What is Type 2 Diabetes?
Type 2 diabetes is a metabolic disorder characterized by high blood sugar levels (hyperglycemia) due to:
- Insulin Resistance: Cells in the body become less responsive to insulin, which impairs the uptake of glucose from the blood.
- Insufficient Insulin Production: The pancreas does not produce enough insulin to compensate for the cells’ resistance.
Pathophysiology:
- Insulin Resistance: In insulin resistance, the cells in muscles, fat, and the liver do not respond effectively to insulin. This leads to elevated glucose levels in the blood as glucose cannot enter the cells properly.
- Beta Cell Dysfunction: Over time, the beta cells in the pancreas, which produce insulin, become damaged due to the chronic high glucose levels, leading to insufficient insulin production.
What are the Symptoms?
Symptoms of type 2 diabetes often develop gradually and may include:
- Increased Thirst (Polydipsia): The body tries to dilute the high blood sugar levels with more fluid intake.
- Frequent Urination (Polyuria): High blood sugar leads to increased urine production.
- Increased Hunger (Polyphagia): Insulin resistance affects the cells’ ability to absorb glucose, leading to persistent hunger.
- Unintended Weight Loss: Despite eating more, weight loss can occur due to the body breaking down fat and muscle for energy.
- Fatigue: The body’s cells are not receiving sufficient glucose for energy.
- Blurred Vision: High blood sugar levels can lead to swelling in the lenses of the eyes.
- Slow-Healing Sores: Elevated glucose levels can impair the body’s ability to heal wounds.
- Frequent Infections: High blood sugar levels can weaken the immune system.
- Numbness or Tingling: Nerve damage (neuropathy) can cause these sensations, particularly in the extremities.
- Darkened Skin: Areas of darkened skin, especially in the armpits and neck (acanthosis nigricans), are indicative of insulin resistance.
Causes and Risk Factors
Several factors can increase the risk of developing type 2 diabetes:
- Weight: Being overweight or obese is the primary risk factor.
- Fat Distribution: Abdominal fat is more associated with diabetes than fat in other areas.
- Inactivity: Lack of physical activity contributes to weight gain and insulin resistance.
- Family History: Having a parent or sibling with type 2 diabetes increases the risk.
- Ethnicity: Certain ethnic groups are at higher risk, including Black, Hispanic, Native American, and Asian populations.
- Blood Lipid Levels: Low HDL cholesterol and high triglycerides increase risk.
- Age: The risk increases with age, especially after 35.
- Prediabetes: Elevated blood sugar levels that are not yet diabetic can progress to type 2 diabetes.
- Gestational Diabetes: Having gestational diabetes or giving birth to a large baby increases the risk.
- Polycystic Ovary Syndrome (PCOS): This condition, often associated with obesity and insulin resistance, raises the risk of type 2 diabetes.
Other things that raise your risk of diabetes have to do with your daily habits and lifestyle. These are the ones you can do something about:
. Smoking.
ALCOHAL
Stress
. Sleeping too little or too much
What are Complication of Type 2
diabetes can lead to numerous complications, affecting various body systems:
- Cardiovascular Disease: Increased risk of heart disease, stroke, high blood pressure, and atherosclerosis.
- Neuropathy: Nerve damage can cause tingling, numbness, pain, and loss of feeling, particularly in the extremities.
- Kidney Disease: Chronic kidney disease can develop, potentially requiring dialysis or a kidney transplant.
- Retinopathy: Damage to blood vessels in the retina can lead to vision problems and blindness.
- Skin Issues: Higher risk of bacterial and fungal infections.
- Delayed Wound Healing: Cuts and blisters may become serious and heal poorly.
- Sleep Apnea: Common, especially among those with obesity.
- Dementia: Increased risk of cognitive decline and Alzheimer’s disease.
HOW can we prevent type 2 DM
Preventing type 2 diabetes involves lifestyle modifications:
- Healthy Eating: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
- Regular Exercise: Aim for at least 150 minutes of moderate to vigorous aerobic activity per week.
