Gloved hands of a health-care worker testing a patient's finger with a glucose meter

Type 2 diabetes is not one-size - fits-all : Subtypes affect complications and treatment options

an essay about type 2 diabetes

PhD Student, Biochemistry, Carleton University

an essay about type 2 diabetes

Associate professor, Department of Biology and Institute of Biochemistry, Carleton University

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Lili Grieco-St-Pierre receives funding from Fonds de recherche du Québec - Santé (FRQS).

Jennifer Bruin receives funding from the Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC), JDRF, Diabetes Canada.

Carleton University provides funding as a member of The Conversation CA.

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You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population . Of those cases, 90 per cent have Type 2 diabetes.

This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease .

Locks and keys

In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.

In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key . Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.

Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.

All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.

These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments .

To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.

This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.

Severe insulin-deficient diabetes: We’re missing keys!

Illustration of a beta cell with a sign saying 'On strike!' and keys with an X over them

Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.

SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness , among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.

Severe insulin-resistant diabetes: But it’s always locked!

A diagram of three closed locks and lots of keys

In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.

This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease . There are many treatment avenues for these patients but no consensus about the optimal approach ; patients often require high doses of insulin.

Mild obesity-related diabetes: The locks are sticky!

Illustration of a lock and key

Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight. Unlike more severe subtypes, MOD is characterized by a more measured response to insulin. The locks are “sticky,” so it is challenging for the key to click in place and open the lock. While MOD is connected to body weight, the comparatively less severe nature of MOD distinguishes it from other diabetes subtypes.

To minimize complications, treatment should include maintaining a healthy diet, managing body weight, and incorporating as much aerobic exercise as possible. This is where drugs like Ozempic can be prescribed to control the evolution of the disease, in part by managing body weight.

Mild age-related diabetes: I’m tired of controlling blood sugar!

Illustration of a lock and a beta cell

Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications.

Among the different subtypes of diabetes, MARD is the most common .

Unique locks, varied keys

While efforts have been made to classify diabetes subtypes, new subtypes are still being identified, making proper clinical assessment and treatment plans challenging.

In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s. Despite initial skepticism from the scientific community, which typically associated Type 2 diabetes with adults rather than children, clinical teams persisted in identifying this as a distinct subtype of Type 2 diabetes, called childhood-onset Type 2 diabetes.

Read more: Indigenous community research partnerships can help address health inequities

Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth. It is undoubtedly linked to the intergenerational trauma associated with colonization in these communities . While many factors are likely involved, recent studies have discovered that exposure of a fetus to Type 2 diabetes during pregnancy increases the risk that the baby will develop diabetes later in life .

Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples. It is hoped that partnered research between communities and researchers will continue to help us understand childhood-onset Type 2 diabetes and how to effectively prevent and treat it.

A mosaic of conditions

Illustration of different subtypes of Type 2 diabetes

Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics. Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve . However, understanding these subtypes is a good starting point to help doctors create personalized plans for people living with the condition.

While Indigenous communities, lower-income households and individuals living with obesity already face a higher risk of developing Type 2 diabetes than the general population, tailored solutions may offer hope for better management. This emphasizes the urgent need for more precise assessments of diabetes subtypes to help customize therapeutic strategies and management strategies. This will improve care for all patients, including those from vulnerable and understudied populations.

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Hypothesis and theory article, type 2 diabetes mellitus: a pathophysiologic perspective.

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  • Department of Medicine, Duke University, Durham, NC, United States

Type 2 Diabetes Mellitus (T2DM) is characterized by chronically elevated blood glucose (hyperglycemia) and elevated blood insulin (hyperinsulinemia). When the blood glucose concentration is 100 milligrams/deciliter the bloodstream of an average adult contains about 5–10 grams of glucose. Carbohydrate-restricted diets have been used effectively to treat obesity and T2DM for over 100 years, and their effectiveness may simply be due to lowering the dietary contribution to glucose and insulin levels, which then leads to improvements in hyperglycemia and hyperinsulinemia. Treatments for T2DM that lead to improvements in glycemic control and reductions in blood insulin levels are sensible based on this pathophysiologic perspective. In this article, a pathophysiological argument for using carbohydrate restriction to treat T2DM will be made.

Introduction

Type 2 Diabetes Mellitus (T2DM) is characterized by a persistently elevated blood glucose, or an elevation of blood glucose after a meal containing carbohydrate ( 1 ) ( Table 1 ). Unlike Type 1 Diabetes which is characterized by a deficiency of insulin, most individuals affected by T2DM have elevated insulin levels (fasting and/or post glucose ingestion), unless there has been beta cell failure ( 2 , 3 ). The term “insulin resistance” (IR) has been used to explain why the glucose levels remain elevated even though there is no deficiency of insulin ( 3 , 4 ). Attempts to determine the etiology of IR have involved detailed examinations of molecular and intracellular pathways, with attribution of cause to fatty acid flux, but the root cause has been elusive to experts ( 5 – 7 ).

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Table 1 . Definition of type 2 diabetes mellitus.

How Much Glucose Is in the Blood?

Keeping in mind that T2DM involves an elevation of blood glucose, it is important to understand how much glucose is in the blood stream to begin with, and then the factors that influence the blood glucose—both exogenous and endogenous factors. The amount of glucose in the bloodstream is carefully controlled—approximately 5–10 grams in the bloodstream at any given moment, depending upon the size of the person. To calculate this, multiply 100 milligrams/deciliter × 1 gram/1,000 milligrams × 10 deciliters/1 liter × 5 liters of blood. The “zeros cancel” and you are left with 5 grams of glucose if the individual has 5 liters of blood. Since red blood cells represent about 40% of the blood volume, and the glucose is in equilibrium, there may be an extra 40% glucose because of the red blood cell reserve ( 8 ). Adding the glucose from the serum and red blood cells totals about 5–10 grams of glucose in the entire bloodstream.

Major Exogenous Factors That Raise the Blood Glucose

Dietary carbohydrate is the major exogenous factor that raises the blood glucose. When one considers that it is common for an American in 2021 to consume 200–300 grams of carbohydrate daily, and most of this carbohydrate is digested and absorbed as glucose, the body absorbs and delivers this glucose via the bloodstream to the cells while attempting to maintain a normal blood glucose level. Thinking of it in this way, if 200–300 grams of carbohydrates is consumed in a day, the bloodstream that holds 5–10 grams of glucose and has a concentration of 100 milligrams/deciliter, is the conduit through which 200,000–300,000 milligrams (200 grams = 200,000 milligrams) passes over the course of a day.

Major Endogenous Factors That Raise the Blood Glucose

There are many endogenous contributors that raise the blood glucose. There are at least 3 different hormones that increase glucose levels: glucagon, epinephrine, and cortisol. These hormones increase glucose levels by increasing glycogenolysis and gluconeogenesis ( 9 ). Without any dietary carbohydrate, the normal human body can generate sufficient glucose though the mechanism of glucagon secretion, gluconeogenesis, glycogen storage and glycogenolysis ( 10 ).

Major Exogenous Factors That Lower the Blood Glucose

A reduction in dietary carbohydrate intake can lower the blood glucose. An increase in activity or exercise usually lowers the blood glucose ( 11 ). There are many different medications, employing many mechanisms to lower the blood glucose. Medications can delay sucrose and starch absorption (alpha-glucosidase inhibitors), slow gastric emptying (GLP-1 agonists, DPP-4 inhibitors) enhance insulin secretion (sulfonylureas, meglitinides, GLP-1 agonists, DPP-4 inhibitors), reduce gluconeogenesis (biguanides), reduce insulin resistance (biguanides, thiazolidinediones), and increase urinary glucose excretion (SGLT-2 inhibitors). The use of medications will also have possible side effects.

Major Endogenous Factors That Lower the Blood Glucose

The major endogenous mechanism to lower the blood glucose is to deliver glucose into the cells (all cells can use glucose). If the blood glucose exceeds about 180 milligrams/deciliter, then loss of glucose into the urine can occur. The blood glucose is reduced by cellular uptake using glut transporters ( 12 ). Some cells have transporters that are responsive to the presence of insulin to activate (glut4), others have transporters that do not require insulin for activation. Insulin-responsive glucose transporters in muscle cells and adipose cells lead to a reduction in glucose levels—especially after carbohydrate-containing meals ( 13 ). Exercise can increase the glucose utilization in muscle, which then increases glucose cellular uptake and reduce the blood glucose levels. During exercise, when the metabolic demands of skeletal muscle can increase more than 100-fold, and during the absorptive period (after a meal), the insulin-responsive glut4 transporters facilitate the rapid entry of glucose into muscle and adipose tissue, thereby preventing large fluctuations in blood glucose levels ( 13 ).

Which Cells Use Glucose?

Glucose can used by all cells. A limited number of cells can only use glucose, and are “glucose-dependent.” It is generally accepted that the glucose-dependent cells include red blood cells, white blood cells, and cells of the renal papilla. Red blood cells have no mitochondria for beta-oxidation, so they are dependent upon glucose and glycolysis. White blood cells require glucose for the respiratory burst when fighting infections. The cells of the inner renal medulla (papilla) are under very low oxygen tension, so therefore must predominantly use glucose and glycolysis. The low oxygen tension is a result of the countercurrent mechanism of urinary concentration ( 14 ). These glucose-dependent cells have glut transporters that do not require insulin for activation—i.e., they do not need insulin to get glucose into the cells. Some cells can use glucose and ketones, but not fatty acids. The central nervous system is believed to be able to use glucose and ketones for fuel ( 15 ). Other cells can use glucose, ketones, and fatty acids for fuel. Muscle, even cardiac muscle, functions well on fatty acids and ketones ( 16 ). Muscle cells have both non-insulin-responsive and insulin-responsive (glut4) transporters ( 12 ).

Possible Dual Role of an Insulin-Dependent Glucose-Transporter (glut4)

A common metaphor is to think of the insulin/glut transporter system as a key/lock mechanism. Common wisdom states that the purpose of insulin-responsive glut4 transporters is to facilitate glucose uptake when blood insulin levels are elevated. But, a lock serves two purposes: to let someone in and/or to keep someone out . So, one of the consequences of the insulin-responsive glut4 transporter is to keep glucose out of the muscle and adipose cells, too, when insulin levels are low. The cells that require glucose (“glucose-dependent”) do not need insulin to facilitate glucose entry into the cell (non-insulin-responsive transporters). In a teleological way, it would “make no sense” for cells that require glucose to have insulin-responsive glut4 transporters. Cells that require glucose have glut1, glut2, glut3, glut5 transporters—none of which are insulin-responsive (Back to the key/lock metaphor, it makes no sense to have a lock on a door that you want people to go through). At basal (low insulin) conditions, most glucose is used by the brain and transported by non-insulin-responsive glut1 and glut3. So, perhaps one of the functions of the insulin-responsive glucose uptake in muscle and adipose to keep glucose OUT of the these cells at basal (low insulin) conditions, so that the glucose supply can be reserved for the tissue that is glucose-dependent (blood cells, renal medulla).

What Causes IR and T2DM?

The current commonly espoused view is that “Type 2 diabetes develops when beta-cells fail to secrete sufficient insulin to keep up with demand, usually in the context of increased insulin resistance.” ( 17 ). Somehow, the beta cells have failed in the face of insulin resistance. But what causes insulin resistance? When including the possibility that the environment may be part of the problem, is it possible that IR is an adaptive (protective) response to excess glucose availability? From the perspective that carbohydrate is not an essential nutrient and the change in foods in recent years has increased the consumption of refined sugar and flour, maybe hyperinsulinemia is the cause of IR and T2DM, as cells protect themselves from excessive glucose and insulin levels.

Insulin Is Already Elevated in IR and T2DM

Clinical experience of most physicians using insulin to treat T2DM over time informs us that an escalation of insulin dose is commonly needed to achieve glycemic control (when carbohydrate is consumed). When more insulin is given to someone with IR, the IR seems to get worse and higher levels of insulin are needed. I have the clinical experience of treating many individuals affected by T2DM and de-prescribing insulin as it is no longer needed after consuming a diet without carbohydrate ( 18 ).

Diets Without Carbohydrate Reverse IR and T2DM

When dietary manipulation was the only therapy for T2DM, before medications were available, a carbohydrate-restricted diet was used to treat T2DM ( 19 – 21 ). Clinical experience of obesity medicine physicians and a growing number of recent studies have demonstrated that carbohydrate-restricted diets reverse IR and T2DM ( 18 , 22 , 23 ). Other methods to achieve caloric restriction also have these effects, like calorie-restricted diets and bariatric surgery ( 24 , 25 ). There may be many mechanisms by which these approaches may work: a reduction in glucose, a reduction in insulin, nutritional ketosis, a reduction in metabolic syndrome, or a reduction in inflammation ( 26 ). Though there may be many possible mechanisms, let's focus on an obvious one: a reduction in blood glucose. Let's assume for a moment that the excessive glucose and insulin leads to hyperinsulinemia and this is the cause of IR. On a carbohydrate-restricted diet, the reduction in blood glucose leads to a reduction in insulin. The reduction in insulin leads to a reduction in insulin resistance. The reduction in insulin leads to lipolysis. The resulting lowering of blood glucose, insulin and body weight reverses IR, T2DM, AND obesity. These clinical observations strongly suggest that hyperinsulinemia is a cause of IR and T2DM—not the other way around.

What Causes Atherosclerosis?

For many years, the metabolic syndrome has been described as a possible cause of atherosclerosis, but there are no RCTs directly targeting metabolic syndrome, and the current drug treatment focuses on LDL reduction, so its importance remains controversial. A recent paper compared the relative importance of many risk factors in the prediction of the first cardiac event in women, and the most powerful predictors were diabetes, metabolic syndrome, smoking, hypertension and BMI ( 27 ). The connection between dietary carbohydrate and fatty liver is well-described ( 28 ). The connection between fatty liver and atherosclerosis is well-described ( 29 ). It is very possible that the transport of excess glucose to the adipose tissue via lipoproteins creates the particles that cause the atherosclerotic damage (small LDL) ( Figure 1 ) ( 30 – 32 ). This entire process of dietary carbohydrate leading to fatty liver, leading to small LDL, is reversed by a diet without carbohydrate ( 26 , 33 , 34 ).

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Figure 1 . Key aspects of the interconnection between glucose and lipoprotein metabolism.

Reducing dietary carbohydrate in the context of a low carbohydrate, ketogenic diet reduces hyperglycemia and hyperinsulinemia, IR and T2DM. In the evaluation of an individual for a glucose abnormality, measure the blood glucose and insulin levels. If the insulin level (fasting or after a glucose-containing meal) is high, do not give MORE insulin—instead, use an intervention to lower the insulin levels. Effective ways to reduce insulin resistance include lifestyle, medication, and surgical therapies ( 23 , 35 ).

The search for a single cause of a complex problem is fraught with difficulty and controversy. I am not hypothesizing that excessive dietary carbohydrate is the only cause of IR and T2DM, but that it is a cause, and quite possibly the major cause. How did such a simple explanation get overlooked? I believe it is very possible that the reductionistic search for intracellular molecular mechanisms of IR and T2DM, the emphasis on finding pharmaceutical (rather than lifestyle) treatments, the emphasis on the treatment of high total and LDL cholesterol, and the fear of eating saturated fat may have misguided a generation of researchers and clinicians from the simple answer that dietary carbohydrate, when consumed chronically in amounts that exceeds an individual's ability to metabolize them, is the most common cause of IR, T2DM and perhaps even atherosclerosis.

While there has historically been a concern about the role of saturated fat in the diet as a cause of heart disease, most nutritional experts now cite the lack of evidence implicating dietary saturated fat as the reason for lack of concern of it in the diet ( 36 ).

The concept of comparing medications that treat IR by insulin-sensitizers or by providing insulin itself was tested in the Bari-2D study ( 37 ). Presumably in the context of consuming a standard American diet, this study found no significant difference in death rates or major cardiovascular events between strategies of insulin sensitization or insulin provision.

While lifestyle modification may be ideal to prevent or cure IR and T2DM, for many people these changes are difficult to learn and/or maintain. Future research should be directed toward improving adherence to all effective lifestyle or medication treatments. Future research is also needed to assess the effect of carbohydrate restriction on primary or secondary prevention of outcomes of cardiovascular disease.

Data Availability Statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

Author Contributions

The author confirms being the sole contributor of this work and has approved it for publication.

Conflict of Interest

EW receives royalties from popular diet books and is founder of a company based on low-carbohydrate diet principles (Adapt Your Life, Inc.).

