Rates of diabetes in 1985 were estimated at 30 million, increasing to 135 million in 1995 and 217 million in 2005.[18] This increase is believed to be primarily due to the global population aging, a decrease in exercise, and increasing rates of obesity.[18] The five countries with the greatest number of people with diabetes as of 2000 are India having 31.7 million, China 20.8 million, the United States 17.7 million, Indonesia 8.4 million, and Japan 6.8 million.[113] It is recognized as a global epidemic by the World Health Organization.[1]
The top 10 countries in number of people with diabetes are currently India, China, the United States, Indonesia, Japan, Pakistan, Russia, Brazil, Italy, and Bangladesh. The greatest percentage increase in rates of diabetes will occur in Africa over the next 20 years. Unfortunately, at least 80% of people in Africa with diabetes are undiagnosed, and many in their 30s to 60s will die from diabetes there.
^ Jump up to: a b c Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z (November 2015). "Treatment of periodontal disease for glycaemic control in people with diabetes mellitus". The Cochrane Database of Systematic Reviews (11): CD004714. doi:10.1002/14651858.CD004714.pub3. PMC 6486035. PMID 26545069.
Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels.[79][80] The goal of treatment is an HbA1C level of 6.5%, but should not be lower than that, and may be set higher.[81] Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.[81] Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal, however.[82]
In both diabetic and nondiabetic patients, coronary vasodilator dysfunction is a strong independent predictor of cardiac mortality. In diabetic patients without coronary artery disease, those with impaired coronary flow reserve have event rates similar to those with prior coronary artery disease, while patients with preserved coronary flow reserve have event rates similar to nondiabetic patients. [82]

Vitamin C may make up for low blood levels of insulin, which normally works to help cells absorb the vitamin. Proper amounts of vitamin C may help the body maintain a good cholesterol level and keep blood sugar levels under control. But too much can cause kidney stones and other problems. Check with your doctor to see if a vitamin C supplement is right for you.


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]
Have you noticed that minimal semen is discharged during ejaculation? Or you produce cloudy urine after an orgasm? You may have a condition called retrograde ejaculation. Basically, this means that during ejaculation, the semen passes into the urinary bladder instead of out through the tip of the penis. This can be easily diagnosed by analysing a sample of urine for the presence of semen.
People with diabetes may also need to regularly see a podiatrist, who is a health professional trained in the treatment of feet and lower leg problems. When there is poor diabetes control, there is also poor blood flow, which can lead to nerve damage in the feet and lower legs. This disorder is called diabetic neuropathy, which makes people with diabetes unable to feel pain, cold, or heat in their lower extremities. 
A proper diet and exercise are the foundations of diabetic care,[23] with a greater amount of exercise yielding better results.[84] Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss.[85] Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[86] Resistance training is also useful and the combination of both types of exercise may be most effective.[86]
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]
Injections of insulin may either be added to oral medication or used alone.[24] Most people do not initially need insulin.[13] When it is used, a long-acting formulation is typically added at night, with oral medications being continued.[23][24] Doses are then increased to effect (blood sugar levels being well controlled).[24] When nightly insulin is insufficient, twice daily insulin may achieve better control.[23] The long acting insulins glargine and detemir are equally safe and effective,[102] and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010.[103] In those who are pregnant insulin is generally the treatment of choice.[23]
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.

In both diabetic and nondiabetic patients, coronary vasodilator dysfunction is a strong independent predictor of cardiac mortality. In diabetic patients without coronary artery disease, those with impaired coronary flow reserve have event rates similar to those with prior coronary artery disease, while patients with preserved coronary flow reserve have event rates similar to nondiabetic patients. [82]
The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body.[62] Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.[62]
Type 2 diabetes begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses, a lack of insulin may also develop.[12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is a combination of excessive body weight and insufficient exercise.[2]
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In a meta-analysis of 20 publications comprising 13,008 cancer patients with concurrent type 2 diabetes, researchers found that patients treated with metformin had better overall and cancer-specific survival than those treated with other types of glucose-lowering agents. [92, 93] These improvements were observed across cancer subtypes and geographic locations. Risk reduction was significant among patients with prostate, pancreatic, breast, colorectal and other cancers, but not for those with lung cancer. However, it remains unclear whether metformin can modulate clinical outcomes in cancer patients with diabetes.


Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose.[70] people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.[71] The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).[72]


Retinopathy . People with type 2 diabetes may already have abnormalities in the eyes related to the development of diabetes. Over time more and more people who initially do not have eye problems related to the disease will develop some form of eye problem. It is important to control not only sugars but blood pressure and cholesterol to prevent progression of eye disease. Fortunately, the vision loss isn't significant in most.
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