Diabetes Mellitus Type II
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Diabetes
NIH - Diabetes (Medical Encyclopedia) 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."
NHS - Diabetes: the facts “Symptoms of diabetes The symptoms of both type 1 and type 2 diabetes include: • Increased thirst, and drinking a lot of fluids. • Passing a lot of urine. • Being tired for no reason. • Weight loss. • Genital itching or repeated bouts of thrush. • Slow healing of wounds. • Blurred vision. In type 1 diabetes, symptoms will typically develop over a few weeks and quickly become very obvious. In type 2, symptoms can develop more slowly, over a period of months. Some people with type 2 diabetes have only very mild symptoms, which they believe have other causes. A few people may have no symptoms at all. … Types of diabetes There are two main types of diabetes. • Type 1: in this type, the body can't produce any insulin. This type of diabetes usually occurs before age 40, and accounts for only around 10% of all cases. But it is the most common form of childhood diabetes. • Type 2: this is where the body doesn't make enough insulin, or where the body builds up a resistance to insulin so that it doesn't work effectively. It's the most common form of diabetes (90% of all cases), and is frequently linked with being overweight. One in 10 people in the UK will eventually develop type 2 diabetes.”
Highlighted Articles
Diabetes Seems to Heighten Glaucoma Risk: Regular screenings may help prevent irreversible nerve damage (2008) "A recent study in the journal Ophthalmology found that women with diabetes have about a 70 percent increased risk of developing the most common form of glaucoma -- primary open-angle glaucoma -- compared to women without diabetes."
Researchers report periodontal disease independently predicts new onset diabetes (2008) “These data add a new twist to the association and suggest that periodontal disease may be there before diabetes," said Ryan T. Demmer, PhD, MPH, associate research scientist in the Department of Epidemiology at the Mailman School of Public Health and lead author. "We found that over two decades of follow-up, individuals who had periodontal disease were more likely to develop Type 2 diabetes later in life when compared to individuals without periodontal disease." “
Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women (Diabetes Care 2008) “CONCLUSIONS—Consumption of green leafy vegetables and fruit was associated with a lower hazard of diabetes, whereas consumption of fruit juices may be associated with an increased hazard among women.”
Diabetic Neuropathy--A Review (Nat Clin Pract Neurol. 2007) "Diabetic neuropathy is the most common neuropathy in industrialized countries, and it is associated with a wide range of clinical manifestations. The vast majority of patients with clinical diabetic neuropathy have a distal symmetrical form of the disorder that progresses following a fiber-length-dependent pattern, with sensory and autonomic manifestations predominating. This pattern of neuropathy is associated with a progressive distal axonopathy. Patients experience pain, trophic changes in the feet, and autonomic disturbances. Occasionally, patients with diabetes can develop focal and multifocal neuropathies that include cranial nerve involvement and limb and truncal neuropathies."
Adiposity Compared With Physical Inactivity and Risk of Type 2 Diabetes in Women (Diabetes Care 2007) "CONCLUSIONS—Obesity and physical inactivity independently contribute to the development of type 2 diabetes; however, the magnitude of risk contributed by obesity is much greater than that imparted by lack of physical activity."
Walking 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."
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Diabetes Mellitus Type II
General Information
NEWS:
10% Of Deaths In 20 To 79-Year-Olds Caused By Diabetes, UK “New figures¹ reveal that more than one in ten (11.6 per cent) deaths among 20 to 79-year-olds in England can be attributed to diabetes, warns leading health charity Diabetes UK. If current trends continue, one in eight (12.2 per cent) deaths among 20 to 79-year-olds will be attributable to the condition by 2010. This work is based on data that shows adults under 80 with diabetes are around twice as likely to die as those without the condition and women with diabetes have a greater increased risk of death compared to their male counterparts.”
