Talk:Type 2 diabetes

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Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 11:51, 17 January 2022 (UTC)

Reversing diabetes

It was mentioned on the news tonight (December 5 2017) that researchers at the University of Glasgow had found a way to reverse progression of Type Two diabetes by putting people on a diet of only 800 calories a day for a period of time. If anybody knows about this study and can find some reliable sources for it, it could go in the article. Vorbee (talk) 18:24, 5 December 2017 (UTC)

This was just published in the Lancet.[1]

Yes weight loss can put type 2 DM into remission.

Will look for a rewiew User:Vorbee Doc James (talk · contribs · email) 21:40, 18 May 2018 (UTC)

Found one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648990/ Doc James (talk · contribs · email) 21:44, 18 May 2018 (UTC)

These might be of interest also https://www.diabetes.org.uk/resources-s3/2017-12/1302_Remission%20Position%20Statement_v1_92kb.pdf and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5998736/ 14.200.91.233 (talk) 23:02, 3 July 2018 (UTC)

I was hoping to add this (sorry, it's a bit UK based, but that's where the research took place): Type 2 Diabetes has been shown to be put into remission in newly diagnosed patients following a low calorie diet for eight to twelve weeks. The diet was developed by scientists working at Newcastle and Glasgow universities and involved diet replacement soups and shakes. The study, funded by a UK based diabetes charity, found 46% of patients were in remission a year later, and in the following year, 70% of these people remained in remission. A link was found between people losing and keeping off weight and remaining in diabetes remission. Overall, trial participants reported a better quality of life, blood glucose levels and reduced diabetes medications.

The diet based treatment has been rolled out by some NHS health trusts in England and Scotland, United Kingdom. — Preceding unsigned comment added by 80.43.143.36 (talk) 19:53, 26 December 2021 (UTC)

Association of type 2 diabetes with titanium dioxide

According to [2] and [3], there is some association of type 2 diabetes with titanium dioxide. Do we need to add this to this article? Thanks.

--Wolfch (talk) 00:46, 25 July 2018 (UTC)

That's one, very small study (statistical sample 11, with only 3 controls) from one team. Generally an encyclopedia article would not take note until there is, if not a consensus, at least a substantial body of evidence. (One study--the other reference is to news coverage of the same study.)

IAmNitpicking (talk) 15:45, 25 July 2018 (UTC)

Thank for the reply--Wolfch (talk) 06:06, 26 July 2018 (UTC)

Semi-protected edit request on 14 September 2018

"Change section Complications of diabetes mellitus Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[10] This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke; a 20-fold increase in lower limb amputations, and increased rates of hospitalizations.[10] In the developed world, and increasingly elsewhere, type 2 diabetes is the largest cause of nontraumatic blindness and kidney failure.[24] It has also been associated with an increased risk of cognitive dysfunction and dementia through disease processes such as Alzheimer's disease and vascular dementia.[25] Other complications include acanthosis nigricans, sexual dysfunction, and frequent infections. [23]

To ADD at the end Comorbidities associated with diabetes include Hypertension (high blood pressure), Dyslipidemia (abnormal LDL, HDL, or triglycerides), Non-Alcoholic Fatty Liver Disease (NAFLD), Cardiovascular disease, kidney disease and obesity. " PCDCMS (talk) 15:44, 14 September 2018 (UTC)

Content in Wikipedia needs to summarize reliable sources. For content about medicine the relevant guideline is MEDRS. Please see your talk page, where I have left you a message to help you get oriented. Jytdog (talk) 16:21, 14 September 2018 (UTC)

New treatment (source)

> 'Spectacular' diabetes treatment could end daily insulin injections - Hour-long procedure that stabilises blood sugar levels of sufferers of type 2 diabetes is still effective one year on, study shows

• https://www.theguardian.com/society/2018/oct/24/spectacular-diabetes-treatment-could-end-daily-insulin-injections 213.152.161.211 (talk) 11:33, 28 October 2018 (UTC)

The Guardian is terrible when it comes to reporting medical and scientific research. Everything is hailed as a spectacular breakthrough. Wait until a reliable medical source (WP:MEDRS) comments on or summarizes the research with the appropriate context before considering adding it to Wikipedia.

