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

JACQUELINE SALAS-SPIEGEL, MD: Type 2 diabetes is a chronic illness that is defined as an abnormality in glucose metabolism where the body cannot effectively handle the carbohydrates that it consumes.

ANNOUNCER: At the heart of this disorder is a problem utilizing a hormone called insulin.

ASTRID ALMODOVAR, MD: If you think of insulin as a key to open the cell for the entrance of glucose, all of a sudden, mostly because of obesity and a sedentary lifestyle, the cells are indifferent to insulin. So we have a lot of insulin circulating, a lot of sugar circulating, but it's not going into the cells. That's what we call insulin resistance.

ANNOUNCER: An estimated 17 million Americans have Type 2 Diabetes. Most don't know it. Millions more are heading toward the disease.

ASTRID ALMODOVAR, MD: Type 2 diabetes is not a sudden illness. It is a process. It is the end product of a continuum of metabolic abnormalities. If you compare type 2 diabetes with a runaway train, you start, especially if you're a minority, you start with a ticket; you already have a ticket and a boarding pass. The moment you start getting sedentary and gaining weight, you start getting on the train and moving along the continuum of diabetes. We start with the metabolic syndrome, then we go prediabetes, and then we have full-blown diabetes.

ANNOUNCER: Doctors say there are five key metabolic abnormalities frequently found in the US population. These are: high blood pressure, poor blood levels of cholesterol and triglycerides, abdominal obesity, and insulin resistance. When a person has any three of these problems, they are said to suffer from metabolic syndrome, and they are at high risk for disease.

JACQUELINE SALAS-SPIEGEL, MD: The metabolic syndrome is definitely associated with an increased risk of cardiovascular mortality. That means an increased risk of heart attack, an increased risk of stroke and other vascular complications. It's also very strongly associated with diabetes.

ANNOUNCER: 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.

ASTRID ALMODOVAR, MD: Prediabetes would be the in-between. You are not normal, but you are not the full-blown diabetic yet. Prediabetes is just stage one or stage two of diabetes. It's part of a continuum, and we've just caught it at a different time.

ANNOUNCER: Prediabetes becomes diabetes when blood sugar levels reach certain defined values. The complications that follow can be serious.

JACQUELINE SALAS-SPIEGEL, MD: In patients with Type 2 diabetes, the major complications can really be put into two groups. There are microvascular and macrovascular complications; that means small-vessel complications and large-vessel complications.

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