Type 2 Diabetes

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    AHealthwise answered

    Many children have had no symptoms before they are diagnosed with type 2 diabetes. Usually, the illness is discovered when a blood or urine test taken for another reason shows diabetes.

    If a doctor suspects that your child may have type 2 diabetes, he or she will do a medical history, physical exam, and blood glucose testing. If the results of these tests meet the criteria for diagnosing diabetes established by the American Diabetes Association (ADA), your child has diabetes.

    Other possible tests

    If it is hard to tell whether your child has type 2 or type 1 diabetes, your doctor may do a C-peptide test or an autoantibodies test. (Autoantibodies are produced when the body's immune system does not work right.) These tests may not be able to confirm the type of diabetes your child has. Getting a definite diagnosis may take months or years. In either case, your child's sugar levels will need to be controlled right away.

    Sometimes a doctor will do a quick home blood sugar test or a urine test for sugar to see whether a child may have diabetes. Although these tests are simple and can show possible diabetes, additional testing is needed to make sure your child actually has the disease.

    Monitoring tests if diagnosed with diabetes

    Because your child is at risk for diabetes complications (eye, heart, kidney, nerve, liver and blood vessel problems), he or she needs to see a doctor regularly for tests to monitor type 2 diabetes.

    Early detection

    If your child is overweight and gets little or no exercise, he or she may be at risk for type 2 diabetes. Early detection and treatment for type 2 diabetes can prevent or delay problems from the disease.

    © Healthwise, Incorporated.

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    AMichael Breus, PhD, Psychology, answered
    We've seen a great deal of research that indicates a strong link between sleep disorders and Type 2 diabetes. Now there's evidence that this link may be genetic. A new study reveals scientists have found a relationship between a gene associated with the "sleep hormone" melatonin, and the risk of developing Type 2 diabetes.

    A group of researchers from France, Canada and the UK have discovered a link between the risk of Type 2 diabetes and several mutations in the body's melatonin receptor gene, a gene known as MTNR1B. Working with a group of 7,632 European women -- 3,186 of whom already had Type 2 diabetes -- researchers found:
    • 40 different -- and rare -- mutations to the melatonin receptor gene associated with varying degrees of increased risk of Type 2 diabetes.
    • 4 of these rare mutations actually caused a total loss of function in the melatonin receptor gene
    • Analyzing these 4 mutations in an additional 11,854 people, researchers found that the presence of any single one was associated with a significantly increased risk of Type 2 diabetes -- a risk as much as six times higher than average.
    Previous research had already established a link between diabetes risk and other, more common mutations to the melatonin receptor gene MTNR1B. This new study has revealed both a wider range of mutations to the gene that can affect diabetes risk, as well as the elevated risk among the 4 rare mutations that disable the receptor gene altogether.
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    ARealAge answered

    More than 85% of people who have type 2 diabetes are overweight or obese. Losing even a little of the extra weight can help improve insulin sensitivity. (In people who have prediabetes -- a state in which blood glucose is elevated but not high enough to be diabetes -- losing just 5% to 10% of your body weight with diet and exercise helps reduce the risk of progressing to full-blown diabetes.) Ask your doctor for specific weight-loss programs that have helped other diabetes patients. "People know intuitively what they need to do to lose weight," says Melinda Maryniuk, RD, CDE, director of clinical education programs for the Joslin Center in Boston. "But they're often more successful if they have support from a program like Weight Watchers, or just having your doctor check in."

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    ARonald Tamler, MD, Endocrinology, Diabetes & Metabolism, answered on behalf of The Mount Sinai Health System

    Making healthy lifestyle changes can often, but not always, be enough to manage type 2 diabetes. I predict that 15 years from now, we will know about many different variations of type 2 diabetes. Certain kinds are totally preventable and can be managed with diet and exercise, while others will progress to requiring more medication, but the patient’s lifestyle can make a huge difference in how much medication is required and how well the diabetes is controlled.

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    AAndrea Pennington, Integrative Medicine, answered
    Type 2 diabetes currently affects about 27 million Americans and is one of the fastest-growing diseases in the nation. A report published by UnitedHealth Group's Center for Health Reform and Modernization estimates that over half of the U.S. population will have diabetes or prediabetes by the year 2020.
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    AMehmet Oz, MD, Cardiology, answered
    Food is fuel. Your body breaks down (or "metabolizes") the food you eat, turning it into glucose, a type of sugar, which then travels through the bloodstream to be used by your cells for energy and for growth. Insulin, a hormone produced by the pancreas, helps your cells digest that glucose, taking it from the blood and breaking it down. But in people with type 2 diabetes, either the pancreas doesn't produce enough insulin, or the cells are unable to use the insulin it produces (insulin resistance). When this occurs, glucose builds up in the blood, gets stored as fat, and overflows into the urine.
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    AHealthwise answered

    A hyperosmolar state develops when a person with type 2 diabetes has very high blood sugar—usually 600 millligrams per deciliter (mg/dL) or more. Sometimes this condition is the first time a person learns that he or she has type 2 diabetes.