Semi-protected edit request on 13 November 2018

Change the Prevalence of Diabetes (2000) map to the right of the epidemiology section and to change it to this updated version

This map shows the Global Prevalence of Diabetes from 2014 utilizing data from 195 countries. The current average rate of global diabetic prevalence is 9.2% or 92 out of every 1000 people.

because the map that is currently displayed is outdated and displays incorrect information. Wwilken2 (talk) 20:20, 13 November 2018 (UTC)

 Done. A source should be displayed. The Wikimedia file shows this source, but no map is illustrated. --Zefr (talk) 20:58, 13 November 2018 (UTC)

Lack of insulin of excess of it?

While in Type 1, there is surely lack of insulin, hence known as IDDM, does type 2 also involve lack of insulin all the time? If I am not wrong, I have read that there is excess of insulin in the beginning and this hyperinsulinemia causes obesity (adiposity) and that causes type 2 diabetes. Kindly correct me if I am wrong. -- Dr. Abhijeet Safai (talk) 05:37, 26 March 2019 (UTC)

Interestingly, what I am saying is already present here on Wikipedia itself in another article. I am copy pasting the the information where I want to bring attention to - "The hallmarks of type II diabetes (T2DM) pathogenesis are insulin resistance and impaired insulin secretion. In the earlier stages of disease development, cells throughout the body become resistant to the effects of insulin. Therefore, insulin is unable to cause cells to take up glucose (among other impairments) and glucose builds up in the blood. As a result, insulin secretion is ramped up, to try to compensate for this lack of response." Thank you. -- Abhijeet Safai (talk) 06:07, 26 March 2019 (UTC)

I believe you are correct. Be bold and correct the article! IAmNitpicking (talk) 13:41, 26 March 2019 (UTC)

Yes, thanks a lot. It really feels good to know that my efforts were worthwhile. But regarding being bold here, I would like to build consensus here first for sometime and then would like the make the changes. Thank you. -- Abhijeet Safai (talk) 04:31, 27 March 2019 (UTC)

Move discussion in progress

There is a move discussion in progress on Talk:Diabetes mellitus type 1 which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 20:45, 19 May 2019 (UTC)

Move discussion in progress

There is a move discussion in progress on Talk:Type 1 diabetes which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 10:59, 27 May 2019 (UTC)

Pathophys image

This image is a poor representation of insulin resistance, as the movement of GLUT4 to the plasma membrane is sufficient to permit glucose transport. I plan to work on the Diabetespage during the next couple of months and will be on the lookout for an image to replace this. UWM.AP.Endo (talk) 04:12, 23 September 2019 (UTC)

I just removed the picture as I think it was very misleading. I am so glad to see there has been a comment holding the similar viewpoint with mine. The picture represents insulin resistance due to poor insulin sensitive glucose uptake, but it is only one of the pathways to insulin resistance and the picture does not have a detailed description as it does not show which is GLUT and which is insulin receptor. I think an illustration of insulin action could be a better way to present insulin resistance. I think it is better to stop the picture from misleading more people until a reasonable illustration is made.--Unravel17 (talk) 10:13, 8 December 2019 (UTC)

Sounds reasonable. Doc James (talk · contribs · email) 00:34, 9 December 2019 (UTC)

Please allow me to add with citations Alekh99 (talk) 14:51, 9 January 2020 (UTC)

Want to add Hypogeusia in sign and symptoms

I want to hypogeusia as symptom and sign . I have three proofs of it .two newspapers article and one published research. Alekh99 (talk) 10:15, 9 January 2020 (UTC)

User:Alekh99 please find sources per WP:MEDRS. Moving text here "The classic symptoms of diabetes are Ageusia(loss of taste function of the tongue particularly the inability to detect sweetness, sourness, bitterness,saltiness) ,Hypogeusia (reduced ability to taste sweet, sour, bitter or salty substances)"

This is a popular press source and not suitable

We need high quality English sources.

