Type 2 diabetes

Definition

Type 2 diabetes is a chronic disease that affects how the body controls glucose-the source of energy in the body. The disease results when the body either becomes resistant to insulin- the hormone that regulates sugar levels in the bloodstream or when it is produced in low levels.  The reasons underlying these abnormalities are not well understood but genetics and lifestyle issues such as excess body weights are contributing factors. The disease has no cure but the people suffering from it may manage the condition by eating well, doing physical exercises and ensuring they maintain healthy weight. It represents 85-90 % of all cases of diabetes.

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Insulin is a hormone produced in the beta cells of pancreas and released into the bloodstream. It circulates to ensure that sugar enters the body cells. When the amount of sugar in the bloodstream is high, more insulin is secreted to bring the sugar levels to normal. In this process, the excess blood sugar is converted into glucagon and stored in the liver. When there is low blood sugar for instance when one have not eaten, the glucagon is converted into glucose and released in the bloodstream with the help of insulin. With Type 2 diabetes, the mechanism of blood sugar regulation does not operate normally. Therefore, when blood sugar is high, it accumulates in the bloodstream to a level that the beta cells of the pancreas become impaired and is unable to produce sufficient insulin demanded by the body.

Though the process of suffering from the type 2 diabetes is not well known, several risk factors have been identified. If one is born in a family which has such history, may it be the parents or the siblings; there is a high chance of getting the disease. Type 2 diabetes is synonymous with the older people. The risk increases as one becomes order mostly after the age of 45 years maybe because of lose muscle mass, less exercise and gain weight as they age. Being overweight is another reason to worry about the disease. The fatty tissues are deposited in the body especially in the internal organs, the more the cells become resistant to insulin. However, it doesn’t mean everyone who is overweight will develop type 2 diabetes. Having pre-diabetes (a condition where the level of blood sugar is higher than normal, but not high enough to be categorized as diabetes) and left untreated, it graduates into type 2 diabetes. Though it isn’t clear, people from particular races such as the Hispanics, Americans Indians and Asian- Americans are highly likely to develop type 2 diabetes probably maybe due to genes interaction. Women who develop gestational diabetes while pregnant have high risk of developing type 2 diabetes. More even when they deliver a baby weighing more than 4 kilograms the risk becomes very high. For women who experience irregular menstrual periods and excess hair growth are at high risk of diabetes.

At early stages of diabetes, one feels healthy since the symptoms are mild thus unnoticeable. The complications of this disease develop gradually so it is vital going for regular checkups in every 2 to 3 months. So many factors affect the levels of sugar in the blood. However, there are warning signs that if well understood can lead to early diagnosis and treatment therefore living a health life. 

The classical signs of diabetes are excessive thirst (polydipsia) and frequent urination (polyuria). When one is suffering from diabetes, the excess sugar builds up in the blood. This triggers the kidneys to work overtime to filter and absorb the excess sugar. When the kidneys are unable to keep up, the excess sugar is drained into the urine. This comes along with draining fluids from the body tissues and this causes increased urination. As this continues, the body becomes dehydrated thus one drinks a lot of fluids to quench the thirst. After drinking more water one urinates even more.

Losing a lot of sugar through frequent urination robs the body calories. This leads to weight loss which is a noble sign of diabetes type 1. The disease may keep the sugar from the food eaten from reaching the cells resulting into constant hunger – a major sign of diabetes. Increased urination causes dehydration which causes the body not to function properly thus make the body not to use sugar for energy needs leading to fatigue. 

 The high levels of blood sugar drain fluids from the body tissues including the lenses of the eyes which affect the ability to focus. Diabetes if it is not treated, causes damage to the new blood vessels in the retina leading to blurred vision. If left undetected, they lead to loss of vision and blindness.

Diabetes could be manifested through slow-healing of wounds and frequent infection. The epithelial lining of the tissues are the first line of defense through fighting diseases in the body. The high level of blood sugar is believed to impair the process of natural healing and ability to fight infections. It is common for women to have repeated vaginal and bladder infections.

Another sign of diabetes is tingling and loss of sensation in the hands and feet, as well as numbness, continuous pain in the arms, hands and legs. These are signs of nerve damage due to the excess sugar in the blood. 

Diabetes reduces the ability of the body to fight germs. This increases the risk of gum infections together with the bones that hold the teeth in place. The teeth may become loose since the gum may pull away the teeth thus developing pockets of pus in the gum.

Damaging of nerves (Neuropathy) that control digestion can cause problems such as Nausea, vomiting and diarrhea. In men, erectile dysfunction could also be a symptom. 

The experts have recommended regular testing of children of between ages 10 and 18 who are obese and who either had a lower birth weight or the mother had diabetes while pregnant with then or even who had any risk factor aforementioned (American Diabetes Association, 2016). 

People aged above 35 years are advised to undergo diabetes screening test. Early diagnosis together with provision of early therapeutic measures has been reported to redue complications associated with diabetes.  The commonly used screening method is the use of an oral glucose tolerance test (OGTT). Going off-food for 2 hours post glucose tests can identify impaired fasting glucose (IFG) (fasting glucose > 110 – < 125mg/dl), impaired glucose tolerance (IGT) (2 hours glucose >140-<200 mg/dl) and the presence of diabetes (fasting >126 and 2 hours glucose >200 mg/dl). If after a random blood glucose test gets a value >150mg/dl, a further confirmation by the OGTT must be conducted. 

Recent estimates given by the international diabetes federation (IDF) indicate that globally there are more that 316 million people (6.9%) living with intolerance glucose tolerance (IGT). Most of these people (>70%) live in the low and middle income countries. 

About one third of the people suffering from intolerant glucose tolerance (IGT) are in the productive age of between 20-39 years and thus are most probably spend many years at high risk of developing diabetes or rather the complications associated with diabetes (International Diabetes Associations, 2013). Some people with pre-diabetes normally experience reactive hypoglycemia for about 2-3 hours after taking a meal. This is a major sign of impaired insulin metabolism that indicate the impending occurrence of diabetes. Such scenarios therefore champion for periodic medical check-ups and screening for people with such risk factors and this would reduce the hazards associated with having undiagnosed diabetes. 

Creating awareness about the various signs and symptoms and the periodic screening mostly when the risk factors are prevalent, would contribute so much in preventing occurrence of new cases of diabetes since the disease could be well countered at the pre-diabetes stage. Proper lifestyle also would reduce prevalence of the disease. Empowerment of the people suffering from the disease through management, such as administering insulin, education and sharing information on management and preventive aspects of diabetes would be a great contribution. 

References 

1American Diabetes Association. Classification and diagnosis of diabetes. Diabetes Care. 2016;39(Suppl. 1):S13–S22

Selph, S; Dana, T; Blazina, I; Bougatsos, C; Patel, H; Chou, R (22 June 2015). “Screening for Type 2 Diabetes Mellitus: A Systematic Review for the U.S. Preventive Services Task Force”. Annals of Internal Medicine. 162 (11): 765–76.

Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Dept of Health and Human Services; 2014. Accessed at www.cdc.gov/diabetes/pubs/factsheet11.htm on 20 August 2014.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013; 36 Suppl 1: S67-74

Ramachandran A. Know the signs and symptoms of diabetes. The Indian Journal of Medical Research. 2014;140(5):579-581.

Diagnosis  

Causes

Signs 

Control

Treatment

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