CLINICAL DIABETES
VOL. 18 NO. 2 Spring 2000


PATIENT INFORMATION


A Few Facts About IGT and Type 2 Diabetes


If you have just been diagnosed with impaired glucose tolerance (IGT) or type 2 diabetes, here are four things you should know.

1. Insulin resistance is the problem.

Patients with IGT and type 2 diabetes share a problem called insulin resistance. Their body tissues have become insensitive to the effects of insulin (a hormone that moves blood glucose into cells, where it is used for energy).

At first, the insulin resistance is mild. IGT has no symptoms. But it carries a high risk for developing type 2 diabetes later.

IGT can last for 710 years (or longer) before diabetes develops. It is rarely diagnosed early, and often it is not diagnosed at all before full-blown diabetes is present. Even people in the early stages of diabetes may not have symptoms for several years, delaying a diagnosis even more.

2. The earlier the diagnosis, the better.

Early diagnosis of IGT can be very helpful.

First, IGT brings an increased risk for heart attacks and strokes. Patients who have IGT should be checked for high blood pressure and high cholesterol and started on treatments, if necessary. People who are not diagnosed until they have diabetes may already have significant heart disease. Second, IGT may be reversible. Only one-third of all people with IGT get diabetes. Changing your eating and exercise habits can stop or slow down the process that leads to diabetes.

And finally, studies are now considering the use of prescription drugs to treat IGT and prevent diabetes.

The risk factors for IGT and type 2 diabetes are the same. People should be screened regularly for these diseases if they are:

  • older than 50 an have at least one additional risk factor
  • are Hispanic, African American, American Indian, or Pacific Islander
  • have a family history of diabetes
  • have central (waistline) obesity
  • have a sedentary lifestyle
  • have ahd gestational (pregnancy-related) diabetes
  • have high blood pressure
  • have blood fat problems, particularly high triglycerides or low levels of high-density lipoprotein (HDL) cholesterol.

3. Early treatment is crucial.

The course of IGT and diabetes can be changed by changing eating habits, exercising, and, if needed, taking prescription drugs. Complications that can occur once diabetes is present, including heart disease, strokes, eye problems, kidney disease, and nerve damage, can be delayed and perhaps avoided with early treatment. Early treatment and tight blood glucose control can also delay the need for insulin.

4. More advanced diabetes may mean more complex treatments.

As diabetes progresses, you may need more than one type of medicine. At its earliest stages, your pancreas, which produces insulin, can overcome your body's insulin resistance by making more and more insulin. Over time, however, the pancreas cannot keep up. At this point, you may need another, different type of oral medicine. Your physician may advise you to keep taking your first medicine as well, since the drugs may work better together than either one does alone.

Also, even with careful diabetes control, many people with type 2 diabetes eventually need insulin. If you do start insulin, you may still need to take your oral drugs to get the best benefit from your diabetes therapy.


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Copyright 2000American Diabetes Association
Updated 4/00
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