This is a case report

This source will work for the discussion and will add it.https://www.ncbi.nlm.nih.gov/books/NBK549775/

Doc James (talk · contribs · email) 10:29, 10 January 2020 (UTC)

References

Addition of a section in the article titled 'Reversal of Type 2 Diabetes'?

I propose that there should be section in the article titled 'Reversal of Type Diabetes'. I request the experts to kindly comment on it. The information present in following references can be used to write this section.

1. Understanding the mechanisms of reversal of type 2 diabetes
2. Prevention and reversal of Type 2 diabetes: highlights from a symposium at the 2019 Diabetes UK Annual Professional Conference
3. Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin
4. Reversing Type 2 Diabetes: A Narrative Review of the Evidence
5. Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet

Thanks in advance for the comments. Thanking you, Yours sincerely, -- Dr. Abhijeet Safai (talk) 08:03, 17 September 2020 (UTC)

Regarding image

I suggest removing the image captioned 'Overview of the most significant symptoms of diabetes.' Several of these symptoms are not of diabetes per se, but of acute hyperglycaemic states such as HONK and DKA; I would direct you to the relevant Wikipedia pages for these distinct conditions.

I would argue that this image is not helpful to laymen in general, since it confuses the usual long-term symptoms of diabetics with findings that only occur in the acutely unwell. No attempt is made to acknowledge or explain this distinction; confusion will result. — Preceding unsigned comment added by 86.3.208.188 (talk) 15:37, 14 October 2020 (UTC)

Semi-protected edit request on 9 March 2021

Supervised aerobic exercise (like physical therapy) has been shown to be the most effective type of exercise at improving HbA1c in those with type 2 diabetes, when compared to unsupervised aerobic exercise, and unsupervised resistance exercise.

Lindseydiioriodpt (talk) 19:30, 9 March 2021 (UTC)

That doesn't appear to be what the source says. Both supervised aerobic and supervised resistance exercises showed a significant reduction in HbA1c compared to no exercise (0.30% lower, 0.30% lower, respectively), however, there was a less reduction when compared to combined exercise (0.17% higher, 0.23% higher).. ScottishFinnishRadish (talk) 20:38, 9 March 2021 (UTC)

References

Semi-protected edit request on 9 March 2021 (2)

Please change :

“A proper diet and exercise are the foundations of diabetic care, with a greater amount of exercise yielding better results. Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss. Aerobic exercise leads to a decrease in HbA_1c and improved insulin sensitivity. Resistance training is also useful and the combination of both types of exercise may be most effective.”

into a sub-section under lifestyle entitled "Exercise". Under this sub-section title would be the following text:

“A proper diet and exercise are the foundations of diabetic care, with a greater amount of exercise yielding better results. Exercise therapy and training helps prevent and treat type 2 diabetes (T2DM), whilst being cost-effective and accessible. Exercise therapy has been proven to have the capability to improve metabolic health of those with type 2 diabetes in various ways. Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss. In addition, exercise also increases glucose uptake and utilization, improves insulin sensitivity. Not only this, but physical exercise and training have also been proven to be effective in lowering insulin resistance, promoting the secretion of insulin, and reducing the risk of cardiovascular disease (CVD) and obesity in patients with type 2 diabetes. Several studies have shown that BMI, waist-to-hip ratio, and visceral fat in obese patients have improved after 8-12 weeks of resistance and aerobic exercise.

