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Selasa, 28 April 2009

TYPE 2 DIABETES

TYPE-2 DIABETES

This topic has general information about type 2 diabetes for people who do not have the disease. If you want to learn how to manage type 2 diabetes, one of the following topics may meet your needs:
Type 2 Diabetes: Recently Diagnosed, if you have been told recently that you have type 2 diabetes.
Type 2 Diabetes: Living With the Disease, if you have type 2 diabetes.
Type 2 Diabetes in Children, if your child has type 2 diabetes.
Type 2 Diabetes: Living With Complications, if you have eye, kidney, heart, nerve, or blood vessel disease caused by your diabetes.
If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.

What is type 2 diabetes?
Type 2 diabetes is a lifelong disease that happens when the cells of the body can't use insulin the right way or when the pancreas can't make enough insulin. Insulin lets blood sugar—also called glucose—enter the body’s cells to be used for energy. When insulin is not able to do its job, the cells can't get the sugar they need, and too much sugar builds up in the blood. Over time, this extra sugar in the blood can damage your eyes, heart, blood vessels, nerves, and kidneys.
More and more adults and children are getting type 2 diabetes. This is largely because of bad eating habits and a lack of physical activity. It is important to know if you or your children are at risk for type 2 diabetes and to know what you can do to help prevent the disease.

What causes type 2 diabetes?
You can get type 2 diabetes if:
Your body does not respond as it should to insulin. This makes it hard for your cells to get sugar from the blood for energy. This is called insulin resistance.
Your pancreas does not make enough insulin.
Your weight, how active you are, and your family history all affect the way your body responds to insulin. If you are overweight, get little or no exercise, or have family members with diabetes, you have a greater chance of getting type 2 diabetes.

What are the symptoms?
Some people don't have symptoms, especially when diabetes is diagnosed early. This is because the blood sugar level may rise so slowly that a person may not know that anything is wrong. Other people may have symptoms, such as:
Being very thirsty.
Urinating a lot.
Losing weight without trying.
Having blurry vision.
Feeling hungrier or more tired than usual.
Sometimes a person finds out that he or she has type 2 diabetes during a regular medical checkup. Or people may find out that they have the disease during an appointment for another health problem such as high blood pressure, an infection, or a wound that heals slowly. Some people don't find out that they have diabetes until they have a complication from the disease, such as vision problems, kidney disease, nerve disease, or heart and blood vessel problems.

How is type 2 diabetes diagnosed?
If your doctor thinks that you have type 2 diabetes, he or she will ask you questions about your medical history, do a physical exam, and order a blood glucose test. A blood glucose test is a blood test that measures the amount of sugar in your blood. The test is usually done first thing in the morning, before you eat or drink anything.

How is it treated?
The key to treating type 2 diabetes is controlling blood sugar levels. All of the following help to lower blood sugar:
Eating healthy foods
Losing weight, if you are overweight
Getting regular exercise
In some cases, taking medicines

Treatment for diabetes also includes checking blood sugar levels to make sure that the disease is under control. It is important to watch for signs of high and low blood sugar. Both can cause problems and need to be treated.
People with diabetes need regular checkups to make sure that the treatment is working and that they do not get more serious health problems.

Can type 2 diabetes be prevented?
If you are at risk for type 2 diabetes or if you have prediabetes, you may prevent diabetes by getting regular exercise and paying attention to what and how much you eat. If you are overweight, losing a little weight (10 to 20 pounds) can go a long way toward preventing or delaying the disease.

Frequently Asked Questions
Learning about type 2 diabetes:
What is type 2 diabetes?
What is the difference between type 1 and type 2 diabetes?
What causes type 2 diabetes?
What are the symptoms?
Who is at risk for it?
How does the body use nutrients in food to control blood sugar?
Who is affected by type 2 diabetes?
Am I at risk for type 2 diabetes?
Being diagnosed:
When should I call a doctor?
What tests are used to diagnose diabetes?
Who should be screened for type 2 diabetes?
Getting treatment:
How is it treated?
Ongoing concerns:
Can type 2 diabetes be prevented?
What are the symptoms of diabetes complications?
Living with type 2 diabetes:
How can you manage diabetes?


