Type 2 Diabetes

What Is Type 2 Diabetes?
     The two major forms of diabetes are type 1 or juvenile-onset diabetes and type 2 or maturity-onset diabetes.
     Both share one central feature: elevated blood sugar ( glucose) levels due to absolute or relative insufficiencies of insulin, a hormone produced by the pancreas. Insulin is a key regulator of the body's metabolism.
     Type 2 diabetes is the most common form of diabetes, accounting for 90% of cases. An estimated 16 million Americans have type 2 diabetes and half are unaware they have it.
     Type 2 diabetes is caused by a complicated interplay of genes, environment, insulin abnormalities, increased glucose production in the liver, increased fat breakdown, and possibly defective hormonal secretions in the intestine. The recent dramatic increase indicates that lifestyle factors (obesity and sedentary lifestyle) may be particularly strong in releasing the genetic elements that cause this type of diabetes.
     The characteristic feature of diabetes type 2 is the body's resistance to the actions of insulin.

Genetic Factors
     Genetic factors play an important role in type 2 diabetes, but the pattern is complicated, since both impairment of beta-cell function and an abnormal response to insulin are involved.
     Some research is now investigating genes that may be responsible for inherited cases of type 2 diabetes in middle-aged Caucasians.

Low Birth Weight
     Research now indicates that low birth weight is a risk factor for type 2 diabetes. Some research indicates that malnutrition in the pregnant woman may be responsible for causing metabolic abnormalities in the developing fetus that eventually lead to diabetes.

Obesity
     In a 2001 study of nearly 85,000 nurses, obesity was the number one risk factor for diabetes type 2. It is estimated that 80% to 95% of the current dramatic increases in type 2 diabetes is due to obesity and having excess fat in the abdominal region. Excess body fat appears to play a strong role in insulin resistance, but the way the fat is distributed is also significant. Weight concentrated around the abdomen and in the upper part of the body (apple-shaped) is associated with insulin resistance and diabetes, heart disease, high blood pressure, stroke, and unhealthy cholesterol levels. Fat that settles in a ‘pear-shape’ around the hips and flank appears to have a lower association with these conditions.

Family History
          Between 25% to 33% of all type 2 patients have family members with diabetes. Having a first-degree relative with the disease poses a 40% risk of developing diabetes. One study reported that people with positive family histories have a higher risk for developing the disease at an earlier stage with more severe features.
Because families share many lifestyle features (eating and exercise habits) it is difficult to determine when genetics or environment play the major role.

Other Medical Conditions
     Sleep Loss. Some interesting research suggests that people who do not sleep enough (six hours or less a night) are at higher risk for obesity and ineffective use of insulin, possibly putting them at risk for diabetes.
     Polycystic Ovary Syndrome. Polycystic ovary syndrome (PCO) is a condition that affects about 6% of women and results in the ovarian production of high amounts of androgens (male hormones), particularly testosterone. It appears to be an important cause of many menstrual disorders. Women with PCO are at higher risk for insulin resistance, and about half of PCO patients also have diabetes.
     Hepatitis C. Patients with hepatitis C appear to have a higher incidence of diabetes type 2.
     Peridontal Disease. Some research has found an association between peridontal disease and diabetes type 2. Bacteria that cause peridontal disease may enter the bloodstream and activate immune cells that produce an inflammatory response. More research is needed.