Excellencies - Diabetology and Endocrine Diseases

Diabetes Type 2

What is

Type 2 diabetes mellitus is the most common form of diabetes, accounting for about 90% of all cases. It is a chronic pathology characterized by high blood glucose levels (i.e. hyperglycemia), and is caused by a more or less severe picture of insulin resistance in which there is a reduced sensitivity of peripheral organs (liver, muscle and adipose tissue) to insulin.

The cause of this insulin resistance is multifactorial and the main risk factors are:

    • Overweight
    • Sedentariness
    • Familiarity grade I for diabetes mellitus type 2
    • Arterial hypertension or antihypertensive therapy
    • Low values of HDL cholesterol and/or high values of triglyceridemia


    • Non-alcoholic liver disease
    • Presence of a cardiovascular disease
    • Polycystic Ovary Syndrome
    • In the woman: delivery of a newborn baby weighing more than 4 kg or previous gestational diabetes


  • Hematochemical tests for haemoglobin glycosylated between 6-6.49 % or altered fasting blood glucose (blood glucose between 100-125 mg/dl), or reduced glucose tolerance (blood glucose between 140-199 mg/dl at 2 hours after oral glucose loading).

6% of the Italian population suffers from type 2 diabetes mellitus mellitus, however, being mainly asymptomatic, it is estimated that about 30% of the disease is not diagnosed because it is not sought after. This shows the importance of screening programmes with the execution of simple haematochemical tests (fasting blood glucose, glycosylated haemoglobin or the execution of a load glycemic curve).
High blood glucose, if prolonged over time, increases the risk of development of microvascular and macrovascular complications of diabetes mellitus: i.e. small and large blood vessels are damaged. Depending on the affected organ, there are complications such as:

  • Diabetic Retinopathy (eye)
  • Diabetic nephropathy (kidney)
  • Diabetic neuropathy (nervous system)
  • Erectile dysfunction
  • Cardiovascular disease (ischemic heart disease, ischemic vasculopathy, peripheral vasculopathy).
How to care for

The treatment of type 2 diabetes involves the treatment of all cardiovascular risk factors and not just blood sugar.
At the basis of type 2 diabetes therapy we find the modification of lifestyle, understood as the setting of a diet aimed at normalizing body weight, the introduction of regular moderate physical activity and smoking cessation if present.
The presence of a multi-specialist diabetological team ensures a comprehensive approach to different aspects of diabetes mellitus therapy. In MultiMedica the team is composed of a diabetologist, dietician, endocrinologist, biologist and dedicated nursing staff.
At each diabetological visit, the patient performs both the medical evaluation for the clinical setting and possible modification of the therapy, and the nursing evaluation with trained and dedicated staff to strengthen the educational aspects of diabetes management.
The nutritional approach is identified according to the clinical features and habits of the patient and, for patients who need it, there is a nutritional path to support weight loss.
The hypoglycemic therapy is tailored to the individual and clinical characteristics of the patient and is constantly updated according to the most recent Guidelines and with the use of innovative drugs that science provides for the best treatment of diabetes mellitus.