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Wednesday, February 16

Type 2 Diabetes Mellitus


Type 2 diabetes is a chronic illness. It is characterized by high levels of sugar in the blood. Type 2 diabetes is also termed type 2 diabetes mellitus and adult-onset diabetes. This is due to the fact that it usually begins in middle- and late adulthood. However, more and more children and teens are developing this illness. Type 2 diabetes is far more common than type 1 diabetes and is really a separate disease. But it shares with type 1 diabetes, high blood sugar levels and the problems of high blood sugar.
 

During digestion, food is broken down into fundamental components. Carbohydrates are broken down into simple sugars, principally glucose. Glucose is a very important source of energy for the body's cells. To provide energy to the cells, glucose needs to leave the circulation and get into the cells.
 
 
Insulin moving through the blood instructs the cells to take up glucose. Insulin is a hormone generated by the pancreas. The pancreas is an organ in the belly. When levels of glucose in the blood rise (for example, after a meal), the pancreas generates more insulin.
 
Type 2 diabetes happens when your body's cells don't like insulin's job of getting glucose from the blood into your cells. This is referred to as insulin resistance. As a result, glucose levels begin to rise in the blood.
 
Insulin resistance causes the pancreas to "see" the blood glucose level growing. The pancreas responds by making more insulin to keep blood sugar levels stable. Insulin resistance in the body deteriorates over time. In reaction, the pancreas produces an increasing amount of insulin. Finally, the pancreas becomes "depleted." It is unable to keep up with the increasing demand for insulin. It poops out. Blood glucose levels begin to rise as a result.
 
Type 2 diabetes is a hereditary disease. Obesity significantly raises one's risk of developing diabetes.
 

Symptoms

 
Diabetes symptoms are associated with elevated blood glucose levels. They include the following:
 
Urination that is excessive, thirst, and hunger
 
 
Susceptibility to infections, particularly yeast or fungal infections, is increased
 
Extremely high blood sugar levels can also cause a condition called a hyperosmolar syndrome, which can be very dangerous. This is a potentially fatal kind of dehydration. Hyperosmolar syndrome is occasionally the first indicator that a person has type 2 diabetes. It results in confused thinking, weakness, nausea, and, in severe cases, seizures and coma.
 
Type 2 diabetes medication might also cause symptoms. Hypoglycemia, or low blood sugar, can happen if you take too much glucose-lowering medication compared to how much food you eat. Hypoglycemia manifests itself in the following ways:
 
Sweating
 
Confusion
 
Trembling
 
Hunger
 
Dizziness
 
Seizures and disorientation (if hypoglycemia is not recognized and corrected)
 
Hypoglycemia can be corrected by eating or drinking something carbohydrate-containing. This results in an increase in your blood sugar level.
 
Diabetes type 2 affects every organ of the body. It can result in significant, life-threatening complications. These include the following:
 
Atherosclerosis – Atherosclerosis is a condition in which fat accumulates in the arterial walls. This might obstruct blood flow to all organs. The most frequently affected organs are the heart, brain, and legs.
 
Retinopathy – When blood sugar levels are elevated, tiny blood vessels in the retina (the back of the eye that sees light) can become damaged. Damage to the retina can result in a blockage of blood flow and bleeding into the retina. Both impair the retina's capacity to perceive light. When detected early, retinal damage can be avoided with strict blood sugar control and laser therapy. Retinopathy, if left untreated, can result in blindness.
 
Neuropathy is a term that refers to nerve injury. Peripheral neuropathy is the most prevalent form. The nerves to the legs are destroyed first, resulting in foot discomfort and numbness. This can progress to the point of causing symptoms in the legs and hands. Additionally, nerves controlling digestion, sexual function, and urination can be damaged.
 
Foot issues – There are two reasons for sores and blisters on the feet:
 
If peripheral neuropathy results in numbness, the individual may be unaware of foot irritation. The skin can deteriorate, forming an ulcer, which can become infectious.
 
Blood circulation can be inadequate, resulting in slow recovery. A simple sore, if left untreated, can become infected and very huge. If medical treatment is unsuccessful in healing the sore, an amputation may be necessary.
 
