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Type 2 Diabetes

What is type 2 diabetes?

Type 2 diabetes is a metabolic disorder resulting from the body’s inability to make enough, or to properly use, insulin. It used to be called non-insulin-dependent diabetes mellitus (NIDDM).
Without adequate production or utilization of insulin, the body cannot move blood sugar into the cells. It is a chronic disease that has no known cure. It is the most common type of diabetes.

What causes type 2 diabetes?

The exact cause of type 2 diabetes is unknown. However, there does appear to be a genetic factor which causes it to run in families. And, although a person can inherit a tendency to develop type 2 diabetes, it usually takes another factor, such as obesity, to bring on the disease.

Treatment for type 2 diabetes:

Specific treatment for type 2 diabetes will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The goal of treatment is to keep blood sugar levels as close to normal as possible.
Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare. Treatment of diabetes is an ongoing process of management and education that includes not only the person with diabetes, but also healthcare professionals and family members.

Often, type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone. However, in some cases, these measures are not enough and either oral medications and/or insulin must be used. Treatment often includes:

  • proper diet
  • weight control
  • an appropriate exercise program
  • regular foot inspections
  • oral medications, other medications, and/or insulin replacement therapy, as directed by your physician

There are various types of medications that may be used to treat type 2 diabetes when lifestyle changes such as diet, exercise, and weight loss are not effective. Oral medications of several different types are available, with each type working in a different manner to lower blood sugar. One medication may be combined with another one to improve blood sugar control. When oral medications are no longer effective, insulin may be required.

New medications for treating diabetes are in development. GLP-1 agonists are one of the new types of medications. GLP-1 agonists work by stimulating insulin production by the pancreas, slowing the emptying of food from the stomach, and inhibiting the production of glucagon in the pancreas (glucagon is a hormone produced by the pancreas that stimulates release of glucose by the liver). Byetta®, a GLP-1 agonist approved by the FDA in 2005, is given by injection.

  • regular monitoring of the hemoglobin A1c levels

The hemoglobin A1c test (also called HbA1c test) shows the average amount of sugar in the blood over the last three months. The result will indicate if the blood sugar level is under control. The frequency of HbA1c testing will be determined by your physician. It is recommended that testing occur at least twice a year if the blood sugar level is in the target range and stable, and more frequently if the blood sugar level is unstable.

Untreated or inappropriately-treated diabetes can cause problems with the kidneys, legs, feet, eyes, heart, nerves, and blood flow, which could lead to kidney failure, gangrene, amputation, blindness, or stroke. For these reasons, it is important to follow a strict treatment plan.

Advances in diabetes research have led to improved methods of managing diabetes and treating its complications. However, scientists continue to explore the causes of diabetes and ways to prevent and treat the disorder. Other methods of administering insulin through inhalers and pills are currently being studied. Scientists are investigating gene involvement in type 1 and type 2 diabetes and some genetic markers for type 1 diabetes have been identified. Pancreas transplants are also being performed.