[brian]

Have you noticed an increase in patients with type II diabetes?

[TreetopAngel_RN]

Originally Posted by brian

Have you noticed an increase in patients with type II diabetes?

Definitely YES!

And many of them say they didn't have diabetes before they went into the hospital. I have patients that I am checking blood sugars four times a day and they have sliding scale insulin. Their blood sugars are within normal limits. I am wondering if a high glucose reading at the time of injury or illness is the criteria, or if it is something the MD has been tracking for a while. I believe high glucose levels are a stress response and they are being mistakenly diagnosed as diabetes and not the body's immune response.

[talaxandra]

All our stroke patients have a routine BSL on admission, but none of them are diagnosed as having diabetes without further work up (HbA1C, glucose tolerance).
I have noticed a small increase over the last decade in the number of patients who have T2DM, but I think it's a combination of generalised increased acuity (and therefore patients with comorbidities comprising a greater percentage of the inpatient population), diabetes awareness campaigns, and increased surveillance by GPs.

[VivaLasViejas]

As we all know, Americans are getting both older and fatter, so a corresponding increase in DM type II would make sense. I also think it's being diagnosed more frequently for a number of reasons, e.g. blood glucose parameters are tighter now (where I work, 'normal' used to be between 70-120; now it's 70-99), testing equipment is more readily available to the public, and doctors are quicker to pick it up in their at-risk patients (over 45, overweight, etc).

What's sad is that DM II is showing up in obese children and teens as well.

[pannie]

I'm noticing it in MY FRIENDS! We're of an "age" and some are overweight. They think a "work out" is a leisurely stroll at the mall.

[escholl]

Certainly, all the above responses have merit. There is one other risk factor that most people are unaware of: veterans of the korean and vietnam wars were exposed to defoliants that are now showing type II diabetes.

[OhERRN1984]

Factor increased overall weight, poor diet, and little or NO exercise in Americans of our times and you have a population boom of Diabetics. Incidence of Diabetes since WWII has been growing in the American population, soon it will be the rarity not to be Diabetic.

This increase is almost entirely made up of type II Diabetics, a straight forward article is found at:

http://www.umm.edu/ency/article/000313.htm

A few Quotes from the article:

"A main component of type II diabetes is insulin resistance at the level of the fat and muscle cells. This means the insulin produced by the pancreas cannot connect with cells to let glucose inside and produce energy. This causes hyperglycemia (high blood glucose)". IE: pancreatic insulin is released, however it gets bound to the FAT cells, and isn`t available to do it`s work.

"Genetics play a large role in type II diabetes and family history is a risk factor. However, environmental factors (such as a low activity level and poor diet) can increase a person's risk for type II diabetes".

The age of incidence is also lowering in direct proportion to fat food diets, er fast fud, U know what I mean, and it boomed with video games/cable TV. Kids no longer play outside, ride bikes, they walk nowhere, Mom drives them, anyhow, it`s getting worse daily. Ask yourself, are you an enabeler? 20 year old Type II Diabetics make me wanna cry.

So in closing Move UR butt, eat a GREAT diet (not typically found at MickyD`s, Burger Kink, Taco Hell, or the other staples of the American diet), and stay fit, but then this doesn`t sound like the typical American. Unfortunately some people due to bad genetics end up getting Diabetes in spite of being healthy/fit, however the increase America is seeing isn`t made up of these people, that % is staying fairly flat. Most are self made Men and Women, You can only teach till they hit the door, the rest is up to them.

OhERRN1984

[eedyah]

NIDDM: type2
Because pancreas produce insulin but patients cells are relatively resistant to insulin commonly in adult and obese patient.Patient should teach importance of home glucose monitoring to reduce long term complications (arteriosclerosis).

[grannynurse FNP student]

Originally Posted by eedyah

NIDDM: type2
Because pancreas produce insulin but patients cells are relatively resistant to insulin commonly in adult and obese patient.Patient should teach importance of home glucose monitoring to reduce long term complications (arteriosclerosis).

I was first diagnosed as being 'pre-diabetic' in 1991. For the next seven years I was able to control it with diet and exercise. I was then but on an oral medication and four years later insulin as well. I received no real education or monitoring. It was not until I was placed on insulin that someone decided it was important for me to monitor my blood sugar. I have also been chosen for a special Medicare home program. The importance of learning is frequently given the short shift, by doctors and nurses. It is changing but I believe it is in response to the increase in the number of diabetic being diagnosed in my age group.

Grannynurse

[Jamesdotter]

"Genetics play a large role in type II diabetes and family history is a risk factor. However, environmental factors (such as a low activity level and poor diet) can increase a person's risk for type II diabetes".

So true. All of my father's sisters who were overweight (but not obese) were type 2s. The two who were normal weight were not. In my generation, there are at least 4 cousins who are type 2s (all overweight, incidentally), and I already see it in a couple of the next generation as well.