Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over time, the pancreas can’t make enough insulin, and blood glucose levels rise.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells don’t respond normally to insulin; this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
Diabetes Canada is one of Canada’s largest charities, a Major 100, with donations and special events revenue of $27.8m in F2017. Administrative costs are 5% of revenues and fundraising costs are 40% of donations. Per dollar donated to the charity, $0.55 goes towards its programs and grants, which falls outside of Ci’s reasonable range for overhead spending. The charity’s funding reserves of $9.2m include $1.5m in donor-endowed funds. Excluding endowed funds, Diabetes Canada can cover 3 months of annual program and granting costs, indicating a need for donations.
Diabetic ketoacidosis can be caused by infections, stress, or trauma, all of which may increase insulin requirements. In addition, missing doses of insulin is also an obvious risk factor for developing diabetic ketoacidosis. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Dehydration can be very severe, and it is not unusual to need to replace 6-7 liters of fluid when a person presents in diabetic ketoacidosis. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, ketone production, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.

People with type 1 diabetes are unable to produce any insulin at all. People with type 2 diabetes still produce insulin, however, the cells in the muscles, liver and fat tissue are inefficient at absorbing the insulin and cannot regulate glucose well. As a result, the body tries to compensate by having the pancreas pump out more insulin. But the pancreas slowly loses the ability to produce enough insulin, and as a result, the cells don’t get the energy they need to function properly.
The risk of diabetes varies by ethnic and geographic background. In the United States, the disease is most common in Native Americans and Alaska Natives. It also has a higher prevalence among people of African American or Hispanic ancestry than those of non-Hispanic white or Asian ancestry. Geographically, diabetes is most prevalent in the southern and Appalachian regions of the United States.
Up to 40 percent of people with type 2 diabetes eventually develop kidney failure — the kidney's inability to filter waste and fluid from the blood, according to the National Kidney Foundation. As blood flows through tiny vessels in the kidneys, waste products are filtered out and leave the body through urine. Too much sugar in the blood can stress these filters, making it hard for the kidneys to work effectively. After a while, the filters can break down and leak protein into the urine. If kidney damage continues, you may need dialysis or a kidney transplant.
Two new high-priority recommendations in the 2018 guidelines involve preventing hypoglycemia. First, all people with diabetes who take agents that can cause hypoglycemia (ie, insulin or insulin secretagogues) should be counseled on safe driving (ie, having sugar on-hand to prevent lows). A new chapter in the 2018 guidelines (guidelines.diabetes.ca/cpg/chapter21) describes how to assess and manage private and commercial drivers, especially those who take insulin or insulin secretagogues.8 Diabetes Canada has handouts to support conversations regarding safe driving, and the guidelines feature a sample diabetes and driving educational resource to fill out with people who have diabetes (guidelines.diabetes.ca/docs/patient-resources/drive-safe-with-diabetes.pdf). Second, the guidelines recommend that medications that pose less risk of hypoglycemia should be used preferentially, especially in the elderly (ie, metformin or dipeptidyl peptidase 4 inhibitors in preference to insulin or insulin secretagogues). Likewise, risks of hypotension should be considered when managing blood pressure. As noted in the previous guideline, recommendations emphasize the safe use of medications when people with diabetes are unwell and when they are at risk of hypovolemia. Euglycemic ketoacidosis is a particular risk with sodium glucose transporter 2 inhibitors, and these should be held on sick days (ie, when patients are at risk of dehydration).17 The Diabetes Canada guidelines have an appendix to support sick-day planning (guidelines.diabetes.ca/docs/cpg/Appendix-8.pdf) and an appendix for therapeutic considerations for renal impairment (guidelines.diabetes.ca/docs/cpg/Appendix-7.pdf).8 The website also features patient resources for primary care physicians to use with their patients for sick-day management (guidelines.diabetes.ca/docs/patient-resources/stay-safe-when-you-have-diabetes-and-sick-or-at-risk-of-dehydration.pdf), as well as for hypoglycemia identification, treatment, and prevention (guidelines.diabetes.ca/docs/patient-resources/hypoglycemialow-blood-sugar-in-adults.pdf).
Type 2 diabetes is a disorder characterized by abnormally high blood sugar levels. In this form of diabetes, the body stops using and making insulin properly. Insulin is a hormone produced in the pancreas that helps regulate blood sugar levels. Specifically, insulin controls how much glucose (a type of sugar) is passed from the blood into cells, where it is used as an energy source. When blood sugar levels are high (such as after a meal), the pancreas releases insulin to move the excess glucose into cells, which reduces the amount of glucose in the blood.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
How long will diabetes stay away after weight loss? Long-term normal blood glucose control in previously diabetic individuals after bariatric surgery demonstrates that diabetes does not recur for up to 10 years, unless substantial weight gain occurs (86). These observations are consistent with the twin cycle hypothesis and the existence of a trigger level for adverse metabolic effects of fat in the pancreas. Hence, for a given individual with type 2 diabetes, reducing the liver and pancreas fat content below his or her personal trigger levels would be expected to result in a release from the fatty acid–mediated dysfunction. Individual tolerance of different degrees of fat exposure vary, and understanding this liposusceptibility will underpin the future understanding of genetically determined risk in any given environment. However, this should not obscure the central point: If a person has type 2 diabetes, there is more fat in the liver and pancreas than he or she can cope with.
Anything that makes life with type 1 diabetes or type 2 diabetes easier is a win, and research shows that using a diabetes app can improve your health. For example, a review published online in March 2018 in the journal Diabetes, Obesity and Metabolism combined the results of 16 trials of type 2 diabetes apps and found that, on average, using a diabetes app led to a drop in hemoglobin A1C of 0.57 percent.
Glucagon is a hormone that causes the release of glucose from the liver (for example, it promotes gluconeogenesis). Glucagon can be lifesaving and every patient with diabetes who has a history of hypoglycemia (particularly those on insulin) should have a glucagon kit. Families and friends of those with diabetes need to be taught how to administer glucagon, since obviously the patients will not be able to do it themselves in an emergency situation. Another lifesaving device that should be mentioned is very simple; a medic-alert bracelet should be worn by all patients with diabetes.

