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Diabetes Type 2 Diabetes

Type 2 Diabetes: Is It More Than Just Blood Sugar?

Summary & Participants

Type 2 diabetes doesn't strike out of the blue. Instead, a person's body undergoes a series of changes. Listen as experts explain the clues that often foreshadow the onset of diabetes.

Medically Reviewed On: June 10, 2008

Webcast Transcript

The microvascular complications include: diabetic retinopathy, which is diabetic eye disease; diabetes nephropathy, which is diabetic kidney disease; and also diabetes neuropathy, which is the nerve damage that we see in 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.

ANNOUNCER: The complications of diabetes are not caused only by high blood glucose levels.

JACQUELINE SALAS-SPIEGEL, MD: For many patients, type 2 diabetes is more than just elevated blood sugar. They also have high cholesterol, high blood pressure and these things in combination can accelerate their development of complications.

The micro vascular complications, the small-vessel disease, I believe is significantly related to the high blood sugar. The large-vessel disease, which is the heart attack and the stroke and the peripheral vascular disease, do have a variety of causes, not just the blood sugar. And they are more related to characteristics of the metabolic syndrome, such as high cholesterol, high triglycerides, low HDL.

ANNOUNCER: Despite the prevalence of type 2 diabetes, doctors say complications can be prevented or controlled. The first steps are changes in diet and increased exercise. And when necessary, the use of many available medications.

ASTRID ALMODOVAR, MD: Fortunately, we have many medications to choose from nowadays. It's medications that help the body get more sensitive to insulin, what we call insulin sensitizers. These are medications like Metformin, Actos and Avandia.

JACQUELINE SALAS-SPIEGEL, MD: This class really addresses the basic problem that's going on in diabetes, which is insulin resistance. So what we're trying to do is to make the body more sensitive to insulin, less resistant to insulin and this class of drugs can really address that problem at the levels where the resistance takes place.

ASTRID ALMODOVAR, MD: The second class of medications, they've been in use for a long, long time, and they work by stimulating the pancreas to produce more insulin.

ANNOUNCER: There is also a new but similar group of drugs that also cause the pancreas to release insulin, but they do so very quickly, so they are taken at mealtime.

ASTRID ALMODOVAR, MD: Other medications that we use early on are the ones that are used to delay the absorption of carbohydrates.

ANNOUNCER: Delaying the absorption of carbohydrates gives the body's natural insulin production a better chance to keep blood glucose levels close to normal.

JACQUELINE SALAS-SPIEGEL, MD: If patients with Type 2 haven't achieved their blood sugar goal with a variety of oral treatments along with diet and exercise, the next step in their treatment is definitely insulin.

ASTRID ALMODOVAR, MD: The beauty of treating diabetes is that we can prevent the complications that I said, and this is not unavoidable. We know that with proper care and management of all the risk factors they can prevent, we can reverse and prevent the cardiovascular complications.

JACQUELINE SALAS-SPIEGEL, MD: The good news about Type 2 diabetes is that, with the current treatment modalities available to us today, which were certainly not available ten years ago, most, if not all, patients with Type 2 diabetes can be well-controlled.

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