Diabetes, Type II

• Definition
· Diabetes Type II is the disease of elevated blood glucose levels due to insulin resistance (failure of naturally occurring insulin to control blood glucose levels).
· Diabetes Type II is diagnosed by:
· An overnight fasting blood glucose greater than or equal to 126 mg/dL
· A blood glucose level greater than 200 mg/dL about two hours after glucose load.

• Overview
· Diabetes Type II affects 17.2 million Americans.
· Diabetes Type II is now the sixth leading cause of death in the United States.
· Diabetes Type II has rapidly increased in frequency due to increases in processed foods along with decreased physical activity and obesity.
· Diabetes Type II is one of the major causes of blindness, cardiovascular disease, lower extremity amputations, and renal failure.
· Diabetes Type II is associated with:
· age at diagnosis greater than 40 years of age
· obesity
· hypertension (high blood pressure)
· high cholesterol
· atherosclerosis (hardening of the arteries)
· frequent or excessive urination

• Symptoms
· Diabetes Type II symptoms include:
· Excessive thirst
· Frequent and excessive urination (due to the diuretic effect of excessive blood glucose levels)
· fatigue
· blurry vision
· peripheral neuropathy
· vaginal fungal infections

• Complications
· Diabetes Type II complications include:
· hypoglycemia (low blood glucose levels due to treatment)
· diabetic retinal disease
· Diabetic kidney disease
· Diabetic neuropathy (impaired function of neurons due to high blood glucose levels)
· infections (diabetes impairs the immune system)
· foot ulcers and gangrene of the feet

• Treatment
· Diabetes Type II treatment includes:
· weight loss
· restriction of excessive dietary carbohydrates
· exercise
· Glucophage (medication that increases insulin sensitivity)
· medications that increase pancreatic insulin production
· Insulin

References
Mooradian AD et al. Narrative review: a rational approach to starting insulin therapy. Ann Intern Med. 2006 Jul 18;145(2):125-34. [PMID: 16847295]
American Diabetes Association. Clinical practice recommendations. Diabetes Care. 2006;29(Suppl 1):S1.
Narayan KM et al: Diabetes-a common, serious, costly, and potentially preventable public health problem. Diabetes Res Clin Pract 2000; 50:77. [PMID: 11024588]

Posted on September 24, 2008

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