Type 2 diabetes

Type 2 diabetes is an acquired metabolic disorder in which the cells of the body lose capacity to respond to insulin. Untreated, high glucose levels, which are the result of insulin resistance, damage large and small blood vessels, ultimately leading to an increased risk for heart attack and stroke, as well as problems with the kidneys, eyes, feet and neurological systems. It is also possible to experience nerve damage to internal organs, such as the stomach, intestines, bladder and genitals. These may result in digestive issues, urinary tract conditions and sexual dysfunction. Damage to small blood vessels also increases the risk of frequent infections and problems with wounds that will not heal.

Conventional medicine treats Type 2 diabetes as a problem with blood sugar control and the medical goal of treatment is to reduce blood glucose levels in order to prevent blood vessel damage. However, as diabetes is primarily triggered by a flawed diet and lack of physical activity, prescriptions to address blood sugar levels fail to address the root cause.

From a social perspective, Type 2 diabetes is considered to be disease of the affluent, resulting from an over-indulgent lifestyle. It is closely associated with obesity, lack of physical exercise and a higher caloric intake which tends to develop when societies adopt a "western lifestyle", that is when they move from a traditional, perhaps subsistence, economy dependent upon agriculture to a cash economy in which many people have a sedentary occupation and purchase all their food and needs in shops.

The two most common forms of diabetes are divided into types 1 and 2. Type 1, or "childhood" diabetes, is where the pancreas completely stops manufacturing insulin. Type 2 diabetes has long been known as an "adult" disease because it develops gradually, usually beginning in middle age, as the body produces less insulin and/or becomes less sensitive to insulin (called insulin resistance). Instead of the muscles and fat cells taking up sugar from the blood under the influence of insulin, they ignore the orders and the liver then releases too much glucose. The result is a dangerous buildup of blood sugar, which somehow damages other body tissues. When a person has insulin resistance, leading to elevated blood sugar levels, but not yet to the point of diabetes, he or she is said to be prediabetic. Insulin resistance develops with obesity, which is now considered a major risk factor for type 2 diabetes.

The major complications with Type 2 diabetes can be put into two groups: microvascular and macrovascular, or small-vessel complications and large-vessel complications. The microvascular complications include: diabetic retinopathy, which is diabetic eye disease; diabetes nephropathy, which is diabetic kidney disease; and also diabetes neuropathy, the nerve damage typical of type 2 diabetes. Macrovascular complications include: heart disease and stroke and other significant circulatory problems, such as peripheral vascular disease, meaning low circulation to the limbs. The micro vascular complications is significantly related to the high blood sugar. The large-vessel diseases have a variety of causes, including high blood sugar but they are more related to characteristics of the metabolic syndrome, such as high cholesterol, high triglycerides, low HDL.

According to the WHO, diabetes is now reaching epidemic proportions as the number of individuals suffering from diabetes continues to rise. According to the Centers for Disease Control and Prevention (CDC), in 2012 there were 20 million US Americans had diabetes or prediabetes; the number in 2018 is over 30 million. This includes 23.1 million diagnosed and 7.2 million who are unaware of their condition. US statistics also indicate there are 84.1 million adults with prediabetes. Total medical costs and lost work and wages are estimated at $245 billion.

Uncontrolled diabetes increases the risk of heart disease, stroke, kidney disorders, nerve damage, blindness and amputations. TThe risk of death for adults with diabetes is 50 percent higher than for nondiabetic adults. Also, people living with Type 2 diabetes are 50 to 65 percent more likely to develop Alzheimer’s disease compared to people with normal blood sugars. The exact link between diabetes and Alzheimer’s disease is not yet fully understood. However, it is believed that high blood sugar or insulin can harm the brain in different ways. Nerve damage in the hands, feet or arms, called diabetic neuropathy, affects nearly half of those with diabetes and is more common in those who have had the disease for a number of years.