Alcohol Intake May Be Inversely Linked With Risk for Type 2 Diabetes in Some Women
Associations between Sleep Loss and Increased Risk of Obesity and Diabetes. (Ann N Y Acad Sci. 2008)
Caffeine Increases Ambulatory Glucose and Postprandial Responses in Coffee Drinkers With Type 2 Diabetes (Diabetes Care 2008)
CDC: About 8 Percent of Americans Have Diabetes
Cinnamon does not control blood sugar or fat levels "Cinnamon does not appear to have any impact on blood sugar or cholesterol levels in people with diabetes, Connecticut-based researchers report in the journal Diabetes Care. "The preponderance of evidence currently available does not suggest that cinnamon has the ability to decrease a person's risk of heart disease by helping them control their diabetes or lower their cholesterol," Dr. Craig I. Coleman, of Hartford Hospital, who was the principal investigator, told Reuters Health. "
Diabetes advice for winter months (Ireland)
Diabetes diet: Guidelines for healthy eating with diabetes
Diabetes forcing many amputations "Around 100 people a week in the UK have a limb amputated as a result of diabetes, a charity has claimed. Diabetes UK highlighted the statistic to raise awareness of the "life-shattering" impact of the illness. People with diabetes are 15 times more likely to need a lower limb amputation than people without the condition."
Diabetes Increases Risk Of Tuberculosis, Studies Show
Diabetes Linked to Sleep Apnea
Diabetes Seems to Heighten Glaucoma Risk: Regular screenings may help prevent irreversible nerve damage "A recent study in the journal Ophthalmology found that women with diabetes have about a 70 percent increased risk of developing the most common form of glaucoma -- primary open-angle glaucoma -- compared to women without diabetes."
Diabetes Study Partially Halted After Deaths "For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday. The researchers announced that they were abruptly halting that part of the study, whose surprising results call into question how the disease, which affects 21 million Americans, should be managed. The study's investigators emphasized that patients should still consult with their doctors before considering changing their medications."
Diabetic Retinopathy May Predict Heart Failure
Fatty Foods and Memory Decline "The researchers believe fatty foods may lead to a mental decline because they can induce oxidative stress, a key factor in Alzheimer's disease and other memory problems. The vitamins may be helping to counteract those effects because of their antioxidant properties."
Impaired Ankle Function Seen in Diabetics: Study
Impaired Vision Twice As Common in Diabetics “People with visual impairment have abnormal vision even with the help of corrective lenses. Diabetes is a well-established risk factor, in large part due to a complication known as diabetic retinopathy -- an eye disease caused by damage to the tiny blood vessels supplying the retina. People with diabetes also have increased rates of glaucoma and cataracts, both of which can lead to vision loss.”
Largest Ever Study Of Diabetes Shows Intensive Glucose Control Reduces Serious Complications
Local diabetes researchers seek to unlock mysteries of vitamin D "Finnish babies born in the 1960s and raised on mega-doses of vitamin D had dramatically lower risk of developing type 1 diabetes, a serious autoimmune disease that requires lifelong injections of insulin. Was it a case of cause and effect? Seattle researchers are trying to find out. Despite suggestions from several studies in the past decade that vitamin D may offer strong protection against juvenile diabetes, none has shown conclusively that there's more than a chance association. . Vitamin D is thought to help suppress the immune response responsible for the attack on the insulin-making cells. But no one understands exactly how that happens, leading to lingering scientific skepticism about vitamin D's promise, said Christiane Hampe, a diabetes researcher at the University of Washington. What researchers do know is that vitamin D absorption -- both from sun's rays and supplements -- has fallen in recent decades. For instance, Finland, whose northern region gets just two hours of sun a day in December, has one of the world's highest reported rates of type 1 diabetes. Since 1964, the daily recommended dose for Finnish infants has been lowered three times, from at least 4,000 IU to one-tenth of that today, reflecting medicine's shift toward the minimum doses necessary. It is possible to go overboard with vitamin D supplements and trigger dangerous calcium deposits in the kidneys and blood vessels, but experts say it takes a lot: more than 10,000 IU a day for a year. "
Lung Capacity Declines Faster With Diabetes "Diabetes, the leading cause of heart disease, stroke, blindness, kidney failure and non-traumatic amputations, can also cause the lungs to deteriorate quicker than they normally do with age, a new study shows. Although everyone experiences a decline in lung function as they grow older, research published in the April issue of Diabetes Care concluded that the lungs of people with type 2 diabetes deteriorate more quickly than normal."
