This topic has general
information about
type 2 diabetes for people who do not have the
disease. If you want to learn how to manage type 2 diabetes, one of the
following topics may meet your needs:
Type 2 diabetes is a
lifelong disease that happens when the cells of the body can't use insulin the
right way or when the
pancreas can't make enough insulin. Insulin lets blood
sugar-also called glucose-enter the body's cells to be used for energy. When
insulin is not able to do its job, the cells can't get the sugar they need, and
too much sugar builds up in the blood. Over time, this extra sugar in the blood
can damage your eyes, heart, blood vessels, nerves, and kidneys.
More and more adults and children are getting type 2 diabetes. This is
largely because of bad eating habits and a lack of physical activity. It is
important to know if you or your children are at risk for type 2 diabetes and
to know what you can do to help prevent the disease.
Your body does not respond as it should to
insulin. This makes it hard for your cells to get
sugar from the blood for energy. This is called
insulin resistance.
Your weight, how active you are, and your
family history all affect the way your body responds
to insulin. If you are overweight, get little or no exercise, or have family
members with diabetes, you have a greater chance of getting type 2
diabetes.
What are the symptoms?
Some people don't have
symptoms, especially when diabetes is diagnosed early. This is because the
blood sugar level may rise so slowly that a person may not know that anything
is wrong. Other people may have symptoms, such as:
Being very thirsty.
Urinating a
lot.
Losing weight without trying.
Having blurry
vision.
Feeling hungrier or more tired than usual.
Sometimes a person finds out that he or she has type 2
diabetes during a regular medical checkup. Or people may find out that they
have the disease during an appointment for another health problem such as
high blood pressure, an infection, or a wound that
heals slowly. Some people don't find out that they have diabetes until they
have a complication from the disease, such as vision problems, kidney disease,
nerve disease, or heart and blood vessel problems.
How is type 2 diabetes diagnosed?
If your doctor
thinks that you have type 2 diabetes, he or she will ask you questions about
your medical history, do a physical exam, and order a blood glucose test. A
blood glucose test is a blood test that measures the amount of sugar in your
blood. The test is usually done first thing in the morning, before you eat or
drink anything.
How is it treated?
The key to treating type 2
diabetes is controlling blood sugar levels. All of the following help to lower
blood sugar:
Eating healthy foods
Losing weight, if you are
overweight
Getting regular exercise
In some cases,
taking medicines
Treatment for diabetes also includes checking blood
sugar levels to make sure that the disease is under control. It is important to
watch for signs of high and low blood sugar. Both can cause problems and need
to be treated.
People with diabetes need regular checkups to make
sure that the treatment is working and that they do not get more serious health
problems.
Can type 2 diabetes be prevented?
If you are at
risk for type 2 diabetes or if you have
prediabetes, you may prevent diabetes by getting
regular exercise and paying attention to what and how much you eat. If you are
overweight, losing a little weight (10 to 20 pounds) can go a long way toward
preventing or delaying the disease.
Your body does not respond properly to
insulin, making it difficult for your cells to get
sugar from the blood to make energy. This is called
insulin resistance.
Your weight, how much physical activity you get, and your
family history all affect the way your body responds
to insulin. If you are overweight, get little or no exercise, or have family
members with diabetes, you have a greater chance of developing type 2
diabetes.
Symptoms
At first, your blood sugar level may rise
so slowly that you may not know that anything is wrong. One-third of all people
who have diabetes do not know that they have the disease.1
If you do have symptoms of
type 2 diabetes, they may include:
Feeling thirsty.
Having to urinate
more than usual.
Feeling more hungry than usual.
Losing
weight without trying to.
Feeling very tired.
Feeling
cranky.
Other signs of type 2 diabetes may include:
Infections and cuts and bruises that heal slowly.
Blurred vision.
Tingling or numbness in your hands or feet.
Trouble with skin, gum, or bladder
infections.
Vaginal yeast infections.
Some people have already developed more serious health
problems by the time they are diagnosed with type 2 diabetes. Over time,
diabetes can lead to problems with the eyes, kidneys, heart, blood vessels, and
nerves. Signs of these problems may include:
Numbness, tingling, burning pain, or swelling
in your feet or hands (diabetic neuropathy).
