Diabetes Prevention (cont.)
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.
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.
In this Article
- Type 2 diabetes prevention facts
- Introduction to diabetes prevention
- What is type 2 diabetes?
- What are the risks factors for developing diabetes?
- What "red flags" or symptoms point to an increased risk for diabetes?
- Is gestational diabetes a risk for developing type 2 diabetes later in life?
- Diabetes prevention and diet
- Is there anything that can help to prevent the onset of type 2 diabetes?
- Are there medications that can help to prevent type 2 diabetes?
- Find a local Family Physician in your town
Introduction to diabetes prevention
There are 2 major forms of diabetes - type 1 and type 2. This article focuses specifically on the prevention of type 2 diabetes. This form of diabetes is virtually a pandemic in the United States. This information 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, even though the pancreas is working its best to produce more and more insulin, 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.
What are the risks factors for developing diabetes?
The risk factors for developing diabetes actually varies depending on where a person lives. This is in part due to the environment the person lives in, and in part due to the genetic makeup of the family. In the United States, it is estimated that one in three males and two out of every five females born in the year 2000 will develop diabetes (the lifetime risk). It has also been calculated that for those diagnosed with diabetes before the age of 40, the average life expectancy is reduced by 12 years for men, and 19 years for women.
The risk for developing diabetes increases in certain cases such as the following.
- Genetics: People with a close relative with type 2 diabetes are at higher risk.
- Ethnic background: For example, the actual prevalence of diabetes in the Caucasian population of the US is about 7.1% while in the African American population, it increases to about 12.6%. Approximately 8.4% of Asian Americans and 11.6% of Hispanic Americans are affected. In a well studied group of Native Americans, the Pima Indians, the prevalence increases to almost 35%.
- Birth weight: There is a relationship between birth weight and developing diabetes, and it's the opposite of what you'd intuitively think. The lower the birth weight the higher the risk of type 2 diabetes. At the other end of the spectrum, a very high birth weight (over 8.8 pounds or 4 kg) also is associated with an increased risk. Additionally, mothers of infants who had a higher birth weight (over 9 pounds) are at increased risk for developing diabetes.
- Metabolic syndrome: People who have the metabolic syndrome are at especially high risk for developing diabetes.
- Obesity: Obesity is probably the most impressive risk factor and in most situations the most controllable. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shape person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shape person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.
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