Symptoms
At first, your blood sugar level may rise so slowly that you may not know that anything is wrong. One-third of all people who have diabetes do not know that they have the disease.1
If you do have symptoms of type 2 diabetes, they may include:
Feeling thirsty.
Having to urinate more than usual.
Feeling more hungry than usual.
Losing weight without trying to.
Feeling very tired.
Feeling cranky.
Other signs of type 2 diabetes may include:
Infections and cuts and bruises that heal slowly.
Blurred vision.
Tingling or numbness in your hands or feet.
Trouble with skin, gum, or bladder infections.
Vaginal yeast infections.
Some people have already developed more serious health problems by the time they are diagnosed with type 2 diabetes. Over time, diabetes can lead to problems with the eyes, kidneys, heart, blood vessels, and nerves. Signs of these problems may include:
Numbness, tingling, burning pain, or swelling in your feet or hands (diabetic neuropathy).
Blurred or distorted vision or seeing flashes of light; seeing large, floating red or black spots; or seeing large areas that look like floating hair, cotton fibers, or spiderwebs (diabetic retinopathy).
Chest pain or shortness of breath. This may be a sign of heart or blood vessel problems.

Exams and Tests
If your doctor thinks that you may have diabetes, he or she will order a couple of blood glucose tests. Blood glucose tests are blood tests that measure how much sugar is in your blood. Usually, they are done first thing in the morning, before you eat or drink anything.
To make a diagnosis of type 2 diabetes, your doctor will use your blood test results and the American Diabetes Association's criteria. He or she also will ask you questions about your medical history and do a physical exam.
If your blood sugar level is above normal but below the level for diabetes, you have prediabetes and are at risk for developing type 2 diabetes. For more information on prediabetes, see the topic Prediabetes.
Other tests
A home blood sugar test or a urine test for sugar are not the best ways to learn whether you have diabetes. However, after you are diagnosed, you may use home blood sugar tests to check your own blood sugar levels.
Along with your home blood sugar tests, your health professional will give you a hemoglobin A1c (glycohemoglobin) test after you start treatment for diabetes. This test finds your average blood sugar level over the previous 2 to 3 months. The A1c test adds to the information from your home blood sugar tests to help you keep track of your blood sugar control.
After you are diagnosed with type 2 diabetes or prediabetes, you may have a thorough exam of your cardiovascular system to check for any heart problems.
Early detection
You can use the American Diabetes Association's risk test for diabetes to see whether you are at risk for developing type 2 diabetes.
If you are age 45 or older, the American Diabetes Association recommends that you be tested for diabetes every 3 years. The United States Preventive Services Task Force (USPSTF) recommends testing for diabetes in people who have either high cholesterol or high blood pressure. Talk with your doctor about your risk factors and how often you need to be tested.
The American Diabetes Association recommends that you be tested more often or begin testing at a younger age if you:3
Have a parent, brother, or sister who has type 2 diabetes.
Are overweight (have a body mass index, or BMI, of 25 or higher). See the body mass index (BMI) chart for adults or the same chart in metric to determine your BMI.
Are African American, Hispanic, Native American, Asian American, or Pacific Islander.
Have prediabetes.
Have high blood pressure.
Have high cholesterol.
Have a history of gestational diabetes or have delivered a baby who weighed 9 lb (4 kg) or more.

What Happens
Type 2 diabetes is a lifelong disease that affects the way your body uses food for energy. The disease develops when the cells of the body become resistant to insulin or when the pancreas cannot make enough insulin. Insulin is a hormone that helps your body's cells get needed energy from sugar. When insulin is not able to do its job, too much sugar builds up in your blood. Over time, this extra sugar in your blood can lead to problems with your eyes, heart, blood vessels, nerves, and kidneys.
Type 2 diabetes usually develops in adulthood; however, more and more children are being diagnosed with type 2 diabetes. Often people who have type 2 diabetes are overweight and get little or no physical exercise.
Sometimes type 2 diabetes develops so slowly that you do not have symptoms until you already have some more serious problems from the disease. Many people have prediabetes—when blood sugar levels are above normal but not high enough to have diabetes—for years before they know they develop type 2 diabetes. For more information on prediabetes, see the topic Prediabetes.
Once you know that you have type 2 diabetes, you will work with your doctor and other health professionals to develop the best treatment plan for you. Treatment usually includes eating healthy foods and spreading carbohydrate throughout the day, exercising regularly, checking your blood sugar levels often, and possibly taking medicine. Working closely with your doctor and other health professionals can help you feel better and more in control of your disease. You can help prevent or delay more serious health problems by keeping your blood sugar within a safe range.
As time goes on, your pancreas may make less and less insulin, which can make it harder to control your blood sugar level. It is important to treat your high blood sugar early anytime your blood sugar level rises above what is safe for you. Treating high blood sugar early can help prevent:
A hyperosmolar state, which is a life-threatening event that can happen when the blood sugar level is very high. It can occur when a person with type 2 diabetes has an illness, such as a severe case of the flu or other infection; has a heart attack; is not drinking enough liquids and becomes dehydrated; or takes medicines (diuretics) that increase fluid loss or affect mental alertness, especially if liquids are not replaced.
Long-term diabetes complications, which result from damage to the body's tissues. Persistent high blood sugar can damage the eyes (diabetic retinopathy), kidneys (diabetic nephropathy), nerves (diabetic neuropathy), heart (leading to a heart attack), and blood vessels (leading to strokes, peripheral arterial disease, and possibly amputation).