Blurred or distorted vision or seeing
flashes of light; seeing large, floating red or black
spots; or seeing large areas that look like floating hair, cotton fibers, or
spiderwebs (diabetic retinopathy).
Chest pain or shortness of breath. This may be a sign of heart or
blood vessel problems.
What Happens
Type 2 diabetes
is a lifelong disease that affects the way your body uses food for energy. The
disease develops when the cells of the body become
resistant to insulin or when the
pancreas cannot make enough
insulin. Insulin is a hormone that helps your body's
cells get needed energy from sugar. When insulin is not able to do its job, too
much sugar builds up in your blood. Over time, this extra sugar in your blood
can lead to problems with your eyes, heart, blood vessels, nerves, and
kidneys.
Type 2 diabetes usually develops in adulthood; however,
more and more children are being diagnosed with type 2 diabetes. Often people
who have type 2 diabetes are overweight and get little or no physical
exercise.
Sometimes type 2 diabetes develops so slowly that you do
not have symptoms until you already have some more serious problems from the
disease. Many people have
prediabetes-when blood sugar levels are above normal
but not high enough to have diabetes-for years before they know they develop
type 2 diabetes. For more information on prediabetes, see the topic
Prediabetes.
Once you
know that you have type 2 diabetes, you will work with your doctor and other
health professionals to develop the best treatment plan for you. Treatment
usually includes eating healthy foods and spreading
carbohydrate throughout the day, exercising regularly,
checking your blood sugar levels often, and possibly taking medicine. Working
closely with your doctor and other health professionals can help you feel
better and more in control of your disease. You can help prevent or delay more
serious health problems by keeping your blood sugar within a safe range.
As time goes on, your pancreas may make less and less insulin,
which can make it harder to control your blood sugar level. It is important to
treat your high blood sugar early anytime your blood sugar level rises above
what is safe for you. Treating high blood sugar early can help prevent:
A
hyperosmolar state, which is a life-threatening event
that can happen when the blood sugar level is very high. It can occur when a
person with type 2 diabetes has an illness, such as a severe case of
the flu or other infection; has a
heart attack; is not drinking enough liquids and
becomes
dehydrated; or takes medicines (diuretics) that
increase fluid loss or affect mental alertness, especially if liquids are not
replaced.
There are some things that
you cannot change that increase your chances of getting
type 2 diabetes:
Risk factors that you cannot control include:
Family history. If you have a parent, brother, or
sister who has type 2 diabetes, you have a greater chance of developing the
disease.
Age. The risk for getting
prediabetes and type 2 diabetes increases with age.
And the number of children being diagnosed with type 2 diabetes is increasing.
Usually, children who get type 2 diabetes have a family history of the disease,
are overweight, and are physically inactive.2
Race and ethnicity. African Americans, Hispanics,
Native Americans, Asian Americans, and Pacific Islanders are at higher risk
than whites for type 2 diabetes.3
History
of
gestational diabetes or having a baby weighing more
than 9 lb (4 kg). Women who
have had gestational diabetes or who have had a large baby are at higher risk
for developing type 2 diabetes later in life.3
Low birth weight. People who weighed less than
5.5 lb (2.5 kg) at birth are
more likely to develop type 2 diabetes later in life.4
There are some things you can do to reduce your chances of
getting diabetes or reduce your chances of developing complications from
diabetes:
Lose weight. Your risk for type 2 diabetes increases as your
weight (or body mass index, BMI) increases. Your risk also increases if most of
your body fat is in your belly area. Reaching and staying at a healthy body
weight can reduce your risk.
Get more exercise. Getting enough
exercise lowers your risk of developing type 2
diabetes.5
Eat foods that are good for
you. Eating a lot of sugary foods, red meat, soft drinks, and fast food can
increase your risk of developing type 2 diabetes.6, 7, 8 Eating
whole grains, nuts, and vegetables can decrease your risk.9
Quit smoking. This change may reduce your chance of having complications from
diabetes.