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: type 2 diabetes, insulin resistance, pre-diabetes, carbohydrate-restricted diets, hyperinsulinemia, hyperglycemia

Citation: Westman EC (2021) Type 2 Diabetes Mellitus: A Pathophysiologic Perspective. Front. Nutr. 8:707371. doi: 10.3389/fnut.2021.707371

Received: 09 May 2021; Accepted: 20 July 2021; Published: 10 August 2021.

Reviewed by:

Copyright © 2021 Westman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Eric C. Westman, ewestman@duke.edu

This article is part of the Research Topic

Carbohydrate-restricted Nutrition and Diabetes Mellitus

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The main goal of this analysis is to examine the trends of type 2 diabetes during 14 years and the effort of federal, state, local authority in the prevention of the condition, which is fundamental to avoid complications from type 2 diabetes, such as damage in the eyes, kidney, nerves, sexual problems, double the risks of heart attack and stroke, cancer, eating disorder, foot problems, joint and bone, brain conditions, oral health, pregnancy related complications and skin issues (Geiss, L; MacKeever

Type 2 Diabetes (T2D)

Type 2 diabetes (T2D) is a highly dominant and long-lasting metabolic disorder (Mukherjee 439). WHO suspects that by the year of 2025 up to 200-300 million people worldwide will have developed type 2 diabetes (Hussain 318). Approximately half of the risk factor for individuals with type 2 diabetes is due to environmental contact and to genetics (Hussain 318). It is collectively known for grown-ups to have type 2 diabetes, but youngsters can also have this disease. Type 2 diabetes can be greatly affected

Type 2 Diabetes (NIDDM)

Type 2 Diabetes - | Mature Onset Diabetes Type 2 diabetes (formerly called non-insulin-dependent diabetes (NIDDM), obesity related diabetes, or adult-onset diabetes) is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency, and hyperglycemia. Type 2 diabetes is often managed by engaging in exercise and following a diabetic diet. Oral medications may also be used, and in more advanced or severe cases, insulin therapy may be prescribed. The condition

Summary Background Type 2 diabetes mellitus (T2D) is a complex, heritable, and metabolic disease. And understanding the genetic underpinnings of T2D is a pivotal topic in complex traits analysis. We aimed to use meta-analysis and multi-omics studies to investigate the genetic architecture of type 2 diabetes. Methods In this study, 243,218 individuals were included from three cohorts: DIAbetes Genetics Replication And Meta-analysis (DIAGRAM), Genetic Epidemiology Research on Adult Health and Aging

Type 2 Diabetes Virus

Diabetes mellitus is a medical condition that either develops because of a virus or develops over time as a result to poor diet and exercise. If left uncontrolled it may lead to serious complications such as stroke, vision loss, amputation, or even death. Type II Diabetes is a preventable disease that usually occurs when a patient has been a pre-diabetic for some time. Most people with Type 2 are overweight or obese which can lead to insulin resistance. “In the United States, 25.6 million or 11.3%

Essay On Type 2 Diabetes

through lifestyle (diet and exercise) and certain medications.” (Webmd, 2014). Receiving a diagnosis of type 2 diabetes does not have to be a death sentence. It does take daily commitment and sticking to the regiment that you and your doctor find appropriate for you. You don’t have to let diabetes control your life. You can control your blood sugar instead, and take charge of your health. Type 2 Diabetes a Chronic Illness A chronic illness can be defined as “medical illnesses or health problems with associated

Science Report Type 2 diabetes is the most common type of diabetes. Some of the causes are because people are not having a healthy diet and less exercise or none at all. Some of these people who have type 2 diabetes are also obese. So do people who are obese have a higher risk of getting type 2 diabetes than people without diabetes ? Type 2 diabetes is when your body is not creating enough insulin to keep their sugar levels at the right level. According to a website called , ‘comvita’ Insulin

many different types of chronic diseases, for instance, Obesity, Epilepsy and seizures, and Type-2 Diabetes. Chronic disease becomes more common with age, yet these diseases are becoming more prevalent in younger kids for many different reasons and most chromic diseases are linked to each other. Type-2 diabetes impacts just about every part of the world, for example it has a prominent stand in Africa. Diabetes in Africa is challenging and puzzling, since most African countries only have 2-3% prevalence

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Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

essay on diabetes

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

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Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

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Type 2 Diabetes - Free Essay Examples And Topic Ideas

Type 2 Diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). Essays could explore the risk factors, prevention strategies, and management of Type 2 Diabetes. Discussions on its socioeconomic impact and the challenges in managing this condition in various healthcare settings could also be enlightening. We have collected a large number of free essay examples about Type 2 Diabetes you can find at PapersOwl Website. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Type 2 Diabetes in America

As we know, America today has become more and more obese. Americans are eating more calories a day than ever before. With increased calorie consumption there is increased carbohydrate consumption. This increased carbohydrate consumption has led to an increase in diabetes in not only adults but children and adolescences as well. Previously type 2 diabetes was very uncommon in children but with the recent increase in calorie intake it has become more prevalent. Type 2 diabetes is preventable. Type 2 […]

A Problem of Hispanics with Diabetes

Introduction The health care industry changes each and every year. Making America a very diverse nation and with diversity many issues present itself in today's society. One of the main issues that is affecting society is the prevalence of Type 2 Diabetes in Hispanics. The purpose of this paper is to provide cultural information and awareness of this issue with ways to assist in the prevention of Diabetes. Knowledge about diabetes is very important and sometimes there is not enough […]

General Characteristic of Type II Diabetes

Type 2 Diabetes Background about the disease- Type 2 Diabetes is a disorder caused by an imbalance of insulin. It is the more common form of diabetes, mostly seen in adults but now increasingly observed in young adults as well. Also known as non-insulin-dependent diabetes, this lifelong disease causes your blood glucose level to rise above the normal range. Pathophysiology and causes- Type 2 diabetes stems from several factors. It can develop when your body becomes resistant to insulin or […]

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History and Types of Diabetes

The first sign of diabetes was discovered in 1500 B.C.E by the Egyptians. According to one study, ancient Indians were familiar with the condition and had even determined two types of the condition. They called it "honey urine" and tested for it by determining if the ants were drawn to the urine. The first mention of the word diabetes was by the Greeks. It means "to go through", it was named this because of its main symptom: the excessive passing […]

Growing Problem of Diabetes

As today's youth grows, health and physical activity haves slowly been shifted to the back of people's thoughts. Everyday life can become busy and the quickest and easiest option is to grab an unhealthy snack or meal for the family or as an individual. Proper nutrition and exercise are the main components to creating a better and healthier lifestyle. In today's society there is an overt disregard in the choices made as a part of a routine which include daily […]

The Basic Problem of Diabetes

Uncontrolled levels of blood glucose are the basic problem in patients admitted to our unit. Many are related to lack of knowledge and self-care in diabetes management, sedentary lifestyle, and food habits. This reveals that when assessing a patient in the hospital, a nurse must consider all factors and design a care plan accordingly. Nurses need to be non-judgmental and assess what factors may limit patients' abilities to follow lifestyle recommendations. According to the American Diabetes Association (ADA), uncontrolled blood […]

Characteristic of Type Two Diabetes

Diabetes is a very harsh form of a metabolic dysfunction which is tagged by an increased level of blood glucose. These increased levels of blood glucose could be from many things but two main things are the deficiency in the production of insulin and deficiency in the use of insulin to transport glucose from the blood into the tissue [insulin and insulin resistance]. There are two types of diabetes, type one and two that are the commonly known types in […]

Diabetes and its Main Types

Diabetes is a disorder of the endocrine system, which messes with the metabolism of carbohydrates, fats, and proteins. The metabolism is compromised because of a lack of insulin, either from destruction of the beta cells, which secrete insulin, or because of insulin resistance. Insulin is secreted by beta cells and it is what enables the cells to use glucose. Type 1 diabetes was formerly called juvenile diabetes because mostly kids were diagnosed with it. It is now changed to be […]

Why you should Learn about Diabetes

Auntie Jeanette is the second oldest out of ten children. She is a loving mother, auntie, and daughter. She is well-respected in the community and is known for her outstanding cooking. Every Thanksgiving and Christmas, she makes her famous collard greens with hamhocks, fried chicken, corn bread, and pasta salad. Everyone from all over would come just to eat her delicious food. Although this was very good food, it was not the healthiest choice. Consuming so much of these unhealthy […]

Adverse Health Effect of Environmental Heavy Metals on Diabetes

ABSTRACT Type 2 diabetes (T2D) and its complications constitute a major public health problem for both developed and developing countries due to the high rate of morbidity and mortality associated with the disease.  New evidence from both experimental and human studies has resulted in increased interest in analyzing the relationship between T2D and heavy metal exposures that are ubiquitous in the environment. Vellore district is a major leather- processing centre in Tamil Nadu, with an estimated 60,000 tannery workers. Tannery […]

What should you Know about Diabetes

What is diabetes? Diabetes is when your blood sugars, or blood glucose, is to high.  Your main source of energy is blood glucose, which comes from the food you eat.  Your pancreas creates a hormone called insulin.  Insulin helps all the glucose from the food you eat get into your body's cells and use it for energy.  But in some cases, the body doesn't create enough insulin, sometimes the body doesn't make any insulin at all.  If this is the […]

How is Low Carbohydrate Diet Beneficial to Diabetes

Abstract: This essay is about the global status of diabetes, what is diabetes, how insulin works, why people easy to have diabetes, what is carbohydrate and why low carbohydrate diet beneficial to the diabetes. With the development of society, people's living standards have gradually improved. The choice of food is gradually becoming more and more, also it has brought us many diseases. Diabetes, as one of the top ten death diseases in the world, has attracted the attention of people […]

Diabetes: One of the Hardest Illness

Diabetes is a standout amongst the most widely recognized maladies that can prompt passing if not treated right. In any case there are particular sorts of this ailment which is Type 1,Type 2, and Gestational diabetes. Diabetes is an illness that happens when your blood glucose, additionally called glucose, is too high. Blood glucose is your fundamental wellspring of significance and begins from the sustenance you eat. Diabetes is the sort of ailment that goes with conspicuous signs with in […]

An Issue of Nutrition and Diabetes

The article I've reviewed is called, "Nutrition Therapy Recommendations for the Management of Adults with Diabetes".  My decision to review this article is based upon interest in links with nutrition and chronic disease.  A National Center for Health Statistics study (Table 18) identified eight of the top ten killers in America as chronic diseases.  I've read multiple books that link the two and this article conducted a systematic review of 228 articles or studies.  The article goes fairly in depth […]

Connection between Genetics and Diabetes

Each single person has a specific set of genes; however, these genetics are greatly influenced by their families. Genetics can also be affected via one's environmental surroundings, as well. These genetics are associated with most diseases, such as cancer, kidney diseases, and psychologic diseases. Diabetes is no different. Genetics are not the only causative factor in diabetes, but it can alert healthcare members to look for this disease due to predisposition. According to the American Diabetes Association (2018), "Type 1 […]

Insulin-Dependent Diabetes Mellitus

Diabetes Mellitus 1, more specifically known as IDDM is a disorder concerning glucose homeostasis, which needs insulin therapy is generally seen in children. Diabetes is generally classified into 2 types IDDM (Insulin dependent diabetes mellitus) and the other NIDDM (Non-insulin dependent diabetes mellitus). Diabetes simply means an increase of glucose levels in the body as a result of the improper or no production of insulin from ones pancreatic ??-cells. The standard auto-immune response of type 1 diabetes is specific destruction […]

Diabetes and Renal Failure

Diabetes and Renal Failure Introduction This is a research article about prevalence of renal failure and its early detection among patients who have long standing diabetes mellitus. End stage renal disease significantly increases the risk of death and requires expert health care. Although diabetes is the most predominant cause of chronic renal disease, maximum individuals with diabetes are not investigated based on national guidelines. Chronic kidney disease warrants improved detection using standardized criteria to improve outcomes. Proper screening of diabetic […]

What are the Main Causes and Treatments of Diabetes

Diabetes is a chronic disease that can cause complications and death if left untreated. It is one of the most common chronic diseases in the world and affects nearly half of the global population. According to Koye et al. (2018), it is also a leading cause of disability worldwide, affecting more than 300 million people globally. Diabetes is one of the most common diseases in the United States, with more than 100 million adults affected by type 2 diabetes and over 6.3 […]

An Evolution of Diabetes

EVOLUTION Diabetes is a major public health problem with a rapid increase in prevalence globally. Twelve percent of all health care spending is related to diabetes. The diagnosis and treatment of diabetes has evolved extensively over the last century. Although there is still no cure for the disorder, diabetes is much more manageable due to advancement in medicine and technology. In the beginning of the 20th century, Edward Schafer concluded that the pancreas of diabetics was unable to produce insulin […]

Acute Coronary Syndrome

The condition is characterized by pains in the chest and it is typically confirmed inside the hospital or the emergency room. It is also manageable if immediately confirmed. Acute syndrome occurs when plaques inside a narrowed vessel of blood splits causing thrombus development. This will consequently lead to unexpected partial or full blockage. The thrombus may also dislodge from a broken plaque consequently blocking the blood vessels. Explain risk factors Acute coronary syndrome may occur gradually in the long run […]

Child and Adolescent Obesity in the United States

Child and adolescent obesity in the United States has nearly tripled sincethe 70s. About 1 out of every 5 children suffer from childhood obesity. It is the duty ofmothers and fathers to prevent and find solutions to child and adolescent obesity. Thispaper will seek to explain the many causes and current results which parents can execute.Child and adolescent obesity comprises of several likely causes such as poor diet and lowphysical activity including numerous adverse effects. Therefore, changes in familyhousehold structures […]

Treatment of Diabetes in Adolescents

Abstract Background: Diabetes is a significant public health challenge facing the US and several other countries around the world. It is mostly perceived as a lifestyle disease, although type 1 diabetes can be viewed as a congenital autoimmune disorder. Diabetes is increasingly becoming a problem among young adolescents in America, with high prevalence and incidence rates. This study sought to establish the impact of treatment of adolescents for diabetes on their maturity process, demand for independence, parent-adolescent conflict, and their […]

Importance of Nursing Theories

Nursing theories are important tools for the designing, understanding, and application of diabetes patient education (Anderson, Funnell, & Hernandez, 2005). Imogene King is one of the nursing theorists who has made significant contributions to nursing. King's Conceptual Framework and Theory of Goal Attainment (TGA) is valuable in the care of diabetes patients and adherence to treatment. In my unit most commonly-used nursing theories include, King's theory of goal attainment to the care of the adult with diabetes mellitus. TGA theory […]

An Issue of Diabetes and Self-Efficacy

Abstract While self-efficacy is a proven clinical predictor of metabolic and glycemic control among people with poorly controlled Type 1 and Type 2 diabetes (Abubakari et al., 2015), few healthcare systems integrate effective biochemical individual strategies for disease management. Customized clinical meal plans, personalized education, high-intensity interval training (HIIT), and targeted health coaching have demonstrated significant improvement in clinical biomarkers associated with Type 2 diabetes and metabolic syndrome (MetS), including HOMA-IR, triglyceride/HDL ratio, HgA1c, fasting insulin, fasting glucose, fasting triglycerides, […]

A Problem of Diabetes

Low socioeconomic status has previously been associated with type 2 diabetes. Health is not only affected by individual risk factors and behaviors, but also a range of economic circumstances. Primarily, this issue is caused by the underuse or reduced access to recommended preventive care in individuals from low socioeconomic backgrounds. Economic issues inherent in diabetes stem from the fact that economically disadvantaged individuals do not have the support for healthy behaviors. Furthermore, economically disadvantaged individuals may lack access to clinical […]

Importance of Speech about Diabetes

On 14th November this year on World Diabetes Day we witnessed an amazing talk by the keynote speaker Dr. Ronny Bell at the University of Florida. The title of the talk was 'Challenges and Opportunities in achieving diabetes health equity.' He spoke about important issues that often get lost and not given too much importance when we talk about diabetes. He mentioned that we all know about the complications, we all know about the emergencies, but what we often don't […]

My Work as a Nurse

I work at Overlake Hospital Medical Center on a Medical Surgical and Oncology Unit. As a bedside nurse, my job and responsibility not only centered around vigilant monitoring for physiological changes and immediate needs of patients but also centered around an emotional aspect of caring and advocating. Our 37-bed unit provides care for various medical-surgical conditions, chemotherapy infusion, blood transfusion, dialysis, oncology with hospice, and end of life care patients on a day to day basis. As a bedside nurse, […]

My Understanding of Diabetes

For this essay I'll be covering the topic of diabetes. I've always found diabetes as an interesting topic; maybe because it's a huge problem for most people in the United States. you might be wonder what diabetes is, Diabetes is a disease in which the body response to the hormone insulin is impaired or not fully functional, resluting  in complications with the metabolism. Having high glucose is also one of the main reasons people get diabetes. Having high glucose in […]

My Research on Diabetes

Diabetes is a type of illness which is metabolic in nature leading to deficiencies in insulin. There are 2 types of diabetes (Type 1 and Type 2). Type 1 Diabetes (5-10% with diabetes), is known to be dependent in insulin, and would usually occur during childhood. This type of diabetes is a result of an autoimmune obliteration of Pancreatic ??-cell function. Another is Type 2 or the non-insulin dependent, correlates for 90-95% of those people with the diabetes. The onset […]

Diabetes Type 2: a Chronic Disease

Diabetes type 2 is a chronic disease which is widespread around the world. According to Mayo Clinic, type 2 diabetes is the most common type of diabetes that occurs due to high blood sugar and the lack of ability of the body to use insulin properly or make enough of it. Diabetes type 2 does not have a cure. However, it can be prevented or delayed. The most common causes of diabetes relate to people's lifestyle and their genetics. Physical […]

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  • Type 2 Diabetes Essays

Type 2 Diabetes Essays (Examples)

810+ documents containing “type 2 diabetes” .

