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Diabetes Type II Half of the 16 million people walking around with type II diabetes don't even know they have it. That's because the symptoms they " re experiencing are easily attributed to something else. When an older woman complains of clouded eyesight, it's likely her doctor will think of cataracts instead of type III (or non insulin-dependent) diabetes. And when an older man starts taking too many trips to the bathroom in the middle of the night, a prostate problem -- not diabetes -- is often the first ailment suspected. "Type II diabetes is the Rodney Dangerfield of chronic diseases. It gets no respect, 's ays Frank Visitor, M. D. , president of the American Diabetes Association (ADA) and a diabetes specialist at the Centers for Disease Control and Prevention in Atlanta.
But the malady is no laughing matter. Type II diabetes is the fourth leading cause of death by disease in this country, and it's rising steadily. The number of adults diagnosed with type III diabetes has tripled since 1958. Untreated, it can cause blindness, heart and kidney disease, or nerve damage; it may even result in amputation. What is it? Diabetes mellitus has two different types -- I and III.
Type I, which usually affects young people, occurs when the pancreas EM to produce insulin, a hormone that helps your body convert food into energy. Insulin is what permits cells to utilize glucose or sugar. Type I patients must depend on daily insulin injections for the rest of their lives. The more common type II diabetes, which mostly occurs in middle-aged adults, happens when the body produces some insulin, but it doesn't work effectively. Most type R diabetics can keep their sugar within acceptable limits with diet and medication, but some may require insulin injections.
Who's at risk? Most people with type II diabetes are over 40 and overweight. Minorities have a higher risk of getting the disease. Between ages 65 and 74, 17 percent of whites will be diagnosed with type III compared with 25 percent of African-Americans and more than 33 percent of Hispanics. It's not clear why there is such a discrepancy between ethnic groups.
Heredity also plays a role. It's estimated about one-fourth of the U. S. population has the genes which would make a person susceptible to type II diabetes, " says F. Xavier Pi-Sunyer, M. D. , chief of endocrinology, diabetes, and nutrition at St.
Lukes-Roosevelt Hospital in New York City. Obesity is another significant trigger for type H diabetes, says Dr. Pi-Sunyer. "Not everyone who is obese gets type II diabetes, " he says, but an overwhelming majority is overweight. " Obesity can provoke certain genes to accelerate the onset of diabetes, Dr. Pi-Sunyer says. Where the fat settles on your body also can make you more vulnerable to type II diabetes. People who gain weight in their midsection, or who have an apple-shaped body, are most at risk.
Those with pear-shaped bodies, who carry extra weight in their thighs and buttocks, are less prone to the disease. Researchers hope to someday be able to identify people susceptible to type II diabetes long before it ever develops. "There are likely several genes that need to be present in the same person, which conspire with each other and with lifestyle and aging to trigger type III diabetes, 's ays Alan Shuldiner, M. D. , associate professor at John Hopkins University School of Medicine, and member of a research team that already has discovered one of these genes. The best way to treat and try to prevent type H diabetes is to eat a healthful diet and exercise regularly. Several studies have shown that weight loss and steady exercise help regulate blood sugar levels.
Patients should work hand-in-hand with doctors and dieticians to outline necessary lifestyle changes. "It's a matter of negotiation and education and being able to help patients make informed decisions and change behavior gradually, " says Jeff Susan, M. D. , vice chair of the department of family medicine at the University of Nebraska Medical Center in Omaha. The old restrictive, no-sweets diabetic diet has been altered as doctors have discovered there's room to maneuver. New dietary standards prescribed by the ADA and the American Dietetic Association are much less stringent and let type II patients indulge in an occasional piece of cake or bowl of ice cream. The body breaks down carbohydrates the same way, whether the food eaten is a potato or a cookie, says Davida Kruger, a nurse practitioner at Henry Ford Hospital in Detroit and senior vice president of the ADA. Simple and complex carbohydrates elevate the body's glucose equally.
