[Late-onset diabetes 1989].
Type II diabetes is a frequent disease among older people (approximately 7% of 60-year-olds in the US). Genetic factors play a more important role in the etiology of type II than of type I diabetes. The metabolic derangements of type II diabetes are due to the combination of a diminished effect of insulin (insulin resistance due to a decreased number of insulin receptors and a postreceptor defect the nature of which is not clear) and a disturbance of insulin secretion. Type II diabetes is associated with a more than doubling of the age-specific mortality, mainly due to diabetic macroangiopathy (myocardial infarctions, cerebrovascular insults). Diet remains the basis of treatment for type II diabetes. The composition of the diet, however, has been altered in that the proportion of carbohydrates has been increased, the proportion of fat decreased and the fibre content increased. If necessary, oral antidiabetics or insulin are added to the dietary treatment. Measurement of C-peptide may help to decide when insulin therapy is required. Measuring HbA1c permits assessment of the mean blood sugar value of the last 1 1/2-2 months. The greatest progress recently made in the treatment of the chronic complications of type II diabetes has been in the field of diabetic retinopathy (photocoagulation for retinopathy lesions, vitrectomy).
Endokrinologische Abteilung, Inselspital Bern.
U
U
Bürgi
D000368:Aged; D000375:Aging / Q000378:metabolism*; D000419:Albuminuria / Q000652:urine; D002096:C-Peptide / Q000032:analysis; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D003930:Diabetic Retinopathy / Q000628:therapy; D015444:Exercise; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008875:Middle Aged
D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin
Altersdiabetes 1989.