Control of blood glucose concentration: In Type 2 diabetes the body cells no longer respond to insulin produced by the pancreas. A carbohydrate controlled diet and an exercise regime are common treatments. Obesity is a risk factor for Type 2 diabetes.

The idea

Type 2 diabetes develops when body cells become less responsive to insulin, so glucose is not removed from the blood efficiently even though the pancreas still produces insulin. Blood glucose therefore tends to stay too high. Treatment focuses on reducing the glucose load and improving insulin sensitivity: a carbohydrate-controlled diet limits glucose intake, while regular exercise increases glucose uptake by muscles and helps lower blood glucose. Obesity is a major risk factor because excess fat tissue is linked to reduced insulin sensitivity. A student can explain this by comparing a person with Type 2 diabetes who eats a high-sugar meal and does little exercise with one who follows a controlled diet and exercises regularly; the latter usually has lower blood glucose. This links cell response, treatment and risk factors.

What earns the marks

• Type 2 diabetes involves body cells no longer responding normally to insulin, so glucose uptake from the blood is reduced.
• The pancreas still produces insulin in Type 2 diabetes, but the cells have become less sensitive to it.
• A carbohydrate-controlled diet reduces the amount of glucose entering the blood from digestion, helping to lower blood glucose concentration.
• Regular exercise increases glucose uptake by muscles and can improve the body's response to insulin.
• Obesity is a risk factor for Type 2 diabetes because excess body fat is associated with reduced insulin sensitivity.
• Treatment aims to manage blood glucose concentration and reduce the risk of long-term health problems.

Common mistakes and how to put them right

• Stating that the pancreas does not produce insulin in Type 2 diabetes.

  Put it right: In Type 2 diabetes the pancreas usually still produces insulin, but body cells respond less well to it.

• Saying that Type 2 diabetes is caused by eating too much sugar alone.

  Put it right: Obesity is a risk factor, but the condition involves reduced cell response to insulin and multiple risk factors.

• Confusing treatment of Type 2 diabetes with insulin injections as the first treatment.

  Put it right: Common treatments are a carbohydrate-controlled diet and an exercise regime; insulin may be used in some cases but is not the standard first approach described here.

Exam tips

• When asked about Type 2 diabetes, always state that cells no longer respond to insulin, not that insulin is absent.
• Link each treatment to its effect on blood glucose: diet reduces glucose intake, exercise increases glucose uptake.
• Use the term 'risk factor' correctly: obesity increases the chance of developing Type 2 diabetes but does not guarantee it.