Aerobic exercise leads to a decrease in HbA_1c and improved insulin sensitivity. Resistance training is also useful and the combination of both types of exercise may be most effective. Resistance exercise or strength training also increases the strength of skeletal muscles which results in the increased numbers of insulin receptors. By increasing the number of insulin receptors, the body then improves its sensitivity to insulin. Imihgo98 (talk) 20:42, 9 March 2021 (UTC)

References

 Done J850NK (talk) 14:25, 28 March 2021 (UTC)

Semi-protected edit request on 22 March 2021

Under Management -> Medications -> Blood sugar control:

"A 2018 review found that SGLT2 inhibitors may be better than glucagon-like peptide-1 analogs or dipeptidyl peptidase-4 inhibitors."

should be changed to the more accurate:

"A 2018 review found that SGLT2 inhibitors and GLP-1 agonists, but not DPP-4 inhibitors, were associated with lower mortality than placebo or no treatment."

For the primary outcome, all-cause mortality, the study states that "There was no significant difference between SGLT-2 inhibitors and GLP-1 agonists". GKjMHHfc (talk) 03:15, 22 March 2021 (UTC)

 Done Ruslik_Zero 07:16, 22 March 2021 (UTC)

Request to edit on 25 August 2021

"The development of type 2 diabetes is caused by a combination of lifestyle and genetic factors.[25][28] While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female gender, and genetics."

s/gender/sex

"The development of type 2 diabetes is caused by a combination of lifestyle and genetic factors.[25][28] While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female sex, and genetics."

Matt-bacon-bcm (talk) 02:15, 26 August 2021 (UTC)

 Done ScottishFinnishRadish (talk) 10:48, 26 August 2021 (UTC)

Exercise for improving Type 2 Diabetes

The study linked below shows the benefits of exercise for people with Type 2 Diabetes and insulin sensitivity.I would like to add a bit about it in the Lifestyle > Exercise portion of this article. Citation: Fealy, CE, Nieuwoudt, S, Foucher, JA, et al. Functional high-intensity exercise training ameliorates insulin resistance and cardiometabolic risk factors in type 2 diabetes. Exp Physiol. 2018; 103: 985– 994. https://doi.org/10.1113/EP086844 Toribarr123 (talk) 18:49, 27 April 2022 (UTC)

Individual articles don't tend to be encyclopedic. IAmNitpicking (talk) 20:35, 27 April 2022 (UTC)

Semi-protected edit request on 23 September 2022

Please remove this bit from the introduction:

Some people are more genetically at risk than others.

and replace it with this:

Some people are genetically more at risk than others.

There's no good reason to split "more at risk" in this manner. 175.39.61.121 (talk) 07:10, 23 September 2022 (UTC)

 Done. Aidan9382 _(talk) 09:44, 23 September 2022 (UTC)

Management of Diabetes through Dental Care

Hey guys, I would like to ask you to add and edit the sections "Complications" and "Management" with some core information about dental care for people with diabetes. For the first section, the International Diabetes Federation published in 2009 the guideline for "Oral health for people with diabetes" [4] that states "Maintenance of proper oral hygiene for good oral health is an accepted part of the normal recommendations for a healthy lifestyle. Poor oral hygiene is associated with gingivitis, which can progress to more severe infection and inflammation leading to periodontitis. Infectious disease is known to be more common in people with diabetes if blood glucose control is poor, and inflammation is known to be associated with a decrease in insulin sensitivity and thus potentially a worsening of blood glucose control" [2] . It also gives 5 recommendations to the clinical care of the people with diabetes:

1) Enquire annually as to whether each person with diabetes follows local recommendations for day-to-day dental care for the general population, and (where access permits) attends a dental professional regularly for oral health check-ups.

2) Enquire at least annually for symptoms of gum disease (including bleeding when brushing teeth, and gums which are swollen or red).

3) In those people not performing adequate day-to-day dental care, remind them that this is a normal part of diabetes self-management, and provide general advice as needed. Advise those not attending for regular dental check-ups on the importance of doing so (where access permits).

4) In those people with possible symptoms of gum disease, advise them to seek early attention from a dental health professional.

5) Education of people with diabetes should include explanation of the implications of diabetes, particularly poorly controlled diabetes, for oral health, especially gum disease.

It is important to inform to the Wiki community about the importance of visiting the Dentist to avoid the adverse effects and complications of a non-controlled diabetes. Currently, at OECD level, very few countries count with recommendations and public health policies aimed to improve the oral health of people with diabetes [3], so this article could be a factor for change.

