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Each year about 200,000 deaths, 400,000 heart attacks, 130,000 strokes, 60,000 amputations, 10,000 new cases of kidney failure requiring dialysis or transplantation and 6,000 new cases of blindness result from the same cause Ð type 2 diabetes mellitus. Type 2 diabetes also leads to other disabilities, especially nerve damage that often results in erectile dysfunction, numbness and weakness, or intractable nausea, vomiting and diarrhea. The disabilities caused by diabetes result in 200 million days of restricted activity, 100 million days of bed rest, and direct and indirect costs of more than $25 billion in the United States alone. Every year, $1 out of every $7 spent on health in the United States is spent on diabetes, the majority (more than 90 percent) with type 2 diabetes.
What Is Type 2 Diabetes?
Type 2 diabetes mellitus, (formerly called non-insulin dependent diabetes mellitus or NIDDM), has many different causes and symptoms. For most, it is a combination of resistance to the normal actions of insulin in muscle and the liver and inadequate production of insulin. It is a disorder characterized by increased blood sugar (glucose) and is often associated with abnormal blood lipids, hypertension and accelerated atherosclerosis.
Who Is Affected?
More than 7 million people are known to have type 2 diabetes, and 3 million of them have some disability. Among the population over age 45, about 6 percent have been diagnosed with type 2 diabetes mellitus. Research studies suggest that another 6 percent have the disorder, but it has not been detected. In addition, another 6 percent have impaired glucose tolerance, a pre-diabetic state associated with increased death from cardiovascular disease. Type 2 diabetes mellitus occurs at higher rates among American Indians, African Americans and Latinos.
What Is the Role of Endocrinology?
Endocrinologists treat diabetes with diet and medications, which may include insulin. In addition, they work with patients on diabetes management to optimize glucose control and monitor for complications of diabetes.
Endocrine research is aimed at understanding the genetics, mechanisms, complications and best treatment of type 2 diabetes mellitus.
- Clinical endocrinologists use the latest advances for successful treatment of type 2 diabetes mellitus and participate in the clinical research and teaching that expand the opportunities for type 2 diabetics and their families.
- Type 2 diabetes mellitus is known to occur more often in some families than others. Recent advances have led to a better understanding of how insulin is produced and released, and have led to the discovery of several genes that cause diabetes in a small proportion of affected families. A major effort is now underway to discover other genes that are involved in the development of diabetes in the majority of patients.
- Recent advances in understanding how hypertension and certain lipid disorders relate to type 2 diabetes mellitus have led to further research aimed at determining the best treatment of these problems in people with this disorder.
- Because most people with type 2 diabetes mellitus have no symptoms, it is unclear what screening tests should be done and whether people with slightly elevated blood sugars should receive treatment. Recent studies have just begun to determine reasonable and cost-effective measures to prevent the complications of this silent killer.
- Most people with type 2 diabetes mellitus are not aware that they have it and often experience complications before the disorder is diagnosed. Current and planned research is focusing on how to reduce the illness and death from type 2 diabetes mellitus. In the future, a combination of genetic and metabolic testing may help identify the people at risk so that early treatment can prevent both type 2 diabetes mellitus and its complications.
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