Mayo Researchers Look For Explanation Behind High Incidence Of Diabetes Among Asian Indians "The incidence of type 2 diabetes is rising, especially in urbanized parts of the world where sedentary lifestyles and obesity abound. In addition to weight and inactivity, race puts some people at increased risk for developing type 2 diabetes. The incidence of diabetes is rapidly increasing globally, and Asian Indians have the highest prevalence. An estimated 32 million Asian Indians have been diagnosed with this condition, and some experts expect this number to double over the next 30 years. In a study published in the March issue of Diabetes, Mayo researchers examined whether Asian Indians have observable differences in the way their cells convert nutrient fuel to available energy and whether these differences may increase the risk for diabetes. "We know that Asian Indians are highly susceptible to this condition, and they often acquire the disease at an earlier age and at lower body mass index than people of European origin," explains Mayo endocrinologist K. Sreekumaran Nair, M.D., Ph.D., the study's lead researcher. "The question we asked is whether any metabolic differences between Asian Indians and Americans of Northern European origin can explain the higher incidence of diabetes in Indians." "
More Than Half of US Diabetics Have Arthritis
One in Five Affluent Indians Have Type 2 Diabetes Mellitus “"The reason for the trend is increasing obesity and lack of exercise reflected in a sedentary lifestyle. Both result in greater insulin resistance and a propensity to develop diabetes at an earlier age." he explained. “
Prevent Diabetic Ills With Chamomile Tea?
Pre-diabetes must be treated, doctors urge “The guidelines recommend that people with metabolic syndrome -- defined by three or more of the following: elevated triglycerides, a low HDL (the so-called good cholesterol), a high fasting glucose, a big waist circumference and high blood pressure -- be considered at high risk for pre-diabetes, as well as women with prior gestational diabetes, people with a family history of type 2 diabetes and obese patients. "These people should all have their glucose tested," Einhorn says. The new guidelines also advise that primary-care physicians and specialists address cardiovascular problems such as blood pressure and lipid levels when diagnosing pre-diabetes. “
Researchers report periodontal disease independently predicts new onset diabetes “"These data add a new twist to the association and suggest that periodontal disease may be there before diabetes," said Ryan T. Demmer, PhD, MPH, associate research scientist in the Department of Epidemiology at the Mailman School of Public Health and lead author. "We found that over two decades of follow-up, individuals who had periodontal disease were more likely to develop Type 2 diabetes later in life when compared to individuals without periodontal disease." “
Resting Heart Rate May Be Tied to Diabetes Mortality
Some Sweeteners Inhibit Enzyme Tied to Type 2 Diabetes
Vitamins block post-meal grogginess in diabetics "Fatty meals may cloud the brains of people with type 2 diabetes, but antioxidant vitamins can help clear the fog, Canadian researchers demonstrated in a study they conducted. The findings suggest, the researchers say, that memory impairment after heavy meals in type 2 diabetics is related to oxidative damage. . 1000 milligrams of vitamin C and 800 international units of vitamin E."
ARTICLES:
JAMA Patient Page: Weight and Diabetes
JOURNAL ARTICLES:
Achilles tendinopathy in diabetes mellitus. (Foot Ankle Int. 2008) "RESULTS: The ultrasonography revealed disorganized tendon fibers in 62 of 70 (89%) patients, and calcification within the Achilles tendon in 53 (76%) patients. The Achilles tendon thickness averaged 5.0 (range, 4 to 8) mm. There was no correlation between patient age and Achilles tendon thickness (r = 0.292, p = 0.014); however, there was a trend for duration of disease and Achilles tendon disorganization (p = 0.073). The oldest patients also appeared to demonstrate a trend for more ultrasound-measured Achilles tendinopathy. There was no correlation between fasting glucose or glycosylated hemoglobin and Achilles tendon alterations. CONCLUSION: This investigation confirms structural abnormalities within the Achilles tendon of diabetic individuals that might represent biologic changes affecting the inherent stiffness that leads to increased forefoot pressure and the development of plantar forefoot ulcers. This process appears to worsen with advanced age and does not appear to be related to diabetes control."
Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies (The Lancet 2008) "Metabolic syndrome and its components are associated with type 2 diabetes but have weak or no association with vascular risk in elderly populations, suggesting that attempts to define criteria that simultaneously predict risk for both cardiovascular disease and diabetes are unhelpful. Clinical focus should remain on establishing optimum risk algorithms for each disease."
