Diabetes is considered one of the most challenging global health issues of our time. The increasing number of people with diabetes every year only proves how serious the problem is. With the increasing burden posed by diabetes around the world, it is just proper to equip ourselves with information to help us prevent and control it.
The two major types of diabetes are:
- Type 1 diabetes known as insulin-dependent diabetes
- Type 2 diabetes known as non-insulin-dependent diabetes
Between these two, diabetes mellitus type 2 is said to be more dangerous. This disease has been associated with an increasing rate of mortality annually.
In the recent information released by the World Health Organization (WHO), 90% of the people with diabetes around the world are diagnosed to have Type 2 diabetes mellitus. In addition to this alarming number of people with type 2 diabetes, WHO cited that in 2012 alone, an estimated 1.5 million people died because of this disease.
In the US, based on the National Diabetes Statistics Report 2014, 29.1 million or 9.3% of the U.S. population have diabetes; 1.25 million of which are type 1 diabetic and the majority are with type 2 diabetes.
Type 2 diabetes mellitus: Definition, Symptoms, and Complications
Type 2 diabetes develops because of the body’s inability to properly utilize insulin. This is largely associated with one’s physical inactivity and body weight. Unlike type 1 diabetes, symptoms of diabetes mellitus type 2 are most of the time unnoticed. In the early stage, symptoms of type 2 diabetes can easily be ignored since you might just feel fine. Thus, the majority of type 2 diabetes are diagnosed late, many years after onset, when complications have already developed and have worsened the body’s condition. Here are some of the most common complications of diabetes type 2.
- Cardiovascular disease. Having type 2 diabetes increases the risk of having several cardiovascular problems. Some may experience heart attack, stroke, narrowing of arteries, and coronary heart disease with chest pain.
- Alzheimer’s disease. Studies support that type 2 diabetes is a contributing factor in having a high of risk Alzheimer’s disease. The poor control of blood sugar increases the risk of having Alzheimer’s disease though there is no clear and established relation between the two at present.
- Nerve damage or neuropathy. A high blood sugar level can damage the walls of blood vessels. This may result in improper blood circulation that causes numbness and tingling sensation in affected areas like your arms and legs. This could also cause permanent numbness or total loss of sense in the affected areas if left untreated.
- Eye damage. Diabetes can destroy the retina by damaging its blood vessels which can result in blurred vision or worse, total blindness. Studies also support that diabetes increases the risk of other eye problems like cataracts and glaucoma.
- Foot damage. Poor blood circulation and blood flow to the foot can result in several foot complications such as cuts and blisters which may lead to severe infection. Type 2 diabetes slows down the healing and repairing
of the wound, which if left untreated can lead to amputation of the affected part. - Kidney damage or nephropathy. The kidney’s main function is to filter waste from the blood and from the body as a whole. A high blood sugar level can damage nerve cells in the kidney which can lead to kidney failure.
- Hearing difficulty. Most people with diabetes experience hearing impairment.
- Skin infections. Type 2 diabetes can lower the skin’s defense against fungal and bacterial I
infections.
These complications brought by type 2 diabetes can be avoided if the disease is detected and treated early. One of the best things you can do is to be aware of the most common signs and symptoms of type 2 diabetes. To help you with that, here are the most common ones.
- Frequent urination. If you have noticed that urination is becoming more frequent than usual, there is a possibility that your blood sugar level is high.
When too much glucose is detected in the blood, the kidney reacts by flushing excess blood sugar into the urine. This results in higher urine production which causes you to urinate more than your normal. - Increased thirst. Dehydration is a domino effect of frequent urination. As the body excessively dumps out water more frequently than usual, you will experience mouth and throat dryness. Thus, the urge for more water intake increases.
- Weight loss. With type 2 diabetes, blood sugar is too high yet it is not getting into the cells. When cells cannot utilize the glucose, they use alternative fuels from the muscles and fats, causing people with diabetes to lose weight. In addition, urinating more often causes you to release more water and calories from the body which also contributes to weight loss.
- Increased hunger. People with type 2 diabetes are insulin-resistant. The insulin does not work properly to get the glucose into the cell. As a result, the pancreas produces more insulin. High insulin in the body makes your brain think you are hungry, which actually makes you feel hungry.
- Numbness and pain in the foot. Diabetes causes improper blood circulation. Poor blood flow to the foot will cause pain, numbness, and tingling sensation.
- Frequent infections. People with type 2 diabetes may experience skin infections caused by bacteria and fungi. Women may obtain reoccurring vaginal yeast infection while men may experience persistent genital thrush.
- Blurred vision. A high blood sugar level can cause eye lenses to swell, affecting one’s ability to see clearly.
Prevention is always better than cure and the best way to prevent Type 2 diabetes is to be aware of what and how your body feels. Being proactive and observant will definitely help you prevent Type 2 diabetes from stabbing you in the back.
