DIABETES (TYPE 2)

 Hello Everyone! Welcome back! It's been a long time since I posted a blog. So, today I am back with another topic. Today's topic revolves around diabetes. I would thoroughly discuss type 2 diabetes. (I have also discussed type 1. For more information, visit my blog and follow me to get the latest notifications to your email!!) Let's get started!!!

GENERAL INTRODUCTION:-

Type 2 diabetes is a diagnosis of exclusion, i.e. it is made when Type 1 Diabetes and other types of diabetes are ruled out, and it is highly heterogeneous. It is characterized by resistance to the action of "Insulin".

NATURAL HISTORY OF TYPE 2 DIABETES:-

In the early stage of the disorder, response to progressive insulin resistance is an increase in insulin secretion by pancreatic cells causing hyperinsulinemia. Eventually, the β Cells are unable to compensate adequately and blood glucose rises, producing hyperglycemia( Note that β cells are beta cells, cells that make insulin. Insulin is a hormone that controls the level of blood glucose.) With further β cell failure, Glycemic control deteriorates, and treatment requirements escalate.

 

CAUSES:-

• Obesity

• Loss of β cells.

• Insulin Resistance

• Age( Old people are more likely to develop this type of diabetes, but it can also affect young people and teenagers due to childhood obesity).

•  Acanthosis nigricans:- A kind of disease when your body becomes resistant to insulin.

• Genes. Scientists have found different bits of DNA that affect how your body makes insulin.

• Metabolic syndrome. People with insulin resistance often have a group of conditions including high blood sugar, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides.

• Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and your liver will usually slow down and store its glucose for later. But some people's livers don't. They keep cranking out sugar.

• Bad communication between cells. Sometimes, cells send the wrong signals or don't pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reaction can lead to diabetes.

• Broken beta cells. If the cells that make insulin send out the wrong amount of insulin at the wrong time, your blood sugar gets thrown off. High blood sugar can damage these cells, too.

Other risk factors include:-

• Family history.

• Ethnicity. (African American, Alaska Native, Native American, Asian American, Hispanic or Latino, or Pacific Islander American).

Risk factors related to your health and medical history include:-

• Prediabetes

• Heart and blood vessel disease

• High blood pressure, even if it's treated and under control

• Low HDL ("good") cholesterol

• High triglycerides

• Being overweight or obese

• Polycystic ovary syndrome (PCOS)

• Depression

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:

• Getting little or no exercise

• Sedentary Lifestyle

• Smoking

• Stress

• Sleeping too little or too much.

SIGNS AND SYMPTOMS:-

The symptoms of type 2 diabetes can be so mild that you don't notice them. About 8 million people who have it don't know it. Symptoms include:

• Being very thirsty

• Excessive Urinating

• Blurry vision

• Tingling or numbness in your hands or feet

• Fatigue/feeling worn out

• Wounds that don't heal

• Yeast infections that keep coming back

• Feeling hungry

• Weight loss without trying

• Getting more infections

DIAGNOSIS AND TESTS:-

Your doctor can test your blood for signs of type 2 diabetes. Usually, they’ll test you for 2 days to confirm the diagnosis. But if your blood glucose is very high or you have many symptoms, one test may be all you need. 

• A1c. It's like an average of your blood glucose over the past 2 or 3 months.

• Fasting plasma glucose. This is also known as a fasting blood sugar test. It measures your blood sugar on an empty stomach. You won't be able to eat or drink anything except water for 8 hours before the test.

• Oral glucose tolerance test (OGTT). This checks your blood glucose before and 2 hours after you drink something sweet to see how your body handles the sugar.

TREATMENTS:- 

Managing type 2 diabetes includes a mix of lifestyle changes and medication.

Lifestyle changes

You may be able to reach your target blood sugar levels with diet and exercise alone.

• Weight loss. Dropping extra pounds can help. While losing 5% of your body weight is good, losing at least 7% and keeping it off seems to be ideal. That means someone who weighs 180 pounds can change their blood sugar levels by losing around 13 pounds. Weight loss can seem overwhelming, but portion control and eating healthy foods are a good place to start.

