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Diabetes Prevention
(Type 2 Diabetes)

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Medical Author:

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C)

Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.

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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Introduction to diabetes prevention

I'm pretty lucky in my office practice. I have friendly patients who are usually already fairly well informed about their disease. They are also generally willing to have discussions about therapies and options.

What I have noticed (much to my delight) is that there are a growing number of patients coming to me for evaluation BEFORE they actually have developed diabetes, wanting to know how to prevent it. Most of them have seen family members with diabetes go through the process of diagnosis and management. As our attitude towards disease changes, and we learn to focus on prevention, I have more and more to discuss with these patients. Ultimately, I hope to see a paradigm shift where our focus is primarily on prevention of chronic diseases such as diabetes. For now, I hope this review provides some information to those of you wanting to make healthy lifestyle changes, and that it encourages you to open up a dialogue with your own doctor about diabetes prevention.

There are 2 major forms of diabetes - type 1 and type 2. This article focuses specifically on type 2 diabetes. This form of diabetes is virtually a pandemic in the United States. This article reviews the risk factors for developing type 2 diabetes and covers key points regarding predicting who is at risk for type 2 diabetes (and what they can do about it).

What is type 2 diabetes?

While diabetes is characterized by high blood sugar values, type 2 diabetes is also associated with a condition known as insulin resistance. While there is an element of impaired insulin secretion from the beta cells of the pancreas especially when toxic levels of glucose occur (when blood sugars are constantly very high), the major defect is the body's inability to respond properly to insulin.

Eventually, the pancreas is working it's best to produce more and more insulin, but the body tissues (for example, muscle and fat cells) do not respond and become insensitive to the insulin. At this point, overt diabetes occurs as the body is no longer able to effectively use its insulin to maintain normal blood sugar levels. Over time, these high levels of sugar result in the complications we see all too often in patients with diabetes.