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Type 2 diabetes defining 'type.

Brody states that "hen the average fasting level of blood sugar (glucose) rises above 100 milligrams per deciliter, diabetes is looming" (210). A rise in blood sugar level can then cause "an increasing cellular resistance to the effects of the hormone insulin... As blood sugar rises... The pancreas puts out more and more insulin (promoting further fat storage) until this gland is exhausted. Then when your fasting blood sugar level reaches 126 milligrams, you have diabetes" (Brody). Once Type 2 diabetes actually develops the potentially devastating effects of the disease may include "heart attacks or strokes" as well as "kidney failure, amputations and blindness" (Brody 210). Moreover, other negative effects of the sharp increase in incidents of Type 2 diabetes besides the devastation to one's health and quality of life (at increasingly young ages) currently also include economic and global effects. For example the treatment of diabetes "ranks No. 1….

Works Cited

Brody, Jane. "Diabesity,': A Crisis in an Expanding Country." 208-211.

Diabetes Type Analysis of Type 2 Diabetes

Diabetes Type Analysis of Type 2 Diabetes Local and National Statistics Compared Incidences and Prevalence According to data seen from 1994 through 1998 at the three university-based diabetes centers in Florida, 92 were classified with Type 2 diabetes. The proportion of patients increased over the five years from 9.4% in 1994 to 20.0% in 1998. From 1994 through 1998, there was a significant overall increase in the percentage of children referred with new-onset diabetes who were considered to have Type 2 diabetes[footnoteRef:1]. [1: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497443 / ] CDC carried out ehavioral Risk Factor Surveillance System (RFSS) surveys between 1995 to 1997, and 2005 to 2007 for examining state-specific changes and assessing geographic distribution of diabetes. During 2005 to 2007, incidence of diabetes ranged from 5.0 to 12.8 per 1,000 persons among 40 states, the District of Columbia, and two territories. The greatest incidence was observed in the South and Puerto Rico. Additionally, among thirty three states,….

Bibliography

Brownell, K.D., & Horgen, K.B. (2004). Food fight: The inside story of the food industry, America's obesity crisis, and what we can do about it. Chicago: Contemporary Publishing.

Flegal, K.M., Carroll, M.D., Ogden, C.L., & Johnson, C.L. (2002). Prevalence and trends in obesity among U.S. adults, 1999-2000. Journal of the American Medical Association 288(14), pp.1723-1727.

Lee, T., & Oliver, J.E. (2002, May). Public opinion and the politics of America's obesity epidemic. Retrieved from Harvard University, John F. Kennedy School of Government, ksgnotes1.harvard.edu/Research/wpaper.nsf/rwp/RWP02-017/$File/rwp02_017_lee.pdf

National Center for Chronic Disease Prevention and Health Promotion, (2004). Prevalence of diabetes. Retrieved June 8, 2004, from  http://www.cdc.gov/diabetes/statistics/prev/national/

Type 2 Diabetes

Type 2 diabetes (T2D) is a major chronic illness in the U.S., with 84 million adults being pre-diabetic (Centres for Disease Control and Prevention, 2017). Whereas risk factors are numerous, minority groups are at a particularly greater risk for T2D compared to the rest of the population. The high risk stems in large part from acculturation challenges – difficulties associated with adapting to the host country’s social and cultural norms (Deng, Zhang & Chan, 2013). This is especially true for Asian Americans (King, 2014), with prevalence for T2D being estimated at 9% (Nguyen et al., 2015). Appropriate intervention strategies are important for preventing type T2D in this group. Literature demonstrates that education can be useful for preventing the condition (Kerr et al., 2011; Deng, Zhang & Chan, 2013). This paper provides an evaluation of literature relating to T2D prevention through education. The evaluation is premised on the following PICOT question:….

Type 2 Diabetes and Its Etiology

Type 2 Diabetes Disease phenotype and genotype Although several major risk factors (particularly obesity/overweightness) have been identified for diabetes mellitus type 2’s (T2D) development, not much information is available on its etiology. Environmental as well as genetic elements play a central role, with disease risk probably a reflection of a multifaceted relationship between the two. Specific T2D epidemiology elements, the extensive susceptibility to it, growth in susceptibility among individuals of particular ethnicities, and the more recent well-defined linkage between disease risk and low weight at birth have triggered multiple theories. Such theories strive towards explaining the disease’s abovementioned key epidemiological facets, in addition to broadening insights into its etiology. A common theme in the thrifty phenotype and genotype theories is the idea that T2D susceptibility might point towards prior nutritional conditions. The latter theory holds that patients’ nutritional history supports genetic polymorphisms that increase likelihood of disease diagnosis. On the other hand,….

Type 2 Diabetes Signs Symptoms Treatments

signs and symptoms of Type 2 diabetes? Signs of Type 2 diabetes include dry mouth and excessive thirst, frequent urination, weight loss, fatigue, and headaches ("Symptoms of Type 2 Diabetes," n.d.). Unfortunately, many people are unaware that they have Type 2 diabetes and do not seek treatment early. The symptoms evolve slowly and emerge over time, which is why seeing a doctor is important. What if you have a positive diagnosis for this disease, do you have to see specific health specialists? Although a general practitioner can address many of the early signs and symptoms of the disease and help recommend treatments, courses of action, interventions, and lifestyle changes, specialists may be necessary as the disease progresses or if it was diagnosed in an advanced stage. Many of the tests administered to patients who have been diagnosed might need to be administered by specialists, but usually a primary or general practitioner is….

American Diabetes Association (2015). Checking blood glucose. Retrieved online:  http://www.diabetes.org/living-with-diabetes/recently-diagnosed/where-do-i-begin/checking-blood-glucose.html?referrer=https://www.google.com/ 

"Complications," (n.d.). Mayo Clinic. Retrieved online:  http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/complications/con-20031902 

Getaneh, A. (n.d.). Should I see a diabetes specialist? Retrieved online:  http://www.everydayhealth.com/specialists/diabetes/getenah/qa/should-i-see-diabetes-specialist/index.aspx 

"Symptoms of Type 2 Diabetes," (n.d.). Retrieved online:  http://www.webmd.com/diabetes/type-2-diabetes-guide/diabetes-warning-signs

Type 2 Diabetes in Australia

Determinants and Interventions for Type 2 Diabetes Type 2 Diabetes - Australia Type 2 Diabetes in Australia: Determinants and Interventions Type 2 diabetes by far the most common form of diabetes and is defined by glucose intolerance and elevated blood glucose levels (hyperglycaemia). Other physiological disorders frequently accompany diabetes, including dysregulation of lipid metabolism (dyslipidaemia), kidney function, and cardiovascular disease, which contribute significantly to the morbidity and mortality suffered by diabetes patients (arr, 2006, p. 6). Unfortunately, the cause of type 2 diabetes in most cases is not known (arr, 2006, p. iii), but a number of risk factors have been identified that if modified can help improve outcomes. A Significant Health Issue Type 2 diabetes mellitus is the fastest growing chronic disease in Australia, with approximately 275 adults developing the disease each day (arr et al., 2006, p. xi). At this rate 0.8% of the population develops diabetes each year (arr et al., 2006,….

Barr, E.L.M. et al. "AusDiab 2005: The Australian Diabetes, Obesity and Lifestyle Study. Tracking the Accelerating Epidemic: Its Causes and Outcomes." International Diabetes Institutes, Melbourne, Australia, (2006),  http://www.bakeridi.edu.au/Assets/Files/AUSDIAB_Report_2005.pdf , accessed May 2011.

Cameron, Adrian. J. et al. (2008). "The Metabolic Syndrome as a Tool for Predicting Future Diabetes: The AusDiab Study." Journal of Internal Medicine 264: 177-186.

Cameron, Adrian J. et al. (2009). "Health and Mortality Consequences of Abdominal Obesity: Evidence from the AusDiab Study." Medical Journal of Australia 191: 202-208.

Cardona-Morell, Magnolia et al. (2010). "Reduction of Diabetes Risk in Routing Clinical Practice: Are Physical Activity and Nutrition Interventions Feasible and are the Outcomes from Reference Trials Replicable? A Systematic Review and Meta-Analysis." BMC Public Health 10: 653-669.

Type 2 Diabetes and Diet

Diabetes and Drug TreatmentsTypes of DiabetesThere are various types of diabetes that can impact people of all ages. Type 1 diabetes is a situation in which a persons body does not produce enough insulin. Type 1 diabetes is also known as juvenile diabetes because it regularly occurs in children and in young adults. Type 2 diabetes is a situation in which the bodys cells simply do not respond in the appropriate way to the insulin produced in their bodies (Arcangelo & Peterson, 2006). Type 2 diabetes is the most common variant of diabetes with roughly 9 out of every 10 cases being one in which the type of diabetes is type 2. This type usually sets in later in life, around middle age.Gestational diabetes happens in pregnant women who have not been diagnosed as diabetic before. Their blood sugar levels to elevate during pregnancy, which causes them to experience this….

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2006). Pharmacotherapeutics for advanced practice: a practical approach (Vol. 536). Lippincott Williams & Wilkins.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: a big picture.  Pharmacoeconomics, 33(7), 673-689.

Does Vitamin D Supplementation Improve Glycemic Control in Type 2 Diabetes

Diabetes is caused by the body's inability to properly produce and handle insulin. Type 2 diabetes is the most common form of the disease, with over one million new cases diagnosed in the United States every year (Pittas, Lau, Hu, & Dawson-Hughes, 2007, 2017). The effects of type 2 diabetes can be devastating, for the patient as well as society as a whole. Diabetes is a leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of adult blindness, as well as a major cause of heart disease and stroke and the seventh leading cause of death in the United States (National Diabetes Information Clearinghouse, 2011). Besides the personal toll diabetes can exert on those afflicted, it is estimated that the disease costs the American healthcare system $174 billion a year, with only an estimated 25% of patients receiving the care necessary to treat and control the disease (Konrad,….

American Diabetes Association. (2012). Diabetes Basics: Type 2. American Diabetes Association. Retrieved from  http://www.diabetes.org/diabetes-basics/type-2/ 

Davis, Shani V. (2011). Vitamin D Deficiency and Type 2 Diabetes in African-Americans: The Common Denominators. Diabetes Spectrum, 24 (3), 148-153.

Endocrine Today. (2010). Surge of Information On Benefits of Vitamin D, But No Interventional Trial Data Exist Yet To Ensure Safety. Endocrine Today, July 2010. Retrieved from  http://www.healio.com/Endocrinology/news/print/Endocrine-Today/%7BD56FCB7D-C519-435C-8AAC-4BD4E5CA12CE%7D/Surge-of-information-on-benefits-of-vitamin-D-but-no-interventional-trial-data-exist-yet-to-ensure-s 

Konrad, Walecia. (2010, November 12). Protecting Yourself From The Cost of Type 2 Diabetes. New York Times. Retrieved from  http://www.nytimes.com/2010/11/13/health/13patient.html

Cultural Beliefs and Dietary Habits of Rural African Americans With Type 2 Diabetes

African-Americans in Louisiana & Type 2 Diabetes ates The poor will be always with us, we are biblically admonished. And for Americans we might add to this ancient maxim that the African-American poor will be always with us. Despite the many gains that they have made in the past 30 years African-Americans remain far more likely to be poor than are white Americans. This has a number of different consequences for African-American populations, including higher rates of certain diseases as well as less access to healthcare for those conditions. This paper examines the conjunction of the economic, social, and cultural status of African-Americans in Louisiana and their rates of Type 2 diabetes. African-Americans in Louisiana - as is true across the South and indeed across the nation - suffer from diabetes at least seemingly disproportionately high rates. However, once economic, social and cultural factors are taken into account, those rates no….

Aggleton, P., & Chalmers, H. (1985). Models and theories. Five. Orem's self-care model. Nursing Times, 81, 36-39.

Akers, R. (1997). Criminological theories: Introduction and evaluation. (2nd edition). Los Angeles: Roxbury Publishing.

Alexander, J.S., Younger, R.E., Cohen, R.M., & Crawford, L.V. (1988). Effectiveness of a nurse-managed program for children with chronic asthma. Journal of Pediatric Nursing: Nursing Care of Children and Families, 3(5), 312-317.

Allison, S.E., McLaughlin, K., & Walker, D. (1991). Nursing theory: a tool to put nursing back into nursing administration. Nursing Administration Quarterly, 15(3), 72-78.

Resistance Training RT in Older Adults with Type 2 Diabetes

Resistance Training (RT) in Older Adults with Type 2 Diabetes Diabetes Mellitus type 2 (T2D) among elderly individuals is a growing, prevalent problem. This age-prevalent metabolic ailment, marked by deficient insulin production owing to insulin resistance, is seen mostly among people aged 80+ years. The projected number of people belonging to this age group by 2050 is forty million. In this paper, the contribution of RT (resistance training) on elderly type 2 diabetics' (mean age=65+ years) metabolic, cardiovascular and neuromuscular functions will be examined (Hovanec et al. 2012). In the last ten years, experts have been showing increasing interest in evaluating RT's likely impact on aged type 2 diabetics. RT serves to activate individuals' muscular systems, creating force in opposition to resistive loads. This may be achieved using multiple exercise machines, calisthenics (lunges, sit-ups, pushups and crunches) and lifting dumbbells and other free-weights. When carried out on a regular basis with increased….

Further, the given meta-analysis revealed that RT has a moderate bearing on blood pressure. This favorable impact on cholesterol and blood pressure can prove to be promising, as the achievement of decreased blood pressure through exercise suggests better cardiovascular function, whilst reduced levels of cholesterol (particularly LDL), can aid in achieving decreased susceptibility to macro- and micro- vascular complications like heart attacks, atherosclerosis, and stroke. Prior studies have revealed positive blood pressure changes potentially brought about by RT. The above findings can prove highly valuable to type 2 diabetics with twice to four times more risks of contracting cardiovascular ailments. Additionally, blood pressure and LDL cholesterol improvements can improve this patient population's health outcomes. Enhanced physical functioning may improve their capacity of happily and safely engaging in a range of physical activities and successively decrease the sedentariness typical of type 2 diabetics. While it is not possible to arrive at sound conclusions using the given meta-analysis, RT's potential positive contribution to aged type 2 diabetics' diabetes management ought to be given some consideration, in view ofthe existing trends in obesity, diabetes and aging (Hovanec et al. 2012).

Hovanec, N., Sawant, A., Overend, T. J., Petrella, R. J., & Vandervoort, A. A. (2012). Resistance training and older adults with type 2 diabetes mellitus: strength of the evidence. Journal of aging research, 2012.

The Genetics of Type 2 Diabetes

1.Health. Diabetes can be inherited. Type 1 diabetes is something that can develop in early adulthood, specifically adolescence. Symptoms for onset of the disease include excessive thirst, frequent urination, and blurred vision (Florez, 2016). The patient, Holly, is exhibiting signs of diabetes. According to her family history, she has a father with type 1 diabetes who has multiple family members with type 1 diabetes. Holly is 17 and falls within the time frame when people begin developing type 1 diabetes complications. While she may only have excessive thirst, frequent urination, and high blood sugar as symptoms, the initial diagnosis of type 1 diabetes may have been favored if the history of the mother did not show a potential type 2 diabetes diagnosis. The mother’s history shows that on her side of the family there is morbid obesity with the mother and grandmother being morbidly obese and the grandmother suffering from type 2….

