Type 2 diabetes


How does smoking affect insulin sensitivity?

It is well known that tobacco smoke is harmful to health and is of particular danger to people with diabetes. All of the chronic complications of diabetes – such as cardiovascular disease, foot problems, kidney disease, and eye damage – are exacerbated by breathing in tobacco smoke. Recently, it was suggested that smoking may increase the risk of developing type 2 diabetes. Although the exact mechanisms are not yet fully understood, it has been suggested that impaired sensitivity to the action of insulin in people who smoke tobacco could be linked to

Cause as well as effect: smoking and diabetes

People who smoke tobacco are at increased risk of cardiovascular disease. Tobacco use contributes to the risk of all the major types of cardiovascular disease, particularly heart attack, stroke and the blockage of blood vessels in the lower limbs. People with diabetes, especially type 2 diabetes, are also at high risk for

Time to stop - for good

Editor-in-chief's editorial

Foods and their effects on blood sugar

Until the discovery of insulin in the 1920’s, dietary modification offered the only means of reducing raised blood sugar levels in people with diabetes. Now a wide variety of sophisticated insulin regimes are available; and for people with Type 2 diabetes, there is a range of oral medication. However, there is increasing appreciation that appropriate food selection remains a cornerstone of diabetes management. While it is important to remember that the way in which

Designer insulins and meal-time blood glucose control

After the discovery of insulin in the 1920´s, available insulin was from natural sources (animal pancreas) until human insulin was made available in the early 1980s. None of these insulins was ideal for injection under the skin. Now, new

Enhancing insulin secretion: novel approaches to glucose control

When we eat, the concentration of glucose in our blood rises due to the uptake of glucose from the digestion of starch and other carbohydrates in the gut. In healthy people, the increase is modest; eating activates other processes that

Enhancing health communication: the German experience

The recent euphoria surrounding the positive effects of preventative measures with people with impaired glucose tolerance or manifest Type 2 diabetes is rarely reflected in the experience of the health-care professionals working with people with diabetes. Despite efforts to advise and inform, there is very little lasting change in health-care behaviour. Many health-care professionals report feelings of frustration and anger. They often describe the people in their care as 'difficult'.

Understanding the psychological barriers to effective diabetes therapy

In order to minimize the risk of diabetes complications, effective therapy for people with Type 2 diabetes involves lifestyle changes and poly-pharmacy targeting levels of blood glucose, blood pressure and blood fat. However, the strict targets set in recent guidelines are seldom achieved by the majority of people with diabetes. Barriers to effective diabetes therapy have been identified within the organization of health care and in the interaction between health-care providers and people with

Psychological insulin resistance: what do patients and providers fear most?

If insulin is such an effective drug, why are so many people with type 2 diabetes reluctant to take it, and sometimes really apprehensive, despite acknowledged poor outcomes on diet and oral blood glucose lowering agents? Are healthcare providers part of the problem? Is there such syndrome as Insulin Resistance (PIR)? For a better understanding of PIR, which is commonly observed as a problem in type 2 diabetes, we need to look beyond the demonstrated efficacy of insulin, and understand people’s beliefs, emotions and concerns regarding insulin treatment.

The case for and against screening for type 2 diabetes

The decision to screen for diabetes may seem an easy one to make as the condition is common, expensive, chronic and with a prognosis highly dependent on the correct treatment. On the other hand, there is a general lack of adequate screening tools, lack of knowledge regarding appropriate treatment, uncertainties regarding economic consequences and a total lack of knowledge regarding the psychological consequences of screening. Studies focusing on these issues should, therefore, be performed before systematic screening can be recommended.