- Weight Management: Achieve and maintain a healthy weight.
- Avoiding Inactivity: Incorporate physical activity throughout the day to avoid long periods of sitting.
- Medical Interventions: For those with prediabetes, medications like metformin may be prescribed to reduce the risk of developing diabetes.
How to make diagnosis of type 2 DM
. Diagnostic Tests:
Glycated Hemoglobin (A1C) Test:
- Purpose: Measures average blood sugar levels over the past 2-3 months.
- Results:
- Below 5.7%: Normal
- 7% to 6.4%: Prediabetes
- 5% or higher (on two separate tests): Diabete
Random Blood Sugar Test:
Purpose: Measures blood sugar regardless of when you last ate.
Results: 200 mg/dL (11.1 mmol/L) or higher: Suggests diabetes, especially if accompanied by symptoms.
Fasting Blood Sugar Test:
Purpose: Measures blood sugar after an overnight fast.
Results:
- Less than 100 mg/dL (5.6 mmol/L): Healthy
- 100 to 125 mg/dL (5.6 to 6.9 mmol/L): Prediabetes
- 126 mg/dL (7 mmol/L) or higher (on two separate tests): Diabetes
Oral Glucose Tolerance Test (OGTT):
Purpose: Measures blood sugar after fasting and drinking a sugary liquid.
Results:
- Less than 140 mg/dL (7.8 mmol/L) after 2 hours: Healthy
- 140 to 199 mg/dL (7.8 to 11.0 mmol/L): Prediabetes
- 200 mg/dL (11.1 mmol/L) or higher: Diabetes
- Screening Recommendations:
- Adults aged 35 or older.
- Younger adults with obesity or overweight and additional risk factors.
- Women with a history of gestational diabetes.
- Individuals with prediabetes.
- Overweight or obese children with a family history of type 2 diabetes or other risk factors.
Management and Treatment OF TYPE 2 dm
Healthy Eating:
Meal Schedule:Maintain regular meal and snack times to regulate blood sugar levels.
Portion Sizes:Opt for smaller portions to control calorie intake and manage weight.
High-Fiber Foods:Include fruits, non-starchy vegetables, and whole grains.
Reduced Refined Grains and Sweets:Limit intake of sugary and starchy foods to avoid blood sugar spikes.
Low-Fat Options:Choose lean meats, low-fat dairy products, and healthy oils like olive oil.
Dietitian Guidance
A registered dietitian can help with meal planning, identifying healthy food choices, and addressing barriers to dietary changes..
Physical Activity:
Aerobic Exercise Engage in at least 150 minutes of moderate aerobic exercise per week (e.g., walking, swimming, biking).
Resistance Exercise:Incorporate 2 to 3 sessions per week of resistance training (e.g., weightlifting, yoga
Limit Inactivity:Break up long periods of sitting with light activity every 30 minutes.
. Weight Loss:
Impact on Health: Weight loss can improve blood sugar control, cholesterol, triglycerides, and blood pressure. Losing 5% to 15% of body weight can have significant health benefits.
Support Collaborate with healthcare providers or dietitians to set and achieve weight-loss goals.
Monitoring Blood Sugar:
Self-Monitoring: Use a blood glucose meter to regularly check blood sugar levels and keep a record for healthcare team review.
Continuous Glucose Monitoring (CGM) An electronic system that provides real-time glucose readings from a sensor under the skin. It can transmit data to a mobile device and send alerts for high or low glucose levels.
Diabetes Medications
Weight-Loss Surgery:Adults with a BMI of 35 or higher, or lower in specific conditions
Commitment:Requires lifelong lifestyle changes, including diet and exercise.
Regular Monitoring and Follow-Up:
Blood Sugar Levels:Essential for managing diabetes and preventing complications.
Complications Screening:Regular check-ups for potential issues such as cardiovascular disease, neuropathy, and retinopathy.
By understanding these aspects of type 2 diabetes, individuals can better manage their condition and work with their healthcare team to maintain optimal health.
