abdominal organs, often termed abdominal obesity; the fat
around the waistline also covers the internal organs within
the abdomen.

Страницы: 1 | 2

• I. SIZE OF THE PROBLEM A. Incidence
  Presently there are more than 16 million type 2 diabetics in the United States, and it is expected that this number will rise to approximately 22 million adults with diabetes in the year 2025. In addition, there are greater than 40 million individuals who may not satisfy strict criteria for the diagnosis of diabetes but have normal or mini¬mally elevated blood glucose levels with associated hyper-insulinemia and peripheral insulin resistance. These ‘‘prediabetic’’ individuals have a 10% annualized risk of developing type 2 diabetes. Importantly, most diabetics die of cardiovascular disease, and atherosclerosis that causes obstruction to arteries in the heart and brain accounts for greater than 80% of all diabetic mortality.
• II. CLINICAL FEATURES AND COMPLICATION OF TYPE 2 DIABETES
  A. Symptoms of Type 2 Diabetes
• III. PATHOGENESIS OF TYPE 2 DIABETES AND RESEARCH IMPLICATIONS
  Type 2 diabetes is a term to be used for idiopathic forms of diabetes with insulin resistance and without severe insulin deficiency or dramatic loss of beta cells. It has recently been appreciated that approximately 5–25% of patients initially diagnosed with type 2 diabetes actually have type 1 diabetes. Very little research can be done in medicine without a thorough knowledge of the patho-genesis and the pathophysiology of the disease pro¬cess. Figure 4 depicts pathophysiology and metabolic abnormalities).
• IV. MATURITY ONSET DIABETES OF THE YOUNG
  Maturity onset diabetes of the young (MODY ) is a clinically heterogenous group of disorders characterized by an autosomal dominant mode of inheritance and onset usually before age 25. It is a primary defect in the function of the beta cells of the pancreas. Mutations in any one of six different genes may result in MODY.
• V. MANAGEMENT OF TYPE 2 DIABETES
  Initially, therapy for diabetes includes special diets to reduce carbohydrate intake and thus blood glucose and weight reduction. Anti-diabetic drugs are the next of course of action.
• VI. HYPERGLYCEMIC HYPEROSMOLAR COMA
  This complication occurs in older patients with type 2 diabetes who cannot recognize the need for water.
• VII. DYSLIPIDEMIA IN TYPE 2 DIABETES
  A. Characteristics
• VIII. CLINICAL STUDIES, TYPE 2 DIABETES A. Tuomilehto et al.
  Study question: Can type 2 diabetes be prevented by interventions that affect the lifestyle of subjects at high risk for the disease? Methods: Randomization of 522 middle-aged, over¬weight subjects with a mean age of 55 years and mean body mass index of 31(weight in kilograms divided by the square of the height in meters) with impaired glucose tolerance to either the intervention group or the con¬trol group was done. Subjects in the intervention group received counseling aimed at reducing weight, total intake of fat, and an increased intake of fiber and physical activity. The diagnosis of diabetes was confirmed by a second test after an oral glucose tolerance test.
• IX. COFFEE CONSUMPTION AND RISK OF TYPE 2 DIABETES
  A. van Dam et al.
• X. INSULIN RESISTANCE A. Abbasi et al.
  Study question: To define the relationship between body mass index and insulin resistance in 314 nondiabetic, normotensive healthy volunteers.
• BIBLIOGRAPHY
  Abbasi, F., Brown, B. W., Lamendola, C. et al. Relationship between obesity, insulin resistance, and coronary heart disease risk. J. Am. Coll. Cardiol., 40:97–143, 2002.