What Increases Your Risk
There are some things that you cannot change that increase your chances of getting type 2 diabetes:
Risk factors that you cannot control include:
Family history. If you have a parent, brother, or sister who has type 2 diabetes, you have a greater chance of developing the disease.
Age. The risk for getting prediabetes and type 2 diabetes increases with age. And the number of children being diagnosed with type 2 diabetes is increasing. Usually, children who get type 2 diabetes have a family history of the disease, are overweight, and are physically inactive.2
Race and ethnicity. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at higher risk than whites for type 2 diabetes.3
History of gestational diabetes or having a baby weighing more than 9 lb (4 kg) . Women who have had gestational diabetes or who have had a large baby are at higher risk for developing type 2 diabetes later in life.3
Low birth weight. People who weighed less than 5.5 lb (2.5 kg) at birth are more likely to develop type 2 diabetes later in life.4
There are some things you can do to reduce your chances of getting diabetes or reduce your chances of developing complications from diabetes:
Lose weight. Your risk for type 2 diabetes increases as your weight (or body mass index, BMI) increases. Your risk also increases if most of your body fat is in your belly area. Reaching and staying at a healthy body weight can reduce your risk.
Get more exercise. The less you exercise, the greater your risk of developing type 2 diabetes. People who do moderate exercise for at least 30 minutes on most or all days of the week have a lower risk of developing type 2 diabetes.5
Eat foods that are good for you. Eating a lot of sugary foods, red meat, soft drinks, and fast food can increase your risk of developing type 2 diabetes.6, 7, 8 Eating whole grains, nuts, and vegetables can decrease your risk.9
Quit smoking. This change may reduce your chance of having complications from diabetes.
Get treatment if you have prediabetes. If your fasting blood sugar levels are in the range from 100 mg/dL to 125 mg/dL, you are at increased risk for developing type 2 diabetes.10
Get treatment if you have high blood pressure (hypertension). People who have blood pressure levels above 140/90 millimeters of mercury (mm Hg) are at greater risk for type 2 diabetes than people who have blood pressure below 140/90.3 The United States Preventive Services Task Force (USPSTF) recommends diabetes testing for people who have blood pressure higher than 135/80.11
Get treatment if you have high cholesterol. People who have high-density lipoprotein (HDL) cholesterol levels of 35 milligrams per deciliter (mg/dL) or less, or triglyceride levels of 250 mg/dL or more are at higher risk of developing complications from type 2 diabetes.3
Other conditions that put you at risk for type 2 diabetes—and that are also linked to obesity and a lack of physical activity—include:
Polycystic ovary syndrome (PCOS), a hormone imbalance that interferes with normal ovulation.
Metabolic syndrome, a group of abnormal physical findings related to the body's metabolism.
If you are concerned about diabetes, you can take a test to determine your risk of getting the disease. If you are at risk, you can discuss with your doctor how to make healthy changes in your life. If you want, your doctor can refer you to health professionals who are trained to help you make your own easy-to-follow plan for eating and exercising. No matter how and when you start, it is important to remember that even small changes can lower your chances of developing diabetes.



Diabetes Management Solutions
Take charge of your health with solutions designed to help you manage your diabetes. Bring your health data together in Microsoft® HealthVault™, then use specialized web tools that work with your data to help you get organized, make smart choices, and stay on target.
A FREE HealthVault account lets you:
Connect your blood glucose meter for easy data transfer
View and track blood glucose numbers online from any computer
Use the data you upload to HealthVault with one or more of the tools below
Manage your diabetes with HealthVault-enabled Web tools
Analyze blood glucose trendsOneTouch® Zoom™ Diabetes Management Program (FREE)
From LifeScan, Inc., a Johnson & Johnson CompanyOneTouch Zoom lets you generate specialized reports to analyzepatterns and trends, which you can keep for your own records and share with caregivers.
Track and manage blood glucoseHeart360 (FREE)
From the American Heart AssociationUse Heart360 to track and help manage your blood glucose while receiving educational information tailored to your condition.