In addition to the second section, "Management", recently, a Cochrane Review synthesizing evidence from 30 trials (results from 2443 participants) showed that periodontitis treatment reduces blood sugar levels (measured by HbA1c) in diabetic patients on average by 0.43 percentage points (e.g. from 7.43% to 7%; 4.7 mmol/mol) 3 to 4 months after receiving the treatment compared with no active treatment or usual care. A difference of 0.30% (3.3 mmol/mol) was seen after 6 months (12 studies), and 0.50% (5.4 mmol/mol) at 12 months (one study) [4]. This reinforce the necessity to include some information about the urgency of dental care in people with diabetes. I really like to read your thoughts and suggestions about this!! Thank you! Chamaquitoso (talk) 20:26, 21 April 2023 (UTC)

Wikipedia is not a guidebook. If you shorten this a lot and make it encyclopedic, rather than medical advice, a section might be appropriate. IAmNitpicking (talk) 02:55, 23 April 2023 (UTC)

Hyphen missing

A hyphen is missing in “leptin-resistant” under the subheading “pathophysiology” in the paragraph starting with “Hypothalamic cells.” 96.235.137.226 (talk) 06:01, 19 January 2024 (UTC)

 Done. Thank you. Ajpolino (talk) 16:11, 19 January 2024 (UTC)

Semi-protected edit request on 26 January 2024

Change "Common symptoms include increased thirst, frequent urination, fatigue and unexplained weight loss." To "Common symptoms include increased thirst, frequent urination, and fatigue."

Weight loss is classic symptom of type 1 diabetes, not type 2. Type 2 diabetes is associated with obesity. 142.169.80.54 (talk) 02:48, 26 January 2024 (UTC)

 Not done for now: Some sources seem to disagree. (NHS inform) (Mayo Clinic) (MedlinePlus) (National Health Service) If you have a contrary source, feel free to reply and provide it so we can reconsider the edit.
— Urro^{[talk][edits]} 14:26, 26 January 2024 (UTC)

Hi! The source currently listed in the article for the area of concern, source 3, states that "Type 2 diabetes is also associated with excess weight". It also lists weight loss as a symptom of diabetes in general, including both Type 1 and Type 2. Patients with type 2 are typically asymptomatic and diagnosed incidentally or with screening. It is absolutely possible for type 2 diabetics to present with weight loss, which is why it is listed in your sources, but it is not common.

UptoDate, a clinical resource for physicians, states "The majority of patients with newly diagnosed type 2 diabetes are asymptomatic, without symptoms of catabolism (eg, without polyuria, polydipsia, or unintentional weight loss). Hyperglycemia may be noted on routine laboratory examination or detected by screening." [5]https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus?search=type%202%20diabetes&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

DynaMed, a Canadian resource for physicians, states "It is often identified through routine screening beginning in middle age, or through targeted screening of adults of any age with overweight or obesity and with risk factors such as metabolic syndrome" [6]https://www.dynamed.com/condition/diabetes-mellitus-type-2-in-adults#GUID-B96C41AD-6FA4-4177-80F2-46E4E55D2165

Apologies if you are unable to access UptoDate or DynaMed due to paywalls, but if you have any physicians on your team they will likely have access.

MedlinePlus (different page than your link) states "Type 2 diabetes usually develops slowly over time. Most people with the disease are overweight or obese when they are diagnosed." and "People with type 2 diabetes often have no symptoms at first." They do not list weight loss as a common symptom. [7]https://medlineplus.gov/ency/article/000313.htm

This is also supported by the infographic in the wikipedia article in symptoms, which illustrates that weight loss is more common in type 1 diabetics. A possible suggested rewording would be that most people with type 2 diabetes are asymptomatic, but they may present with increased thirst, frequent urination, fatigue, or unintentional weight loss. Something to consider! Thanks! 207.179.134.202 (talk) 19:52, 26 January 2024 (UTC)