Culturally appropriate education may help people with type 2 diabetes control their blood sugar levels, for up to 24 months.[91] If changes in lifestyle in those with mild diabetes has not resulted in improved blood sugars within six weeks, medications should then be considered.[23] There is not enough evidence to determine if lifestyle interventions affect mortality in those who already have DM2.[63]


You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts.

Home blood sugar (glucose) testing is an important part of controlling blood sugar. One important goal of diabetes treatment is to keep the blood glucose levels near the normal range of 70 to 120 mg/dl before meals and under 140 mg/dl at two hours after eating. Blood glucose levels are usually tested before and after meals, and at bedtime. The blood sugar level is typically determined by pricking a fingertip with a lancing device and applying the blood to a glucose meter, which reads the value. There are many meters on the market, for example, Accu-Check Advantage, One Touch Ultra, Sure Step and Freestyle. Each meter has its own advantages and disadvantages (some use less blood, some have a larger digital readout, some take a shorter time to give you results, etc.). The test results are then used to help patients make adjustments in medications, diets, and physical activities.
I just wanted to let you know about an app that I use and love. The app is called “Diabetes:M”. It is free and has helped me manage my diabetes. I am a Type 1. It lets you log carbs, insulin, etc. and you can send all of the info from it by e-mail to your provider. It has graphs and charts that help out a lot as well. Hope this helps someone else as much as it has helped me. Thanks.

^ Jump up to: a b c Maruthur NM, Tseng E, Hutfless S, Wilson LM, Suarez-Cuervo C, Berger Z, Chu Y, Iyoha E, Segal JB, Bolen S (June 2016). "Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 164 (11): 740–51. doi:10.7326/M15-2650. PMID 27088241.


Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. In certain types of diabetes, the cells' inability to utilize glucose gives rise to the ironic situation of "starvation in the midst of plenty". The abundant, unutilized glucose is wastefully excreted in the urine.
Women seem to be at a greater risk as do certain ethnic groups,[10][109] such as South Asians, Pacific Islanders, Latinos, and Native Americans.[23] This may be due to enhanced sensitivity to a Western lifestyle in certain ethnic groups.[110] Traditionally considered a disease of adults, type 2 diabetes is increasingly diagnosed in children in parallel with rising obesity rates.[10] Type 2 diabetes is now diagnosed as frequently as type 1 diabetes in teenagers in the United States.[13]
This app allows you to talk with a registered dietitian who can help you with questions you may have or just someone when you need the extra support. This app helps you get a better understanding of the foods you consume and has its own database of over 700,000 different foods to better help you track your weight loss and diabetes. This app is available for $9.99.

