Type 1 diabetes is when the body does not generate sufficient insulin.
Type 2 diabetes is when the cells do not respond to insulin.
Diabetes type 2 is the most common type of diabetes and affects 90-95% of diabetics. It is characterized by insulin resistance or a defective response by the cells to insulin. In some cases, production of insulin by the pancreas may be reduced.
Glucose or blood sugar provides fuel for the cells in the body. Insulin is responsible for transporting glucose from the bloodstream into the cells. When insulin cannot move the glucose into the cells, glucose accumulates in the blood and can cause diabetes complications such as damage to the nerves, kidneys, cardiovascular system and vision.
What Causes Type 2 Diabetes?
Type 2 diabetes is primarily caused by lifestyle factors and genetics. A sedentary lifestyle, obesity, and a diet high in carbohydrates and sweets are the most common causes of diabetes 2.
Signs and Symptoms of Type 2 Diabetes
The usual symptoms of diabetes are increased frequency of urination, increased thirst, and increased hunger. People who have diabetes may also lose weight for no apparent reason.
When left untreated, diabetes can result in vision damage. Prolonged high levels of glucose in the blood can cause glucose absorption in the lens of the eye, resulting in changes in its shape leading to blurred vision.
Other symptom of diabetes are skin rashes and wounds that heal very slowly.
Treatment of Type 2 Diabetes
Type 2 diabetes is a chronic disease with no known cure. As such, “treatment” may be a misnomer. A better term might be “management” of the disease. Management focuses on keeping blood glucose levels as close as possible to normal. If you are diagnosed with diabetes type 2, your doctor may prescribe some form of medication. Diet and exercise are also important in controlling type 2 diabetes.
Recent studies show that type 2 diabetes can be successfully managed without the need for medications. A healthy diet that is low in carbohydrates and high in fiber, protein, wholegrain cereals, dairy products, fruits and vegetables can keep blood sugar at normal or near-normal levels. The right diet and exercise help diabetics manage their blood sugar levels and prevent or reduce complications of diabetes such as blindness, kidney damage, nerve damage, and heart disease.
Type 2 diabetes is the more prevalent form of the disease, accounting for about 90 percent of cases. Often tied to obesity, type 2 diabetes involves a gradual decline in how insulin responds to changes in blood sugar (glucose).
The new drug, called TAK-875, is a pill designed to enhance the secretion of insulin in response to such changes, which means that it has no effect on insulin secretion when blood sugar levels are normal — potentially reducing the risk for hypoglycemia.
The trial, led by Dr. Charles Burant of the University of Michigan Medical School, included 426 patients with type 2 diabetes who were not getting adequate blood sugar control through diet, exercise or treatment with the first-line diabetes drug metformin.
The patients were randomly assigned to receive either TAK-875 (303 patients), placebo (61 patients), or another diabetes drug called glimepiride (brand named Amaryl).
The study was funded by Takeda Pharmaceutical (which is developing the drug), and appears online Feb. 26 in The Lancet.
After 12 weeks, all the patients taking the different doses of TAK-875 had significant drops in their blood sugar levels, the researchers said. A similar reduction occurred in patients taking glimepiride.
However, the incidence of episodes of hypoglycemia was much lower among patients taking TAK-875 (2 percent) than among those taking glimepiride (19 percent) and the same as those taking the placebo (2 percent).
The incidence of treatment-related side effects was 49 percent among patients taking TAK-875, 48 percent among those in the placebo group, and 61 percent among those in the glimepiride group, according to the researchers. They write that they are “excited about the potential of TAK-875 and are eager to conduct larger trials to find out how well this drug works, how safe it is and what its place is in the treatment of diabetes.”
In a journal commentary, Clifford Bailey of Aston University in Birmingham, England, cautioned that, “on the journey to approval of a new class of treatment for type 2 diabetes, many questions will be asked of [drugs such as TAK-875],” including questions of how long they might remain effective, as well as safety issues.
Other diabetes experts had mixed views on the new findings.
Dr. Loren Wissner Greene is clinical associate professor of endocrinology at NYU Langone Medical Center in New York City. She noted that glitazones — a separate class of newer drugs such as Rezulin, Avandia and Actos that also target insulin resistance — have all shown initial promise in clinical trials before worrisome side effects began to surface in users (Avandia was recently withdrawn from the U.S. market due to heart risks).
As for TAK-875, it targets a separate mechanism “but again, until more is known about short-term and long-term cardiovascular effects, we need to proceed with moderated enthusiasm for each new drug and drug mechanism,” Wissner Greene said.
Dr. Minisha Sood, endocrinologist at Lenox Hill Hospital in New York City stressed that, “given the rising global incidence of type 2 diabetes, the medical community is eagerly awaiting the development of novel agents to add to our existing armamentarium of anti-diabetic agents.”
She said that, “though this study includes a small sample size followed for a short period of time, the results are promising in that TAK-875 appears to be effective for glycemic [blood sugar] control without significant risk for hypoglycemia or weight gain. However, like Wissner-Greene, Sood said that “further investigation is warranted, especially including [heart disease] patients.”
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes medicines.
The FDA recently approved a weekly treatment for Type2 Diabetes. Let’s take a look at that:
Jan. 27, 2012 — The FDA has given its nod to Bydureon, making it the first weekly treatment for type 2 diabetes, according to drug’s manufacturer.
Given as a shot, Bydureon (pronounced by-DUR-ee-on) is the long-acting form of Byetta, a twice-daily injection. It works by stimulating pancreas cells to produce insulin when blood sugar is too high. It is used along with diet and exercise to improve blood sugar control among people with type 2 diabetes, the form of the disease most commonly linked to obesity.
The approval marks the third time the FDA has considered Bydureon, which is manufactured by Alkermes PLC and Amylin Pharmaceuticals Inc. Previously the FDA had expressed concerns that it may increase the risk of heart problems. As part of the new approval, Bydureon manufacturers must now conduct a study to determine whether the drug does increase these risks.
The approval is based on results from a 24-week study that showed people who used the new drug had greater improvements in their blood sugar with just one dose per week, compared with people treated with Byetta injection. The most common side effects were nausea, diarrhea, headache, vomiting, constipation, itching at the injection site, a small bump at the injection site, and indigestion.
“With Bydureon, U.S. physicians and patients can now choose a therapy that offers continuous blood sugar control in just one dose per week,” says John Buse, MD, PhD, professor of medicine, director of the Diabetes Care Center, and chief of the division of endocrinology at the University of North Carolina School of Medicine in Chapel Hill, in a news release. “New treatment options are essential for the millions of adults with type 2 diabetes who continue to struggle to achieve optimal blood sugar control.”
- New Blood Glucose Tracking Technology That Will Save Your Fingers! (epicagear.com)
- Based On CE Analysis Of Oral Medications, ACP Recommends Metformin To Treat Type 2 Diabetes (medicalnewstoday.com)
- ACP recommends metformin to treat type 2 diabetes based on CE analysis of oral medications (eurekalert.org)
- Weight loss surgery slashes diabetes risk, research finds (mya.co.uk)
- Diabetes drug developer Lumena raises $2.5M; compound regulates blood sugar (medcitynews.com)
- An Increase In Type 2 Diabetes (philadelphia.cbslocal.com)
- Kidney Damage Greatly Raises Diabetics’ Risk for Death (nlm.nih.gov)
Maria Dorfner is the founder of NewsMD. This is her blog
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