Type 2 Diabetes (Non-insulin Dependent Diabetes)

This used to be called non-insulin dependent diabetes or mature-age onset diabetes. It is by far the most common form, affecting 85-90% of all people with diabetes. While it usually affects mature adults, more and more younger people, even children, are getting Type 2 diabetes.

Type 2 diabetes is a lifestyle disease and is strongly associated with high blood pressure, high cholesterol and the classic ‘apple shape’ body where there is extra weight around the waist.

Unlike those with Type 1, people with Type 2 diabetes are always insulin resistant. This means that their pancreas is making insulin but the insulin is not working as well as it should, so it must make more. Eventually it can’t make enough to keep the glucose balance right.

Adopting a healthy lifestyle may delay the need for tablets and/or insulin. However it is important to know that when you do need tablets and/or insulin, this is just the natural progress of the disease. By taking tablets and/or insulin as soon as they are needed, complications caused by diabetes can be reduced.

Who is most likely to get Type 2 diabetes?

While there is no single cause for developing Type 2 diabetes, there are well-known risk factors. Some of these can be changed and some cannot.

Risk factors which cannot be changed:

People who are most likely to get Type 2 diabetes often have these risk factors:

  • · A family history of diabetes.
    · Age – the risk increases as we get older.
    · Are Aborigines or Torres Strait Islanders.
    · Are from ethnic backgrounds more likely to have Type 2 diabetes such as   Melanesian, Polynesian, Chinese or people from the Indian sub-continent.
    · Women who have:
    ·given birth to a child over 4.5kgs (9lbs) or had gestational diabetes when pregnant.
    ·a condition known as Polycystic Ovarian Syndrome.

Risk factors which can be changed

  • · Lifestyle
    · Weight
    · level of physical activity
    · Blood pressure
    · the type of food we eat
    · Cholesterol
    · Smoking

Can Type 2 diabetes be prevented?

Yes. People at risk of Type 2 diabetes can delay and even prevent getting it by following a healthy lifestyle. This includes regular physical activity, making healthy food choices and not putting on a lot of weight, especially if they have been told that they have a pre-diabetic condition.

What are the pre-diabetic conditions linked to Type 2 diabetes?

There are three common conditions linked to developing Type 2 diabetes:

  1. Impaired Fasting Glucose (IFG),
  2. Impaired Glucose Tolerance (IGT), and
  3. diabetes during pregnancy, called Gestational Diabetes.

1 Impaired Fasting Glucose (IFG). This condition is diagnosed when the fasting* blood glucose level (usually blood is taken from the arm) is higher than normal but after a sweet drink (Oral Glucose Tolerance Test) the level is not high enough to be called Impaired Glucose Tolerance or diabetes.

2 Impaired Glucose Tolerance (IGT). This condition is diagnosed when the fasting* blood glucose level is higher than normal, even higher after the Oral Glucose Tolerance Test but still not high enough to be called diabetes.

Who is most likely to get Impaired Fasting Glucose or Impaired Glucose Tolerance?

These two pre-diabetic conditions are most common in people who have a family history of Type 2 diabetes, are inactive and overweight. People who carry excess weight around the waistline are at the greatest risk. Like Type 2 diabetes, Impaired Fasting Glucose and Impaired Glucose Tolerance are a result of insulin not working as well as it should because of insulin resistance.

* ‘Fasting’ means having nothing to eat or drink for eight hours before the test is done.

3 Gestational diabetes. Gestational diabetes occurs during pregnancy and usually goes away after the baby is born. In pregnancy, the placenta makes hormones that help the baby to grow and develop. Gestational diabetes occurs because these hormones also block the action of the mother’s insulin. This is called insulin resistance.

The pregnant woman needs extra insulin so the glucose can get from the blood into the cells where it is used for energy. When a woman is pregnant, she needs 2 or 3 times more insulin than normal. If the body is unable to produce this much insulin, diabetes develops. When the pregnancy is over and the woman’s insulin needs return to normal, the diabetes usually goes away.

Who is most likely to get gestational diabetes?

From 3 to 8 % of all pregnant women will develop gestational diabetes around her 24th to 28th week of pregnancy. Those most at risk include women over 30, who have a family history of Type 2 diabetes and are overweight. Aborigines and Torres Strait Islanders are at increased risk as are certain ethnic groups including Indian, Vietnamese, Chinese, Middle Eastern and Polynesian/Melanesian.

Gestational diabetes is diagnosed with a non-fasting Oral Glucose Tolerance Test (OGTT).

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