Note: The American Heart Association created Heart360 to help patients set goals and track progress in reducing heart disease risk factors. The products on this Web site were not selected by the American Heart Association and the placement of product ads on this site does not mean that the American Heart Association endorses or recommends these products or services.

Develop meal plansMy Wellness Center (FREE)
From MSN Health & FitnessMy Wellness Center is a comprehensive health-management tool that makes it easy to develop a diabetic meal plan that offers you flexible choices while helping you meet your health goals, based on information you provide in your profile.
Organize information for your doctorNoMoreClipboard (FREE)
From NoMoreClipboard.comNoMoreClipboard.com can help you get the blood glucose readings you've stored in HealthVault into your doctor's hands.
Collect blood glucose readingsOneTouch® UltraSmart® blood glucose meter
From Lifescan, Inc., a Johnson & Johnson CompanyThe OneTouch UltraSmart Meter is ideal for people who make insulin adjustments. It automatically collects and organizes glucose results into useful charts and graphs, including average by time of day.

Medications
Some people with type 2 diabetes need medicine to help their bodies make more insulin, to decrease insulin resistance, or to slow down how quickly their body absorbs carbohydrate.
You may take no medicine, one medicine, or a few medicines. Some people need medicine for short periods of time, while others always need to take medicine. How much medicine you need depends on how well you can keep your blood sugar within a safe range.
Some people who have type 2 diabetes take medicines for high blood pressure or high cholesterol. They may also take aspirin to prevent a heart attack, a stroke, or other large blood vessel diseases (macrovascular disease).

Home Treatment
Making healthy choices is a large part of treating type 2 diabetes. The more you learn about the disease, the more motivated you may be to make good choices and to follow your treatment plan. By understanding what is happening in your body, you may also feel more in control of your disease.
If you have type 2 diabetes, your daily routine will include:
Eating healthy foods and spreading carbohydrate throughout the day.
Getting some physical activity that raises your heart rate, including resistance exercises like weight lifting or even yard work.
Checking your blood sugar levels.
Taking pills for type 2 diabetes and insulin, or other shots if prescribed.
Drinking enough fluids to avoid dehydration.
Taking a low-dose aspirin, if your doctor advises you to.
Other important issues
If you have type 2 diabetes, you also need to:
Always wear medical identification to let health professionals know in an emergency that you have diabetes. Medical ID necklaces or bracelets are available from your doctor, your local pharmacy, or online.
Know how to recognize and to quickly treat high blood sugar and low blood sugar.
Take extra care of your skin, teeth, feet, and gums.
Know how to care for yourself when you are sick.

Other Treatment
You may be tempted to try products or pills that promise to cure your type 2 diabetes. But these products and remedies can be harmful and expensive. If you are considering taking any medicines or herbal remedies without a prescription, talk to your doctor first.

When to Call a Doctor
Call your doctor about type 2 diabetes if you:
Are age 45 or older and you have never been tested for type 2 diabetes or you have not been tested in more than 3 years.
Are younger than 45, are at high risk for type 2 diabetes, and want to be tested.
Have one or more of the common symptoms of diabetes, such as increased thirst, frequent urination, increased hunger, unusual weight loss, or extreme fatigue.
Have other signs that you may have type 2 diabetes, such as wounds that are not healing well or frequent infections.
Have not been diagnosed with type 2 diabetes but notice symptoms of complications from the disease, such as:
Having burning pain, numbness, or swelling in your feet or hands.
Feeling dizzy or weak when you sit up or stand up suddenly.
Seeing flashing lights; seeing large, floating red or black spots; or seeing large areas that look like floating hair, cotton fibers, or spiderwebs.
Are overweight, get little or no exercise, and want help to reduce your risk for developing type 2 diabetes.
Have been told that your blood sugar level is above the normal range (prediabetes) and you want to know more about decreasing your risk for type 2 diabetes.
Watchful Waiting
If you think you may have symptoms of diabetes, it is not a good idea to ignore them or to wait and see what happens. Type 2 diabetes can get worse and can cause serious problems if it is not diagnosed early. Be sure to talk with your doctor about any symptoms of or concerns you have about type 2 diabetes, especially if you have any risk factors that make it more likely for you to develop the disease.
Who to See
The following health professionals can diagnose diabetes:
Family medicine doctor
General practitioner
Internal medicine doctor
Pediatrician
Nurse practitioner
Physician assistant
Endocrinologist

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