Fat distribution. If you store fat mainly in the abdomen, you have a greater risk of type 2 diabetes than if you store fat elsewhere, such as in your hips and thighs. Your risk of type 2 diabetes rises if you're a man with a waist circumference above 40 inches (101.6 centimeters) or a woman with a waist that's greater than 35 inches (88.9 centimeters).
Chuck Kremin left because of his diabetes and the fact that his wife was afraid of ghosts. — Los Angeles Times, "Gold Point, Nev., has a population of 6. One of them runs the inn. It’s not exactly his calling," 5 Aug. 2019 It is considered a key contributor to life-threatening conditions such as diabetes and heart disease. — Maryann Struman, Detroit Free Press, "Obesity expert Stephen O'Rahilly to receive $100K Taubman Prize for Excellence," 16 July 2019 Pyle missed only five of 126 possible games in his nine years with the Bears despite needing halftime insulin injections to regulate his diabetes. — Will Larkin, chicagotribune.com, "Ranking the 100 best Bears players ever: No. 66, Mike Pyle," 1 July 2019 Leal has learned the same lesson about managing his diabetes. — Lauren Caruba, ExpressNews.com, "A ‘scary disease’: Children with Type 2 diabetes suffer from advanced complications, study finds," 28 June 2019 He was discharged from the hospital on March 29 after receiving extensive treatment for his diabetes and infection. — Cynthia Hubert, sacbee, "He cycled between the streets and ER four times since February. Is this program the answer? | The Sacramento Bee," 11 May 2018 Jones actually found out about his diabetes by accident, which isn't uncommon. — Tehrene Firman, Good Housekeeping, "James Earl Jones Discusses His Diabetes for the First Time in Two Decades," 4 Jan. 2018 Paula Deen's recent announcement about her diabetes was a wake-up call for me. — Aarti Sanan, Redbook, "7 Easy Ways to Avoid "Bad" Carbs," 2 Feb. 2012 Licurtis had been given a diagnosis of diabetes, and leaned against a stool for support. — Lizzie Presser, ProPublica, "The Reels Brothers Spent Eight Years in Jail for Refusing to Leave It.," 15 July 2019
Onset of type 2 diabetes can be delayed or prevented through proper nutrition and regular exercise.[62][63][needs update] Intensive lifestyle measures may reduce the risk by over half.[24][64] The benefit of exercise occurs regardless of the person's initial weight or subsequent weight loss.[65] High levels of physical activity reduce the risk of diabetes by about 28%.[66] Evidence for the benefit of dietary changes alone, however, is limited,[67] with some evidence for a diet high in green leafy vegetables[68] and some for limiting the intake of sugary drinks.[69] There is an association between higher intake of sugar-sweetened fruit juice and diabetes, but no evidence of an association with 100% fruit juice.[70] A 2019 review found evidence of benefit from dietary fiber.[71]
The word diabetes (/ˌdaɪ.əˈbiːtiːz/ or /ˌdaɪ.əˈbiːtɪs/) comes from Latin diabētēs, which in turn comes from Ancient Greek διαβήτης (diabētēs), which literally means "a passer through; a siphon".[114] Ancient Greek physician Aretaeus of Cappadocia (fl. 1st century CE) used that word, with the intended meaning "excessive discharge of urine", as the name for the disease.[115][116] Ultimately, the word comes from Greek διαβαίνειν (diabainein), meaning "to pass through,"[114] which is composed of δια- (dia-), meaning "through" and βαίνειν (bainein), meaning "to go".[115] The word "diabetes" is first recorded in English, in the form diabete, in a medical text written around 1425.

Nauck MA, Del Prato S, Meier JJ, Duran-Garcia S, Rohwedder K, Elze M, et al. Dapagliflozin versus glipizide as add-on therapy in patients with type 2 diabetes who have inadequate glycemic control with metformin: a randomized, 52-week, double-blind, active-controlled noninferiority trial. Diabetes Care. 2011 Sep. 34(9):2015-22. [Medline]. [Full Text].
Type 2 diabetes is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[53] This is in contrast to type 1 diabetes in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas and gestational diabetes that is a new onset of high blood sugars associated with pregnancy.[13] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances.[50] If the diagnosis is in doubt antibody testing may be useful to confirm type 1 diabetes and C-peptide levels may be useful to confirm type 2 diabetes,[54] with C-peptide levels normal or high in type 2 diabetes, but low in type 1 diabetes.[55]
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include:
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include:

A 2010 Consensus Report from a panel of experts chosen jointly by the American Diabetes Association and the American Cancer Society suggested that people with type 2 diabetes are at an increased risk for many types of cancer. [89] Patients with diabetes have a higher risk for bladder cancer, particularly those patients who use pioglitazone. [90, 91] Age, male gender, neuropathy, and urinary tract infections were associated with this risk.


