Stage of Susceptibility:
At this stage, the individual is predisposed to having diabetes mellitus due to some factors called the risk factors. These factors are: Family history of diabetics, i.e if any of the parent or of the lineage has diabetics before. B). overweight this is when the body mass index is more than or equal 25. C).habitual physical activity i.e. when an individual does not participate in any physical activity. D. Some forms are also predominant in some races. E). a person who has been previously identified as having impaired fasting glucose. F). Hypertension and history of gestational diabetes and individuals who has polycystic ovarian syndrome.
Stage of Pre-symptomatic Disease:
Diabetics mellitus does not have prolonged stage of prolong stage of pre-symptomatic. Since there are two major problems in type 2 DM, there is insulin resistance and there is pancreatic beta cell dysfunction. The beta cell dysfunction might be cause be many factor including autoimmune antibodies directed on some antigen which will have reduce the number and effectiveness of the beta cell.
Stage of Clinical Disease:
When the diabetics is full blown common symptoms include polyuria (passing of excess urine both in the day and at night), polydipsia (drinking of excess water to compensate for the fluid been loss by the urinary system), obesity, easy fatigability. some patient will have in addition to theses nausea and vomiting, this is the stage that usually present in the hospital
Stage of Disability:
Diabetics’ type 2 mellitus if not treated early may cause some complication. These complications are divided into acute and chronic. The acute complication s are the effect which can result from excess glucose that is build up in the blood, this is called Diabetic Ketoacidosis (DKA) in which the excess glucose is converted to acetyl-coA and in the process form ketone bodies. The chronic complications are neuropathy, kidney damage, retinopathy, stroke, and leg ulcers
The aim of primary treatment is to reduce the predisposing and risk factor of type 2 diabetes mellitus, this can be done through proper nutrition i.e. eating high fiber, low fat diet, low salt and alcohol intake, and having regular exercise. We ensure that some underline diseases are taking care of every time for instance hypertension.
Here the aim of the secondary prevention is to alleviate the symptoms, to normalize the glucose level in the body, and to prevent its complications. This is done by aggressively controlling the hypertension if the patient is hypertensive, giving diabetic diet, by the use of antihypertensive. Insulin can sometimes be given in type 2 but not in all cases, but since we know that there is insulin resistance we will give the patient drugs that will improve the resistance this include Sulphonyuras class of drugs.
This is the treatment given when the disease has presented with complications. This is done by rigidly monitoring the blood glucose within a close range so as to reduce the already develop complications. Some times operations are carried out on patient with retinopathy so as to correct the sight. In a patient with chronic leg ulcer, the best therapy is to amputate the gangrenous legs so that it will not deteriorate.
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