Reviewed by Michael Dansinger on May 02, 2012
C. Ronald Kahn, MD - President / Director, Joslin Diabetes Center; Mary K Iacocca Professor of Medicine, Harvard Medical School. His discoveries in insulin signals/receptors revolutionized diabetes research.
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C. Ronald Kahn, M.D. President and Director, Joslin Diabetes Center: Type-two diabetes is affected by processes that occur in normal aging. Part of it is we do tend to gain weight even if we don't necessarily eat more partly because we are more sedentary. And being less active, gaining a little more weight will make your body more insulin resistant. So that's part of why type two diabetic patients often see a gradual progression in their disease.
C. Ronald Kahn, M.D. (cont.): A second thing is that the pancreas is trying to compensate for this insulin resistance by making more insulin. And eventually as we get older the pancreas also is less good at compensating. It just can't always keep up with the challenge. So yes, the answer is that for people with type-two diabetes usually there is kind of a gradual decline in the ability of their body to respond and often they need additional medications as they get older. Not everybody, but some do, especially if you've had early onset type-two diabetes, this is ..you've got a longer period to go.
C. Ronald Kahn, M.D. (cont.): So we need to keep following people with type-two diabetes. You can't assume that the medicines you got two years ago will be working this year or next year. You need to keep following it, just like a type-one diabetic would monitor their sugars to a certain extent, a type-two diabetic needs to do it. Maybe not four times a day, maybe not even twice a day for every one, but they need to be monitoring it with some frequency, so that they have a sense of yes, they're on the right track, and if they're not, to do more to try to get on the right track.