Abstract
Diabetes is one of the largest health problems facing the world today. It is estimated that by the year 2030 over 7 % of the world’s adult population will have diabetes. Numerous risk factors play into an individual’s risk of developing diabetes. Some are modifiable such as obesity, diet, and exercise. Other risk factors including genetic and environmental factors are topics of ongoing research. The physiology of diabetes is a complex interplay between beta-cell function and insulin resistance. Other hormones such as GLP-1 and leptin also play a role. The classic presentation of type 2 diabetes is polyuria, polydipsia, and unintentional weight loss. However, many people are diagnosed with diabetes on routine screening either with a hemoglobin A1c test or an oral glucose tolerance test. The treatment of type 2 diabetes is multifaceted and crosses multiple disciplines. Patient education regarding diet and exercise and adjustment of modifiable risk factors remain the cornerstone of treatment. Patients should be screened for microvascular and macrovascular complications. While studies have shown a benefit of intensive glycemic control for type 2 diabetes in reducing microvascular complications, the effect on macrovascular complications has been less clear. Long-term studies do suggest that good glycemic control near the time of diagnosis can have beneficial impact decades later.
References
ACCORD Study Group, Gerstein HC, Miller ME, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364(9):818-828.
Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545-2559.
ADVANCE Collaborative Group, Patel A, MacMahon S, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560-2572.
Ahmadian M, Suh JM, Hah N, et al. PPARgamma signaling and metabolism: the good, the bad and the future. Nat Med. 2013;19(5):557-566.
Alonso-Magdalena P, Vieira E, Soriano S, et al. Bisphenol A exposure during pregnancy disrupts glucose homeostasis in mothers and adult male offspring. Environ Health Perspect. 2010;118(9):1243-1250.
American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-1046.
American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care. 2015a;38(Suppl 1):S8-S16.
American Diabetes Association. 6. Glycemic targets. Diabetes Care. 2015b;38(Supplement 1):S33-S40.
Barnett AH, Eff C, Leslie RDG, et al. Diabetes in identical twins. Diabetologia. 1981;20:87-93.
Bonds DE, Miller ME, Bergenstal RM, et al. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ. 2010;340:b4909.
Cappuccio FP, D’Elia L, Strazzullo P, et al. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010;33(2):414-420.
Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U S Department of Health and Human Services; 2014.
Chan JM, Rimm EB, Colditz GA, et al. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17(9):961-969.
Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus – present and future perspectives. Nat Rev Endocrinol. 2011;8(4):228-236.
Cobo-Vuilleumier N, Gauthier BR. To beta-e or not to beta-e replicating after 30: retrospective dating of human pancreatic islets. J Clin Endocrinol Metab. 2010;95(10):4552-4554.
Dabelea D, Mayer-Davis EJ, Saydah S, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014;311(17):1778-1786.
D’Alessio D. The role of dysregulated glucagon secretion in type 2 diabetes. Diabetes Res Clin Pract. 2011;13(s1):126-132.
Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378(9785):31-40.
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-986.
Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study. Lancet. 2009;374(9702):1677-1686.
Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129-139.
Farooqi, IS. Matarese, G. Lord, GM. et al. Beneficial effects of leptin on obesity, T cell hyporesponsiveness, and neuroendocrine/metabolic dysfunction of human congenital leptin deficiency. J Clin Invest. 2002;110(8):1093.
Feig DS, Zinman BF, Wang X, et al. Risk of development of diabetes mellitus after diagnosis of gestational diabetes. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne 2008;179(3):229-239.
Festa A, Williams K, D’Agostino R, Jr, et al. The natural course of beta-cell function in nondiabetic and diabetic individuals: the insulin resistance atherosclerosis study. Diabetes. 2006;55(4):1114-1120.
Ford ES, Li CF, Sattar N. Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes care 2008;31(9):1898-1904.
Frati AC, Iniestra F, Ariza CR. Acute effect of cigarette smoking on glucose tolerance and other cardiovascular risk factors. Diabetes Care. 1996;19(2):112-118.