    A hyperosmolar state can develop when a person is very sick and/or dehydrated, such as from the flu, a severe infection, a heart attack, or water pills (diuretics). If the person does not drink enough liquids, he or she may become confused. Older people are at increased risk for developing a hyperosmolar state.

    Symptoms of a hyperosmolar state include:

    • Increased urination for several days.
    • Dehydration, which develops because the person doesn't drink enough liquids.
    • A change in alertness from generalized fatigue to stupor, coma or seizures. These changes may be mistaken for a stroke or mental illness.

    Hyperosmolar state is treated in a hospital with insulin to reduce the blood sugar level and extra fluids through a vein (IV) to replace the lost fluids.

    The best way to prevent a hyperosmolar state is to treat high blood sugar levels early and drink enough liquids.

    © Healthwise, Incorporated.

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    ARobert Hedaya, Psychiatry, answered
    Caught and treated early, insulin resistance is reversible in more than 90% of patients, and there is a clear improvement in well-being associated with this reversal. To get to the foundation of the problem, you must do a diagnostic work-up, to identify and deal with the layered factors which promote insulin resistance and diabetes. Factors to be assessed include:

    1. Cortisol -- levels which are too high, (as might be the case in anxiety disorders, mood disorders, and psychotic disorders) cause insulin to be elevated, and increase appetite. Cortisol can be reduced easily enough by either supplements or medications, as well as psychotherapeutic methods (e.g., biofeedback, certain therapies, body work etc).

    2. Female and male hormones -- low levels of testosterone result in lowered lean body mass (therefore lower metabolic rate), lower energy and vitality. High levels of estrogens (e.g. with potent birth control pills) can also cause weigh gain, albeit in a different pattern of distribution.

    3. Stress -- many people over eat when tired, angry, frustrated, bored, lonely; Becoming mindful of your sense of hunger before eating, can, over time, reduce unconscious habitual stress eating. Identifying the situations which make you stressed and problem solving them when possible can help reduce stress eating. Keeping a daily log (what you ate, when you ate it, and situations in which you over-ate) will definitely raise consciousness.

    4. Lifestyle -- getting adequate sleep (7-9 hours for most people), moderate exercise 4-5 times per week will reduce the tendency to eat highly processed foods in an out of control manner when you are tired.

    5. Inflammation and toxins -- inflammation due to infection, or toxins in your environment can cause weight gain, as a hormone called Leptin can rise to unusual levels. Irvingia Gabonensis has been shown to help reverse leptin elevation and therefore help with appetite reduction and weight loss.

    6. Nutritional deficiencies (e.g., chromium, vanadium, thiamine) can lead to trouble handling carbohydrates in the body.

    7. Calorie restriction -- the hardest part of the program is to reduce calories, but with the above measures, perhaps a support group (e.g. weight watchers, over-eaters anonymous, food addicts anonymous), you can do it.
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    Doctors believe that tight control can prevent complications in people with type 2 diabetes. Most people with type 2 diabetes do not take insulin. You may be wondering how you can achieve tight control without it.

    One way is to lose weight. Shedding excess pounds may bring your glucose levels down to normal. The key to losing weight and keeping it off is changing your behavior so that you eat less and exercise more. Your doctor should work with you to find an eating and exercise plan you can stick to. Even if you don't need to lose weight, exercise is helpful in controlling your blood glucose levels. It makes your cells take glucose out of the blood.

    You will need to check your blood glucose regularly. You should decide with your doctor how often. Once a day or even once a week may be enough for some people with type 2 diabetes. If exercise and good eating habits are not enough to keep your glucose under control, you doctor may prescribe pills. And if these don't work, you may need to take insulin. People with type 2 diabetes should talk to their doctors before starting tight control.
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    These days, eating sweets isn't "cheating"-- it's a choice. People with diabetes can eat sweets and still keep their blood glucose (sugar) levels on track. These options are all available for sweetening your foods:

    • sugar and other sweeteners with calories (such as honey and brown sugar)
    • reduced-calorie sweeteners (such as isomalt and sorbitol)
    • low-calorie sweeteners (such as aspartame and sucralose)