Nephropathy - Kidney damage. if blood sugar levels stay high and hypertension isn't treated quickly, this is more likely to happen.


Diagnosis

 
Diabetes is diagnosed through blood sugar testing. Blood is drawn in the morning following an overnight fast.
 
After going without food for a while, the body usually keeps blood sugar levels between 70 and 100 milligrams per deciliter (mg/dL). Diabetes is diagnosed when the blood sugar level after fasting exceeds 125 mg/dL.
 
Your physician will examine you to look for the following:
 
Obesity, particularly abdominal obesity, significantly increases a person's chance of developing type 2 diabetes.
 
People who have type 2 diabetes are more likely to have high blood pressure, which increases the risk of heart disease and stroke when it is combined with diabetes.
 
Blood clots or large yellow patches on the retina of your eyes—both are complications of diabetes and hypertension that raise your chance of blindness.
 
People with diabetes may not be able to feel their legs as well as they used to. This can make it hard for them to notice the development of sores on the underside of their feet.
 
Weak pulses in the feet is a disease that can slow or stop the healing of foot ulcers and, in some cases, lead to amputation.
 
Blisters, ulcers, or foot infections
 
Additionally, laboratory testing is commonly done to evaluate diabetes. These include the following:
 
The fasting plasma glucose (FPG) level is determined. Blood is drawn in the morning following an overnight fast. The normal range for blood sugar is between 70 and 100 milligrams per deciliter (mg/dL). Diabetes is diagnosed when the fasting blood sugar level exceeds 126 mg/dL.
 
test of oral glucose tolerance (OGTT). Two hours after drinking 75 grams of glucose, blood sugar is tested. Diabetes is diagnosed when the blood sugar level is 200 mg/dL or above after two hours.
A blood glucose test was conducted at random. There must also be signs and symptoms of diabetes in order to diagnose diabetes. A blood sugar level of 200 mg/dL or more at any time of the day is enough to make a diagnosis.
 
A1C hemoglobin (glycohemoglobin). This test shows the average level of glucose in the blood over the last two to three months. Diabetes is diagnosed when the haemoglobin A1C level exceeds 6.5 per cent.
 
Creatinine in the blood and microalbumin in the urine. tests to determine the presence of renal disease.
The lipid profile Triglyceride and total, HDL, and LDL cholesterol levels are determined. This assesses the risk of developing atherosclerosis. People with diabetes who also have high total or LDL cholesterol are at a much greater risk of heart disease and stroke.

 
Expected Timeframe

 
Diabetes is a chronic disease that requires lifelong management. However, some people with type 2 diabetes can sometimes get their blood sugar levels back to normal just by eating a healthy diet, exercising, and losing weight.
 
Aging and episodic sickness might result in an increase in the body's insulin resistance. As a result, subsequent treatment is frequently required over time.
 

Prevention

 
If a close relative, like a parent or sibling, has type 2 diabetes, or if you have "pre-diabetes," which is when your blood sugar levels are between 100 and 125 mg/dL, you are more likely to get type 2 diabetes. You can help avoid type 2 diabetes by following these steps:
 
Keeping your body weight within a healthy range.
 
Regular exercise, such as a brisk walk of 1-2 miles every 30 minutes, at least five times a week, even if you do not achieve your desired weight, This is because even if you do not lose weight, consistent exercise reduces insulin resistance.
 
Consuming a nutritious diet.
 
Medications Metformin (Glucophage) provides some additional protection for individuals with pre-diabetes.
 
If you currently have type 2 diabetes, you can still delay or avoid problems by following the following steps:
 
Maintain strict control of your blood sugar. This significantly minimizes the chance of the majority of problems.
 
The best way to lower your risk of heart-related problems is to take aspirin every day. This is even more important if you already have some heart disease symptoms.
 
Adequately controlling other atherosclerosis risk factors, such as:
 
Hypertension
 
Cholesterol and triglyceride levels are abnormally high.

Smoking cigarettes
 
Obesity
 
Each year, see an eye doctor and a foot expert to prevent eye and foot complications.



