|March 26, 2016|
Diabetes mellitus type 2 – formerly non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes – is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary modification. As the condition progresses, medications may be needed. Unlike type 1 diabetes, there is very little tendency toward ketoacidosis though it is not unheard of. One effect that can occur is nonketonic hyperglycemia. Long-term complications from high blood sugar can include increased risk of heart attacks, strokes, amputation, and kidney failure.
The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), fatigue and weight loss.
Type 2 diabetes is due primarily to lifestyle factors and genetics. It was also found that oligomers of islet amyloid polypeptide (IAPP), a protein that forms amyloid deposits in the pancreas during type 2 diabetes, triggered the NLRP3 inflammasome and generated mature IL-1β. One therapy for type 2 diabetes, glyburide, suppressed IAPP-mediated IL-1β production in vitro.
A number of lifestyle factors are known to be important to the development of type 2 diabetes. In one study, those who had high levels of physical activity, a healthy diet, did not smoke, and consumed alcohol in moderation had an 82% lower rate of diabetes. When a normal weight was included the rate was 89% lower. In this study a healthy diet was defined as one high in fiber, with a high polyunsaturated to saturated fat ratio, and a lower mean glycemic index. Obesity has been found to contribute to approximately 55% type 2 diabetes, and decreasing consumption of saturated fats and trans fatty acids while replacing them with unsaturated fats may decrease the risk. The increased rate of childhood obesity in between the 1960s and 2000s is believed to have led to the increase in type 2 diabetes in children and adolescents.
Environmental toxins may contribute to recent increases in the rate of type 2 diabetes. A positive correlation has been found between the concentration in the urine of bisphenol A, a constituent of some plastics, and the incidence of type 2 diabetes.
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3 Brian J. Welch, MD and Ivana Zib, MD: Case Study: Diabetic Ketoacidosis in Type 2 Diabetes: “Look Under the Sheets”, Clinical Diabetes, October 2004, vol. 22 no. 4, 198-200
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8 Centers for Disease Control and Prevention (CDC) (November 2004). "Prevalence of overweight and obesity among adults with diagnosed diabetes—United States, 1988–1994 and 1999–2002". MMWR. Morbidity and Mortality Weekly Report 53 (45): 1066–8. PMID 15549021. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5345a2.htm.
9 Arlan Rosenbloom, Janet H Silverstein (2003). Type 2 Diabetes in Children and Adolescents: A Clinician's Guide to Diagnosis, Epidemiology, Pathogenesis, Prevention, and Treatment. American Diabetes Association, U.S.. pp. 1. ISBN 978-1580401555.
10 Lang IA, Galloway TS, Scarlett A, et al. (September 2008). "Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults". JAMA 300 (11): 1303–10. doi:10.1001/jama.300.11.1303. PMID 18799442.
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