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Diabetes mellitus is a disorder in which levels of glucose (a simple sugar) are abnormally high because the body doesn’t release or use insulin adequately.
Diabetes mellitus type 2 is the most common type of diabetes. It is a chronic problem in which blood sugar can no longer be regulated.
There are two reasons for this. First, the cells of the body become resistant to insulin (insulin resistance). Insulin works like a key to let glucose (blood sugar) move out of the blood and into the cells where it is used as fuel for energy. When the cells become insulin resistant, it requires more and more insulin to move sugar into the cells and too much sugar stays in the blood.
Over time if the cells require more and more insulin the pancreas cannot make enough insulin to keep up, and it begins to fail.
Type 2 diabetes mellitus is often associated with certain genetic predispositions, environmental factors, lifestyle choice and the dynamic interactions between all of these different aspects. Since insulin is responsible for the cellular uptake of glucose the sugar molecules will remain in the blood stream.
You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese. Extra weight sometimes aggravates the location of body fat, and also makes a difference in manifestation of obesity. Extra belly fat is linked to insulin resistance, and heart and blood vessel disease.
To see if your weight puts you at a risk of type 2 diabetes, check your body mass index (BMI).
BMI = Weight is kg/Height in m2(squared)
If BMI is below 25- you are alright
If BMI is 26 to 29 – you are overweight
If BMI is 30 and above you are obese.
Type 2 diabetes runs in the family and occurs more in Africans, African-Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, Native Hawaiians and Pacific Islanders.
People whose parents had diabetes have a genetic pre-disposition, that is they are more likely to get type 2 diabetes themselves.
There are some unavoidable risk factors that must be noted so as to be cautious.
Half of those with an identical twin, who has type 2 diabetes will also develop it.
Age – the risk increases as a person gets older.
Ethnic background – people from the above enumerated ethnicity, are predisposed to type 2 diabetes.
Having polycystic ovarian syndrome or a history of gestational diabetes during pregnancy
Low birth weight is thought to predispose to diabetes mellitus due to poor beta-cell development and function.
Avoidable risk factors Include:
Obesity and overweight
Physical inactivity
High blood pressure
Diet
Impaired glucose metabolism
During the early stages of the disease, type 2 diabetes often doesn’t present any symptoms at all. Still you should be aware of the symptoms and early warning signs such as:
Frequent urination and extreme thirst
Sudden or unexpected weight loss
Increased hunger
Blurry vision
Dark velvety patches of skin (called acanthoses nigricans)
Fatigue
Wounds that won’t heal.
The high blood glucose can damage blood vessels, nerves and organs, leading to a number of potential complications. The first symptoms of diabetes are related to the direct effects of high blood sugar levels. When the fasting blood sugar level rises above 160 to 180mg/dl (normal range 75 to 135mg/dl), glucose passes into the urine. When the level rises higher, the kidneys excrete additional water to dilute the large amounts of glucose lost. Because the kidneys produce excessive urine, a person with diabetes urinates large volumes frequently (polyuria). The excessive urine creates abnormal thirst (polydipsia). Because excessive calories are lost in the urine, the person loses weight.
To compensate, the person often feels excessively hungry (polyphagia). As mentioned earlier, other symptoms include blurred vision, drowsiness, nausea, and decreased endurance during exercise.
In addition people whose diabetes is poorly controlled are more susceptible to infection. Sometimes, complex sugar-based substances build up in the walls of small blood vessels, causing them to thicken and leak. As they thicken, they supply less and less blood, especially to the skin and nerves resulting in atherosclerosis (the build up of plaque in blood vessels). Poor circulation through both the large and small blood vessels can harm the heart, brain, legs, eyes, kidneys, nerves and skin. This makes healing of injuries slow.
Recent research has shown that complications of diabetes can be prevented, delayed or slowed down by controlling blood sugar levels.
The main goal of diabetes treatment is to keep blood sugar levels within the normal range as much as possible. Completely normal levels are difficult to maintain, but the more closely they can be kept within the normal range the less likely that temporary or long-term complications will develop.
The main problem with trying to control blood sugar levels tightly is an increased chance of overshooting, resulting in low blood sugar levels (hypoglycemia).
The treatment of diabetes requires attention to weight control, exercise and diet. Many obese people with type 2 diabetes would not need medication if they lost weight and exercised regularly. However, weight reduction and increased exercise are difficult for most people with diabetes.
Therefore, either insulin replacement therapy or an oral hypoglycemic medication is often needed. Exercise directly lowers blood sugar levels often reducing the amount of insulin needed.
Diet management is very important. In general, people with diabetes should not eat too much sweet food and should eat their meals on regular schedule. However, eating a snack at bedtime or in the late afternoon often helps prevent hypoglycemia in people who inject themselves in the morning or evening, with intermediate acting insulin.
Most people with diabetes benefit a lot from learning about diabetes and what they can do to control it. This education is best provided by a nurse trained in diabetes education.
All diabetics must understand how diet and exercise affect their blood sugar levels and be aware of how to avoid complication such as checking their skin for ulcerations. They must also take special care to avoid foot infections and can often benefit from having their toenails cut by a podiatrist.
Yearly eye examinations are essential to check for changes in the blood vessels that can lead to blindness (diabetic retinopathy).
In case of injury, high or low blood sugar levels, people with diabetes should always carry a card or wear a Medic Alert bracelet identifying the disease. Alerting health care professionals to the presence of a diabetic, allows them to start life saving treatment quickly. Always be medically guided.
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