur after meals -- with the drug Precose (also known as acarbose) does not delay the progression of early type 2 diabetes, according to a study."
Inhaled Insulin Approved by FDA
Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature (2005)
Exercise
Effects of moderate-intensity exercise training on plasma biomarkers of inflammation and endothelial dysfunction in older patients with type 2 diabetes. (Nutr Metab Cardiovasc Dis. 2006) "CONCLUSIONS: A twice-weekly, 6-month, progressive aerobic-training programme, without a concomitant weight loss diet, is associated with significant decreases in circulating P-selectin and ICAM-1 levels and with a less atherogenic lipid profile in overweight, non-smoking, older type 2 diabetic individuals."
Diabetes control maintained with exercise training "Resistance training at a community center is helpful for maintaining control of blood sugar levels in adults with type 2 diabetes, an Australian study suggests."
Exercise and diabetes. (cta Biomed Ateneo Parmense. 2006) "Long-term effects of regular exercise are particularly advantageous for type 2 diabetic patients. Regular aerobic exercise reduces of visceral fat mass and body weight without decreasing lean body mass, ameliorates insulin sensitivity, glucose and blood pressure control, lipid profile and reduces the cardiovascular risk. For these reasons, regular aerobic physical activity must be considered an essential component of the cure of type 2 diabetes mellitus. In this regard, individual behavioral strategies have been documented to be effective in motivating sedentary type 2 diabetic subjects to the adoption and the maintenance of regular physical activity."
Exercise for type 2 diabetes mellitus. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: The meta-analysis shows that exercise significantly improves glycaemic control and reduces visceral adipose tissue and plasma triglycerides, but not plasma cholesterol, in people with type 2 diabetes, even without weight loss."
Exercise plus med improves diabetes control
New Recommendations Regarding Exercise and Type 2 Diabetes Issued
Effect of a diet and exercise intervention on oxidative stress, inflammation and monocyte adhesion in diabetic men. (Diabetes Res Clin Pract. 2006) "A combination of diet and exercise ameliorates oxidative stress, inflammation, and monocyte-endothelial interaction. Intensive lifestyle modification may improve novel CAD risk factors in men with diabetes."
Exercise training and the antioxidant alpha-lipoic acid in the treatment of insulin resistance and type 2 diabetes. (Free Radic Biol Med. 2006) "These studies highlight the effectiveness of combining endurance exercise training and antioxidants in beneficially modulating the molecular defects in insulin action observed in insulin-resistant skeletal muscle."
Physical Activity and Life Expectancy With and Without Diabetes (Diabetes Care 2006)
Walking for exercise: does three times per week influence risk factors in type 2 diabetes? (Diabetes Research and Clinical Practice 2006)"Our results suggest that an increase of regular physical activity equivalent to 45 min of walking 3 days/week may suffice to improve systolic and diastolic blood pressure, lipid metabolism and BMI in patients with type 2 diabetes."
Exercise training and the antioxidant alpha-lipoic acid in the treatment of insulin resistance and type 2 diabetes. (Free Radic Biol Med. 2006) "These studies highlight the effectiveness of combining endurance exercise training and antioxidants in beneficially modulating the molecular defects in insulin action observed in insulin-resistant skeletal muscle."
General Information
Treatment and control of blood pressure in patients with diabetes mellitus (American Journal of Health-System Pharmacy 2006)
The role of the family physician in the diagnosis and treatment of type 2 diabetes mellitus. (J Fam Pract. 2006)
Early intervention to achieve optimal outcomes in type 2 diabetes: A case presentation. (lin Cornerstone. 2006)
Diabetics who control blood sugar today are more likely to have healthy feet and nerves tomorrow "Two-thirds of all people with diabetes have some degree of nerve problems, or neuropathy, related to their diabetes. The most common sign is numbness or pain in the feet and legs, which can progress over time to cause disability. Neuropathy plays a major role in 80,000 foot and leg amputations in American diabetics each year. . the results reinforce a key message for all of today's diabetes patients, though Type 2 diabetics tend to have other health problems that can interfere with the protective effects of tight sugar control. That message: Check your blood sugar levels regularly, and take steps to keep them under tight control, with few extremes of low or high sugar."
