Explain the cause of type 2 diabetes and how it is controlled

The idea

Type 2 diabetes develops when body cells no longer respond properly to insulin, a condition called insulin resistance, so blood glucose is not lowered effectively even though the pancreas still produces insulin. Risk is increased by obesity, a diet high in sugar and lack of exercise. Control focuses on lifestyle: losing weight, eating a balanced diet with less refined sugar, and taking regular exercise, which improve cell response to insulin. If these are insufficient, medication such as tablets may be prescribed, and some people eventually need insulin injections. Blood glucose is monitored to check control. Unlike type 1, the pancreas still makes insulin, so the problem is response rather than production.

What earns the marks

• Cause: body cells become less responsive to insulin (insulin resistance), so glucose is not taken up effectively.
• The pancreas still produces insulin, but blood glucose remains higher than normal.
• Risk factors include obesity, a diet high in sugar and lack of exercise.
• Control: weight loss, a balanced diet lower in sugar and regular exercise improve insulin response.
• If lifestyle change is insufficient, medication such as tablets may be used, and some people later need insulin injections; blood glucose is monitored.

Common mistakes and how to put them right

• Saying type 2 diabetes is caused by the immune system destroying pancreatic cells.

  Put it right by stating that is type 1, whereas type 2 involves reduced cell response to insulin.

• Claiming the pancreas makes no insulin in type 2.

  Put it right by stating insulin is still produced but cells respond poorly.

• Treating insulin injections as the first-line control for all type 2 cases.

  Put it right by stating lifestyle change is the main control, with medication if needed.

• Ignoring monitoring: correct this by including regular blood glucose checks as part of control.

Exam tips

• Distinguish cause (insulin resistance) from control (lifestyle change, then medication) when choosing an option.
• Reject options that describe autoimmune destruction, which belongs to type 1.
• Look for options combining diet, exercise and weight loss as the main control measures.