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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Type 2 diabetes is a chronic disease associated with significant morbidity and mortality that is increasing in prevalence worldwide. Although our current methods for treating type 2 diabetes and its complications have improved, prevention of the disease is preferable, Epidemiologic data suggest that most cases of type 2 diabetes could be attributed to habits and forms of modifiable behavior. Recent evidence from randomized controlled trials has confirmed that lifestyle plays a central role in diabetes prevention. However, the optimal prevention strategy remains to be determined. This review presents the evidence for dietary components that may modify diabetes risk and suggests nutritional interventions that may be of benefit in preventing the disease.
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PMID:Nutrition interventions for prevention of type 2 diabetes and the metabolic syndrome. 1469 96

The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8-13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P < 0.01) and negatively related to triglycerides (P < 0.001) and systolic (P < 0.01) and diastolic blood pressure (P < 0.05). Insulin sensitivity significantly decreased (P < 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.
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PMID:The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. 1471 36

Atherosclerosis is a complex, chronic disease state that usually arises from the converging action of several pathogenic processes, including hypertension, hyperlidemia, obesity and insulin resistance. Significantly, due to the increasing incidence of type 2 diabetes worldwide, several aspects of the renin-angiotensin system, including the capacity for angiotensin II synthesis and binding are increased in human and animal models of type II diabetes, and potentiate vascular lesion formation. Angiotensin II, an important vasoactive peptide of the renin-angiotensin system, profoundly accelerates atherosclerosis in animal models of diabetes. Conversely, in both human and animal studies, inhibition of angiotensin II synthesis or activity has been shown to significantly reduce atherosclerosis and cardiovascular mortality. Cardiovascular protection is independent of blood pressure and baseline activity of the renin-angiotensin system, suggesting an important and direct role for the vascular renin-angiotensin system in atherosclerotic progression. Angiotensin II appears to accelerate atherosclerosis through activation of several distinct signal transduction pathways, and via these mechanisms can function as a vascular growth and migration factor, a pro-inflammatory cytokine and an oxidative stress agent. Thiazolidinediones, a class of oral insulin-sensitizing agents in broad clinical use for the treatment of type 2 diabetes, have been shown to ameliorate cardiovascular disease in animal trials and clinical studies. Thiazolidinediones also appear to regulate angiotensin II signaling at multiple levels, significantly reducing the expression of the angiotensin II type 1 receptor and repressing signal transduction through this receptor to suppress vascular remodeling, lesion formation, and oxidative stress.
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PMID:Angiotensin II, PPAR-gamma and atherosclerosis. 1476 73

Type 2 diabetes and its associated complications impose a substantial burden on those affected by the disease and have a significant economic impact on the national health care system. Recent estimates indicate a substantial increase in diabetes prevalence in the United States in the past decade, with the largest increases occurring in minority populations. Although diet and exercise are important treatment components, they ultimately fail to control hyperglycemia in many patients. Most patients initially require oral pharmacologic therapy, and many will need multiple agents to stabilize and maintain glycemic control over time. Simplifying oral treatment regimens and reducing pill burden could improve patients' adherence to treatment substantially. Implementation of early and aggressive glycemic control along with appropriate monitoring can reduce the incidence of complications associated with diabetes, thereby improving patients' outcomes and ultimately decreasing health care costs. Toward these goals, the Diabetes Quality Improvement Project (now the National Quality Improvement Alliance) has developed measures designed to improve the care of patients with type 2 diabetes. These measures, along with new oral treatment options, may allow patients and their health care providers to achieve better glycemic control, improve adherence, and reduce the costs associated with this progressive and chronic disease.
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PMID:Improving oral pharmacologic treatment and management of type 2 diabetes. 1500 30

It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. The health status of American children has generally improved over the past three decades. However, the number of children who are overweight has more than doubled among 2- to 5-year-old children and more than tripled among 6- to 11-year-old children, which has major health consequences. This increase in childhood overweight has broadened the focus of dietary guidance to address children's over consumption of energy-dense, nutrient-poor foods and beverages and physical activity patterns. Health promotion will help reduce diet-related risks of chronic degenerative diseases, such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. This position paper reviews what US children are eating and explores trends in food and nutrient intakes as well as the impact of school meals on children's diets. Dietary recommendations and guidelines and the benefits of physical activity are also discussed. The roles of parents and caregivers in influencing the development of healthy eating behaviors are highlighted. The American Dietetic Association works with other allied health and food industry professionals to translate dietary recommendations and guidelines into achievable, healthful messages. Specific recommendations to improve the nutritional well-being of children are provided for dietetics professionals, parents, and caregivers.
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PMID:Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years. 1505 55