Management of Type 2 Diabetes in the Primary Care Setting: A Practice-Based Research Network Study (Annals of Family Medicine 2006) ". Despite the intensity of diabetes care being provided, only a modest number (40.5%) of patients actually achieved the established target for glycemic control ."
In the Treatment of Diabetes, Success Often Does Not Pay
Guidelines
Standards of Medical in Diabetes - 2006
NGC - Management of diabetes mellitus. (2006)
NGC - Adult diabetes clinical practice guidelines. (2005)
MOH - Diabetes Mellitus Clinical Practice Guideline (2006)
New Guidelines for Management of Hyperglycemia of Type 2 Diabetes "To meet the goal of achieving and maintaining glucose levels close to the nondiabetic range, the guidelines and treatment algorithm emphasize initial therapy with lifestyle intervention and metformin; rapid addition of medications, and transition to new regimens, when target glycemic goals are not achieved or sustained; and early addition of insulin therapy in patients who do not meet these target goals."
Diabetic peripheral neuropathic pain: Consensus guidelines for treatment. (J Fam Pract. 2006)
NGC - Guidance on the use of glitazones for the treatment of type 2 diabetes. (2003 (2006 Alert))
NGC - Standards of medical care in diabetes. V. Diabetes care. (2006)
Immunotherapy
Internet Sites
Treatment Information
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. (Diabetes Care. 2006) "CONCLUSIONS: Both a low-fat vegan diet and a diet based on ADA guidelines improved glycemic and lipid control in type 2 diabetic patients. These improvements were greater with a low-fat vegan diet."
Vegan diet reverses diabetes symptoms, study finds "People who ate a low-fat vegan diet, cutting out all meat and dairy, lowered their blood sugar more and lost more weight than people on a standard American Diabetes Association diet ."
Low-Carb Diet Has Lasting Benefits in Obese Type 2 Diabetics
A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes. A case report. (Nutr Metab (Lond). 2006)
Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycemic control during 22 months follow-up (Nutrition & Metabolism 2006) "Conclusion Advice on a 20 % carbohydrate diet with some caloric restriction to obese patients with type 2 diabetes has lasting effect on bodyweight and glycemic control."
Overweight, Obesity & Weight Loss
Other
Other Treatments
Periodontal therapy may help diabetic patients improve sugar control
Experimental
Radiotherapy
Supplements-Vitamins-CAM
Herbs, Vitamins, and More for Diabetes
Effects of melatonin and zinc on glycemic control in type 2 diabetic patients poorly controlled with metformin. (Saudi Med J. 2006) "CONCLUSION: The combination of melatonin and zinc acetate, when used alone or in combination with metformin improves fasting and post-prandial glycemic control in T2DM patients."
Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials (Diabetic Medicine 2006) "Conclusions Oral magnesium supplementation for 4–16 weeks may be effective in reducing plasma fasting glucose levels and raising HDL cholesterol in patients with Type 2 diabetes, although the long-term benefits and safety of magnesium treatment on glycaemic control remain to be determined."
Effects of n-3 fatty acids in subjects with type 2 diabetes: reduction of insulin sensitivity and time-dependent alteration from carbohydrate to fat oxidation. (Am J Clin Nutr. 2006)
Chromium may help control diabetes
Magnesium and diabetes mellitus: Their relation (Clinical Nutrition 2006) " . the supplementation with magnesium has been suggested in patients with diabetes mellitus who have proven hypomagnesemia and the presence of its complications."
Antiglycation properties of aged garlic extract: possible role in prevention of diabetic complications. (J Nutr. 2006)
People with Diabetes Often Use Alternative And Normal Therapy
Surgery
Transplantation
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