For people with either type of diabetes, exercise can lower the chance of having a heart attack or stroke and can improve circulation. It may offer stress relief, as well. People with type 2 diabetes who need to lose weight can benefit from moderate exercise. Most people with diabetes are encouraged to get at least 150 minutes each week of moderate-intensity aerobic physical activity, like walking. Strength training is often recommended at least twice a week. Talk to your doctor about what type of exercise is right for you.
Disclosure: Amylin Honoraria Speaking and teaching; AstraZeneca Consulting fee Consulting; Lilly Consulting fee Consulting; Takeda Consulting fee Consulting; Bristol Myers Squibb Honoraria Speaking and teaching; NovoNordisk Consulting fee Consulting; Medtronic Minimed Consulting fee Consulting; Dexcom Honoraria Speaking and teaching; Roche Honoraria Speaking and teaching
The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment.[77]
Lifestyle factors are important to the development of type 2 diabetes, including obesity and being overweight (defined by a body mass index of greater than 25), lack of physical activity, poor diet, stress, and urbanization.[10][32] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of cases in Pima Indians and Pacific Islanders.[13] Among those who are not obese, a high waist–hip ratio is often present.[13] Smoking appears to increase the risk of type 2 diabetes.[33]

Patients using less frequent insulin injections or noninsulin therapies – Use SMBG results to adjust to food intake, activity, or medications to reach specific treatment goals; clinicians must not only educate these individuals on how to interpret their SMBG data, but they should also reevaluate the ongoing need for and frequency of SMBG at each routine visit.
^ Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H. "Diagnosis, Prognosis, and Treatment of Impaired Glucose Tolerance and Impaired Fasting Glucose". Summary of Evidence Report/Technology Assessment, No. 128. Agency for Healthcare Research and Quality. Archived from the original on 16 September 2008. Retrieved 20 July 2008.
Diabetes is one of the first diseases described[21] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[114] The first described cases are believed to be of type 1 diabetes.[114] Indian physicians around the same time identified the disease and classified it as madhumeha or honey urine noting that the urine would attract ants.[114] The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius Of Memphis.[114] The disease was rare during the time of the Roman empire with Galen commenting that he had only seen two cases during his career.[114]
Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin resistance. When there isn't enough insulin or the insulin is not used as it should be, sugar (glucose) can't get into the body's cells to be used for fuel. When sugar builds up in the blood instead of going into cells, the body's cells are not able to function properly. Other problems associated with the build up of sugar in the blood include:
Type 1 diabetes is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin.[38] It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Although it has been called "juvenile diabetes" due to the frequent onset in children, the majority of individuals living with type 1 diabetes are now adults.[39]
Diabetes was one of the first diseases described,[110] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[111] The Ebers papyrus includes a recommendation for a drink to take in such cases.[112] The first described cases are believed to have been type 1 diabetes.[111] Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.[111][112]
In the UKPDS, more than 5000 patients with type 2 diabetes were followed up for up to 15 years. Those in the intensely treated group had a significantly lower rate of progression of microvascular complications than did patients receiving standard care. Rates of macrovascular disease were not altered except in the metformin-monotherapy arm in obese individuals, in which the risk of myocardial infarction was significantly decreased.
^ Schwingshackl, Lukas; Hoffmann, Georg; Lampousi, Anna-Maria; Knüppel, Sven; Iqbal, Khalid; Schwedhelm, Carolina; Bechthold, Angela; Schlesinger, Sabrina; Boeing, Heiner (2017-04-10). "Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies". European Journal of Epidemiology. 32 (5): 363–375. doi:10.1007/s10654-017-0246-y. ISSN 0393-2990. PMC 5506108. PMID 28397016.

As of 2017, an estimated 425 million people had diabetes worldwide,[9] with type 2 diabetes making up about 90% of the cases.[17][18] This represents 8.8% of the adult population,[9] with equal rates in both women and men.[19] Trend suggests that rates will continue to rise.[9] Diabetes at least doubles a person's risk of early death.[2] In 2017, diabetes resulted in approximately 3.2 to 5.0 million deaths.[9] The global economic cost of diabetes related health expenditure in 2017 was estimated at US$727 billion.[9] In the United States, diabetes cost nearly US$245 billion in 2012.[20] Average medical expenditures among people with diabetes are about 2.3 times higher.[21]
Inhalable insulin has been developed.[128] The original products were withdrawn due to side effects.[128] Afrezza, under development by the pharmaceuticals company MannKind Corporation, was approved by the United States Food and Drug Administration (FDA) for general sale in June 2014.[129] An advantage to inhaled insulin is that it may be more convenient and easy to use.[130]
Although the pathophysiology of the disease differs between the types of diabetes, most of the complications, including microvascular, macrovascular, and neuropathic, are similar regardless of the type of diabetes. Hyperglycemia appears to be the determinant of microvascular and metabolic complications. Macrovascular disease may be less related to glycemia.
The risk for coronary heart disease (CHD) is 2-4 times greater in patients with diabetes than in individuals without diabetes. Cardiovascular disease is the major source of mortality in patients with type 2 diabetes mellitus. Approximately two thirds of people with diabetes die of heart disease or stroke. Men with diabetes face a 2-fold increased risk for CHD, and women have a 3- to 4-fold increased risk.

Type 2 diabetes occurs when the body does not produce enough insulin, or when the cells are unable to use insulin properly, which is called insulin resistance. Type 2 diabetes is commonly called “adult-onset diabetes” since it is diagnosed later in life, generally after the age of 45. It accounts for 90-95 percent of people with diabetes. In recent years, Type 2 diabetes has been diagnosed in younger people, including children, more frequently than in the past.

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