Diabetes Mellitus (DM) is a complicated metabolic problem that is characterized by persistently high levels of sugar in the body. This situation is also known as hyperglycemia. Diabetes either results from the inability of pancreatic beta cells to secret insulin (type1) or failure of the insulin response mechanism (type 2).
Type 2 diabetes used to be known as adult-onset diabetes but now it can affect people at any age, including children. However, it is more predominant in middle-aged and older people. It results from insulin resistance; there is impaired uptake of blood glucose by fat, liver, and muscle cells. This leads to high blood glucose(hyperglycemia). As a result, the body needs more insulin to help glucose enter cells. At first, the pancreas keeps up with the added demand by making more insulin. Over time, the pancreas doesn’t make enough insulin when blood sugar levels increase, such as after meals. Summarily, with type 2 diabetes the body resists insulin effects or produces insufficient insulin to maintain normal glucose levels
Causes of type 2 diabetes
Type 2 diabetes results from an interaction between genetic(Inheritance) and environmental factors. Several lifestyle factors are known to be important to the development of type 2 DM. These include physical inactivity, sedentary lifestyle, cigarette smoking, and generous consumption of alcohol.
There is a strong inheritable genetic connection in type 2 diabetes, having relatives (especially first degree) with type 2 diabetes increases the risks of developing type 2 diabetes. Moreover, obesity (which is an independent risk factor for type 2 DM) is strongly inherited.
Many medical conditions can potentially give rise to type 2 DM. These include obesity, hypertension, and elevated cholesterol (combined hyperlipidemia). Other causes include acromegaly, Cushing’s syndrome, thyrotoxicosis, pheochromocytoma, chronic pancreatitis, cancer, and drugs. Additional factors found to increase the risk of type 2 DM include aging, high-fat diets, and a less active lifestyle
A combination of these factors cause insulin resistance and a deficit in insulin secretion, leading to a distortion in the functionality of insulin on surrounding tissues, as well as the functionality of pancreatic beta cells
Signs and symptoms of type 2 diabetes often develop slowly. You can have type 2 diabetes for years and not know it. Look for:
- Excessive thirst (polydipsia)
- Frequent urination (polyuria)
- Excessive hunger (polyphagia)
- Excessive weight loss
- Blurred vision
- Slow-healing sores
- Frequent infections
- Areas of darkened skin, usually in the armpits and neck
Diagnosis of Type 2 DM.
Tests for screening and diagnosis of DM are readily available. The test recommended for screening is the same as that for making the diagnosis, with the result that a positive screen is equivalent to a diagnosis of pre-diabetes or diabetes. Most diabetes patients already have microvascular complications at the time of diagnosis suggesting that they have had the disease for more than 5 years at the time of diagnosis.
Someone with a single raised glucose reading with symptoms (polyuria, polydipsia, polyphagia, and weight loss), otherwise raised values on two occasions, of either fasting plasma glucose (FPG) ≥7.0 mmol/L (126 mg/dL) or with an oral glucose tolerance test (OGTT), two hours after the oral dose a plasma glucose ≥11.1 mmol/L (200 mg/dL) is considered diabetic. An additional diagnostic criterion for diabetes is an HbA1c result of ≥6.5%
Treatment of Type 2 Diabetes.
There’s no known cure for type 2 diabetes, it can, however, be managed by:
- Using diabetes medicines (metformin, Glucophage, etc)
- Insulin therapy
- Making healthy food choices
- Being physically active
- Controlling your blood pressure levels
- Controlling your fat intake and cholesterol levels
Factors that may increase your risk of type 2 diabetes include:
Being overweight is the main risk factor for type 2 diabetes. However, you don’t have to be overweight to develop type 2 diabetes.
If you store fat mainly in the abdomen, you have a greater risk of type 2 diabetes than if you store fat elsewhere, such as in your hips and thighs.
The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose as energy, and makes your cells more sensitive to insulin.
The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes.
Although it is unclear why, people of certain races including black, are more likely to develop type 2 diabetes than white people are.
The risk of type 2 diabetes increases as you get older, especially after age 45. That’s probably because people tend to exercise less, lose muscle mass, and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents, and younger adults.
Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. If left untreated, prediabetes can progress to type 2 diabetes.
If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.
Polycystic ovarian syndrome.
For women, having polycystic ovarian syndrome a common condition characterized by irregular menstrual periods, excess hair growth, and obesity increases the risk of diabetes.
Areas of darkened skin, usually in the armpits and neck.
This condition often indicates insulin resistance.
Complications of type 2 DM
Type 2 diabetes might not be noticed initially because its signs and symptoms are not evident. As the situation aggravates, diabetes affects major organs such as the eyes, kidneys, nerves, heart, etc. These complications develop gradually, but can eventually become deadly. Controlling your blood sugar levels can help prevent these complications.
Complications of type 2 diabetes include:
Eye diseases such as glaucoma and cataracts are major complications of diabetes. It may also damage the blood vessels of the retina, potentially leading to blindness
Nerve damage (neuropathy).
Hyperglycemia can result in tingling, numbness, burning, or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Affected limbs may end up losing sensitivity to touch. Damage to nerves of the alimentary canal can result in nausea, indigestion, and diarrhea. Erectile dysfunction can become a major issue in men.
Heart and blood vessel disease.
Diabetes increases the risk of heart disease, stroke, high blood pressure, and narrowing of blood vessels (atherosclerosis).
Type 2 diabetes can lead to kidney disease and/ or kidney failure.
If left untreated, cuts and blisters can become serious infections, which may heal poorly and require amputation. This happens as a result of nerve damages and impaired blood flow
Hearing problems are predominant in diabetes patients.
Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Obstructive sleep apnea is common in people with type 2 diabetes. Obesity may be the main contributing factor to both conditions. Treating sleep apnea may lower your blood pressure and make you feel more rested.
Prevention of type 2 Diabetes:
Even if type two diabetes is hereditary in your family, a healthy lifestyle can prevent occurrence. A healthy lifestyle can also prevent or slow the progression of prediabetes to diabetes, and if diagnosed a healthy lifestyle can prevent complications.
Preventive majors include:
Choose foods lower in fat and calories and higher in fiber. Consume more fruits, vegetables, and whole grains.
Aim for a minimum of 30 to 60 minutes of moderate physical activity or 15 to 30 minutes of vigorous aerobic activity on most days. If you cannot fit in a long workout, spread your activity throughout the day.
If you’re overweight, losing 5 to 10 percent of your body weight can reduce the risk of diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy, and improved self-esteem.
Avoiding being sedentary for longs periods.
Sitting still for long periods can increase your risk of type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.
Type 2 DM is a metabolic disease that can be prevented by modifying your lifestyle; diet control, and control of overweight. There’s no known cure available for the disease, however, management should be directed towards improving the quality of life of individuals with type 2 DM.
Abdulfatai B. Olokoba, Olusegun A. Obateru, Lateefat B. Olokoba(2012) Type 2 Diabetes Mellitus: A Review of Current Trends. Oman Medical Journal (2012) Vol. 27, No. 4: 269-273 DOI 10. 5001/omj.2012.68
National Institute of Diabetes and Digestive and Kidney Diseases: Your Guide to Diabetes: Type 1 and Type 2