Health Program to Manage Type 2 Diabetes

Health Policy to Prevent and Manage Diabetes Health Issue and affected Population In the United States and other part of the world, the type 2 diabetes have become a major health concern for policy makers and health planners. Although, there are three types of diabetes, however 90% of people diagnosed with diabetes have type 2 diabetes, which is one of the predominant non-communicable diseases. The type 2 diabetes is one of the major public health challenges. While more than 150 million people are suffering from diabetes globally, however it is projected that the case of diabetes can reach 299 million by the year 2025. The type 2 diabetes occurs when there is an underproduction of insulin leading to several health complications such as damages to organs such as kidneys, eyes, heart, nerves and blood vessels. Alternatively, type 2 diabetes occurs when the body is unable to effectively use the insulin. The insulin….

CDC (2014).National Diabetes Statistics Report, 2014. U.S. Department of Health and Human Services.

Evelyn, Y.H. Chesla, C.A. & Chun, K.M. (2011). Health Communication With Chinese-Americans About Type 2 Diabetes. The Diabetes Educator.38(1):67-76.

Jacob, S. & Serrano-Gil, M. (2010). Engaging and Empowering Patients to Manage Their Type 2 Diabetes, Part II: Initiatives for Success. Adv Ther. 27(10):665-680.

Milstead, J.A. (2013). Health Policy and Politics: A Nurse's Guide. Chicano. Jones & Bartlett Publishers.

Complications of Type II Diabetes

Background Patient V.G., a 47 year old African American male, was diagnosed two years ago with type II diabetes. During a follow up, the patient complained of increased tingling in lower extremities. His medical history shows high or abnormal cholesterol levels (dyslipidemia, hypertension (HTN), obesity, and former smoking habits (stopped 2 years ago). He has no declared history of alcohol use. Living alone in subsidized housing and relying on food stamps and welfare, on occasion he works for extra income. The potential reason for the complaint of tingling lower extremities could come from not taking his medications for almost a week. He takes several medications: Lisinopril 20mg, Januvia 50mg QD, Lipitor 40mg QD and has a high blood pressure of 160/100. Lipitor is a known cholesterol lowering drug. Doctors prescribe Lisinopril to treat high blood pressure. Januvia helps lower blood sugar and therefore provides some relief for his type II diabetes. Without….

Effectiveness of Culturally Tailored Diabetes Education among Asian Americans

Introduction There are various risk factors that have been associated with the development of type 2 diabetes. These include, but they are not limited to, ethnicity and lifestyle. With regard to ethnicity, it is important to note that people of Asian descent have a higher predisposition to type 2 diabetes, in comparison to persons of European ancestry. Some of the complications associated with type 2 diabetes include cardiovascular disease, kidney damage, and nerve damage. It therefore follows that the relevance of proper control and management of type 2 diabetes cannot be overstated. For most persons with type 2 diabetes, the optimal control of the same tends to be a challenge. In that regard, therefore, there is need to assess how effective patient-specific dietary and lifestyle modifications are towards the control and management of type 2 diabetes. Towards this end, this study will chart pre-education and post-education glucose levels of 5-10 Asian….

Asian Americans Suffer from Diabetes

Overview The scholarly activity that I participated in was a workshop organized by the Hindu/Sikh community of our city at the Shri Durga Temple. The purpose of the workshop was to provide basic health education and basic health screenings—for example, cholesterol level checks, blood sugar level checks, blood pressure exams, BMI, weight measurements, free blood pressure monitoring and a blood donation camp. The target market for the activity was the non-white, Asian-American population, which is a population that is at increased levels of risk for type 2 diabetes, as several researchers have shown (Hus, Araneta, Kanaya, Chiang & Fujimoto, 2015; Islam et al., 2015). The benefit of this activity to me was that I was able to provide some health education to the Hindu/Sikh community, which is an Asian-American population at risk for developing type 2 diabetes. By providing this education I was able to fulfill my mandate as a health….

I\'m in need of some essay topics on recent childhood obesity epidemic. Can you provide assistance?

Essay Topics on the Recent Childhood Obesity Epidemic Introduction: In recent years, childhood obesity has emerged as a significant public health concern, affecting millions of children worldwide. The epidemic has far-reaching implications for both the physical and mental well-being of our children. This essay presents a comprehensive overview of the current childhood obesity epidemic, exploring its causes, consequences, and potential solutions. Causes of Childhood Obesity: Dietary Factors: The consumption of processed foods, sugary drinks, and unhealthy fats contributes significantly to childhood obesity. Sedentary Lifestyle: Lack of physical activity and increased screen time have led to decreased energy expenditure and increased calorie intake. Genetic....

Can you provide guidance on how to outline an essay focusing on Infectious diseases and lifestyle diseases

I. Introduction A. Brief explanation of infectious diseases B. Brief explanation of lifestyle diseases II. Infectious Diseases A. Definition and characteristics 1. Caused by pathogens such as bacteria, viruses, and fungi 2. Transmitted through direct contact, contaminated food or water, or vectors B. Common examples 1. Influenza 2. Tuberculosis 3. Malaria C. Prevention and control 1. Vaccinations 2. Good hygiene practices 3. Public health measures III. Lifestyle Diseases A. Definition and characteristics 1. Chronic diseases caused by unhealthy lifestyle choices 2. Develop over time due to factors such as poor diet, lack of exercise, and smoking B. Common examples 1. Cardiovascular diseases (heart disease, stroke) 2. Type 2 diabetes 3. Obesity C. Prevention and management 1. Healthy diet and nutrition 2. Regular physical activity 3. Smoking....

Outline: Infectious and Lifestyle Diseases I. Introduction - Hook: Start with a captivating statistic or narrative that highlights the global burden of infectious and lifestyle diseases. - Thesis statement: State the central argument that infectious and lifestyle diseases pose significant risks to human health, and that these risks are influenced by various lifestyle factors. II. Infectious Diseases - Definition of infectious diseases and their modes of transmission. - Examples of common infectious diseases (e.g., influenza, pneumonia, tuberculosis) and their associated symptoms and severity. - Factors contributing to the spread of infectious diseases, including poverty, poor sanitation, and lack of access to healthcare. - The role of public health....

I\'ve seen the common essay topics on type 2 diabetese. Any lesser-known but interesting ones you can recommend?

Certainly! Here are some lesser-known but interesting essay topics on type 2 diabetes: 1. The Impact of Sleep Deprivation on Type 2 Diabetes: Explore the connection between lack of sleep and an increased risk for developing type 2 diabetes, as well as the potential implications for managing the condition in individuals who already have it. 2. The Role of Gut Microbiota in Type 2 Diabetes: Investigate the relationship between the gut microbiome and the development and progression of type 2 diabetes, and discuss potential interventions that target the microbiome as a treatment strategy. 3. Socioeconomic Disparities in Type 2 Diabetes Care: Analyze the....

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  • Patient Care & Health Information
  • Diseases & Conditions
  • Type 2 diabetes

Type 2 diabetes is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel. That sugar also is called glucose. This long-term condition results in too much sugar circulating in the blood. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.

In type 2 diabetes, there are primarily two problems. The pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into the cells. And cells respond poorly to insulin and take in less sugar.

Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults. But the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.

There's no cure for type 2 diabetes. Losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to control blood sugar, diabetes medications or insulin therapy may be recommended.

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Symptoms of type 2 diabetes often develop slowly. In fact, you can be living with type 2 diabetes for years and not know it. When symptoms are present, they may include:

  • Increased thirst.
  • Frequent urination.
  • Increased hunger.
  • Unintended weight loss.
  • Blurred vision.
  • Slow-healing sores.
  • Frequent infections.
  • Numbness or tingling in the hands or feet.
  • Areas of darkened skin, usually in the armpits and neck.

When to see a doctor

See your health care provider if you notice any symptoms of type 2 diabetes.

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Type 2 diabetes is mainly the result of two problems:

  • Cells in muscle, fat and the liver become resistant to insulin As a result, the cells don't take in enough sugar.
  • The pancreas can't make enough insulin to keep blood sugar levels within a healthy range.

Exactly why this happens is not known. Being overweight and inactive are key contributing factors.

How insulin works

Insulin is a hormone that comes from the pancreas — a gland located behind and below the stomach. Insulin controls how the body uses sugar in the following ways:

  • Sugar in the bloodstream triggers the pancreas to release insulin.
  • Insulin circulates in the bloodstream, enabling sugar to enter the cells.
  • The amount of sugar in the bloodstream drops.
  • In response to this drop, the pancreas releases less insulin.

The role of glucose

Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues. The use and regulation of glucose includes the following:

  • Glucose comes from two major sources: food and the liver.
  • Glucose is absorbed into the bloodstream, where it enters cells with the help of insulin.
  • The liver stores and makes glucose.
  • When glucose levels are low, the liver breaks down stored glycogen into glucose to keep the body's glucose level within a healthy range.

In type 2 diabetes, this process doesn't work well. Instead of moving into the cells, sugar builds up in the blood. As blood sugar levels rise, the pancreas releases more insulin. Eventually the cells in the pancreas that make insulin become damaged and can't make enough insulin to meet the body's needs.

Risk factors

Factors that may increase the risk of type 2 diabetes include:

  • Weight. Being overweight or obese is a main risk.
  • Fat distribution. Storing fat mainly in the abdomen — rather than the hips and thighs — indicates a greater risk. The risk of type 2 diabetes is higher in men with a waist circumference above 40 inches (101.6 centimeters) and in women with a waist measurement above 35 inches (88.9 centimeters).
  • Inactivity. The less active a person is, the greater the risk. Physical activity helps control weight, uses up glucose as energy and makes cells more sensitive to insulin.
  • Family history. An individual's risk of type 2 diabetes increases if a parent or sibling has type 2 diabetes.
  • Race and ethnicity. Although it's unclear why, people of certain races and ethnicities — including Black, Hispanic, Native American and Asian people, and Pacific Islanders — are more likely to develop type 2 diabetes than white people are.
  • Blood lipid levels. An increased risk is associated with low levels of high-density lipoprotein (HDL) cholesterol — the "good" cholesterol — and high levels of triglycerides.
  • Age. The risk of type 2 diabetes increases with age, especially after age 35.
  • Prediabetes. Prediabetes is a condition in which the blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type 2 diabetes.
  • Pregnancy-related risks. The risk of developing type 2 diabetes is higher in people who had gestational diabetes when they were pregnant and in those who gave birth to a baby weighing more than 9 pounds (4 kilograms).
  • Polycystic ovary syndrome. Having polycystic ovary syndrome — a condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.

Complications

Type 2 diabetes affects many major organs, including the heart, blood vessels, nerves, eyes and kidneys. Also, factors that increase the risk of diabetes are risk factors for other serious diseases. Managing diabetes and controlling blood sugar can lower the risk for these complications and other medical conditions, including:

  • Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels, a condition called atherosclerosis.
  • Nerve damage in limbs. This condition is called neuropathy. High blood sugar over time can damage or destroy nerves. That may result in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
  • Other nerve damage. Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. Nerve damage also may cause erectile dysfunction.
  • Kidney disease. Diabetes may lead to chronic kidney disease or end-stage kidney disease that can't be reversed. That may require dialysis or a kidney transplant.
  • Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
  • Skin conditions. Diabetes may raise the risk of some skin problems, including bacterial and fungal infections.
  • Slow healing. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
  • Hearing impairment. Hearing problems are more common in people with diabetes.
  • Sleep apnea. Obstructive sleep apnea is common in people living with type 2 diabetes. Obesity may be the main contributing factor to both conditions.
  • Dementia. Type 2 diabetes seems to increase the risk of Alzheimer's disease and other disorders that cause dementia. Poor control of blood sugar is linked to a more rapid decline in memory and other thinking skills.

Healthy lifestyle choices can help prevent type 2 diabetes. If you've received a diagnosis of prediabetes, lifestyle changes may slow or stop the progression to diabetes.

A healthy lifestyle includes:

  • Eating healthy foods. Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains.
  • Getting active. Aim for 150 or more minutes a week of moderate to vigorous aerobic activity, such as a brisk walk, bicycling, running or swimming.
  • Losing weight. If you are overweight, losing a modest amount of weight and keeping it off may delay the progression from prediabetes to type 2 diabetes. If you have prediabetes, losing 7% to 10% of your body weight may reduce the risk of diabetes.
  • Avoiding long stretches of inactivity. Sitting still for long periods of time can increase the risk of type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.

For people with prediabetes, metformin (Fortamet, Glumetza, others), a diabetes medication, may be prescribed to reduce the risk of type 2 diabetes. This is usually prescribed for older adults who are obese and unable to lower blood sugar levels with lifestyle changes.

More Information

  • Diabetes prevention: 5 tips for taking control
  • Professional Practice Committee: Standards of Medical Care in Diabetes — 2020. Diabetes Care. 2020; doi:10.2337/dc20-Sppc.
  • Diabetes mellitus. Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dm. Accessed Dec. 7, 2020.
  • Melmed S, et al. Williams Textbook of Endocrinology. 14th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 3, 2020.
  • Diabetes overview. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/all-content. Accessed Dec. 4, 2020.
  • AskMayoExpert. Type 2 diabetes. Mayo Clinic; 2018.
  • Feldman M, et al., eds. Surgical and endoscopic treatment of obesity. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Oct. 20, 2020.
  • Hypersmolar hyperglycemic state (HHS). Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/hyperosmolar-hyperglycemic-state-hhs. Accessed Dec. 11, 2020.
  • Diabetic ketoacidosis (DKA). Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetic-ketoacidosis-dka. Accessed Dec. 11, 2020.
  • Hypoglycemia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/hypoglycemia. Accessed Dec. 11, 2020.
  • 6 things to know about diabetes and dietary supplements. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/tips/things-to-know-about-type-diabetes-and-dietary-supplements. Accessed Dec. 11, 2020.
  • Type 2 diabetes and dietary supplements: What the science says. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/providers/digest/type-2-diabetes-and-dietary-supplements-science. Accessed Dec. 11, 2020.
  • Preventing diabetes problems. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/all-content. Accessed Dec. 3, 2020.
  • Schillie S, et al. Prevention of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recommendations and Reports. 2018; doi:10.15585/mmwr.rr6701a1.
  • Caffeine: Does it affect blood sugar?
  • GLP-1 agonists: Diabetes drugs and weight loss
  • Hyperinsulinemia: Is it diabetes?
  • Medications for type 2 diabetes

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  • Mayo Clinic Q and A: Diabetes risk in Hispanic people Oct. 20, 2022, 12:15 p.m. CDT
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Home Essay Examples Health Type 2 Diabetes

Understanding Type 2 Diabetes

  • Category Health
  • Subcategory Disease
  • Topic Type 2 Diabetes

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Diabetes mellitus is a common metabolic disease that is classified by hyperglycemia due to disruption of normal insulin activity (American Diabetes Association [ADA], 2010). Hyperglycemia can be caused by disruption of insulin production or the body may be unable to respond to insulin (Toniolo et al. 2019). There are various forms of diabetes, for example, Type 1, Type 2, and gestational diabetes. The first type of diabetes is an autoimmune disease that results in complete insulin deficiency caused by the attack of B-cells in the pancreas (ADA, 2010).

While the second type of diabetes is classified as only relative insulin deficiency, typically caused by a secretion defect or insulin resistance (ADA, 2010). Gestational diabetes is restricted to pregnancy and typically goes away after delivery, but does increase the risk for later developing type 2 (ADA, 2010). However, type 2 diabetes is responsible for up to 90% of diagnosed cases (Chireh & D’Arcy, 2019). Common symptoms for diabetes include unexpected weight loss, fatigue, frequent urination, dry mouth, and losing feeling in your feet (Ramachandran, 2014). There are various risk factors for developing type 2 diabetes. The greatest risk factor is obesity, which is typically caused by poor diet and an inactive lifestyle (Reinehr, 2013). Cases of type 2 diabetes has increased greatly in the last 20 years in both children and adults, resulting in a need for prevention awareness (Reinehr, 2013). Type 2 diabetes is expensive and requires a lot of self-monitoring in order to maintain healthy insulin levels, which can put a lot of stress onto affected individuals and their loved ones. According to the American Diabetes Association (2018), the financial weight of diabetes was $327 billion in 2017, which is a rise of $82 billion within the last six years. Since cases and costs are increasing, this disease should be considered as a serious health issue. The concern of type 2 diabetes in adults can be better understood from analyzing the causes, diagnosis, and available treatments.