• Healthy eating. There’s no specific diet for type 2 diabetes. A registered dietitian can teach you about carbs and help you make a meal plan you can stick with. Focus on:

• Eating fewer calories

• Cutting back on refined carbs, especially sweets

• Adding veggies and fruits to your diet

• Getting more fiber

• Exercise. Try to get 30 to 60 minutes of physical activity every day. You can walk, bike, swim, or do anything else that gets your heart rate up. Pair that with strength training, like yoga or weightlifting. If you take a medication that lowers your blood sugar, you might need a snack before a workout.

• Watch your blood sugar levels. Depending on your treatment, especially if you’re on insulin, your doctor will tell you if you need to test your blood sugar levels and how often to do it.

Even if you change your lifestyle and take your medicine as directed, your blood sugar may still get worse over time. That doesn’t mean you’ve done something wrong. Diabetes is progressive, and many people eventually need more than one drug.

When you take more than one drug to control your type 2 diabetes, that’s called combination therapy.

You and your doctor should work together to find the best mix for you. Usually, you'll keep taking metformin and add something else.

What that is may depend on your situation. Some drugs control blood sugar spikes (your doctor may call this hyperglycemia) that come right after meals, for instance. Others are more effective at stopping drops in blood sugar (hypoglycemia) between meals. Some may help with weight loss or cholesterol, as well as your diabetes. You and your doctor should talk about any possible side effects. Cost may be an issue as well. If you take medication for something else, that will need to be factored into any decision. You’ll need to see your doctor more often when you start taking a new combination of drugs. You might find that adding a second drug doesn’t bring your blood sugar under control. Or the combination of two drugs might work only for a short time. If that happens, your doctor might consider a third noninsulin drug, or you may start insulin therapy.

 

OTHER COMPLICATIONS THAT PRECEDE DIABETES:-

Over time, high blood sugar can damage and cause problems with your:

• Heart and blood vessels. You’re up to five times more likely to get heart disease or have a stroke. You’re also at high risk of blocked blood vessels (atherosclerosis) and chest pain (angina).

• Kidneys. If your kidneys are damaged or you have kidney failure, you could need dialysis or a kidney replacement.

• Eyes. High blood sugar can damage the tiny blood vessels in the backs of your eyes (retinopathy). If this isn’t treated, it can cause blindness.

• Nerves. This can lead to trouble with digestion, the feeling in your feet, and your sexual response.

• Skin. Your blood doesn’t circulate as well, so wounds heal slower and can become infected.

• Sleep. You might develop sleep apnea, a condition in which your breathing stops and starts while you sleep.

• Hearing. You’re more likely to have hearing problems, but it’s not clear why.

• Brain. High blood sugar can damage your brain and might put you at higher risk of Alzheimer’s disease.

• Depression. People with the disease are twice as likely to get depressed as people who don’t have it.

PREVENTIONS:-

The best way to avoid these complications is to manage your type 2 diabetes well.

• Take your diabetes medications or insulin on time.

• Check your blood sugar.

• Eat right, and don't skip meals.

• See your doctor regularly to check for early signs of trouble.

PREVALENCE:-

The incidence of diabetes is rising. Globally, it is estimated that 366 million people had diabetes in 2011( approximately 8.3% of the world’s population, or 3 new cases every 10 seconds), And this figure is expected to reach 552 million by 2030. This global pandemic principally involves type 2 diabetes,  the prevalence of which varies considerably around the world, being associated with differences in genetic as well as environmental factors such as greater longevity, obesity, unsatisfactory diet, sedentary lifestyle, increasing urbanization, and economic development. A pronounced rise in the prevalence of type 2 diabetes occurs in the immigrant population to industrialized countries, as in Asian and in Afro-Caribbean immigrants to the UK or USA. Type 2 diabetes is now being observed in children and adolescents, particularly in some ethnic groups such as Hispanic and Afro-Americans.

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