Fung TT, Schulze M, Manson JE, et al. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med. 2004;164(20):2235-2240.
Gregg EW, Chen H, Wagenknecht LE, et al. Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA. 2012;308(23):2489-2496.
Grøntved A, Hu FB. Television viewing and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis. JAMA. 2011;305(23):2448-2455.
Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359(15):1577-1589.
Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259(5091):87-91.
http://www.who.int/diabetes/publications/report-hba1c_2011.pdf. Accessed April 21, 2015.
http://www.idf.org/webdata/docs/WHO_IDF_definition_diagnosis_of_diabetes.pdf. Accessed April 21, 2015.
Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345(11):790-797.
Ikramuddin S, Billington CJ, Lee WJ, et al. Roux-en-Y gastric bypass for diabetes (the diabetes surgery study): 2-year outcomes of a 5-year, randomised, controlled trial. Lancet Diabetes Endocrinol. 2015;3(6):413-422.
InterAct Consortium, Scott RA, Langenberg C, et al. The link between family history and risk of type 2 diabetes is not explained by anthropometric, lifestyle or genetic risk factors: the EPIC-InterAct study. Diabetologia. 2013;56(1):60-69.
Jeon CY, Lokken RP, Hu FB, et al. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007;30(3):744-752.
Jiang R, Manson JE, Stampfer MJ, et al. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA. 2002;288(20):2554-2560.
Jurgens CA, Toukatly MN, Fligner CL, et al. Beta-cell loss and beta-cell apoptosis in human type 2 diabetes are related to islet amyloid deposition. Am J Pathol. 2011;178(6):2632-2640.
Kahn S. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia. 2003;46(1):3-19.
Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383(9922):1068-1083.
Kahn SE, Prigeon RL, McCulloch DK, et al. Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function. Diabetes. 1993;42(11):1663-1672.
Kanaya AM, Wassel Fyr C, Vittinghoff E, et al. Adipocytokines and incident diabetes mellitus in older adults: the independent effect of plasminogen activator inhibitor 1. Arch Intern Med. 2006;166(3):350-356.
Knowler WC, Pettitt DJ, Saad MF, et al. Diabetes mellitus in the pima indians: incidence, risk factors and pathogenesis. Diabetes Metab Rev. 1990;6(1):1-27.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
Lang IA, Galloway TS, Scarlett A, et al. Association of urinary bisphenol a concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008;300(11):1303-1310.
Li C, Ford ES, Zhao G, et al. Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006. Diabetes Care. 2009;32(2):342-347.
Lo JC, Feigenbaum SL, Yang J, et al. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357-1363.
Look AHEAD Research Group, Wing RR, Bolin P, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-154.
Mantzoros CS, Li T, Manson JE, et al. Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. J Clin Endocrinol Metab. 2005;90(8):4542-4548.
McCarthy MI. Genomics, type 2 diabetes, and obesity. N Engl J Med. 2010;363(24):2339-2350.
McMullan CJ, Schernhammer ES, Rimm EB, et al. Melatonin secretion and the incidence of type 2 diabetes. JAMA. 2013;309(13):1388-1396.
Meigs JB, Cupples LA, Wilson PW. Parental transmission of type 2 diabetes: the framingham offspring study. Diabetes. 2000;49(12):2201-2207.
Melzer D, Rice NE, Lewis C, et al. Association of urinary bisphenol a concentration with heart disease: evidence from NHANES 2003/06. PLoS One. 2010;5(1):e8673.
Micha RR, Wallace SB, Mozaffarian DM Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271-2283.
Morioka T, Asilmaz E, Hu J, et al. Disruption of leptin receptor expression in the pancreas directly affects beta cell growth and function in mice. J Clin Invest. 2007;117(10):2860-2868.
Mozaffarian D, Marfisi R, Levantesi G, et al. Incidence of new-onset diabetes and impaired fasting glucose in patients with recent myocardial infarction and the effect of clinical and lifestyle risk factors. Lancet. 2007;370(9588):667-675.