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The exact cause of Type 2 diabetes is undetermined, there are multiple well-known factors that contribute to its development. The most common risk factor for Type 2 diabetes is obesity, which can likely cause the body to develop resistance to insulin (ADA, 2010). A combination of inefficient diet choices and absence of physical activity can be a source of obesity. Another known risk factor of diabetes type 2 is genetics. A family history increases the risk of development, in fact it can increase by up to 40% when parents are diagnosed (Toniolo et al, 2019). While family history increases the risk of developing diabetes, it may have both genetic and environmental dynamics. This means that obese family members may impact the risk of their loved ones by normalizing poor diet choices and sedentary routines. However, genetics can impact the risk by passing down effected alleles like PPARD and PPARGC1A (Temelkova-Kurktschiev et al. 2011). These certain alleles can negatively influence how successful healthy diet choices and physical activity are to these individuals. Which means that even if effected individuals make proactive decisions on diet choices and staying physically active, their bodies do not properly show it and may result in obesity. In addition, certain alleles can be the source of insulin deficiency by reducing the body’s ability to respond to insulin. Type 2 diabetes can be attributed to various environmental and genetic factors.

A variety of serious health problems can arise as a result of type 2 diabetes. The most common cause of death for this form of diabetes is cardiovascular disease (Wu et al. 2014). Cardiovascular disease is a serious health problem because the heart is detrimental to the wellness of the body. Other increased health issues include diabetic neuropathy, nephropathy, and retinopath (Wu et al. 2014). The complication of diabetic neuropathy is losing feeling in body parts due to nerve damage (Wu et al. 2014). Foot amputations are a common consequence of diabetic neuropathy because it causes patients to lose awareness of their feet, making them vulnerable to infections. And untreated infections can spread throughout the body, becoming more serious complications. Nephropathy is a kidney disease complication that occurs when protein is found in urine (Wu et al. 2014). Another complication can result in vessels of the retina being damaged, possibly causing hemorrhage or fluid pooling in the retina (Wu et al. 2014). These health issues can progress slowly so it is important to be aware of the possible complications in order to be prepared. It has been found that the number of health issues is reduced by early detection (Aschner et al. 2016). A simple way to avoid serious health problems is staying alert and on top of your diagnosis. This means keeping up with doctor appointments and doing routine checks on your body, especially foot care in order to catch any problems early. Type 2 diabetes is a serious chronic disease that when untreated can cause severe health issues.

Most common available treatments for type 2 diabetes include lifestyle modifications, oral medicines, and insulin injections. Primary care providers have multiple treatment options available for patients with diabetes that range from prescription drugs to devices (Aschner et al. 2016). The most effective treatment to reduce high levels of glucose in blood is insulin injections (Wu et al. 2014). Insulin is a hormone that regulates glucose levels in blood by converting glucose to cellular energy. So these insulin injections allow people with high levels of glucose in their bodies return to normal levels. A few oral medications that can help regulate type 2 diabetes include biguanides, sulfonylureas, and thiazolidinediones (Wu et al. 2014). These types of medications work in different ways varying from decreasing glucose production to insulin sensitizers to increasing secretion of insulin (Wu et al. 2014). There are various treatment options, yet the most vital part is patient cooperation. Patients with diabetes need to take an active role once they are diagnosed because most treatments are self-monitored and lifestyle changes depend on their actions. There is a diversity in available treatments for diabetes that are individually determined for each patient based on their severity and ability to manage.

Type 2 Diabetes is a chronic disease that impacts people all over the world. While there is not one definite cause of this form of diabetes, genetic and environmental factors have been found to increase the risk (ADA, 2010). Practicing a healthy lifestyle by choosing nutritious diets and maintaining physical activity can reduce both the risk of development and the progression of serious health complications. Cardiovascular disease, kidney disease, nerve loss, and retina damage are serious health issues that can arise from diabetes (Wu et al. 2014). Without proper self monitoring, such serious health issues can slowly progress and turn into life threatening consequences. While oral medicines and insulin injections are common treatments, lifestyle modification is a non-hormonal treatment option available as well (Wu et al. 2014). Primary care providers commonly come into contact with diabetes and it is their responsibility to determine the best fit treatment for each patient. It is very important to understand the risk factors, complications, and treatment options of type 2 diabetes because it is a very common disease.

  • American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes care, 33 (1), S62–S69. https://doi.org/10.2337/dc10-S062
  • American Diabetes Association (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes care, 41 (5), 917-928. Doi: 10.2337/dci18-0007
  • Aschner, P. M., Muñoz, O. M., Girón, D., García, O. M., Fernández-Ávila, D. G., Casas, L. Á., Bohórquez, L. F., Arango T, C. M., Carvajal, L., Ramírez, D. A., Sarmiento, J. G., Colon, C. A., Correa G, N. F., Alarcón R, P., & Bustamante S, Á. A. (2016). Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults. Colombia Medica (Cali, Colombia), 47(2), 109–131.
  • Chireh, B., & D’Arcy, C. (2019). Shared and unique risk factors for depression and diabetes mellitus in a longitudinal study, implications for prevention: an analysis of a longitudinal population sample aged ⩾45 years. Therapeutic Advances in Endocrinology and Metabolism, 10, 10-15. https://doi.org/10.1177/2042018819865828
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  • Toniolo, A., Cassani, G., Puggioni, A., Rossi, A., Colombo, A., Onodera, T., & Ferrannini, E. (2019). The diabetes pandemic and associated infections: suggestions for clinical microbiology. Reviews in medical microbiology: A Journal of the Pathological Society of Great Britain and Ireland, 30(1), 1–17. Doi: 10.1097/MRM.0000000000000155
  • Wu, Y., Ding, Y., Tanaka, Y., & Zhang, W. (2014). Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. International journal of medical sciences, 11 (11), 1185–1200. https://doi.org/10.7150/ijms.10001

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Misconceptions and Beliefs Related to Diabetes Care and Their Effect on A1c Values in People With Type 2 Diabetes

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Heba Almasri , Ryan A. Popp; Misconceptions and Beliefs Related to Diabetes Care and Their Effect on A1c Values in People With Type 2 Diabetes. Clin Diabetes 2024; cd230071. https://doi.org/10.2337/cd23-0071

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Despite recent therapeutic advances, diabetes remains the seventh leading cause of death in the United States. Clinicians caring for people with diabetes often find that low health literacy interferes with diabetes care. The aim of this cross-sectional study was to determine which diabetes-related misunderstandings or potentially maladaptive health beliefs were present among people at a low-income community clinic in Harris County, TX, and to determine the effect of such misconceptions on A1C values.

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Effect of diet on type 2 diabetes mellitus: A review

1 Faculty of Industrial Management, Universiti Malaysia Pahang, Lebuhraya Tun Razak, 26300 Gambang, Kuantan, Pahang, Malaysia

2 Department of Public Health & Community Medicine, College of Medicine, Majmaah University, Kingdom of Saudi Arabia

Tahir Ansari

3 Department of Family Medicine, College of Medicine, Majmaah University, Kingdom of Saudi Arabia

Nadeem Shafique Butt

4 Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia

Mohd Rashid Ab Hamid

Globally, type 2 diabetes mellitus (T2DM) is considered as one of the most common diseases. The etiology of T2DM is complex and is associated with irreversible risk factors such as age, genetic, race, and ethnicity and reversible factors such as diet, physical activity and smoking. The objectives of this review are to examine various studies to explore relationship of T2DM with different dietary habits/patterns and practices and its complications. Dietary habits and sedentary lifestyle are the major factors for rapidly rising incidence of DM among developing countries. In type 2 diabetics, recently, elevated HbA1c level has also been considered as one of the leading risk factors for developing microvascular and macrovascular complications. Improvement in the elevated HbA1c level can be achieved through diet management; thus, the patients could be prevented from developing the diabetes complications. Awareness about diabetes complications and consequent improvement in dietary knowledge, attitude, and practices lead to better control of the disease. The stakeholders (health-care providers, health facilities, agencies involved in diabetes care, etc.) should encourage patients to understand the importance of diet which may help in disease management, appropriate self-care and better quality of life.

Introduction

Diabetes mellitus (DM) was first recognized as a disease around 3000 years ago by the ancient Egyptians and Indians, illustrating some clinical features very similar to what we now know as diabetes. 1 DM is a combination of two words, “diabetes” Greek word derivative, means siphon - to pass through and the Latin word “mellitus” means honeyed or sweet. In 1776, excess sugar in blood and urine was first confirmed in Great Britain. 2 , 3 With the passage of time, a widespread knowledge of diabetes along with detailed etiology and pathogenesis has been achieved. DM is defined as “a metabolic disorder characterized by hyperglycemia resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled DM can lead to damage various organs, especially the eyes, kidney, nerves, and cardiovascular system. 4 DM can be of three major types, based on etiology and clinical features. These are DM type 1 (T1DM), DM type 2 (T2DM), and gestational DM (GDM). In T1DM, there is absolute insulin deficiency due to the destruction of β cells in the pancreas by a cellular mediated autoimmune process. In T2DM, there is insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy. DM can arise from other diseases or due to drugs such as genetic syndromes, surgery, malnutrition, infections, and corticosteroids intake. 5 - 7

T2DM factors which can be irreversible such as age, genetic, race, and ethnicity or revisable such as diet, physical activity and smoking. 8 , 9

Epidemiology

Globally, T2DM is at present one of the most common diseases and its levels are progressively on the rise. It has been evaluated that around 366 million people worldwide or 8.3% in the age group of 20-79 years had T2DM in 2011. This figure is expected to rise to 552 million (9.9%) by 2030. 10 This disease is associated with severe complications which affect patient’s health, productivity, and quality of life. More than 50% of people with diabetes die of cardiovascular disease (CVD) (primarily heart disease and stroke) and is a sole cause of end stage renal disease which requires either dialysis or kidney transplantation. It is also a major cause of blindness due to retinal damage in adult age group referred to as diabetic retinopathy (DR). People with T2DM have an increased risk of lower limb amputation that may be 25 times greater than those without the disease. This disease caused around 4.6 million deaths in the age-group of 20-79 years in 2011. 11

Physical Activity and Lifestyle

A large number of cross-sectional as well as prospective and retrospective studies have found significant association between physical inactivity and T2DM. 12 A prospective study was carried out among more than thousand nondiabetic individuals from the high-risk population of Pima Indians. During an average follow-up period of 6-year, it was found that the diabetes incidence rate remained higher in less active men and women from all BMI groups. 13 The existing evidence suggests a number of possible biological pathways for the protective effect of physical activity on the development of T2DM. First, it has been suggested that physical activity increases sensitivity to insulin. In a comprehensive report published by Health and Human Services, USA, 2015 reported that physical activity enormously improved abnormal glucose tolerance when caused by insulin resistance primarily than when it was caused by deficient amounts of circulating insulin. 14 Second, physical activity is likely to be most beneficial in preventing the progression of T2DM during the initial stages, before insulin therapy is required. The protective mechanism of physical activity appears to have a synergistic effect with insulin. During a single prolonged session of physical activity, contracting skeletal muscle enhances glucose uptake into the cells. This effect increases blood flow in the muscle and enhances glucose transport into the muscle cell. 15 Third, physical activity has also been found to reduce intra-abdominal fat, which is a known risk factor for insulin resistance. In certain other studies, physical activity has been inversely associated with intra-abdominal fat distribution and can reduce body fat stores. 16 Lifestyle and environmental factors are reported to be the main causes of extreme increase in the incidence of T2DM. 17

Patient’s Knowledge Regarding DM

Among the patients, diabetes awareness and management are still the major challenges faced by stakeholders worldwide. Poor knowledge related to diabetes is reported in many studies from the developing countries. 18 Some studies have suggested that the occurrence of diabetes is different in various ethnic groups. 19 Knowledge is a requirement to achieve better compliance with medical therapy. 20 According to a study conducted by Mohammadi 21 patient’s knowledge and self-care management regarding DM was not sufficient. Low awareness of DM affects the outcome of diabetes. Another study conducted in Slovakia by Magurová 22 compared two groups of patients (those who received diabetes education and those who did not). The results indicated that receiving diabetes education significantly increased awareness about the disease in patients ( p < 0.001). The study further concluded that having diabetes knowledge can notably improve patient’s quality of life and lessen the burden on their family. Dussa 23 conducted a cross-sectional study on assessment of diabetes awareness in India. The study concluded that level of diabetes awareness among patients and general population was low. Another study conducted in India by Shah 24 reported that 63% of T2DM patients did not know what DM is and the majority were also unaware about its complications.

According to the study conducted by Bani 25 in Saudi Arabia, majority of the patients 97.3% males and 93.1% females were unaware about the importance of monitoring diabetes, with no significant gender difference. Diabetes knowledge, attitude, and practice were also studied in Qatari type 2 diabetics. The patients’ knowledge regarding diabetes was very poor, and their knowledge regarding the effect of diabetes on feet was also not appreciable. 26 Results from a study conducted in Najran, Saudi Arabia 27 reported that almost half of the patients did not have adequate knowledge regarding diabetes disease. Males in this study had more knowledge regarding diabetes than female patients. Diabetes knowledge among self-reported diabetic female teachers was studied in Al-Khobar, Saudi Arabia. 28 The study concluded that diabetes knowledge among diabetic female teachers was very poor. It was further suggested that awareness and education about diabetes should be urgently given to sample patients. The knowledge of diabetes provides the information about eating attitude, workout, weight monitoring, blood glucose levels, and use of medication, eye care, foot care, and control of diabetes complications. 29

Relation between Diet and Type 2 DM

The role of diet in the etiology of T2DM was proposed by Indians as mentioned earlier, who observed that the disease was almost confined to rich people who consumed oil, flour, and sugar in excessive amounts. 30 During the First and Second World Wars, declines in the diabetes mortality rates were documented due to food shortage and famines in the involved countries such as Germany and other European countries. In Berlin, diabetes mortality rate declined from 23.1/100,000 in 1914 to 10.9 in 1919. In contrast, there was no change in diabetes mortality rate in other countries with no shortage of food at the same time period such as Japan and North American countries. 31 Whereas few studies have found strong association of T2DM with high intake of carbohydrates and fats. Many studies have reported a positive association between high intake of sugars and development of T2DM. 32 In a study, Ludwig 33 investigated more than 500 ethnically diverse schoolchildren for 19 months. It was found that for each additional serving of carbonated drinks consumed, frequency of obesity increased, after adjusting for different parameters such as dietary, demographic, anthropometric, and lifestyle.

A study was conducted which included the diabetic patients with differing degrees of glycemic control. There were no differences in the mean daily plasma glucose levels or diurnal glucose profiles. As with carbohydrates, the association between dietary fats and T2DM was also inconsistent. 34 Many of prospective studies have found relations between fat intake and subsequent risk of developing T2DM. In a diabetes study, conducted at San Louis Valley, a more than thousand subjects without a prior diagnosis of diabetes were prospectively investigated for 4 years. In that study, the researchers found an association between fat intake, T2DM and impaired glucose tolerance. 35 , 36 Another study observed the relationship of the various diet components among two groups of women, including fat, fiber plus sucrose, and the risk of T2DM. After adjustment, no associations were found between intakes of fat, sucrose, carbohydrate or fiber and risk of diabetes in both groups. 37

Recently, evidence suggested a link between the intake of soft drinks with obesity and diabetes, resulting from large amounts of high fructose corn syrup used in the manufacturing of soft drinks, which raises blood glucose levels and BMI to the dangerous levels. 38 It was also stated by Assy 39 that diet soft drinks contain glycated chemicals that markedly augment insulin resistance. Food intake has been strongly linked with obesity, not only related to the volume of food but also in terms of the composition and quality of diet. 40 High intake of red meat, sweets and fried foods, contribute to the increased the risk of insulin resistance and T2DM. 41 In contrast, an inverse correlation was observed between intake of vegetables and T2DM. Consumption of fruits and vegetables may protect the development of T2DM, as they are rich in nutrients, fiber and antioxidants which are considered as protective barrier against the diseases. 42 Recently, in Japanese women, a report revealed that elevated intake of white rice was associated with an increased risk of T2DM. 43 This demands an urgent need for changing lifestyle among general population and further increase the awareness of healthy diet patterns in all groups.

Dietary Knowledge of Type 2 Diabetics

American Diabetes Association has defined self-dietary management as the key step in providing the diabetics, the knowledge and skill in relation with treatment, nutritional aspects, medications and complications. A study showed that the dietary knowledge of the targeted group who were at high risk of developing T2DM was poor. Red meat and fried food were consumed more by males as compared to females. The percent of males to females in daily rice consumption was significantly high. 44

In recent times in Saudi Arabia, food choices, size of portions and sedentary lifestyle have increased dramatically that resulted in high risk of obesity. Unfortunately, many Saudis are becoming more obese because of the convenience of fast foods, and this adds to the scary diabetes statistics. 45 On the other hand, Saudis drink too many high-sugar drinks. In addition, Backman 46 reported dietary knowledge to be a significant factor that influences dietary behaviors. In another study conducted by Savoca and Miller 47 stated that patients’ food selection and dietary behaviors may be influenced by the strong knowledge about diabetic diet recommendations. Significant positive relationship was observed between knowledge regarding diabetic diet and the amount of calorie needs (r = 0.27, p < 0.05). 48 The study concluded that knowledge regarding diabetic diet is essential and is needed to achieve better dietary behaviors. Results of study conducted in Saudi Arabia 25 reported that more than half of the diabetic patients denied modifying their dietary pattern, reduction in weight and perform exercise.