Pathophysiology of Type 2 Diabetes
Type 2 diabetes is a heterogeneous disorder characterized by improper metabolism of fat and carbohydrates. The pathophysiology of this disease is characterized by:
- Resistance to peripheral insulin. Insulin aids in transporting blood sugar (glucose) from the bloodstream to the muscles and other tissues. Insulin resistance happens when the muscles and tissues do not accept insulin, thus preventing the glucose from entering the cells. As a result, the pancreas produces more insulin in the body. The glucose level in the blood will be controlled as long as there is enough or more insulin in the body. The problem arises once the pancreas is no longer able to cope. In this stage, blood sugar starts to rise.
- Abnormal regulation of hepatic glucose production. With type 2 diabetes, the liver is programmed to overproduce and underuse blood sugar.
- Beta-cell dysfunction. This occurs when there is an impairment in the first phase of insulin secretion during blood sugar stimulation. This may exacerbate the intolerance of glucose in type 2 diabetes mellitus patients.
Studies support that these primary events cause the initial insulin deficit. In many cases, insulin deficiency is associated with the body’s insulin resistance.
How to treat Type 2 diabetes?
Having type 2 diabetes is not really a death sentence. But we cannot deny the fact that this disease is indeed challenging and could be fatal if left untreated. There are many ways to treat type 2 diabetes. In fact, there are some type 2 diabetics who are able to manage a normal blood sugar level just through a healthy diet and exercise. But for those who are in a more serious condition, medication and insulin therapy are available to properly control and normalize your blood sugar level. Here are some medications that your doctor might prescribe if needed.
- Metformin. In most cases, metformin is one of the first medications prescribed by doctors for type 2 diabetes. This works by increasing the capability of muscles and tissues to positively react to insulin, making your body use insulin effectively. Together with metformin, your doctor might also recommend a lifestyle change such as diet and exercise to achieve the full potential of the medication. Side effects may include diarrhea and nausea.
- Sulfonylureas. The purpose of this medication is to help your body produce and secrete more insulin. Possible side effects are increased weight and low blood sugar.
- Meglitinides. More fast-acting than sulfonylureas, these medications also help the body to secrete more insulin. These may also cause low blood sugar but not as much risk as with sulfonylureas. Gaining weight is another possible side effect.
- Thiazolidinedione. These medications react like metformin, making the body more sensitive to insulin. However, thiazolidinedione is not a priority medication since it has been linked to weight gain and serious side effects like fractures and heart failure.
- DPP-4 inhibitors. These medications help lower the glucose level in the blood.
- GLP-1 receptor agonist. The main target of this medication class is to slow digestion and lower blood sugar. Nausea and increased risk of pancreatitis are possible side effects of these medications.
- SGLT2 inhibitors. These prevent the kidneys from reabsorbing sugar in the blood and help in excreting sugar through urine.
- Insulin therapy. Because of its benefits, insulin therapy is now often prescribed at the early part of treatment unlike before. With type 2 diabetes, insulin taken orally is interfered with by digestion. In this case, insulin is more effective when injected. Doctors will prescribe the right insulin combination and dose that a patient can use daily.
Living with Type 2 Diabetes
Type 2 diabetes should not stop your world from revolving. A disciplined and well-balanced lifestyle is one of the key factors in coping with this disease. Proper management should help type 2 diabetics to live a normal life. Here are some recommendations that can help you manage type 2 diabetes mellitus in addition to your doctor’s prescribed medications and insulin therapy.
- Healthy diet. Generally, our body is made of what we eat. Diabetics should center their diet on high-fiber and low-fat foods such as fruits, vegetables, and whole grains. It will be best to consult a dietician who can help create a diet plan suitable to your condition. Dieticians can also educate you on how to properly monitor your carbohydrate intake per meal to help achieve a normal sugar level.
Discipline yourself in avoiding foods that contain high sugar concentration. Be accountable for your body and always be conscious of what you eat.
- Physical activity. Exercise is a must. This helps our body to be stronger and healthier. Involve yourself with an exercise plan that is approved by your doctor.
It is also important that you pick activities that you can enjoy and at the same time help you manage your blood sugar. Examples of these are biking, walking, swimming, and dancing. Aerobic exercises like these when combined with stretching and strengthening exercises can help reduce high blood sugar levels to normal.
- Monitor sugar level regularly. Being aware of your blood sugar level will help you to be conscious of the things you can and cannot do. Do not hesitate to ask your doctor how many times you should check your sugar level every day, especially for those who are under insulin therapy. Careful monitoring of your blood sugar is an effective way to maintain its normal level.
- Find support. Finding people who can understand your situation can definitely make your life better and easier. Support groups can help you better understand what you are going through. Being part of a support group will also increase your knowledge and awareness of how to manage the challenges that type 2 diabetes can bring. Your family and friends could also be of great support as you go through life with diabetes.
Diabetes type 2 brings so many challenges and it can be life threatening if not given enough attention. But then again, this disease should not stop someone’s life from continuing in the most normal way possible. Battling with this enemy is tough. But thanks to the advancement of medicine and improved diabetes management programs, the fight against diabetes becomes a lot easier. Gone are those days when diabetes can really get out of control and people get amputated or go blind. With advanced medications and treatment, diabetes can be prevented and cured. Be aggressive against diabetes. Observe for symptoms and consult a doctor.
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