Get treatment if you have
prediabetes. If your fasting blood sugar levels are in
the range from 100
mg/dL to 125 mg/dL, you are at increased risk for
developing type 2 diabetes.10
Get treatment if you have
high blood pressure (hypertension). People who have
blood pressure levels above 140/90 millimeters of mercury (mm Hg) are at
greater risk for type 2 diabetes than people who have blood pressure below
140/90.3 The United States Preventive Services Task
Force (USPSTF) recommends diabetes testing for people who
have blood pressure higher than 135/80.11
Get treatment if you have
high cholesterol. People who have
high-density lipoprotein (HDL) cholesterol levels of
35 milligrams per deciliter (mg/dL) or less, or triglyceride levels of 250
mg/dL or more are at higher risk of developing complications from type 2
diabetes.3
Other conditions that put you at risk for type 2
diabetes-and that are also linked to
obesity and a lack of physical activity-include:
Metabolic syndrome, a group of abnormal physical
findings related to the body's metabolism.
If you are concerned about diabetes, you can take
a test to determine your risk of getting the disease. If you are at risk, you can
discuss with your doctor how to make healthy changes in your life. If you want,
your doctor can refer you to health professionals who are trained to help you
make your own easy-to-follow plan for eating and exercising. No matter how and
when you start, it is important to remember that even small changes can lower
your chances of developing diabetes.
Are age 45 or older and you have never been tested for type 2
diabetes or you have not been tested in more than 3 years.
Are
younger than 45, are at high risk for type 2 diabetes, and want to be
tested.
Have one or more of the common symptoms of diabetes, such
as increased thirst, frequent urination, increased hunger, unusual weight loss,
or extreme fatigue.
Have other signs that you may have type 2
diabetes, such as wounds that are not healing well or frequent
infections.
Have not been diagnosed with type 2 diabetes but notice
symptoms of complications from the disease, such as:
Having burning pain, numbness, or swelling
in your feet or hands.
Feeling dizzy or weak when you sit up or
stand up suddenly.
Seeing
flashing lights; seeing large, floating red or black
spots; or seeing large areas that look like floating hair, cotton fibers, or
spiderwebs.
Are overweight, get little or no exercise, and
want help to reduce your risk for developing type 2 diabetes.
Have
been told that your blood sugar level is above the normal range (prediabetes) and you want to know more about
decreasing your risk for type 2 diabetes.
Watchful Waiting
If you think you may have
symptoms of diabetes, it is not a good idea to ignore them or to wait and see
what happens. Type 2 diabetes can get worse and can cause serious problems if
it is not diagnosed early. Be sure to talk with your doctor about any symptoms
of or concerns you have about type 2 diabetes, especially if you have any risk
factors that make it more likely for you to develop the disease.
Who to See
The following health professionals can
diagnose diabetes:
If your doctor thinks that you may
have diabetes, he or she will order a couple of
blood glucose tests. Blood glucose tests are blood
tests that measure how much sugar is in your blood. Usually, they are done
first thing in the morning, before you eat or drink anything.
If your blood sugar level
is above normal but below the level for diabetes, you have
prediabetes and are at risk for developing type 2
diabetes. For more information on prediabetes, see the topic
Prediabetes.
Other tests
A
home blood sugar test or a
urine test for sugar are not the best ways to learn
whether you have diabetes. However, after you are diagnosed, you may use home
blood sugar tests to check your own blood sugar levels.
Along with
your home blood sugar tests, your health professional will give you a
hemoglobin A1c (glycohemoglobin) test after you start treatment for
diabetes. This test finds your average blood sugar level over the previous 2 to
3 months. The A1c test adds to the information from your home blood sugar tests
to help you keep track of your blood sugar control.
After you are
diagnosed with type 2 diabetes or prediabetes, you may have a thorough exam of
your cardiovascular system to check for any heart
problems.
Early detection
You can use the American Diabetes Association's
risk test for diabetes to see whether you are at risk for developing type 2
diabetes.
If you are age 45 or older, the American Diabetes
Association recommends that you be tested for diabetes every 3 years. The
United States Preventive Services Task Force (USPSTF) recommends testing for
diabetes in people who have either high cholesterol or high blood pressure.
Talk with your doctor about your risk factors and how often you need to be
tested.
The American Diabetes Association recommends that you be
tested more often or begin testing at a younger age if you:3
Have a parent, brother, or sister who has type 2 diabetes.
Have a history of
gestational diabetes or have delivered a baby who
weighed 9 lb (4 kg) or
more.