High-quality diabetes care involves a series of periodic conversations about self-management and about both pharmacologic and nonpharmacologic treatments that fit with each patient’s goals (ie, shared decision making). Incorporating these conversations into regular practice provides FPs with opportunities to maximize likely benefits of treatments and decrease the risk of harms, to support patients in initiating and sustaining desired lifestyle changes, and to help patients cope with the burdens of both diabetes and comorbid conditions. Family physicians can access the guideline at guidelines.diabetes.ca and might consider downloading the free smartphone app for quick access to guideline chapters and interactive tools at guidelines.diabetes.ca/app.
A previous test result indicating abnormally high blood sugar may indicate temporary metabolic problems or pre-diabetes. An unusually high blood sugar maybe a warning sign that you are at high risk of developing full-blown diabetes in the future. Women who have had gestational diabetes (high blood sugar during pregnancy) are at higher risk of developing type 2 diabetes later in life.
Type 2 diabetes is a condition where blood sugar is too high. It can develop when your body is unable to make enough insulin and/or respond properly to insulin. Insulin is a hormone that normally helps our bodies use or store glucose from food. Having type 2 diabetes increases your risk for life-threatening complications, such as heart disease and other organ damage.

Cataracts and glaucoma are also more common among diabetics. It is also important to note that since the lens of the eye lets water through, if blood sugar concentrations vary a lot, the lens of the eye will shrink and swell with fluid accordingly. As a result, blurry vision is very common in poorly controlled diabetes. Patients are usually discouraged from getting a new eyeglass prescription until their blood sugar is controlled. This allows for a more accurate assessment of what kind of glasses prescription is required.


At present, the American Diabetes Association does not recommend general screening of the population for type 1 diabetes, though screening of high risk individuals, such as those with a first degree relative (sibling or parent) with type 1 diabetes should be encouraged. Type 1 diabetes tends to occur in young, lean individuals, usually before 30 years of age; however, older patients do present with this form of diabetes on occasion. This subgroup is referred to as latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Of all the people with diabetes, only approximately 10% have type 1 diabetes and the remaining 90% have type 2 diabetes.
Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves.[31] Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness.[31] Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that diabetics visit an eye doctor once a year.[32] Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.[31] Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes.[31] The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle atrophy and weakness.

An award-winning diabetes logbook app, Diabetes:M allows users to enter glucose readings, insulin injections, and carbohydrates consumed at meals. There is a bolus calculator as well as a food database for looking up and tracking various foods. Detailed graphs, analytical charts, and the ability to generate reports to share with health-care providers are some of the additional features.


This app allows you to talk with a registered dietitian who can help you with questions you may have or just someone when you need the extra support. This app helps you get a better understanding of the foods you consume and has its own database of over 700,000 different foods to better help you track your weight loss and diabetes. This app is available for $9.99.
Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors,[40] such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans.[40][41] Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood.[42][43]
Type 2 diabetes used to be called adult-onset diabetes or non-insulin dependent diabetes because it was diagnosed mainly in adults who did not require insulin to manage their condition. However, because more children are starting to be diagnosed with T2D, and insulin is used more frequently to help manage type 2 diabetes, referring to the condition as “adult-onset” or “non-insulin dependent” is no longer accurate.
Fast forward a few months, and you’d find a much happier Dr. Clary – and much healthier patient. “The retinal bleeding had stopped, and her eyesight had begun to improve,” says the Virginia doctor. “I think her vision has very likely been spared because she was able to catch her uncontrolled diabetes in the early stages, before major damage to her retina.” 
Family doctors and other primary care clinicians provide most of the care for Canadians living with diabetes and its complications.1 The increasing number and complexity of cases of this chronic disease2 provides an opportunity to ensure better supports are in place for persons with diabetes and their care providers. Given recent pharmacologic advances, as well as new evidence about the potential for specific benefits and harms, clinicians today are faced with a range of options when selecting the most appropriate treatment approach for people with diabetes. The challenge for FPs is compounded by the vast amount of new evidence available on a range of clinical topics relevant to the people with diabetes whom they see in their practices. Guidelines help to summarize evidence, but it is not feasible3 or appropriate4 for FPs to incorporate every single guideline recommendation relevant to primary care into practice. Which high-priority items deserve attention and action? Which recommendations should FPs make a special effort to understand and discuss with their patients?
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level by promoting the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
Glucosio is an app for people with type 1 and type 2 diabetes. It monitors important metrics such as weight, hemoglobin A1c, ketones, cholesterol, blood pressure, and more. The app also includes glucose target tools and an HbA1c conversion calculator. Set reminders to keep you in tune with taking medication, working out, and other important tasks. You can share data from the app anonymously if you choose.
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