TYPE II DIABETES MELLITUS



 
 
 

*INTRODUCTION
*SYMPTOMS
*CAUSES
*TREATMENTS
*COMPLICATIONS
*HOME

Type II diabetes mellitus, or noninsulin-dependent diabetes mellitus (NIDDM), is the most common form of diabetes, accounting for 90-95% of diabetes cases.3 This form of diabetes usually develops in adults over the age of 40 and is most common in overweight women, African Americans (60% higher incidence than non-Hispanic whites), Hispanics, and American Indians.18  American Indians have the highest rate of diabetes in the world. 
The Centers for Disease Control (CDC) reports indicate that the prevalence of Type II diabetes has increased by 33% in the US during the 1990s; Hispanics had a 38% increase, whites had a 29% increase, and blacks had a 26% increase.3 Approximately 800,000 new diabetes cases are diagnosed each year, and diabetes is the 7th leading cause of death in the US.23  
In contrast to Type I diabetics, Type II patients can produce normal levels of insulin. However, they have abnormalities in their liver and muscle cells that resist insulin's actions to get glucose from the bloodstream into the cells.22 Insulin is able to attach to receptors on cells, but glucose can't actually get inside the cells. As a result, glucose builds up in the blood, overflows into the urine, and passes out the body. 
 
Figure1. Shows the millions of persons diagnosed with diabetes each year. It is clear that the prevalence of diabetes has increased dramatically over the last 30 years. This figure is courtesy of <http://www.niddk.nih.gov/health/diabetes/pubs/dmover/dmover.htm>
Common Symptoms:
* Excessive thirst
* Increased urination
* Fatigue
* Weight loss
* Blurred vision
* In women-vaginal yeast infections
* Itching
* Tingling in the extremities

 
Possible Causes:
* Causes of insulin resistance: 1. Intra-abdominal fat (IAF)- Studies have shown that an increase in IAF plays a major role in the pathogenesis of insulin resistance, which leads to the development of Type II diabetes and cardiovascular diseases.1 Research by Beaufrere and Morio (2000) has suggested that the metabolic link between increased IAF and insulin resistence could be increased oxidation of free fatty acids in the body produced from the breakdown of fat. In addition, it has been found that physical inactivity inhances both IAF accumulation and insulin resistence.

2. Elevated levels of leptin (A protein produced by fat cells)
3. Elevated levels of tumor-necrosis factor (TNF) (part of immune system)

* Amyloid in human islets of langerhans-Research has shown that amylod derived from islet amyloid polypeptide, a beta-cell product, has caused a beta-cell (cell in the pancreas) lesion in Type II diabetes, thereby disrupting the structure of insulin (Westermark and Westermark 2000). 

* Genetic factors- Researchers have identified several possible genes that may be responsible in the development of Type II diabetes:17
1. P2 gene-appears to be critical in link between obesity and insulin resistance.
2. LpL gene- may cause coronary heart disease and type II diabetes
3. Gene that regulates glucose metabolism
4.Defective gene that reduces activity of B3 adrenergic receptor- The defective gene results in slow-down in metabolism and increase in obesity.

*Age- People usually develop type II diabetes after the afe of 40. Aging has been found to be associated with the accumulation of intra-abdominal fat (IAF), which may cause insulin resistance (Beaufrere and Morio 2000). One major concern is that diabetes has increased among children possibly due to a rise in childhood obesity.

*Obesity- Excess body fat, especially around the abdomen and upper part of the body is associated with diabetes and heart disease.17

*Smoking

*Family History
 

 
Possible Complications:
* Hypoglycemia
* Vascular abnormalities
* Neuropathy
* Cardiovascular complications
* Mental function and Dementia
* Eye complications-retinopathy, cataracts, glaucoma
* Kidney damage
* to learn more about these complications visit: my.webmd.com/content/dmk/dmk_article_4002