Treatment Overview
It can be scary to learn that
you, your child, a family member, or a friend has
type 2 diabetes or is at risk for the disease. Many
people are shocked when they find out that they have type 2 diabetes. Others
are relieved to know what has been causing their symptoms. Although it is
normal to feel angry or depressed about having a serious lifelong disease, it
is important to remember that many people who have type 2 diabetes enjoy
healthy, active lives when they are able to control their blood sugar.
Exercising, eating healthy foods, and taking medicines all help control blood
sugar.
There is no cure for type 2 diabetes, but there are ways to
treat the disease. Even if you do not feel sick, you still need treatment to
prevent more serious health problems in the future.
Some people
can control their blood sugar by changing the way they eat and exercising more.
Other people also need to take medicines. Treatment for type 2 diabetes
includes:
Changing the way you eat-to a healthier, more balanced
diet.
Limiting calories in order to avoid gaining weight, or to
help you lose weight.
Exercising regularly to help your body use insulin
better.
Checking your blood sugar at home to know when the level is
above or below your target range.
Taking
pills, if eating differently and exercising more do not keep your blood sugar
levels within a safe range. You may need one or more medicines to help your
body make more
insulin or to use insulin better.
Taking
insulin shots for a while or for the rest of your life. Insulin is usually
given by injection, and it may be used alone or with other medicines that are
in the form of pills.
Seeing your doctor regularly to make sure that your treatment is
working and that you have not developed any serious problems such as eye,
cardiovascular, nerve, or kidney disease.
Other important issues
If you have type 2
diabetes, you also need to:
Always wear medical identification to let
health professionals know in an emergency that you have diabetes. Medical ID
necklaces or bracelets are available from your doctor, your local pharmacy, or
online.
Know how to recognize and quickly treat high blood sugar
and low blood sugar.
Take extra care of your skin, teeth, feet,
and gums.
You can take steps to
prevent
type 2 diabetes. Even small changes can make a
difference, and it is never too late to start making healthier choices.
Maintain a healthy weight. To find out if you are overweight, you can use the
body mass index (BMI) chart for adults or the same
chart in metric. If you need to lose weight, losing as few as
10 lb (4.5 kg) to
20 lb (9.1 kg) can help reduce
your risk of developing diabetes.12
Exercise regularly. Getting enough exercise lowers your risk
of developing type 2 diabetes.5 Do activities that
raise your
heart rate. Try to do
moderate activity at least 2½ hours a week. Or try to
do
vigorous activity at least 1¼ hours a week. It's fine
to be active in blocks of 10 minutes or more throughout your day and week. Also
include resistance exercises in your exercise program.13, 14 Resistance exercises can include
activities like weight lifting or even yard work. This does not mean that you
have to do strenuous activities or join an expensive gym-anything that
increases your heart rate counts. Walking groups or programs where you use a
pedometer to count the number of steps you take in a day are great ways to
start exercising and to stay motivated. If you are at risk for type 2 diabetes,
using an
exercise planning form may help you and your doctor or
other health professional to create a personalized exercise
program.
Eat healthy foods.
Eat a balanced diet, including whole
grains, lean meat, and vegetables.
Limit calories in order to avoid gaining weight, or to help
you lose weight.
Reduce your intake of soft drinks, sugary foods,
and junk food.
Eat smaller meals more often in order to keep blood
sugar levels within your target range.
Eating more vegetables, whole grains, and nuts can lower
your risk for developing type 2 diabetes.9 Eating a
lot of sugary foods, fast foods, and red meat (especially processed red meat)
and drinking a lot of soft drinks can increase your risk for developing type 2
diabetes.6, 7, 8 If you want to learn more about eating well, see the topic
Healthy Eating.
Take an angiotensin-converting enzyme (ACE) inhibitor or
angiotensin II receptor blocker (ARB) medicine at the first sign of
diabetic nephropathy, even if you do not have high
blood pressure.
Get regular eye exams.
Take good care of your
feet.
Quit smoking. If you smoke cigarettes, talk with your doctor
about ways to quit. Smoking contributes to the early development of diabetes
complications.15 For more information, see the topic
Quitting Smoking.
Home Treatment
Making healthy choices is a large
part of treating
type 2 diabetes. The more you learn about the disease,
the more motivated you may be to make good choices and to follow your treatment
plan. By understanding what is happening in your body, you may also feel more
in control of your disease.
If you have type 2 diabetes, your
daily routine will include:
Eating healthy foods and spreading
carbohydrate throughout the day.
