DB2 is more common in older people, especially older women who are overweight, and occurs more often among African Americans, Hispanics, and Native Americans. Compared with non-Hispanic whites, Type 2 diabetes rates are about 60 percent higher in African Americans and 110 to 120 percent higher in Mexican Americans and Puerto Ricans. Native Americans have the highest rates of DB2 in the world. Among Pima Indians living in the United States, for example, half of all adults have DB2.
Increased Body Fat
An overweight group dominates DB2. Most overweight diabetics begin with excessive amounts of insulin rather than a deficiency but the insulin does not work properly and blood sugar rises. About 80 percent of people with DB2 are overweight. Glucose in the blood increases because of the inability of the body to make efficient use of its main source of fuel. The symptoms of DB2 develop gradually.
The first stage of DB2 is referred to as "glucose intolerance" since blood glucose levels rises excessively after eating food. Fasting blood sugars remain normal and other signs of diabetes have not yet appeared. As the glucose intolerance progresses, high glucose levels become more persistent and other problems appear.
The term 'insulin resistance" refers to observation that most people with DB2 when it is first diagnosed have normal to high insulin levels in their blood when their blood sugar is elevated - clearly the available insulin is not working properly. Insulin works by attaching to receptors on cells that respond to the signals by letting glucose enter the cell. If insulin receptors are deficient, blocked or otherwise not working, the net effect is insulin resistance. Increase fasting insulin levels precede the onset of fasting hyperglycemia. When fasting hyperglycemia appears, liver glucose production usually increases, aggravating the tendency to high blood sugar.
Restoring a healthy diet and exercise with weight loss will often prevent progression from glucose intolerance to DB2, by reducing insulin resistance.
Progression of Diabetes becomes a Multisystem Disorder
As diabetes progresses, more tissues in the body deteriorate. Each person who is diagnosed with DB2 has choices. The basic fact is that eating too much of the wrong food and exercising too little will lead the diabetic down a path of that leads to disease, misery and progressive disability. A collection of metabolic problems is often found in patients with type 2 Diabetes. The metabolic syndrome involves insulin resistance, gout, hypertension, obesity, hypertension, hypertriglyceridemia, hyperapobetalipoproteinemia and low concentrations of HDL. These metabolic problems are all risk factors for atherosclerosis, coronary artery disease and strokes. All the abnormalities will improved with exercise, better food choices and caloric restriction.
Clearly, heroic efforts are more
that justified to change diet and life-style determinants of the disease so that
the terrible consequences of neglected diabetes are avoided. The disturbing fact
is that most diabetics will go on to develop one or more chronic microvascular
and neuropathic complications. These problems include retinopathy, neuropathy,
nephropathy (also called the "triopathies") and cardiovascular disease.
Hyperglycemia is known to result in acute changes in cellular metabolism and
causes cumulative long-term changes in macromolecules, described as advanced
glycation end-products (AGEs). Potential pathogenic mechanisms include the
accumulation of fructose and sorbitol and the modification of proteins by