What is type 2 diabetes?
A disease that’s set to become an epidemic
This is by far the most common type of diabetes, accounting for more than 90% of all diabetes cases.
Type 2 diabetes occurs more frequently in mid-life, though it’s now rapidly increasing among people of all ages. With the major increase in childhood obesity, type 2 diabetes is now increasingly found in children.
Obesity and inactivity are currently on the rise, which lead experts to describe the current surge in the disease as an epidemic. The numbers of people affected worldwide could double by 2025. In the UK, estimates based on current population trends predict that almost 5 million people will have diabetes by 2035, with type 2 accounting for almost all of that increase. Diabetes currently costs our health systems almost £10 billion each year and tackling the rise in the disease is vital
The disease runs in families. If either of your parents has type 2 diabetes, there is a 10–15% chance that you’ll get it.
Difficult to diagnose, tricky to treat
Type 2 diabetes is such a tricky condition because its onset is gradual, starting imperceptibly, initially with a normal blood glucose levels but raised serum insulin implying resistance to the action of insulin, the hallmark of Type 2 diabetes. And because it doesn’t start with obvious symptoms, it’s estimated that as many as 25% of people with this kind of diabetes are unaware that they have it.
Overt type 2 diabetes occurs because there is not enough insulin produced by the beta cells in the pancreas and also because there is resistance to the effective action of this insulin. In time, insulin production slowly declines and treatment with insulin may become necessary.
Insulin resistance is the key
The mechanism behind this early insulin resistance is believed to be the excess fat in muscle, pancreas and liver. So treatment is initially directed at increasing insulin sensitivity by weight loss and exercise where appropriate, and by the use of drugs that increase insulin sensitivity, assist weight loss, avoid hypoglycaemia and protect from heart and kidney disease.
Looking after your arteries
This insulin resistant state is now also known to be associated with high blood pressure, as well as raised triglyceride and low high density lipoprotein cholesterol levels. All of these abnormalities increase the risk of coronary heart disease and stroke. The intensive management of all of these risk factors is now known to be as important as normalising blood glucose.
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Carol Willis - Diabetes Clinic Facilitator
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