National Center for Health Statistics reported that socioeconomic status plays an important role in the development of T2DM; where it was known as a disease of the rich. 49 On the contrary, the same reference reported that T2DM was more prevalent in lower income level and in those with less education. The differences may be due to the type of food consumed. Nutritionists advised that nutrition is very important in managing diabetes, not only type but also quantity of food which influences blood sugar. Meals should be consumed at regular times with low fat and high fiber contents including a limited amount of carbohydrates. It was observed that daily consumption of protein, fat and energy intake by Saudi residents were higher than what is recommended by the International Nutritional Organization. 50

Attitude of Type 2 Diabetics Toward Food

DM can be controlled through improvement in patient’s dietary knowledge, attitudes, and practices. These factors are considered as an integral part of comprehensive diabetes care. 51 Although the prevalence of DM is high in gulf countries, patients are still deficient in understanding the importance of diet in diabetes management. 52 Studies have shown that assessing patients’ dietary attitude may have a considerable benefit toward treatment compliance and decrease the occurrence rate of complications as well. 52 A study conducted in Egypt reported that the attitude of the patients toward food, compliance to treatment, food control with and without drug use and foot care was inadequate. 53 Another study presented that one-third of the diabetic patients were aware about the importance of diet planning, and limiting cholesterol intake to prevent CVD. Various studies have documented increased prevalence of eating disorders and eating disorder symptoms in T2DM patients. Most of these studies have discussed about the binge eating disorder, due to its strong correlation with obesity, a condition that leads to T2DM. 53 Furthermore, a study revealed that the weight gain among diabetic patients was associated with the eating disorder due to psychological distress. 54 In another study that examined eating disorder-related symptoms in T2DM patients, suggested that the dieting-bingeing sequence can be applied to diabetics, especially obese diabetic patients. 55 Unhealthy eating habits and physical inactivity are the leading causes of diabetes. Failure to follow a strict diet plan and workout, along with prescribed medication are leading causes of complications among patients of T2DM. 56 Previous studies 57 conducted in Saudi Arabia have reported that diabetic patients do not regard the advice given by their physicians regularly regarding diet planning, diet modification and exercise.

Dietary Practices of Type 2 Diabetics

Diabetic’s dietary practices are mainly influenced by cultural backgrounds. Concerning each of the dimensions of dietary practices, there were significant positive relationships between knowledge regarding diabetic diet and dietary practices. Knowledge was a salient factor related to dietary behaviors control. 46 Moreover, patients’ knowledge on a recommended diet indicates their understanding of dietary guidelines which influenced their food selection and eating patterns. 47 The association between dietary knowledge and dietary practices among T2DM patients in the previous studies were inconsistent. Another study revealed that there was no relationship between dietary knowledge and compliance of dietary practices. 58 On the other hand, the same study found that a high dietary knowledge score was associated with following dietary recommendations and knowledgeable patients performed self-management activities in a better way. Dietary knowledge significantly influences dietary practices. In Indonesia, a study was conducted to measure dietary practices among diabetic patients, which elaborated that the Indonesian people, preferred to consume high-fat foods which lead to an increased risk of CVD. 59 The trend of skipping breakfast has dramatically increased over the past 10 years in children, adolescents, and adults. 60 , 61 There is increasing evidence that skipping breakfast is related with overweight and other health issues. 62 In addition, frequent eating or snacking may also increase the body weight and risk of metabolic diseases. 63 , 64 Rimm 65 demarcated western and prudent dietary patterns. The prudent dietary pattern was characterized by increased consumption of fish, poultry, various vegetables and fruits whereas; the western dietary pattern was characterized by an increased consumption of processed and red meat, chips, dairy products, refined grains, and sweets and desserts. These patterns were previously associated with T2DM risk. The glycemic index is an indicator of the postprandial blood glucose response to food per gram of carbohydrate compared with a reference food such as white bread or glucose. Hence, the glycemic load represents both the quality and quantity of the carbohydrates consumed. 66 - 69 Another study conducted in Lebanon demonstrated direct correlation of the refined grains and desserts and fast food patterns with T2DM, however, in the same study an inverse correlation was observed between the traditional food pattern and T2DM among Lebanese adults. 70

Type 2 Diabetes Complications

DM is the fourth among the leading causes of global deaths due to complications. Annually, more than three million people die because of diabetes or its complications. Worldwide, this disease weighs down on health systems and also on patients and their families who have to face too much financial, social and emotional strains. Diabetic patients have an increased risk of developing complications such as stroke, myocardial infarction, and coronary artery disease. However, complications such as retinopathy, nephropathy, and neuropathy can have a distressing impact on patient’s quality of life and a significant increase in financial burden. The prevalence reported from studies conducted worldwide on the complications of T2DM showed varying rates. The prevalence of cataracts was 26-62%, retinopathy 17-50%, blindness 3%, nephropathy 17-28%, cardiovascular complications 10-22.5%, stroke 6-12%, neuropathy 19-42%, and foot problems 5-23%. Mortality from all causes was reported between 14% and 40%. 71 In a study, researchers found that 15.8% incidence of DR is in the developing countries. The prevalence of DR reported from Saudi Arabia, Sri Lanka, and Brazil was 30%, 31.3%, and 35.4%, respectively; while in Kashmir it was 27% and in South Africa it was 40%. The prevalence of DR 26.1% was observed among 3000 diabetic patients from Pakistan; it was significantly higher than that what was reported in India (18%) and in Malaysia (14.9%). 72 - 76 Studies conducted on diabetes complications in Saudi Arabia are very few and restricted. A 1992 study from Saudi Arabia showed that in T2DM patients; occurrence rate of cataract was 42.7%, neuropathy in 35.9% patients, retinopathy in 31.5% patients, hypertension in 25% patients, nephropathy in 17.8% patients, ischemic heart disease in 41.3% patients, stroke in 9.4% patients, and foot infections in 10.4% of the patients. However, this study reported complications for both types of diabetes. 77

Relation between Dietary Practices and Diabetes Complications

Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of dyslipidemia in diabetic patients. 78 Several dietary interventional studies recommended nutrition therapy and lifestyle changes as the initial treatment for dyslipidemia. 79 , 80 Metabolic control can be considered as the cornerstone in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing microvascular complications and may also protect CVD, particularly in newly diagnosed patients. 81 Carbohydrate intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal macronutrient of worry in glycemic management. 82 In addition, an individual’s food choices and energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions and continuing the support for changes. 83 - 85 A study suggested that intake of virgin olive oil diet in the Mediterranean area has a beneficial effect on the reduction of progression of T2DM retinopathy. 86 Dietary habits are essential elements of individual cardiovascular and metabolic risk. 87 Numerous health benefits have been observed to the Mediterranean diet over the last decades, which contains abundant intake of fruit and vegetables. The beneficial effects of using fish and olive oil have been reported to be associated with improved glucose metabolism and decreased risk of T2DM, obesity and CVD. 88

The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.

Type 2 Diabetes: Prevention and Education Essay

Most people believe that type 2 diabetes is a disease of older people. However, in recent years, more and more young people have been diagnosed with Type 2 diabetes, which is usually associated with inadequate diet and lack of physical activity (Serbis et al., 2021). For this reason, prevention and education of adolescents and young people about diabetes are a necessity. Schillinger et al. (2018) came to the same conclusion; thus, their findings on the study of the Bigger Picture (TBP) campaign effectiveness among youth of color are necessary to explore diabetes prevention.

The first helpful idea that the authors suggest is how to motivate young people in disease prevention. Schillinger et al. (2018) say that long-term healthcare perspectives are weak motivators for adolescents while giving young people self-reliance. The ability to take the initiative and challenge authorities is more effective. In other words, older people require individual motivation, while youth is receptive to collective action (Cartagena et al., 2021; Schillinger et al., 2018). For this reason, the Bigger Picture (TBP) was shown to be effective among the participants as they perceived social and economic barriers more as the cause of Type 2 diabetes and communicated the need to confront them. At the same time, respondents also noted the importance of the individual choice of a healthy lifestyle. In addition, highlighted barriers such as unhealthy diets due to low family income, limited access to farm shops, and the promotion of unhealthy food are also useful information for learning about diabetes prevention. Consequently, these findings on youth motivation, individual and structural barriers, and the effectiveness of The Bigger Picture (TBP) will be used to research the topic of diabetes prevention and its complications and formulate recommendations.

Cartagena, V.M., Tort-Nasarre, G., & Rubinat Arnaldo, E. (2021). Barriers and facilitators for physical activity in adults with type 2 diabetes mellitus: A scoping review . International Journal of Environmental Research and Public Health , 18 (10), 1-16.

Schillinger, D., Tran, J., & Fine, S. (2018). Do low-income youth of color see “The Bigger Picture” when discussing type 2 diabetes: A qualitative evaluation of a public health literacy campaign? International Journal of Environmental Research and Public Health, 15 (5), 1-14.

Serbis, A., Giapros, V., Kotanidou, E.P., Galli-Tsinopoulou, A., & Siomou, E. (2021). Diagnosis, treatment and prevention of type 2 diabetes mellitus in children and adolescents. World Journal of Diabetes, 12 (4), 344-365.

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‘The ADA has a major say in how diabetes is managed globally.’

Low-carb diets work. Why does the American Diabetes Association push insulin instead?

The American Diabetes Association takes millions from companies that stand to profit from our reliance on drugs. Is that affecting their guidance?

F or a glimpse into how big business influences the $4tn US healthcare system, look no further than the world’s most powerful diabetes advocacy and research non-profit, the American Diabetes Association (ADA).

Diabetes afflicts 38 million Americans, with another 90 million considered pre-diabetic. Every year the disease claims the lives of over 100,000 Americans and disproportionately affects people of color. It is also ruinously expensive, as doctors visits, hospital stays, insulin, blood test strips, leg amputations, continuous glucose monitors and numerous glucose-lowering drugs add up to about $400bn a year. To put it bluntly, we are losing the war on diabetes.

And unlike many other diseases – such as certain cancers, Alzheimer’s, kidney disease, or Crohn’s – type 2 diabetes is reversible.

This bears repeating and elaboration. Numerous nutritional studies have shown that diabetes can be reversed through a strict diet low in carbohydrates, the macronutrient that people with diabetes cannot metabolize without the help of drugs. The ADA concedes this – but you wouldn’t necessarily know it from the drug therapies or the foods and recipes that the organization recommends to people suffering from the condition.

In 2020, the then ADA president, Tracey D Brown, rocked the diabetes world when she disclosed that she had type 2 diabetes and had gotten off insulin and other medications by adhering to a low-carbohydrate diet.

“Here is what I do. And it is pretty simple,” she said in an interview that might have made the ADA’s pharmaceutical benefactors crazy. “Elevated blood sugars happen when you have sugars in your body and you don’t have insulin to manage the sugars in your body. Carbohydrates turn into sugar. So I just try to get people to be aware of how many carbohydrates you are actually putting in your body.”

The very next day, the low-carb-focused website DietDoctor.com published a “breaking news” story about the “highly encouraging news” that “the influential CEO of the American Diabetes Association (ADA) is on the record as a low-carb eater”. The following year, Brown resigned her position at the ADA to take a senior role at Walgreens.

The evidence that low-carb diets can effectively treat diabetes has been around at least since before insulin’s discovery in 1921, when doctors often prescribed very low-carb (ie low-sugar), fat-rich diets to their patients. In the late 18th century, as recounted in Gary Taubes’s book Rethinking Diabetes: What Science Reveals About Diet, Insulin and Successful Treatments, a Scottish doctor by the name of John Rollo helped two patients with diabetes (a rarer condition those days) return to health by restricting their carbohydrate intake.

“The ingenious author of the work now before us,” a 1797 article in the Edinburgh review Annals of Medicine said, “recommends a mode of treatment, which in some cases, has been decidedly productive of remarkable benefit.”

In 2019, the ADA quietly and grudgingly acknowledged the low-carb diet’s effectiveness. In a journal article on dietary guidelines in its medical journal Diabetes Care, the ADA gave the low-carb diet its due:

“Low carbohydrate eating patterns, especially very low-carbohydrate eating patterns, have been shown to reduce A1C” – the metric that measures one’s blood sugar levels over a period of time – “and the need for antihyperglycemic medications. These eating patterns are among the most studied eating patterns for people with type 2 diabetes.”

Unfortunately, the ADA still sees diabetes as a progressive disease that gets worse over time. It still sanctions insulin therapy for people with type 2 diabetes, a remedy many doctors say will harm patients in the long run.

“Type 2 diabetes is a condition of too-high blood sugar and too-high insulin where the body is resisting the effects of insulin, and signaling that it has stored enough,” Mariela Glandt, a Harvard-trained endocrinologist who prescribes a low-carbohydrate diet to her patients in the Bronx, told me. “Giving insulin to someone with diabetes is like giving more alcohol to an alcoholic when they are shaking. It will treat the symptom – ie, the high sugar will come down – but in the end we make the disease worse and increase the chances of long-term complications.”

As I previously wrote about in the Guardian, I was diagnosed with type 2 diabetes three years ago and prescribed insulin shots and metformin, but was able to get off all medication by adhering to a strict low-carbohydrate diet.

The experience left me baffled. I couldn’t understand why only a tiny minority of clinicians seem to recommend a diet-based approach to diabetes treatment, rather than the insulin-heavy regimen I was initially prescribed. Or why the ADA’s huge educational campaigns soft-pedaled the diet, and preferred to let millions of people with type 2 diabetes take numerous medications or shoot themselves up with insulin instead.

This is not a minor matter; if people with diabetes were told clearly and unambiguously that if they stopped eating carbohydrate-rich foods they could probably arrest or reverse their diabetes, could thousands of lives and billions of dollars be saved?

“The reality is that if you want to treat type 2 diabetes effectively, the first thing you have to do is throw out the ADA’s dietary guidelines,” Sami Inkinen told me. Inkinen founded Virta Health, a healthcare startup that treats people with diabetes by prescribing a very low-carb diet. “The ADA has been slow to accept change. Very slow.”

The ADA’s messaging seems almost calculated to add to the confusion – as if, after 80 years of existence and billions of dollars spent on medical research, the ADA is merely a helpless observer in the low-carb diet debates.

“From carb-free to low-carb, to whole and empty carbs, it’s hard to know what it all means,” the ADA website reads . “‘Carbohydrates’ or ‘carbs’ get a lot of attention these days and it’s no secret that carbs can affect your blood glucose (blood sugar). You might be wondering if you should eat less of them, or even eat them at all. You’re not alone!”

The ADA’s chief scientific and medical officer, Dr Robert A Gabbay, said that the ADA’s dietary guidelines were the result of a rigorous scientific process undertaken annually by a team of medical experts who scrutinize the latest studies about how best to treat type 2 diabetes. “There is no ‘one size fits all’,” he told me. “There is more than one way for people to successfully manage their diabetes.”

He added that corporate funders have no say in the organization’s guidelines: “The standards of care process receives no funding from the industry, [and] our guidelines and recommendations are based on science.”

The ADA has a major say in how diabetes is managed globally. Its medical practice committees issue Standards of Care medical guidelines to American physicians and doctors around the world. The organization boasts a $100m annual budget, 600,000 volunteers and has 20,000 members from the healthcare community. It holds bike-a-thons and walk-a-thons, and publishes dietary guidelines and recipes that are downloaded by the millions every year. It publishes academic journals and holds medical conferences in which the latest research is presented. It funds medical research. It hosts summer camps for children with diabetes.

“Their professional practice committee writes all of the guidelines that we follow,” Kasia Lipska, an endocrinologist at the Yale School of Medicine, told me. “Clinicians have a lot of respect for that body. Their guidelines are the bible for diabetes medical practice.”

The ADA is far from the only obstacle to widespread adoption of a low-carb diet. Absent a national health education initiative that links carbohydrates to the diabetes epidemic, low-carb clinicians will be a voice in the wilderness. It can be challenging for many people with diabetes to forgo the breads, sweets, pastas and starches that form the basis of many diets. And given the dearth of healthy eating options on the shelves of many American supermarkets, some clinicians I spoke with, each of whom was dedicated to their patients’ wellbeing, said it was more effective to simply prescribe their patients pharmaceuticals.