The prevalence of type 2 diabetes is dramatically increasing worldwide and expected to double over the next 25 years, reaching epidemic proportions and thus incurring a considerable financial burden on the health care system. In order to cure the epidemic and minimize expensive complications, a program aimed at optimizing metabolic control and improving surveillance and quality assessment needs to be developed and implemented nation-wide. Most diabetic patients should be treated within the primary care system. In order to meet treatment targets, improve metabolic control and avoid complications, the knowledge and skills needed to treat this chronic disease should be reinforced by dedicated multidisciplinary teams from centers specializing in diabetes care. The specialized diabetes clinics should be devoted to both the treatment of complicated cases of diabetes, that are not achieving treatment targets in the primary care setting, and to the education, updating and empowerment of all primary care teams involved in the treatment of patients with diabetes. A local framework for shared care should be developed through the combined efforts, of the staff of the diabetes center and the primary care physicians and nurses in order to secure the shared goals of optimal treatment and prevention of complications.
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PMID:[Primary care for type 2 diabetes]. 1519 Aug 47

Family context exerts a strong influence on disease management among patients with chronic disease, but it is not clear which aspects of family life are most influential. This study examined the linkages between patient-appraised couple emotion management (conflict resolution, expressiveness, and respect) and disease management (biological, morale/depression, quality of life, and behavioral) among a relatively understudied group, Chinese American patients with type 2 diabetes. Significant main effects were found between patient-appraised couple emotion management, especially conflict resolution, and the morale component of disease management, but not the biological or behavioral components; both diabetes-specific and general relationship qualities (marital satisfaction) were independently linked to disease management. Acculturation did not qualify the findings. Similarities among ethnic groups in family and disease management relationships may be more common than differences.
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PMID:Patient-appraised couple emotion management and disease management among Chinese American patients with type 2 diabetes. 1522 37

In this study, the authors examined the relation between glycemic control and sense of coherence (SOC) and the mediating role of psychological distress and of adherence to self-care behaviors in 67 people with type 1 and type 2 diabetes. In addition, 29 individuals without any chronic disease composed a control group. The authors determined glycemic control by glycosylated hemoglobin (HbA1c) measures. The participants answered a questionnaire that included questions about medical data, an adherence to self-care behaviors inventory, Derogatis' Brief Symptoms Inventory, and Antonovsky's SOC scale. People with diabetes showed higher levels of psychological distress than matched controls, but similar SOC scores. A path analysis revealed that SOC was indirectly related to glycemic control, through adherence to self-care behaviors and psychological distress. Adherence did not mediate the effect of psychological distress on glycemic control In addition, the type of diabetes of the subject was directly related to glycemic control. The model explained 38% of the variance of glycemic control. The results suggest a possible role of SOC in the psychological and physical wellbeing of people with diabetes. SOC should constitute a focus of further research, particularly studies of possible psychological intervention to enhance SOC in people with diabetes.
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PMID:Relation between sense of coherence and glycemic control in type 1 and type 2 diabetes. 1536 98

The interference of a chronic disease on the aging process reduces patients efficiency in confronting everyday life events and their Quality of Life (QOL). The purpose of this study was to examine the interaction between cognitive problems and emotional difficulties as related to several chronic diseases commonly present among aged patients in contributing to their QOL reduction. Diseases considered were: chronic cerebro-vascular disorders non-insulin dependent diabetes mellitus and hypertension. Memory characteristics and subjective evaluation of several areas of daily living where problems could be present were assessed. Severity of cognitive and behavioral deterioration emerged as a major component independent from type of disease, contributing to reduction of QOL. Disease type determined the different risk of presence of an objective reduction of memory efficiency. The QOL of aged patients was identified as a multidimensional array of different components among which cognitive deterioration assumes a primary role. These results, together with analogous findings from previous studies, underline the importance of considering cognitive efficiency in aged patients even with chronic diseases not directly affecting CNS in order to evaluate their needs.
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PMID:Quality of life in chronic diseases of the aged: the importance of cognitive deterioration. 1537 70

Obesity is a multifactorial, chronic disorder that has reached epidemic proportions in most industrialized countries and is threatening to become a global epidemic. Obese patients are at higher risk from coronary artery disease, hypertension, hyperlipidemia, diabetes mellitus, cancers, cerebrovascular accidents, osteoarthritis, restrictive pulmonary disease, and sleep apnoea. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hypertension, hypertriglyceridemia, high uremic acid levels, low high density lipoprotein (HDL) cholesterol to define a variously named syndrome or metabolic syndrome. Metabolic syndrome is now considered a major cardiovascular risk factor in a large percentage of population in worldwide. Both obesity and metabolic syndrome are particularly challenging clinical conditions to treat because of their complex pathophysiological basis. Indeed, body weight represents the integration of many biological and environmental components and relationships among fat and glucose tolerance or blood pressure are not completely understood. Efforts to develop innovative anti-obesity drugs, with benefits for metabolic syndrome, have been recently intensified. In general two distinct strategies can be adopted: first, to reduce energy intake; second, to increase energy expenditure. Here we review some among the most promising avenues in these two fields of drug therapy of obesity and, consequently, of metabolic syndrome.
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PMID:Emerging aspects of pharmacotherapy for obesity and metabolic syndrome. 1545 65


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