Understanding Type 2 Diabetes Mellitus | Causes, Symptoms, Treatment

Filed in Health by on August 29, 2021 0 Comments

Overview

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, disorders in fat, and protein metabolism in an untreated patient which could be due to relative or absolute deficiency of insulin or its function. In this case, the level of glucose builds up in the bloodstream with several attendant complications if left unmanaged.

The receptors found on the cell of the body are not responding properly to insulin, which on a later stage could lead to a complete lack of insulin secretion which can lead to chronic hyperglycemia manifesting with several symptoms.

Symptoms Of Type 2 Diabetes Mellitus

Due to the fact that type 2 diabetes can develop slowly, many patients with this condition are asymptomatic, especially at the early stage. However, the early, clinical manifestations include the following:

  • Body weakness
  • Polyuria
  • Polydipsia
  • Xerostomia
  • Polyphagia
  • Itchy skin
  • Blurring of vision
  • Weight loss

Symptoms become more severe as the disease progresses. Chronic hyperglycemia can present with the following symptoms:

  • Difficulty in wound healing
  • Peripheral neuropathy
  • Retinopathy
  • Acanthosis nigricans
  • Persistent fungal infections
  • nephropathy

These symptoms can become life-threatening,

Therefore with two or more of these symptoms, the person should consult a physician.

Causes Of Type 2 Diabetes Mellitus

Insulin is a polypeptide hormone produced by the ductless gland in the pancreas by the beta cells of the islet of Langerhans. This hormone ensures that glucose gets to the cells of the body for proper metabolism and utilization. It acts on receptors located on the cell surfaces, and with the help of glucose transporters, glucose gets into the required cells.

In type 2 diabetes there is a combination of peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells due to excess stimulation to produce insulin however not utilized.  Insulin resistance, which has been attributed to elevated levels of free fatty acids and proinflammatory cytokines in plasma, leads to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat.

A role for excess glucagon cannot be underestimated; indeed, type 2 diabetes is an islet paracrinopathy in which the reciprocal relationship between the glucagon-secreting alpha cell and the insulin-secreting beta-cell is lost, leading to hyperglucagonemia and hence the consequent hyperglycemia.

So, for type 2 diabetes to occur, both insulin resistance and inadequate insulin secretion must exist. For example, all overweight individuals have insulin resistance, but diabetes develops only in those who cannot increase insulin secretion sufficiently to compensate for their insulin resistance. Their insulin concentrations may be high, yet inappropriately low for the level of glycemia.

There is also a genetic predisposition in which the disease runs in family.

 Treatment Of Type 2 Diabetes

Type 2 diabetes can be effectively managed if the diagnosis is made early and strict measures followed and compliance to bring the glucose level to a certain rage.

The following are several ways of management of type 2 diabetes:

  • Self-management education(Regular blood glucose check)
  • Nutrition(vegetable, fibre containing food, less animal fat intake, etc)
  • Physical activity(Regular exercise)
  • Smoking cessation
  • Psychosocial care
  • Glycemic treatment
  • Therapeutic targets
  • Early diagnosis and treatment of vascular complications
  • Intensification of insulin therapy in type 2 diabetes.

Medications For Type 2 Diabetes Mellitus

  • Biguanides(e.g metformin): Improves the body’s response to insulin
  • Sulphonyluria(e.g glipizide, glyburide, glimepiride): they are insulin secretagogues,  which stimulates insulin production by beta cells of the pancreas
  • meglitinides, which are fast-acting, short-duration medications that stimulate your pancreas to release more insulin
  • thiazolidinediones, which enhance the body’s sensitivity to insulin.
  • dipeptidyl peptidase-4 inhibitors, which are milder medications that help reduce blood glucose levels.
  • Alpha-glucosidase inhibitors
  • Thiazolidinediones (TZDs)
  • Dipeptidyl peptidase IV (DPP-4) inhibitors.
  • glucagon-like peptide-1 (GLP-1) receptor agonists, which slow digestion and improve blood glucose levels.
  • insulin injections, fast-acting on cells to increase glucose utilization
  • sodium-glucose cotransporter-2 (SGLT2) inhibitors, which help prevent the kidneys from reabsorbing glucose into the blood and sending it out through the urine.

Cardiovascular complications of hyperglycemia can also be addressed.

Diets For Type 2 Diabetes

Diets for type 2 diabetic patients are the same however,  it boils down to some specific measures as:

  • Have a specific meal times
  • Choose foods that are low in calories
  • Avoid overeating and junk foods
  • Avoid late-night eating

Foods To Avoid

  • High-fat dairy products
  • Processed snacks
  • High sugary drinks
  • White rice & pasta
  • Margarine and shellfish

Foods To Choose

  • Beans
  • Oats
  • Non-starch vegetables
  • Fruits
  • Mono and polyunsaturated fats (peanuts, almond oil, avocado, etc)

The Bottom Line

Discuss with your doctor to guide you on the choice of healthy food and your food plans.