“The low-carb diet can resonate,” a retired endocrinologist told me. “But of all the patients I had who adopted low-carb diets, very few were from lower socio-economic classes.”

Diabetes was hijacked as a business opportunity almost from the moment that insulin – the hormone that people with type 1 diabetes cannot produce – was first discovered by a team of researchers at the University of Toronto. In 1923, the University of Toronto board of governors sold the patent for insulin to Eli Lilly and Company for $1, because Lilly was better able to manufacture and distribute the synthetic hormone. “Insulin does not belong to me,” the insulin medication’s co-inventor, Sir Frederick G Banting, said. “It belongs to the world.”

Eventually two international drug companies – now known as Novo Nordisk and Novartis – wrangled patents as well.

“The reason the insulin story is so outrageous is that the inventors of insulin wanted insulin to belong to everybody,” David Mitchell, the founder of the non-profit organization Patients For Affordable Drugs, told me. “Somehow these three drug companies got together to create a global oligopoly. It’s a remarkable thing when you consider the birth of insulin.”

The ADA’s corporate contributions are not precisely traceable. Based on financial filings , this is what we know: between 2017 and 2024, more than 50 pharmaceutical and device manufacturers contributed over $134m to the organization, or roughly 20% of its total funding. Food industry contributions were not broken out.

It isn’t difficult to see how contributors to the ADA get bang for their buck. The ADA’s social media feed is a virtual supermarket of products purveyed by its funders.

Need a diabetes test? Go to CVS! ($10m 3 year partnership in 2021.) Want to learn more about kidney care? Do it with DaVita! ( $1.5m in 2024 .) Want to donate to the ADA? Just head over to your local GNC store and put your money in the tin can. ($100k in 2024.) Needless to say, a low-carbohydrate product that lowers blood sugar also reduces need for the drugs and ancillary products that make diabetes such a boon for the healthcare industry.

In 2021, Patients for Affordable Drugs published a landmark report exploring connections between 15 patient advocacy groups and the pharmaceutical industry. The ADA scored lowest because it: “Accepts funding from pharma industry” and also because it “Has board members with financial ties to pharma industry; Shares lobbyist and/or lobby firm with pharma,” the report said.

Reading the ADA’s publications, one would get the impression it is a grassroots organization supported by moms and pops. A banner on their website blares: “Your Support Goes Twice as Far!” Every few seconds, a pop-up announces a new small donation: “Patrick F donated $100.” “L Robert H. donated $12.” “Al S donated $20.” These small donors may not know that, in 2021, the Patients for Affordable Drugs report, found that a third “of the members of the ADA board of directors have financial ties to the pharmaceutical industry”.

Diabetes is a national scandal hiding in plain sight. Despite infinite medical innovations, including glucose-lowering drugs, fast- and slow-acting insulin, A1C tests, continuous glucose monitors and insulin pumps, more than 100,000 Americans die from the condition annually. In 1980, before many of these medical breakthroughs were available, that number was 35,000.

The big winners of the ADA’s cozy arrangements with industry, of course, are the pharmaceutical companies that enjoyed an estimated $58bn in annual sales in 2017, and the medical device and food companies who donate to the ADA in exchange for recipe endorsements.

The losers are the millions of people with diabetes who suffer amputations, blindness, neuropathy, often daily shoot themselves with insulin and eat carbohydrate-rich foods because they simply are not informed about their healthier options. It is not too late for the ADA to, loudly and in no uncertain terms, tell people with diabetes the truth. It might lose funders, but it would also save lives.

Neil Barsky, a former Wall Street Journal reporter and investment manager, is the founder of The Marshall Project

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  • New guidelines recommend GLP-1 drugs such as Ozempic to help treat type 2 diabetes in adults

an essay about type 2 diabetes

  • Researchers report that GLP-1 and SGLT-2 drugs can help people with type 2 diabetes control blood sugar .
  • They note that the high cost of drugs such Jardiance and Ozempic can be a barrier to treatment .
  • DPP-4 drugs were not recommended because researchers said they don’t appear to reduce morbidity or mortality .

Medications such as Jardiance and Ozempic can help people with type 2 diabetes who have trouble controlling their blood sugar when the drugs are used in conjunction with the diabetes medication metformin as well as interventions to improve diet and exercise.

That’s what the American College of Physicians (ACP) is saying in their newly revised clinical recommendations published today in the Annals of Internal Medicine .

“ACP recommends adding a sodium-glucose cotransporter-2 (SGLT-2) inhibitor or glucagon-like peptide-1 (GLP-1) agonist to metformin and lifestyle interventions in patients with type 2 diabetes and inadequate glycemic control,” said organization officials in updating their diabetes treatment guidelines for the first time since 2017.

“The American College of Physicians’ updated guidelines on pharmacological treatments for type 2 diabetes provides valuable recommendations for physicians, particularly in highlighting the benefits of SGLT-2 inhibitors and GLP-1 agonists for reducing serious complication risks,” Dr. William Hsu , an endocrinologist and chief medical officer at health nutrition firm L-Nutra, told Medical News Today . “However, it’s crucial to recognize that medication alone is not sufficient for optimal diabetes management. Type 2 diabetes is fundamentally a metabolic disorder rooted in insulin resistance and beta cell fatigue driven by factors like obesity, inactivity, a suboptimal diet, and aging. To achieve transformative diabetes care, we must address these underlying root causes. This is where innovative nutrition-based interventions can play a pivotal role.”

Ozempic, Jardiance as type 2 diabetes treatments

The physicians’ group said using a SGLT-2 inhibitor such as Jardiance can reduce the risk of all-cause mortality, major adverse cardiovascular events, progression of chronic kidney disease, and hospitalization due to congestive heart failure. SGLT-2 inhibitors help control diabetes by increasing excretion of glucose via urination.

GLP-1 agonists such as Ozempic help control blood sugar by stimulating the pancreas to release insulin and suppressing the release of a hormone called glucagon, which normally regulates blood glucose levels.

The ACP said this class of drugs can reduce the risk of all-cause mortality, major adverse cardiovascular events, and stroke among people with type 2 diabetes.

“Ozempic is a very powerful medication with specific mechanisms that address diabetes better than most other drugs, but it alone cannot address all the things diet and exercise can,” Dr. Suzannah Gerber , a researcher at the Tufts Friedman School of Nutrition Science and Policy in Boston, told Medical News Today .

“However, Ozempic can get strong results quickly which can be very encouraging for patients — an opportunity to bolster other healthy lifestyle behaviors,” she added.

Weight loss drugs are effective but expensive

“SGLT-2s and GLP-1s are costly, but lower cost options (like sulfonylureas) were inferior in reducing all-cause mortality and morbidity,” the ACP stated.

No genetic versions of the recommended drugs are currently available. An editorial published with the new guidelines noted that cost presents a significant barrier to people using these medications.

“Patients with obesity and diabetes need easier access to these medications, especially given their unmatched effectiveness for glucose control and weight reduction,” according to the editorial penned by physicians at the Duke University Division of General Internal Medicine in North Carolina.

“It’s frustrating to hear how well these medications are working but how difficult they are to get,” Stacey Simms , host of the podcast Diabetes Connections TYPE 2, told Medical News Today . “I have several listeners who’ve started on Ozempic or Mounjaro and see great success in bringing down their A1C [blood sugar levels]. But a few months in, the pharmacy tells them the supply isn’t there. I just spoke to a man who’s been taking Mounjaro since August of 2023 and now can’t find it anywhere. His doctor recommended he switch to Zepbound …That’s easier to find for some reason. He made the switch, but insurance won’t cover it. His choice is to pay $1,000 a month or worry that his A1C will go back up.”

Putting type 2 diabetes medication guidelines to use

The ACP guidelines focused on beneficial clinical outcomes rather than metrics such as glycemic control.

The physicians’ group noted that treatment needs to be tailored to the needs of each individual, taking into account factors such as age, co-morbidities, and personal preferences.

“These updates are in line with current guidelines from the American Diabetes Association and the American College of Cardiology and reflect current clinical practice,” Dr. Jacqueline Lonier , an assistant professor of medicine at Columbia University Irving Medical Center’s Naomi Berrie Diabetes Center in New York, told Medical News Today . “As most patients with type 2 diabetes are treated in the primary-care setting, the increasing utilization of SGLT2 inhibitors and GLP1 agonists by our primary-care colleagues will improve outcomes in people with type 2 diabetes on a population level.”

The clinical guidelines cautioned against treating people with type 2 diabetes with inadequate glycemic control with dipeptidyl peptidase-4 (DPP-4) inhibitors, saying that “high-certainty evidence showed that adding a DPP-4 inhibitor does not reduce morbidity or all-cause mortality.”

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Associations between Type 2 diabetes subtypes and complications

Analysis of the Malaysia national diabetes registry

Kazlauskaite, R., Ellermeier, N. , Ngongo, C. , Chandran, A., Desai, P., Ritz, E. , Nugent, R. , & Mustapha, F. I. (2023). Associations between Type 2 diabetes subtypes and complications: Analysis of the Malaysia national diabetes registry . Journal of Endocrinology and Metabolism , Online First (1). Advance online publication. https://doi.org/10.14740/jem879

Background: The aim of the study was to investigate type 2 diabetes (DM2) subtypes and associations with complications in a multiethnic Asian population. Methods: Analytical cohort (n = 60,946), extracted from 2019 Malaysia National Diabetes Registry, included 63.8% Malay, 16.7% Chinese, 11.3% Indian, and 11.3% other. A K-means cluster analysis was performed with complete data on six variables: age, DM2 duration, body mass index, metabolic syndrome severity, triglyceride-glucose index, and glycated hemoglobin­. Separate Cox regression models and time-to-event analysis (from DM2 diagnosis) assessed the hazard ratio (HR) and time-to-complications, adjusting for sex, age, and ethnicity. Results: Four clusters emerged: mild age-related diabetes (MARD) in 21,059 (35.6%), severe insulin-deficient diabetes (SIDD) in 11,751 (19.3%), mild obesity-related diabetes (MOD) in 14,700 (24.1%), and severe insulin-resistant diabetes (SIRD) in 13,436 (22.0%). Each cluster was compared to MARD. SIDD had later-onset and lowest HR for chronic kidney disease (CKD) (HR 0.25 (0.24 - 0.26)), retinopathy (HR 0.28 (0.27 - 0.30)), cerebrovascular disease (HR 0.57 (0.47 - 0.69)), and ischemic heart disease (HR 0.83 (0.76 - 0.91)). MOD had lowest HR (0.53 (0.34 - 0.84)) for limb amputations, and low HR for CKD, retinopathy, and cerebrovascular disease. SIRD had highest HR (1.43 (1.13 - 1.81)) for foot ulcers, and low HR (0.59 (0.56 - 0.63)) for retinopathy and CKD (HR 0.77 (0.74 - 0.80)). Known severe CKD cases were excluded from National Diabetes Registry. Conclusions: DM2 subtypes associate differently with complications in Malaysia, similar to patterns found in European cohorts. DM2 subtypes complications, particularly for advanced CKD, are affected by registry-related selection bias and deserve further longitudinal investigation.

10.14740/jem879

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Healthy Living with Diabetes

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How can I plan what to eat or drink when I have diabetes?

How can physical activity help manage my diabetes, what can i do to reach or maintain a healthy weight, should i quit smoking, how can i take care of my mental health, clinical trials for healthy living with diabetes.

Healthy living is a way to manage diabetes . To have a healthy lifestyle, take steps now to plan healthy meals and snacks, do physical activities, get enough sleep, and quit smoking or using tobacco products.

Healthy living may help keep your body’s blood pressure , cholesterol , and blood glucose level, also called blood sugar level, in the range your primary health care professional recommends. Your primary health care professional may be a doctor, a physician assistant, or a nurse practitioner. Healthy living may also help prevent or delay health problems  from diabetes that can affect your heart, kidneys, eyes, brain, and other parts of your body.

Making lifestyle changes can be hard, but starting with small changes and building from there may benefit your health. You may want to get help from family, loved ones, friends, and other trusted people in your community. You can also get information from your health care professionals.

What you choose to eat, how much you eat, and when you eat are parts of a meal plan. Having healthy foods and drinks can help keep your blood glucose, blood pressure, and cholesterol levels in the ranges your health care professional recommends. If you have overweight or obesity, a healthy meal plan—along with regular physical activity, getting enough sleep, and other healthy behaviors—may help you reach and maintain a healthy weight. In some cases, health care professionals may also recommend diabetes medicines that may help you lose weight, or weight-loss surgery, also called metabolic and bariatric surgery.

Choose healthy foods and drinks

There is no right or wrong way to choose healthy foods and drinks that may help manage your diabetes. Healthy meal plans for people who have diabetes may include

  • dairy or plant-based dairy products
  • nonstarchy vegetables
  • protein foods
  • whole grains

Try to choose foods that include nutrients such as vitamins, calcium , fiber , and healthy fats . Also try to choose drinks with little or no added sugar , such as tap or bottled water, low-fat or non-fat milk, and unsweetened tea, coffee, or sparkling water.

Try to plan meals and snacks that have fewer

  • foods high in saturated fat
  • foods high in sodium, a mineral found in salt
  • sugary foods , such as cookies and cakes, and sweet drinks, such as soda, juice, flavored coffee, and sports drinks

Your body turns carbohydrates , or carbs, from food into glucose, which can raise your blood glucose level. Some fruits, beans, and starchy vegetables—such as potatoes and corn—have more carbs than other foods. Keep carbs in mind when planning your meals.

You should also limit how much alcohol you drink. If you take insulin  or certain diabetes medicines , drinking alcohol can make your blood glucose level drop too low, which is called hypoglycemia . If you do drink alcohol, be sure to eat food when you drink and remember to check your blood glucose level after drinking. Talk with your health care team about your alcohol-drinking habits.

A woman in a wheelchair, chopping vegetables at a kitchen table.

Find the best times to eat or drink

Talk with your health care professional or health care team about when you should eat or drink. The best time to have meals and snacks may depend on

  • what medicines you take for diabetes
  • what your level of physical activity or your work schedule is
  • whether you have other health conditions or diseases

Ask your health care team if you should eat before, during, or after physical activity. Some diabetes medicines, such as sulfonylureas  or insulin, may make your blood glucose level drop too low during exercise or if you skip or delay a meal.

Plan how much to eat or drink

You may worry that having diabetes means giving up foods and drinks you enjoy. The good news is you can still have your favorite foods and drinks, but you might need to have them in smaller portions  or enjoy them less often.

For people who have diabetes, carb counting and the plate method are two common ways to plan how much to eat or drink. Talk with your health care professional or health care team to find a method that works for you.

Carb counting

Carbohydrate counting , or carb counting, means planning and keeping track of the amount of carbs you eat and drink in each meal or snack. Not all people with diabetes need to count carbs. However, if you take insulin, counting carbs can help you know how much insulin to take.

Plate method

The plate method helps you control portion sizes  without counting and measuring. This method divides a 9-inch plate into the following three sections to help you choose the types and amounts of foods to eat for each meal.

  • Nonstarchy vegetables—such as leafy greens, peppers, carrots, or green beans—should make up half of your plate.
  • Carb foods that are high in fiber—such as brown rice, whole grains, beans, or fruits—should make up one-quarter of your plate.
  • Protein foods—such as lean meats, fish, dairy, or tofu or other soy products—should make up one quarter of your plate.

If you are not taking insulin, you may not need to count carbs when using the plate method.

Plate method, with half of the circular plate filled with nonstarchy vegetables; one fourth of the plate showing carbohydrate foods, including fruits; and one fourth of the plate showing protein foods. A glass filled with water, or another zero-calorie drink, is on the side.

Work with your health care team to create a meal plan that works for you. You may want to have a diabetes educator  or a registered dietitian  on your team. A registered dietitian can provide medical nutrition therapy , which includes counseling to help you create and follow a meal plan. Your health care team may be able to recommend other resources, such as a healthy lifestyle coach, to help you with making changes. Ask your health care team or your insurance company if your benefits include medical nutrition therapy or other diabetes care resources.

Talk with your health care professional before taking dietary supplements

There is no clear proof that specific foods, herbs, spices, or dietary supplements —such as vitamins or minerals—can help manage diabetes. Your health care professional may ask you to take vitamins or minerals if you can’t get enough from foods. Talk with your health care professional before you take any supplements, because some may cause side effects or affect how well your diabetes medicines work.

