Type 2 Diabetes
Key points
  • Diabetes mellitus is a severe chronic disease that occurs in the production of insulin by the body, or a violation of its effective use against the background of sufficient production. There are 3 main types of diabetes mellitus: type 1 diabetes mellitus, type 2 diabetes mellitus and gestational diabetes mellitus.
  • Type 1 diabetes most often occurs in childhood but can occur at any age. At this time, it cannot be prevented. People with type 1 diabetes can only live full lives with an uninterrupted supply of insulin, sufficient awareness, support, and the availability of blood glucose testing equipment.
  • Type 2 diabetes mellitus accounts for the vast majority (about 90%) of diabetes worldwide. It is possible to effectively influence its occurrence and course through education, support and adoption of a healthy lifestyle in combination with medication, if necessary.
  • "Prediabetes" is a term that is increasingly used for people with impaired glucose tolerance and / or with impaired fasting glucose. It determines the risk of future development of type 2 diabetes and diabetes-related complications.
  • Pregnant women with gestational diabetes may have high blood sugar, blood pressure, and high birth weight in babies as a result of gestational diabetes, which increases the risk of pregnancy and childbirth complications for both mother and baby.
Type 2 diabetes is the most common type of diabetes, accounting for about 90% of all diabetes worldwide. In type 2 diabetes, hyperglycemia is the result of the initially inability of the body's cells to respond fully to insulin, which is called insulin resistance. With insulin resistance, the hormone is ineffective, and this, according to the feedback principle, contributes to an increase in insulin production. Over time, inadequate insulin production can develop as a result of pancreatic β cells failing to meet demand. Type 2 diabetes is most commonly seen in adults, but is increasingly seen in children and young adults due to weight gain, physical inactivity, and poor diet.
Type 2 diabetes mellitus can have symptoms similar to type 1 diabetes, but generally, the course of type 2 diabetes is much less dramatic, and the condition at the onset of the disease may be completely asymptomatic. In addition, the exact time of onset of type 2 diabetes is usually impossible to determine. As a result, there is often a long period of preliminary diagnosis. Overall, one-third to one-half of people with type 2 diabetes in the population may go undiagnosed. If not recognized for a long time, complications such as retinopathy or a lower extremity ulcer that does not heal may be present at diagnosis. The causes of type 2 diabetes are not fully understood, but there is a credible link with overweight and obesity, increasing age, and ethnicity and family history. As with type 1 diabetes, type 2 diabetes is the result of a combination of multigenic predisposition and environmental triggers.

Type 2 diabetes is the most common type of diabetes, accounting for about 90% of all diabetes worldwide.
The cornerstone of controlling type 2 diabetes is lifestyle promotion, which includes eating a healthy diet, exercising regularly, quitting smoking, and maintaining a healthy body weight. As a contribution to improving the control of type 2 diabetes, in 2017 the IDF issued the IDF Clinical Practice Guidelines for Type 2 Diabetes in Primary Care. If lifestyle changes are not enough to control blood glucose, oral medications (metformin as a first-line treatment) are usually started.
If treatment with a single antidiabetic drug is not sufficient, a number of combination therapy options are available (e.g., sulfonylureas, dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide 1 (GLP-1) analogues). In the absence of sufficient effect of oral medications, insulin injections may be necessary.
In addition to controlling elevated glucose, it is vital to monitor blood pressure and blood lipid levels, as well as regularly assess metabolic control (at least annually). This allows screening for renal complications, retinopathy, neuropathy, peripheral arterial disease, and foot ulcers. With regular check-ups, healthy lifestyles, and medication if necessary, people with type 2 diabetes can live a normal healthy life.
As already mentioned, type 2 diabetes has become a problem for children and young people as a result of the increasing prevalence of obesity. Unfortunately, population studies in this area are not numerous, there is a great variety of methods and the quality of published observations. Type 2 diabetes has been found to be particularly prevalent in groups such as Pima, Navajo, and Canadian First Nation, as well as in people of Asian and African American descent.
In these groups, as well as among Hispanic, Japanese, and Chinese children, type 2 diabetes appears to be on the rise, while there is no increase in children of other nationalities, likely reflecting different genetic susceptibility to type 2 diabetes.

Worldwide, the prevalence of type 2 diabetes is high and increasing in all regions. This growth is driven by aging populations, economic development, and increased urbanization, leading to sedentary lifestyles and greater consumption of junk food with a calorie surplus. But, early detection, effective treatment and, as a result, longer life expectancy also contribute to the increase in prevalence.
According to the materials IDF DIABETES ATLAS 10th edition 2021