Type 2

Type 2 diabetes are the most common type accounting for not less than 90% of all diabetic population , people with that type of diabetes have insulin resistance and relative, rather than absolute, insulin deficiency which means that the defect is a spectrum from insulin deficiency and insulin inefficiency. The treatment is based primarily on non drug measures like weight control, proper dieting and increased age-appropriate physical activity. Oral tablets are usually needed if these non drug measures are not satisfactory. These patients do not need insulin to survive but may require insulin over time for optimal management, especially if oral tablets become ineffective. Type 2 diabetes commonly goes undiagnosed for years because it is often asymptomatic in its early stages to the extent that almost half of persons with type 2 diabetes are not yet diagnosed. Those individuals with undiagnosed type 2 diabetes are at increased risk for developing macro- and microvascular complications.

WHO description of Type 2 Diabetes

Type 2 (predominantly insulin resistance with relative insulin deficiency or predominantly an insulin secretory defect with/without insulin resistance)
Diabetes mellitus of this type previously encompassed non-insulin-dependent diabetes, or adult-onset diabetes. It is a term used for individuals who have relative (rather than absolute) insulin deficiency. People with this type of diabetes frequently are resistant to the action of insulin . At least initially, and often throughout their lifetime, these individuals do not need insulin treatment to survive. This form of diabetes is frequently undiagnosed for many years because the hyperglycaemia is often not severe enough to provoke noticeable symptoms of diabetes . Nevertheless, such patients are at increased risk of developing macrovascular and microvascular complications . There are probably several different mechanisms which result in this form of diabetes, and it is likely that the number of people in this category will decrease in the future as identification of specific pathogenetic processes and genetic defects permits better differentiation and a more definitive classification with movement into "Other types". Although the specific aetiologies of this form of diabetes are not known, by definition autoimmune destruction of the pancreas does not occur and patients do not have other known specific causes of diabetes .

The majority of patients with this form of diabetes are obese, and obesity itself causes or aggravates insulin resistance . Many of those who are not obese by traditional weight criteria may have an increased percentage of body fat distributed predominantly in the abdominal region . Ketoacidosis is infrequent in this type of diabetes; when seen it usually arises in association with the stress of another illness such as infection . Whereas patients with this form of diabetes may have insulin levels that appear normal or elevated, the high blood glucose levels in these diabetic patients would be expected to result in even higher insulin values had their beta-cell function been normal . Thus, insulin secretion is defective and insufficient to compensate for the insulin resistance. On the other hand, some individuals have essentially normal insulin action, but markedly impaired insulin secretion. Insulin sensitivity may be increased by weight reduction, increased physical activity, and/or pharmacological treatment of hyperglycaemia but is not restored to normal . The risk of developing Type 2 diabetes increases with age, obesity, and lack of physical activity . It occurs more frequently in women with prior GDM and in individuals with hypertension or dyslipidaemia. Its frequency varies in different racial/ethnic subgroups . It is often associated with strong familial, likely genetic, predisposition . However, the genetics of this form of diabetes are complex and not clearly defined.
Some patients who present with a clinical picture consistent with Type 2 diabetes have autoantibodies similar to those found in Type 1 diabetes, and may masquerade as Type 2 diabetes if antibody determinations are not made. Patients who are non-obese or who have relatives with Type 1 diabetes and who are of Northern European origin may be suspected of having late onset Type 1 diabetes.


ADA description of Type 2 Diabetes

Type 2 diabetes results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Approximately 90-95% (16 million) of Americans who are diagnosed with diabetes have type 2 diabetes. Type 2 diabetes is the most common form of diabetes. In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use sugar. Sugar is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can cause two problems:

  • Right away, your cells may be starved for energy.
  • Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart.

Finding out you have diabetes is scary. But don't panic! Diabetes is serious, but people with diabetes can live long, healthy, happy lives. You can too by taking good care of yourself