Research shows that regular physical activity helps people manage their diabetes and stay healthy. Benefits of physical activity may include

  • lower blood glucose, blood pressure, and cholesterol levels
  • better heart health
  • healthier weight
  • better mood and sleep
  • better balance and memory

Talk with your health care professional before starting a new physical activity or changing how much physical activity you do. They may suggest types of activities based on your ability, schedule, meal plan, interests, and diabetes medicines. Your health care professional may also tell you the best times of day to be active or what to do if your blood glucose level goes out of the range recommended for you.

Two women walking outside.

Do different types of physical activity

People with diabetes can be active, even if they take insulin or use technology such as insulin pumps .

Try to do different kinds of activities . While being more active may have more health benefits, any physical activity is better than none. Start slowly with activities you enjoy. You may be able to change your level of effort and try other activities over time. Having a friend or family member join you may help you stick to your routine.

The physical activities you do may need to be different if you are age 65 or older , are pregnant , or have a disability or health condition . Physical activities may also need to be different for children and teens . Ask your health care professional or health care team about activities that are safe for you.

Aerobic activities

Aerobic activities make you breathe harder and make your heart beat faster. You can try walking, dancing, wheelchair rolling, or swimming. Most adults should try to get at least 150 minutes of moderate-intensity physical activity each week. Aim to do 30 minutes a day on most days of the week. You don’t have to do all 30 minutes at one time. You can break up physical activity into small amounts during your day and still get the benefit. 1

Strength training or resistance training

Strength training or resistance training may make your muscles and bones stronger. You can try lifting weights or doing other exercises such as wall pushups or arm raises. Try to do this kind of training two times a week. 1

Balance and stretching activities

Balance and stretching activities may help you move better and have stronger muscles and bones. You may want to try standing on one leg or stretching your legs when sitting on the floor. Try to do these kinds of activities two or three times a week. 1

Some activities that need balance may be unsafe for people with nerve damage or vision problems caused by diabetes. Ask your health care professional or health care team about activities that are safe for you.

 Group of people doing stretching exercises outdoors.

Stay safe during physical activity

Staying safe during physical activity is important. Here are some tips to keep in mind.

Drink liquids

Drinking liquids helps prevent dehydration , or the loss of too much water in your body. Drinking water is a way to stay hydrated. Sports drinks often have a lot of sugar and calories , and you don’t need them for most moderate physical activities.

Avoid low blood glucose

Check your blood glucose level before, during, and right after physical activity. Physical activity often lowers the level of glucose in your blood. Low blood glucose levels may last for hours or days after physical activity. You are most likely to have low blood glucose if you take insulin or some other diabetes medicines, such as sulfonylureas.

Ask your health care professional if you should take less insulin or eat carbs before, during, or after physical activity. Low blood glucose can be a serious medical emergency that must be treated right away. Take steps to protect yourself. You can learn how to treat low blood glucose , let other people know what to do if you need help, and use a medical alert bracelet.

Avoid high blood glucose and ketoacidosis

Taking less insulin before physical activity may help prevent low blood glucose, but it may also make you more likely to have high blood glucose. If your body does not have enough insulin, it can’t use glucose as a source of energy and will use fat instead. When your body uses fat for energy, your body makes chemicals called ketones .

High levels of ketones in your blood can lead to a condition called diabetic ketoacidosis (DKA) . DKA is a medical emergency that should be treated right away. DKA is most common in people with type 1 diabetes . Occasionally, DKA may affect people with type 2 diabetes  who have lost their ability to produce insulin. Ask your health care professional how much insulin you should take before physical activity, whether you need to test your urine for ketones, and what level of ketones is dangerous for you.

Take care of your feet

People with diabetes may have problems with their feet because high blood glucose levels can damage blood vessels and nerves. To help prevent foot problems, wear comfortable and supportive shoes and take care of your feet  before, during, and after physical activity.

A man checks his foot while a woman watches over his shoulder.

If you have diabetes, managing your weight  may bring you several health benefits. Ask your health care professional or health care team if you are at a healthy weight  or if you should try to lose weight.

If you are an adult with overweight or obesity, work with your health care team to create a weight-loss plan. Losing 5% to 7% of your current weight may help you prevent or improve some health problems  and manage your blood glucose, cholesterol, and blood pressure levels. 2 If you are worried about your child’s weight  and they have diabetes, talk with their health care professional before your child starts a new weight-loss plan.

You may be able to reach and maintain a healthy weight by

  • following a healthy meal plan
  • consuming fewer calories
  • being physically active
  • getting 7 to 8 hours of sleep each night 3

If you have type 2 diabetes, your health care professional may recommend diabetes medicines that may help you lose weight.

Online tools such as the Body Weight Planner  may help you create eating and physical activity plans. You may want to talk with your health care professional about other options for managing your weight, including joining a weight-loss program  that can provide helpful information, support, and behavioral or lifestyle counseling. These options may have a cost, so make sure to check the details of the programs.

Your health care professional may recommend weight-loss surgery  if you aren’t able to reach a healthy weight with meal planning, physical activity, and taking diabetes medicines that help with weight loss.

If you are pregnant , trying to lose weight may not be healthy. However, you should ask your health care professional whether it makes sense to monitor or limit your weight gain during pregnancy.

Both diabetes and smoking —including using tobacco products and e-cigarettes—cause your blood vessels to narrow. Both diabetes and smoking increase your risk of having a heart attack or stroke , nerve damage , kidney disease , eye disease , or amputation . Secondhand smoke can also affect the health of your family or others who live with you.

If you smoke or use other tobacco products, stop. Ask for help . You don’t have to do it alone.

Feeling stressed, sad, or angry can be common for people with diabetes. Managing diabetes or learning to cope with new information about your health can be hard. People with chronic illnesses such as diabetes may develop anxiety or other mental health conditions .

Learn healthy ways to lower your stress , and ask for help from your health care team or a mental health professional. While it may be uncomfortable to talk about your feelings, finding a health care professional whom you trust and want to talk with may help you

  • lower your feelings of stress, depression, or anxiety
  • manage problems sleeping or remembering things
  • see how diabetes affects your family, school, work, or financial situation

Ask your health care team for mental health resources for people with diabetes.

Sleeping too much or too little may raise your blood glucose levels. Your sleep habits may also affect your mental health and vice versa. People with diabetes and overweight or obesity can also have other health conditions that affect sleep, such as sleep apnea , which can raise your blood pressure and risk of heart disease.

Man with obesity looking distressed talking with a health care professional.

NIDDK conducts and supports clinical trials in many diseases and conditions, including diabetes. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.

What are clinical trials for healthy living with diabetes?

Clinical trials—and other types of clinical studies —are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help health care professionals and researchers learn more about disease and improve health care for people in the future.

Researchers are studying many aspects of healthy living for people with diabetes, such as

  • how changing when you eat may affect body weight and metabolism
  • how less access to healthy foods may affect diabetes management, other health problems, and risk of dying
  • whether low-carbohydrate meal plans can help lower blood glucose levels
  • which diabetes medicines are more likely to help people lose weight

Find out if clinical trials are right for you .

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical trials for healthy living with diabetes are looking for participants?

You can view a filtered list of clinical studies on healthy living with diabetes that are federally funded, open, and recruiting at www.ClinicalTrials.gov . You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your primary health care professional before you participate in a clinical study.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.

NIDDK would like to thank: Elizabeth M. Venditti, Ph.D., University of Pittsburgh School of Medicine.

IMAGES

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COMMENTS

  1. Type 2 Diabetes

    The typical symptoms of type 2 diabetes include: recurrent urination, excessive thirst, and persistent hunger (Wilson &Mehra, 1997). Type 2 diabetes is caused by a mixture of lifestyle and hereditary factors. Even though some factors, like nutrition and obesity, are under individual control, others like femininity, old age, and genetics are not.

  2. Management of Type 2 Diabetes: Current Strategies, Unfocussed Aspects

    Introduction. Insulin resistance and β-cell dysfunction are the 2 major hallmarks of type 2 diabetes mellitus (T2DM) that appear as the result of disturbed homeostasis [].Failure of β-cells (∼80% of their β-cell function) and insulin resistance in muscles and the liver is a vicious triumvirate responsible for the core physiological defects.

  3. 357 Diabetes Essay Topics & Examples

    357 Diabetes Essay Topics & Examples. Updated: Feb 25th, 2024. 26 min. When you write about the science behind nutrition, heart diseases, and alternative medicine, checking titles for diabetes research papers can be quite beneficial. Below, our experts have gathered original ideas and examples for the task. We will write.

  4. Pathophysiology of diabetes: An overview

    This type of diabetes is often described as "Latent Autoimmune Diabetes in Adults (LADA)," also known as "slowly progressing insulin-dependent diabetes." LADA is the most common form of adult-onset autoimmune diabetes and accounts for 2-12% of all diabetic cases in the adult population.[ 16 ]

  5. Type 2 diabetes is not one-size-fits-all: Subtypes affect complications

    In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This ...

  6. Type 2 Diabetes as a Public Health Issue Essay

    High mortality rates are caused by the disease complications that gradually progress, significantly reducing the quality and duration of one's life. This paper aims to examine type 2 diabetes, including the related problems, potential solutions, and recommendations. We will write a custom essay on your topic. 809 writers online.

  7. Type 2 Diabetes Mellitus: A Pathophysiologic Perspective

    Type 2 Diabetes Mellitus (T2DM) is characterized by chronically elevated blood glucose (hyperglycemia) and elevated blood insulin (hyperinsulinemia). When the blood glucose concentration is 100 milligrams/deciliter the bloodstream of an average adult contains about 5-10 grams of glucose. Carbohydrate-restricted diets have been used effectively to treat obesity and T2DM for over 100 years ...

  8. The prevention and control the type-2 diabetes by changing lifestyle

    Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or ...

  9. Type 2 Diabetes Essay

    Type 2 diabetes (T2D) is a highly dominant and long-lasting metabolic disorder (Mukherjee 439). WHO suspects that by the year of 2025 up to 200-300 million people worldwide will have developed type 2 diabetes (Hussain 318). Approximately half of the risk factor for individuals with type 2 diabetes is due to environmental contact and to genetics ...

  10. Essay on Diabetes for Students and Children

    Diabetes Mellitus can be described in two types: 1) Type 1. 2) Type 2. Description of two types of Diabetes Mellitus are as follows. 1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly ...

  11. Type 2 Diabetes

    Type 2 Diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). Essays could explore the risk factors, prevention strategies, and management of Type 2 Diabetes. Discussions on its socioeconomic impact and the challenges in managing this condition in various healthcare settings could also be enlightening.

  12. Type 2 Diabetes Essays (Examples)

    Diabetes Type Analysis of Type 2 Diabetes Local and National Statistics Compared Incidences and Prevalence According to data seen from 1994 through 1998 at the three university-based diabetes centers in Florida, 92 were classified with Type 2 diabetes. The proportion of patients increased over the five years from 9.4% in 1994 to 20.0% in 1998. From 1994 through 1998, there was a significant ...

  13. The Role of Obesity in Type 2 Diabetes Mellitus—An Overview

    Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in all age groups. It has reached pandemic dimensions, making the treatment of obesity crucial in the prevention and management of type 2 DM worldwide. Multiple clinical studies have demonstrated that moderate and sustained weight ...

  14. Type 2 diabetes

    Causes. Type 2 diabetes is mainly the result of two problems: Cells in muscle, fat and the liver become resistant to insulin As a result, the cells don't take in enough sugar. The pancreas can't make enough insulin to keep blood sugar levels within a healthy range. Exactly why this happens is not known.

  15. Type 2 diabetes mellitus

    The aim of this essay is to explore the psychological implications for a person suffering from type 2 diabetes and others involved in the experience of that illness. Type 2 diabetes, is caused as the result of reduced secretion of insulin and to peripheral resistance to the action of insulin; that is, the insulin in the body does not have its ...

  16. Public Health Issue: Diabetes Mellitus

    In the majority of cases, type 2 diabetes is treated with lifestyle changes such as eating healthier, weight loss, and increasing physical exercise (Diabetes UK, 2007b). There are currently 2.6 million people in the UK with diabetes, and it is thought up to a further 1.1 million are undiagnosed. (Diabetes UK, 2010).

  17. Understanding Type 2 Diabetes: Essay Example, 1473 words

    There are various forms of diabetes, for example, Type 1, Type 2, and gestational diabetes. The first type of diabetes is an autoimmune disease that results in complete insulin deficiency caused by the attack of B-cells in the pancreas (ADA, 2010). While the second type of diabetes is classified as only relative insulin deficiency, typically ...

  18. Misconceptions and Beliefs Related to Diabetes Care and Their Effect on

    Clinicians caring for people with diabetes often find that low health literacy interferes with diabetes care. The aim of this cross-sectional study was to determine which diabetes-related misunderstandings or potentially maladaptive health beliefs were present among people at a low-income community clinic in Harris County, TX, and to determine ...

  19. Undiagnosed type 2 diabetes: an invisible risk factor

    In contrast, the diagnosis of type 2 diabetes is substantially more straightforward. Yet, recent figures from the UK Office for National Statistics (ONS) estimate that 30% (approximately 1 million) of the adults living with type 2 diabetes in England between 2013 and 2019 were undiagnosed. The ONS data indicate that 7-10% of adults in England had type 2 diabetes and around one in nine adults ...

  20. The Type 1 and Type 2 Diabetes: [Essay Example], 454 words

    Type 1 diabetes is always treated with insulin. Meal planning also helps with keeping blood sugar at the right levels. Type 1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with type 2 diabetes who appear to have immune-mediated loss of pancreatic beta cells. Type 2 ...

  21. Effect of diet on type 2 diabetes mellitus: A review

    Type 2 Diabetes Complications. DM is the fourth among the leading causes of global deaths due to complications. Annually, more than three million people die because of diabetes or its complications. Worldwide, this disease weighs down on health systems and also on patients and their families who have to face too much financial, social and ...

  22. What Is Diabetes?

    People with type 1 diabetes need to take insulin every day to stay alive. Type 2 diabetes. If you have type 2 diabetes, the cells in your body don't use insulin properly. The pancreas may be making insulin but is not making enough insulin to keep your blood glucose level in the normal range. Type 2 diabetes is the most common type of diabetes.

  23. Type 2 Diabetes: Prevention and Education Essay

    Type 2 Diabetes: Prevention and Education Essay. Most people believe that type 2 diabetes is a disease of older people. However, in recent years, more and more young people have been diagnosed with Type 2 diabetes, which is usually associated with inadequate diet and lack of physical activity (Serbis et al., 2021).

  24. What Is Type 2 Diabetes Mellitus Nursing Essay

    Type 2 diabetes is the most common form of the disease. Diabetes mellitus is where the body cells cannot use glucose properly for lack of or resistance to the hormone insulin, which is produced by the pancreas. Diabetes can lead to serious complications over time if left untreated. The high blood sugar levels from uncontrolled diabetes can ...

  25. Low-carb diets work. Why does the American Diabetes Association push

    "Type 2 diabetes is a condition of too-high blood sugar and too-high insulin where the body is resisting the effects of insulin, and signaling that it has stored enough," Mariela Glandt, a ...

  26. Type 2 diabetes: New guidelines on using GLP-1 drugs such as Ozempic

    Researchers report that GLP-1 and SGLT-2 drugs can help people with type 2 diabetes control blood sugar.; They note that the high cost of drugs such Jardiance and Ozempic can be a barrier to treatment

  27. Associations between Type 2 diabetes subtypes and complications

    Background: The aim of the study was to investigate type 2 diabetes (DM2) subtypes and associations with complications in a multiethnic Asian population. Methods: Analytical cohort (n = 60,946), extracted from 2019 Malaysia National Diabetes Registry, included 63.8% Malay, 16.7% Chinese, 11.3% Indian, and 11.3% other.

  28. Exercise shown to curb appetite in diabetes and prediabetes patients

    Please use one of the following formats to cite this article in your essay, paper or report: APA. Sai Lomte, Tarun. (2024, April 15). Exercise shown to curb appetite in diabetes and prediabetes ...

  29. Healthy Living with Diabetes

    Healthy living is a way to manage diabetes. To have a healthy lifestyle, take steps now to plan healthy meals and snacks, do physical activities, get enough sleep, and quit smoking or using tobacco products. Healthy living may help keep your body's blood pressure, cholesterol, and blood glucose level, also called blood sugar level, in the ...

  30. Nutrients

    Gestational diabetes mellitus (GDM) is one of the common complications during pregnancy. Numerous studies have shown that GDM is associated with a series of adverse effects on both mothers and offspring. Due to the particularity of pregnancy, medical nutrition treatment is considered to be the first choice for the treatment of GDM. This contribution reviews the research progress of medical ...