Risk Factors For Type 2 Diabetes

  • Positive family history
  • Obesity
  • Women with polycystic ovarian syndrome
  • Uncontrolled gestational diabetes.
  • Increase in age >45yrs.
  • African-American, pacific Islanders descents are at high risk.
  • Sedentary lifestyle
  • Unhealthy diets (Junk foods)

Receiving A Type 2 Diabetes Diagnosis

Persons with the above symptoms should see an endocrinologist for adequate clinical examinations and some diagnostic testing as follows:

  • A fasting plasma glucose (FPG) level of 126 mg/dL (7.0 mmol/L) or higher.
  • A 2-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during a 75-g oral glucose tolerance test (OGTT).
  • Random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis.
  • A hemoglobin A1c (HbA1c) level of 6.5% or higher.

Tips On How To Prevent Diabetes.

  • Moderate Exercises
  • Avoid smoking
  • Healthy diets
  • Reduction in weight.

Complications Of Type 2 Diabetes Mellitus

The complications can be divided into microvascular and macrovascular complications

Macrovascular, They incudes:

  • Hypertension
  • Heart failure
  • Heart attacks
  • Angina
  • Stroke

Microvascular, they include:

  • Diabetic retinopathy
  • Diabetic nephropathy
  • Peripheral neuropathy
  • Erectile dysfunction

Others include:

  • Poor wound healing
  • Hearing impairment
  • Bacteria and fungal infections
  • Foot gangrene
  • Weight loss
  • Hypo and hyperglycemia
  • Macrosomia
  • Complications in Labour
  • Erectile dysfunction

Type 2 Diabetes In Children

Type 2 diabetes is an emerging condition. According to the American Diabetes Association (ADA), around 193,000 Americans under age 20 have type 1 or type 2 diabetes. One study found that the incidence of type 2 diabetes in youth has increased to about 5,000 new cases per year. Recent studies have also shown that there is a remarkable rise in the people of younger. This could be attributed to the following risk factors:

  • Overweight, or a body mass index above the 85th percentile.
  • Birth weight >4kg
  • Born to a mother With gestational diabetes.
  • Positive family history of type 2 diabetes.
  • Sedentary lifestyle from an early age.
  • Descent of African-American, Hispanic American, Asian-American, Native American, or a Pacific Islander.

The symptoms are the same for both children and adults.

A random blood glucose test, glycated hemoglobin level monitoring for 3 months, and fasting blood glucose may reveal high blood glucose levels.

If your child is diagnosed with diabetes, then their doctor will need to determine if it’s type 1 or type 2 as their method of treatment differs.

The risk in children can be lowered by encouraging a good diet and regular exercise especially in children with tendencies of childhood obesity.

Statistics About Type 2 Diabetes

The World Health Organization (WHO)Trusted Source reports the following statistics concerning type 2 diabetes in recent years:

  • The 2014 global prevalence of diabetes was 8.5 percent for adults.
  • In 1980, only 4.7 percent of adults worldwide had diabetes.
  • Diabetes directly caused about 1.6 million deaths worldwide in 2016.
  • Diabetes nearly triples the risk of heart attack and stroke in adults.
  • Diabetes is also a leading cause of kidney failure.
  • Diabetes’s impact is widespread. It touches the lives of nearly half-a-billion of people around the world. View some infographics that shine a light on other diabetes statistics you should know.

American Diabetes Associations(ADA) has the following reports:

  • In 2017, diabetes cost the United States $327 billion in direct medical costs and reduced productivity.
  • The average medical expenses for people with diabetes are about 2.3 times higher than they would be in the absence of diabetes.
  • Diabetes is the seventh leading cause of death in the United States, either as the underlying cause of death or as a contributing cause of death.

The center for disease control(CDC), has the following statistical reports concerning Diabetes in the United States.

  • Over 30 million people have diabetes mellitus. That’s around 10 percent of the population.
  • One in four people have no idea they have diabetes.
  • Prediabetes affects 84.1 million adults, and 90 percent of them are unaware of it.
  • Non-Hispanic black, Hispanic, and Native American adults are about twice as likely trusted Source to have diabetes as non-Hispanic white adults.

Managing Type 2 Diabetes

Management of type 2 diabetes requires the teamwork of health workers, including:

  • Physicians
  • Dermatologist
  • Plastic surgeon.
  • Nurses
  • Health counselors.
  • Neurologist
  • Medical rehabilitation.

They will work together to monitor blood glucose and prevent complications.

The following tips will help to manage your diabetes:

  • Maintain a balanced diet that includes non-starchy vegetables, whole-grains fiber, lean proteins, and unsaturated fats. Avoid unhealthy fats, sugars, and simple carbohydrates.
  • Achieve and maintain a healthy weight.
  • Exercise daily.
  • Take all your medication as recommended.
  • Use a home monitoring system to test your own blood glucose levels between visits to your doctor. Your doctor will tell you how often you should do that and what your target range should be.
  • It may also be helpful to bring your family into the loop. Educate them about the warning signs of blood glucose levels that are too high or too low so that they can help in an emergency.

If everyone in your home follows a healthy diet and participates in physical activity, you’ll all benefit.

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