Cognitive Dysfunction and Diabetes Mellitus. (Endocr Rev. 2008)
Diabetes and vascular disease. (Expert Rev Cardiovasc Ther. 2008)
Diabetic foot infection. (American Family Physician 2008) “Foot infections are common in patients with diabetes and are associated with high morbidity and risk of lower extremity amputation. Diabetic foot infections are classified as mild, moderate, or severe. Gram-positive bacteria, such as Staphylococcus aureus and beta-hemolytic streptococci, are the most common pathogens in previously untreated mild and moderate infection. Severe, chronic, or previously treated infections are often polymicrobial. The diagnosis of diabetic foot infection is based on the clinical signs and symptoms of local inflammation. Infected wounds should be cultured after debridement. … The risk of methicillin-resistant S. aureus infection should be considered when choosing a regimen. Antibiotic treatment should last from one to four weeks for soft tissue infection and six to 12 weeks for osteomyelitis and should be followed by culture-guided definitive therapy.”
Diabetic retinopathy and risk of heart failure. (J Am Coll Cardiol. 2008) "CONCLUSIONS: The presence of diabetic retinopathy signifies an excess risk of HF, independent of known risk factors. This further supports a contribution of microvascular disease to the development of HF in people with diabetes."
Early-Onset Type 2 Diabetes Mellitus: A Condition With Elevated Cardiovascular Risk? (Br J Diabetes Vasc Dis. 2008)
Examining a Bidirectional Association Between Depressive Symptoms and Diabetes (JAMA. 2008)
How strong is the association between abdominal obesity and the incidence of type 2 diabetes? (Int J Clin Pract. 2008) "Conclusions: There is a strong association between measures reflecting abdominal obesity and the development of type 2 diabetes. Reducing WC may reduce the risk of developing type 2 diabetes."
Muscle performance and ankle joint mobility in long-term patients with diabetes (BMC Musculoskelet Disord. 2008) “The investigation revealed ankle functional impairments in patients with diabetes, with or without neuropathy, thus suggesting that other mechanisms besides neuropathy might contribute to alter foot-ankle biomechanics. Such impairments may then play a role in the development of abnormal gait and in the onset of plantar ulcers.”
Plasma carotenoids and diabetic retinopathy. (Br J Nutr. 2008)
Prevalence of peripheral arterial disease in patients with diabetes mellitus in a primary care setting. (Med J Malaysia. 2007) “The overall prevalence of PAD was 16% in this diabetic population. The prevalence of PAD was 5.8% in Malays, 19.4% in Chinese and 19.8% in Indians. The prevalence of peripheral neuropathy was 41%, foot ulcer 9.5%, and gangrene 3.0%. The presence of foot ulcer was weakly associated with PAD (P=0.052). No significant relationships were found between age, gender, smoking status, duration of diabetes mellitus, hypertension, dyslipidaemia, and PAD. PAD is common in the diabetic population of this study.”
Self-Reported Prediabetes and Risk-Reduction Activities --- United States, 2006 (MMWR 2008)
Small-fibre involvement in diabetic patients with neuropathic foot pain (Diabetic Medicine 2008) “Although the exact mechanism of neuropathic pain in diabetic patients is not known, pain is almost invariably accompanied by small-fibre dysfunction and pathology irrespective of autonomic or large-fibre involvement.”
Snoring and witnessed sleep apnea is related to diabetes mellitus in women. (Sleep Med. 2008) "CONCLUSIONS: Snoring and witnessed sleep apneas are related to diabetes mellitus in women. Witnessed sleep apnea is related to diabetes mellitus in men younger than 55 years old."
Study Finds Bidirectional Link Between Depression and Type 2 Diabetes “First, it confirmed that symptoms of depression are associated with an increased risk for diabetes. Patients with depressive symptoms were more likely to be overweight, consume more calories, exercise less, and smoke, suggesting that some poor health behaviors associated with depression may lead to the development of diabetes, she noted. Second, the study showed that patients with treated diabetes were at increased risk of developing symptoms of depression. People with treated diabetes were more likely to have high blood pressure and protein in their urine (suggesting kidney damage from diabetes), she added. The implications are that "future studies that target individuals with elevated symptoms of depression should look at interventions that will also help them modify adverse health behaviors associated with depressive symptoms," which can complement diabetes prevention strategies, she said.”
Type 2 diabetes mellitus as risk factor for colorectal cancer. (Arch Physiol Biochem. 2008)
Visceral fat amount is associated with carotid atherosclerosis even in type 2 diabetic men with a normal waist circumference. (Int J Obes (Lond). 2008)
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