Treatment

 
Exercise and Diet
 
Type 2 diabetes treatment typically begins with weight loss through diet and exercise. A diabetic's diet should include the following:
 
Saturated fats and no cholesterol
Contains no trans fats
The total calorie count is low.
nutrient-dense with ample levels of
Foods made entirely of grains
Monounsaturated oils
Vegetables and fruits
For the majority of patients with diabetes, a daily multivitamin is suggested.
 
Type 2 diabetes can be controlled in some people solely via diet and exercise. Even if medication is required, diet and exercise remain critical for diabetes control.
 
Pills medication.
 
These drugs exert their effects in a variety of ways. Among them are drugs that:
 
To reduce muscle and liver insulin resistance,
Increase the pancreas's production and release of insulin.
Each meal should result in a burst of insulin release.
Delay the intestine's absorption of sugars.
Reduce the rate of your digestion.
The appetite for huge meals should be reduced.
Reduce the rate of fat conversion to glucose.
Increase the amount of sugar excreted in the urine by the kidneys.
 
Insulins
 
Due to the fact that type 2 diabetes develops when the pancreas is unable to produce enough insulin to overcome insulin resistance, approximately one in every three people with the disease requires some form of insulin injection.
 
Insulin may be needed more than once a day and in higher doses for people with advanced type 2 diabetes or those who want to keep an eye on their blood sugar levels.
 
Treatment regimens that combine both very long-acting and very short-acting insulin are typically the most effective for blood sugar control. With meals, very short-acting insulin is given to assist in managing the blood sugar increase that occurs with a meal. Very short-acting insulin may be especially beneficial if a person does not eat on a regular schedule.
 
Side Effects of Treatment
 
Drugs used to treat type 2 diabetes may cause adverse effects. These change according to medicine. Possible adverse effects include the following:
 
Hypoglycemia (hypoglycemia)
Gain in weight
Nausea
Diarrhea
Leg edema
Heart failure deteriorates
Inflammation of the liver
Gas and bloating in excess
Urination on a frequent basis
 
The benefits of treatment generally outweigh the risks. People with type 2 diabetes who have other health problems, like advanced kidney disease, should not take some medicines or get non-insulin injections.
 
The medications that help regulate blood sugar levels aren't the only things people with type 2 diabetes take. They also often take other medications to lower their chances of developing diabetes complications or to delay their onset. Among these are drugs that:
 
Reduce the progression of kidney disease—specifically, medications known as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).
 
Reduce cholesterol. All diabetics should consider taking a cholesterol-lowering medicine, typically one of the statins.
 
Blood pressure should be reduced. If lifestyle changes alone don't help diabetics keep their blood pressure in check, they should take medicine.
 
Protect yourself from heart attacks. Most people with diabetes who take low-dose aspirin on a regular basis are better off.


When Should You Consult a Medical Professional?

 
Consult with your doctor on a frequent basis if you have diabetes.
 
Individuals with elevated blood sugar levels are at a greater risk of dehydration. Consult your doctor right away if you start vomiting or diarrhea and can't drink enough water.
 
As directed by your health care provider, monitor your blood sugar. Notify your physician of any substantial changes in your blood sugar levels.


Prognosis

 
Your treatment strategy is almost certain to require modification over time. Insulin resistance worsens as people age. Even more so, the cells in the pancreas that make insulin may die out as the pancreas tries to keep up with the body's increased insulin needs.
 
After the first few years, the majority of people with type 2 diabetes require many medications to maintain control of their blood sugar.
 
The prognosis for type 2 diabetic patients varies. It all comes down to how well someone can control his or her risk of complications. Premature death can occur as a result of heart attack, stroke, or kidney disease. A disability can be caused by things like blindness, an amputation, heart disease, stroke, or nerve damage. Some people with type 2 diabetes need dialysis or need to have their kidneys transplanted because their kidneys have failed.
 

Additional Info

American Diabetes Association

http://www.diabetes.org/

Weight-Control Information Networkhttp://www.niddk.nih.gov/health/nutrit/win.htm
The American Dietetic Association http://www.eatright.org/National Institute of Diabetes & Digestive & Kidney Disordershttp://www.niddk.nih.gov/National Diabetes Information Clearinghousehttp://diabetes.niddk.nih.gov/
 
 
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