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Type 2 Diabetes
Mellitus What is type 2 diabetes
mellitus? When you have type 2 diabetes, your body does not make enough insulin or
is unable to use insulin properly. This problem with insulin affects the level
of sugar in your blood. Insulin is a hormone produced by the pancreas. (The pancreas is the
large gland that lies behind the stomach.) When you digest food, your body
breaks down much of the food into sugar (glucose). Your blood carries the sugar
to the cells of your body for energy. Insulin helps the sugar leave the
bloodstream and enter the cells. This is how insulin lowers the level of sugar
in your blood. When your body does not have enough insulin or has trouble using
insulin, the cells of your body do not absorb enough sugar from your blood. As a
result, you have high levels of sugar in your blood. When you have too much
sugar in your blood, many problems may begin to occur. These problems can be
life-threatening if they are not treated. However, proper treatment can control
your blood sugar level. Type 2 diabetes occurs
mostly in adults over age 40, especially overweight adults. Overweight children
and adolescents can also have this type of diabetes. More people are becoming
diabetic as more people become overweight. About 16 million people
in the U.S. are diabetic. The highest rates of type 2 diabetes in America are
among native Americans, Hispanics, and African Americans. How does it occur? The precise cause of
type 2 diabetes is not known, although age and weight appear to be factors. As
people become older or overweight, they are more likely to have diabetes. Cells
in the body become unable to use the insulin made by the pancreas. Heredity is
also an important factor. Women who have given
birth to large babies (for example, babies weighing 9 pounds or more), or have
had diabetes of pregnancy (gestational diabetes), have a higher risk of
developing type 2 diabetes later in life. What are the symptoms? Type 2 diabetes may
cause the following symptoms:
increased urination
excessive thirst and the drinking of a lot of fluids
increased appetite
weight gain or loss
blurred vision
skin infections
vaginal infections
tiredness
slowly healing sores
abnormal feelings of prickling, burning, or itching of the skin, usually
on the hands or feet
infections of the foreskin in uncircumcised men. Most people have no symptoms,
especially at first. How is it diagnosed? Your health care provider will
ask about your symptoms and test the level of sugar in your blood. If your
morning fasting blood sugar (before breakfast) is above 126 milligrams per
deciliter (mgldL), you may be diabetic. Sometimes another test
called a glucose tolerance test is done. For this test a sample of your blood is
taken when you have not eaten anything since the night before. Then you drink a
sugar drink and your blood is tested 2 hours later. If after 2 hours your blood
sugar level is over 200 mgldL, you are probably diabetic. Your health care
provider may also test a sample of your urine for sugar. How is it treated? The goal of treatment
is to control the level of sugar in your blood. You want to try to keep the
sugar level in the same range as a nondiabetic person. This is done by:
measuring your blood sugar regularly
meal planning
exercise
medicine. Blood sugar
measurements Keep a log of your
blood sugar measurements. Your health care provider will check the log to see
how well your treatment is working. Also, a test called hemoglobin Alc can show
what your average blood sugar has been over the past 3 months. Your provider may
do this test every 3 to 6 months to check your overall control of your blood
sugar level. Meal planning Your health care
provider or a dietitian will give you clear guidelines about which foods you
should eat and how many calories you should eat each day. If you are overweight,
the main treatment is to eat less. Limiting the calories in your diet will help
you lose weight. Losing even 7 to 10 pounds can reduce or eliminate your need to
take medicine for diabetes. Exercise Physical activity is important
in managing type 2 diabetes. Exercise improves your circulation and uses up more
sugar in your blood. Walking is one of the best exercises you can do. Ask your
health care provider for exercise recommendations. Medicine If you cant control your
blood sugar with diet and exercise, your health care provider will prescribe
medicine to lower your blood sugar. You may need more than one type of medicine
to keep your blood sugar in the normal range. Common oral
blood-sugar-lowering medicines used for type 2 diabetes are:
Sulfonylureas, which help your pancreas release more insulin. Examples of
this type of medicine are tolbutamide (Orinase), tolazamide (Tolinase),
glyburide (DiaBeta, Glynase, Micronase), glipizide (Glucotrol), and glimepiride
(Amaryl). These medicines are taken by mouth 1 to 3 times a day. They often
cause weight gain, especially if your diet is not well controlled.