Getting plenty of physical activity that raises your
heart rate, including resistance exercises like weight
lifting or even yard work.
Checking your blood sugar
levels.
Taking pills for type 2 diabetes and
insulin, or other shots if
prescribed.
Taking a low-dose aspirin, if
your doctor advises you to.
Other important issues
If you have type 2
diabetes, you also need to:
Always wear medical identification to let
health professionals know in an emergency that you have diabetes. Medical ID
necklaces or bracelets are available from your doctor, your local pharmacy, or
online.
Know how to recognize and to quickly treat high blood sugar
and low blood sugar.
Take extra care of your skin, teeth, feet,
and gums.
You may take
no medicine, one medicine, or a few medicines. Some people need medicine for
short periods of time, while others always need to take medicine. How much
medicine you need depends on how well you can keep your blood sugar within a
safe range.
Surgery is not a treatment for
type 2 diabetes. But if you are very overweight and
are considered a good candidate for surgery,
gastrointestinal surgery can help you lose weight and
improve your diabetes control. For more information, see the topic
Obesity.
Other Treatment
You may be tempted to try products
or pills that promise to cure your
type 2 diabetes. But these products and remedies can
be harmful and expensive. If you are considering taking any medicines or herbal
remedies without a prescription, talk to your doctor first.
Other Places To Get Help
Organizations
American Association of Diabetes
Educators
100 West Monroe Street
Suite 400
Chicago, IL 60603
Phone:
1-800-338-3633
Fax:
(312) 424-2427
E-mail:
aade@aadenet.org
Web Address:
www.aadenet.org
The American Association of Diabetes Educators is made up of
doctors, nurses, dietitians, and other health professionals with special
interest and training in diabetes care. The Web site can supply the names of
these types of health professionals in your local area.
American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA 22311
Phone:
1-800-DIABETES (1-800-342-2383)
E-mail:
AskADA@diabetes.org
Web Address:
www.diabetes.org
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
National Diabetes Education Program
(NDEP)
1 Diabetes Way
Bethesda, MD 20814-9692
Phone:
1-800-438-5383 to order materials (301) 496-3583
E-mail:
ndep@mail.nih.gov
Web Address:
http://ndep.nih.gov
The National Diabetes Education Program (NDEP) is
sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers
for Disease Control and Prevention (CDC). The program's goal is to improve the
treatment of people who have diabetes, to promote early diagnosis, and to
prevent the development of diabetes. Information about the program can be found
on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC
(www.cdc.gov/team-ndep).
National Diabetes Information Clearinghouse
(NDIC)
1 Information Way
Bethesda, MD 20892-3560
Phone:
1-800-860-8747
Fax:
(703) 738-4929
TDD:
1-866-569-1162 toll-free
E-mail:
ndic@info.niddk.nih.gov
Web Address:
http://diabetes.niddk.nih.gov
This clearinghouse provides information about research
and clinical trials supported by the U.S. National Institutes of Health. This
service is provided by the National Institute of Diabetes and Digestive and
Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).
Weight-Control Information Network
(WIN)
1 WIN Way
Bethesda, MD 20892-3665
Phone:
1-877-946-4627 toll-free
Fax:
(202) 828-1028
E-mail:
win@info.niddk.nih.gov
Web Address:
http://win.niddk.nih.gov/index.htm
The Weight-control Information Network (WIN) is a
service of the National Institute of Diabetes and Digestive and Kidney
Diseases, part of the National Institutes of Health. WIN supplies information
on weight control, obesity, and nutritional disorders for the public and for
health professionals.
American Diabetes Association (2008). All About Diabetes. Available online:
http://www.diabetes.org/about-diabetes.jsp.
American Diabetes Association (2000). Type 2 diabetes
in children and adolescents. Pediatrics, 105(3): 671-680.
American Diabetes Association (2004). Screening for
type 2 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S11-S14.
Capes S, Anand S (2001). What is type 2 diabetes? In
HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 151-163. Hamilton, ON: BC Decker.
Diabetes Prevention Program Research Group (2002).
Reduction in the incidence of type 2 diabetes with lifestyle intervention or
metformin. New England Journal of Medicine, 346(6):
393-403.
Funt TT, et al. (2004). Dietary patterns, meat intake,
and the risk of type 2 diabetes in women. Archives of Internal Medicine, 164(20): 2235-2240.
