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Diabetes Mellitus II

Early detection, intervention can lead to positive management of disease

According to Wendell Myers, an endocrinologist at the Kentucky Diabetes Endocrinology Center, type II diabetes is the most common form of diabetes mellitus.

“Type II diabetes is typically associated with overweight or obesity and insulin resistance,” said Myers. This means anyone who is overweight may be at risk for Type II diabetes. “However, 10 percent of patients with Type II Diabetes Mellitus are not overweight,” said Myers.

Type II diabetes, like type 1 diabetes, is diagnosed by a fasting blood glucose of >126mg/dL x2, random blood glucose of >200mg/dL x2, positive oral glucose tolerance test or HgbA1c of >6.5 percent, which is the newest criteria, said Myers.

Type II diabetes often runs in families. “Women who have had polycystic ovarian syndrome or who have had gestational diabetes mellitus are also at high risk for type II diabetes mellitus,” said Myers. Latino, African American, Native Hawaiian or Pacific Islander persons are also at higher risk for type II diabetes.

Diagnosis is made by measuring the fasting blood glucose, performing a random blood glucose test or an oral glucose tolerance test or an HgbA1c.

Some complications associated with Type II diabetes include cardiovascular disease, ophthalmic disorders, especially retinal disease, and renal disease. Type II diabetes can be managed with lifestyle modifications such as diet, exercise, weight loss, oral medications, insulin or other injectable medications. “We have many newer treatments available for type II,” said Myers. “Type II is typically characterized by progressive beta cell failure in the pancreas, and most patients with type II will eventually need some form of insulin therapy.” Treatment is meted out on a case-by-case basis.

Some other diseases are commonly associated with diabetes. “Patients with type 2 diabetes may have hypertension and dyslipidemia, which raises the risk for cardiovascular disease,” Myers said. “Type II diabetes has also been associated with sleep apnea and higher risk for certain cancers.”

Diabetes sometimes brings on additional troubles. “It can lead to microvascular complications such as retinopathy, neuropathy and nephropathy and macrovascular complications such as cardiovascular and cerebrovascular disease,” said Myers. Seventy to 80 percent of people with diabetes die from cardiovascular disease, which makes it important to emphasize that if a patient develops complications, they should not ignore them.

“Patients who develop complications may benefit from seeing an endocrinologist, and those patients who require multiple daily insulin injections or are interested in insulin pump therapy could also be referred,” said Myers. Early detection and intervention are the keys to a positive outcome.

By Jamie Lober, Staff Writer



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