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May 22, 2013
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Diabetes (cont.)

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Types of Diabetes?

Type 1 diabetes (T1D): The body stops producing insulin or produces too little insulin to regulate blood glucose level.

  • Type 1 diabetes involves about 10% of all people with diabetes in the United States.
  • Type 1 diabetes is typically diagnosed during childhood or adolescence. It used to be referred to as juvenile-onset diabetes or insulin-dependent diabetes mellitus.
  • Type 1 diabetes can occur in an older individual due to destruction of the pancreas by alcohol, disease, or removal by surgery. It also results from progressive failure of the pancreatic beta cells, the only cell type that produces significant amounts of insulin.
  • People with type 1 diabetes require insulin treatment daily to sustain life.

Type 2 diabetes (T2D): Although the pancreas still secretes insulin, the body of someone with type 2 diabetes is partially or completely unable to use this insulin. This is sometimes referred to as insulin resistance. The pancreas tries to overcome this resistance by secreting more and more insulin. People with insulin resistance develop type 2 diabetes when they fail to secrete enough insulin to cope with their higher demands.

  • At least 90% of adult individuals with diabetes have type 2 diabetes.
  • Type 2 diabetes is typically diagnosed in adulthood, usually after age 45 years. It used to be called adult-onset diabetes mellitus, or non-insulin-dependent diabetes mellitus. These names are no longer used because type 2 diabetes does occur in younger people, and some people with type 2 diabetes require insulin therapy.
  • Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. However, more than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness.

Gestational diabetes (GDM) is a form of diabetes that occurs during the second half of pregnancy.

  • Although gestational diabetes typically resolves after delivery of the baby, a woman who develop gestational diabetes is more likely than other women to develop type 2 diabetes later in life.
  • Women with gestational diabetes are more likely to have large babies.

Metabolic syndrome (also referred to as syndrome X) is a set of abnormalities in which insulin-resistant diabetes (type 2 diabetes) is almost always present along with hypertension (high blood pressure), high fat levels in the blood (increased serum lipids, predominant elevation of LDL cholesterol, decreased HDL cholesterol, and elevated triglycerides), central obesity, and abnormalities in blood clotting and inflammatory responses. A high rate of cardiovascular disease is associated with metabolic syndrome.

Prediabetes is a common condition related to diabetes. In people with prediabetes, the blood sugar level is higher than normal but not yet high enough to be considered diagnostic of diabetes.

  • Prediabetes increases a person's risk of developing type 2 diabetes, heart disease, or stroke.
  • Prediabetes can typically be reversed (without insulin or medication) with lifestyle changes such as losing a modest amount of weight and increasing physical activity levels. Weight loss can prevent, or at least delay, the onset of type 2 diabetes.
  • An international expert committee of the American Diabetes Association redefined the criteria for prediabetes, lowering the blood sugar level cut-off point for prediabetes. Approximately 20% more adults are now believed to have this condition and may develop diabetes within 10 years if they do make lifestyle changes such as exercising more and maintaining a healthy weight.

About 17 million Americans (6.2% of adults in North America) are believed to have diabetes. It has been estimated that about one third of adults with diabetes do not know they have diabetes.

  • About 1 million new cases of diabetes is diagnosed occur each year, and diabetes is the direct or indirect cause of at least 200,000 deaths each year.
  • The incidence of diabetes is increasing rapidly. This increase is due to many factors, but the most significant are the increasing incidence of obesity associated with the prevalence of a sedentary lifestyle.

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Diabetes - Symptoms

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Read What Your Physician is Reading on Medscape

Diabetes Mellitus, Type 2 »

Type 2 diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular (ie, retinal, renal, possibly neuropathic), macrovascular (ie, coronary, peripheral vascular), and neuropathic (ie, autonomic, peripheral) complications.

Read More on Medscape Reference »


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