Repaglinide (Prandin) and nateglinide (Starlix), which also help release
more insulin. They are taken by mouth before meals.
Metformin (Glucophage), which lowers blood sugar without causing weight
gain. It is taken by mouth 2 to 3 times a day. It may be combined with a
sulfonylurea medicine or insulin.
Rosiglitazone (Avandia) and pioglitazone (Actos), which help the body use
insulin better. They are taken by mouth once a day and may be combined with
sulfonylureas, metformin, or insulin. While you are taking either of these
medicines, you will have blood tests to check the effect on your liver. Insulin is used when
diet, exercise, and oral medicines are not keeping your blood sugar levels
normal. Insulin is available in different forms:
regular insulin, which is short-acting
NPH and lente insulins, which are intermediate-acting
long-acting forms of insulin (ultralente). If you need insulin,
your health care provider will teach you how to give shots to yourself. You may
need a shot 1 to 4 times a day. It is common to combine short-acting and
intermediate-acting forms in one dose (in one needle and syringe). When you are using any
type of diabetic medicine, you must carefully follow your health care
providers directions for checking your blood sugar. This will not only help
you achieve good blood sugar control, but it will help you prevent possibly
life-threatening low levels of blood sugar (hypoglycemia). How long will the effects
last? Exercising more and
not overeating can often help the body restore its balance of sugar and insulin. You may or may not
need to continue taking medicine. Your improvement depends on following the diet
and exercise plans prescribed by your health care provider to keep your blood
sugar in the recommended range. How can I take care of
myself? Taking good care of
yourself to avoid complications is especially important with diabetes. Possible
diabetic complications include heart disease, stroke, blindness, kidney failure,
and nerve damage, especially to your feet and legs. Carefully controlling your
blood sugar and blood pressure will delay or prevent these complications. Follow your diet plan.
Learn how to make healthy choices when you eat out.
Ask for diabetic meals when you travel (for instance, at hotels or on
planes).
Drink water or other noncaloric drinks when you have the urge to eat
between meals.
Avoid compulsive eating.
Limit the amount of alcohol you drink.
Buy only the types of food included in your diet plan.
Eat on a regular schedule.
Eat slowly and chew your food thoroughly. Follow your health
care providers advice for physical activity.
Choose activities you like.
Exercise with friends. Stop smoking. Carefully follow the
instructions your health care provider has given you for taking any medicine he
or she has prescribed. Other things you can
do are:
Learn how to do proper skin and foot care every day.
Always carry identification that says you have diabetes, in case of an
emergency. Learn about diabetes
and its complications so you can make the correct decisions to control your
blood-sugar levels. Many hospitals have diabetes educators and dietitians who
can help you. Ask your health care provider to refer you to these people. You can get pamphlets
and information about diabetes, including diabetic cookbooks, from: The American Diabetes
Association 1701 North Beauregard
Street Alexandria, VA 22311 Phone:
800-DIABETES (800-342-2383) Web site: http://www.diabetes.org How can I help prevent type
2 diabetes? Even if there is a history of
diabetes in your family, you may be able to avoid developing the disease if you:
Maintain your recommended weight.
Exercise regularly according to your health care providers
recommendations.
Eat a healthy diet. Reviewed and approved by the Wilmer Eye Institute of The Johns Hopkins Medical Institutions, Baltimore. MD. Web site: http://www.wilmer.jhu.edu Developed by McKesson Clinical Reference Systems Published by McKesson Clinical Reference Sys~rns. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional Adult Health Advisor 2002.2 Index Adult Health Advisor 2002.2 Credits Copyright © 199 1-2002 McKesson Health Solutions LLC. All rights reserved. |
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