This allows people with type II diabetes to plan ahead for that special treat by exchanging servings within recommended food groups. For example, if you want to eat dessert after dinner, Kruger explains, you need to eliminate bread servings to compensate for the sugar difference. And calories still count. The following literature is helpful in dealing with Diabetes Type II: Active insulin infusion using optimal and derivative-weighted control.
Med Eng Phys. 2002 Dec; 24 (10): 663 - 72. Diabetes and insulin secretion: whither KATP? Am J Physiol Endocrinol Metab. 2002 Sep; 283 (3): E 403 - 12. From receptor to effector: insulin signal transduction in skeletal muscle from type II diabetic patients. Ann N Y Acad Sci. 2002 Jun; 967: 120 - 34. High insulin requirements and poor metabolic control do not modify the expression, regulation and PKC mediated activation of the p 21 ras pathway in PBMC from type II diabetic patients.
Int J Exp Res. 2001; 2 (1): 47 - 54. Improved stability, insulin-releasing activity and anti diabetic potential of two novel N-terminal analogues of gastric inhibitory polypeptide: N-acetyl-GIP and p Glu-GIP. Diabetologia. 2002 Sep; 45 (9): 1281 - 91. Insulin regulation of glucose uptake: a complex interplay of intracellular signaling pathways. Diabetologia. 2002 Nov; 45 (11): 1475 - 83.
Long-term insulin independence following repeated islet transplantation in totally pancreatectomized diabetic pigs. Cell Transplant. 2002; 11 (1): 55 - 66. Effects of hormone replacement therapy on cardiovascular responses in postmenopausal women with and without type II diabetes. Maturitas. 2002 Nov 20; 43 (3): 157 - 64.
Effect of hormone replacement therapy on insulin secretion and insulin sensitivity in postmenopausal diabetic women. Gynecol Endocrinol. 2002 Feb; 16 (1): 67 - 74. Genes and engineered cells as drugs for type I and type II diabetes mellitus therapy and prevention. Curr Opin Investing Drugs. 2002 May; 3 (5): 735 - 51. The role of angiotensin receptor blockers in preventing the progression of renal disease in patients with type II diabetes. Am J Hypertens. 2002 Oct; 15 (10 Pt 2): 123 S- 128 S.
The Use of Hormonal Replacement Therapy in Patients with type II diabetes. Kardiologiia. 2001; 41 (12): 85 - 93. Thiazolidinediones and type II diabetes: new drugs for an old disease. Med J Aust. 2002 Apr 15; 176 (8): 381 - 6. Additive effect of overweight and type II diabetes in the appearance of coronary heart disease but not of stroke: a cross-sectional study. Acta Diabetes. 2002 Jun; 39 (2): 83 - 90.
Assessing the impact of complications on the costs of type II diabetes. Diabetologia. 2002 Jul; 45 (7): S 13 - 7. The association between components of adult height and type II diabetes and insulin resistance: British Women's Heart and Health Study. Diabetologia. 2002 Aug; 45 (8): 1097 - 106. Blood pressure control early in diabetes: a balance between angiotensin and nitric oxide. Clin Exp Pharmacol Physiol. 2002 Jan-Feb; 29 (1 - 2): 127 - 31.
Calculation of coronary risk in type II diabetes: another cause for concern. Clin Sci (Lond). 2002 Aug; 103 (2): 217 - 9; discussion 219. Circadian variation in oxidative stress markers in healthy and type II diabetic men. Chronobiol Int. 2002 Mar; 19 (2): 423 - 39. Comparison of clinical arterial pressure, home-arterial pressure measurement, and ambulatory arterial pressure monitoring in patients with type II diabetes mellitus and diabetic nephropathy. Nefrologia. 2002; 22 (2): 179 - 89.
Diabetic retinopathy and HLA antigens in type II diabetes mellitus. Eur J Ophthalmol. 2002 Mar-Apr; 12 (2): 89 - 93. Effects of size at birth and childhood growth on the insulin resistance syndrome in elderly individuals. Diabetologia. 2002 Mar; 45 (3): 342 - 8. The effect of poly neuropathy on foot microcirculation in type II diabetes. Diabetologia. 2002 Aug; 45 (8): 1164 - 71.
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