Narayan KMV, Boyle JP, Thompson TJ, et al. Effect of BMI on lifetime risk for diabetes in the U.S. Diabetes Care. 2007;30(6):1562-1566.
Nathan DM, Cleary PA, Backlund JY, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353(25):2643-2653.
Nauck MA, Baller B, Meier JJ. Gastric inhibitory polypeptide and glucagon-like peptide-1 in the pathogenesis of type 2 diabetes. Diabetes. 2004;53 Suppl 3:S190-S196.
Nolan CJ, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet. 2011;378(9786):169-181.
Pan A, Sun Q, Bernstein AM, et al. Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of us men and women. JAMA Intern Med. 2013;173(14):1328-1335.
Picon MJ, Murri M, Munoz A, et al. Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening. Diabetes Care. 2012;35(8):1648-1653.
Poitout V, Robertson RP. Glucolipotoxicity: fuel excess and beta-cell dysfunction. Endocr Rev. 2008;29(3):351-366.
Ravelli AC, van der Meulen JH, Michels RP, et al. Glucose tolerance in adults after prenatal exposure to famine. Lancet. 1998;351(9097):173-177.
Rockette-Wagner B, Edelstein S, Venditti EM, et al. The impact of lifestyle intervention on sedentary time in individuals at high risk of diabetes. Diabetologia. 2015;58(6):1198-1202.
Ruderman N, Chisholm D, Pi-Sunyer X, et al. The metabolically obese, normal-weight individual revisited. Diabetes. 1998;47(5):699-713.
Salas-Salvado J, Bullo M, Babio N, et al. Reduction in the incidence of type 2 diabetes with the mediterranean diet: results of the PREDIMED-reus nutrition intervention randomized trial. Diabetes Care. 2011;34(1):14-19.
SalmerĂłn J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001;73(6):1019-1026.
Schulze M, Manson J, Ludwig D, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA. 2004;292(8):927-934.
Selvin E, Steffes MW, Zhu H, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362(9):800-811.
Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4-14.
Tinker LF, Bonds DE, Margolis KL, et al. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the women’s health initiative randomized controlled dietary modification trial. Arch Intern Med. 2008;168(14):1500-1511.
Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343-1350.
UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837-853.
van Dam RM, Hu FB. Coffee consumption and risk of type 2 diabetes: a systematic review. JAMA. 2005;294(1):97-104.
van dam RM, Willett WC, Stampfer MJ, et al.. Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Ann Intern Med. 2002; 136(3):201.
Watson RT, Kanzaki M, Pessin JE. Regulated membrane trafficking of the insulin-responsive glucose transporter 4 in adipocytes. Endocr Rev. 2004;25(2):177-204.
Weyer C, Bogardus C, Mott DM, et al. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest. 1999;104(6):787-794.
Whincup PH, Kaye SJ, Owen CG, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008;300(24):2886-2897.
Willi C, Bodenmann P, Ghali WA, et al. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007;298(22):2654-2664.
Williamson DA, Rejeski J, Lang W, et al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163-171.
Yoon KH, Lee JH, Kim JW, et al. Epidemic obesity and type 2 diabetes in asia. Lancet. 2006;368(9548):1681-1688.
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414(6865):782-787.
Zoeller RT, Brown TR, Doan LL, et al. Endocrine-disrupting chemicals and public health protection: a statement of principles from the endocrine society. Endocrinology. 2012;153(9):4097-4110.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this entry
Cite this entry
Burns, C., Sirisena, I. (2016). Type 2 Diabetes: Etiology, Epidemiology, Pathogenesis, Treatment. In: Ahima, R.S. (eds) Metabolic Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-11251-0_34
Download citation
DOI: https://doi.org/10.1007/978-3-319-11251-0_34
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-11250-3
Online ISBN: 978-3-319-11251-0
eBook Packages: MedicineReference Module Medicine