Pereira MA, et al. (2005). Fast-food habits, weight
gain, and insulin resistance (the CARDIA study): 15-year prospective analysis.
Lancet, 365(9453): 36-42.
Schulze MB, et al. (2004). Sugar-sweetened beverages,
weight gain, and incidence of type 2 diabetes in young and middle-aged women.
JAMA, 292(8): 927-934.
American Diabetes Association (2004). Magnesium intake
and risk of type 2 diabetes in men and women. Diabetes Care, 27(Suppl 1): 134-140.
American Diabetes Association (2008). Standards of
medical care in diabetes. Diabetes Care, 31(Suppl 1):
S12-S54.
U.S. Preventive Services Task Force (2008). Screening
for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force
recommendation statement. Annals of Internal Medicine,
148(11): 846-854.
Cooppan R (2005). General approach to the treatment of
diabetes mellitus. In CR Kahn et al., eds., Joslin's Diabetes Mellitus, 14th ed., pp. 587-596. Philadelphia: Lippincott Williams and
Wilkins.
Sigal RJ, et al. (2006). Physical activity/exercise
and type 2 diabetes: A consensus statement from the American Diabetes
Association. Diabetes Care, 29(6):
1433-1438.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
American Diabetes Association (2004). Smoking and
diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S74-S75.
Other Works Consulted
American Diabetes Association (2004). A prospective
study of red meat consumption and type 2 diabetes in middle-aged and elderly
women. Diabetes Care, 27(9): 2108-2115.
American Diabetes Association (2004). Nutrition
principles and recommendations in diabetes. Position Statement 2004.
Diabetes Care, 27(Suppl 1): S36-S46.
American Diabetes Association (2004). Prevention or
delay of type 2 diabetes. Clinical Practice Recommendations 2004.
Diabetes Care, 27(Suppl 1): S47-S50.
Hu FB, et al. (2003). Television watching and other
sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus
in women. JAMA, 289(14): 1785-1791.
Van Dam RM, et al. (2002). Dietary patterns and risk
for type 2 diabetes mellitus in U.S. men. Annals of Internal Medicine, 136(3): 201-209.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
American Diabetes Association (2008). All About Diabetes. Available online:
http://www.diabetes.org/about-diabetes.jsp.
American Diabetes Association (2000). Type 2 diabetes
in children and adolescents. Pediatrics, 105(3): 671-680.
American Diabetes Association (2004). Screening for
type 2 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S11-S14.
Capes S, Anand S (2001). What is type 2 diabetes? In
HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 151-163. Hamilton, ON: BC Decker.
Diabetes Prevention Program Research Group (2002).
Reduction in the incidence of type 2 diabetes with lifestyle intervention or
metformin. New England Journal of Medicine, 346(6):
393-403.
Funt TT, et al. (2004). Dietary patterns, meat intake,
and the risk of type 2 diabetes in women. Archives of Internal Medicine, 164(20): 2235-2240.
Pereira MA, et al. (2005). Fast-food habits, weight
gain, and insulin resistance (the CARDIA study): 15-year prospective analysis.
Lancet, 365(9453): 36-42.
Schulze MB, et al. (2004). Sugar-sweetened beverages,
weight gain, and incidence of type 2 diabetes in young and middle-aged women.
JAMA, 292(8): 927-934.
American Diabetes Association (2004). Magnesium intake
and risk of type 2 diabetes in men and women. Diabetes Care, 27(Suppl 1): 134-140.
American Diabetes Association (2008). Standards of
medical care in diabetes. Diabetes Care, 31(Suppl 1):
S12-S54.
U.S. Preventive Services Task Force (2008). Screening
for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force
recommendation statement. Annals of Internal Medicine,
148(11): 846-854.
Cooppan R (2005). General approach to the treatment of
diabetes mellitus. In CR Kahn et al., eds., Joslin's Diabetes Mellitus, 14th ed., pp. 587-596. Philadelphia: Lippincott Williams and
Wilkins.
Sigal RJ, et al. (2006). Physical activity/exercise
and type 2 diabetes: A consensus statement from the American Diabetes
Association. Diabetes Care, 29(6):
1433-1438.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
American Diabetes Association (2004). Smoking and
diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S74-S75.
