Type 2 Diabetes

Topic Highlights

●    Type 2 diabetes is a disease in which blood glucose levels are consistently high and insulin produced in the body is deficient or not efficiently used for glucose metabolism.

●    Diabetes can eventually damage the eyes, kidneys, nerves, and increase risk of cardiovascular diseases.

●    This presentation focuses on Type 2 Diabetes its causes, symptoms, diagnosis, treatment, monitoring blood sugar, diet, and self-help.

Transcript

The number of people with diabetes is growing at an alarming rate worldwide. There are already 170 million people in the world with diabetes, and experts believe that this will double by the year 2030. There are two forms of diabetes: Type 1 and Type 2. Type 1 typically begins before the age of 40. Patients with this form do not produce any insulin themselves so must take regular insulin injections. In type 2 diabetes there may not be enough insulin or it may not be used properly. Type 2 is linked to genetics and, often, to being overweight. It usually affects older people although it is increasingly seen in overweight children.

Glucose is a form of sugar found in carbohydrate foods. After we eat, glucose is absorbed into our bloodstream, so it can travel to all parts of our body. Glucose from the blood moves into our cells where it is used to make energy. Excess glucose is stored in the form of glycogen in liver or muscle cells. Our body can only store glycogen in small quantities. Once the glycogen stores are full, any extra glucose is stored in cells as fat.

Insulin is a hormone produced by beta cells in the pancreas. It is released into the bloodstream after we eat. Insulin regulates the amount of glucose that can leave the bloodstream and enter the body's cells to produce energy or to be stored as glycogen for future use. Insulin binds with receptors on the cell surface acting like a key to unlock the cell, so glucose can enter.

In type 2 diabetes, the body does not produce enough insulin or does not use it properly. As cells become less sensitive to insulin, it is unable to unlock the door to let glucose enter. Glucose levels in the blood rise and the cells are starved of energy.

Over the long-term, high blood glucose levels can cause several complications: the most serious are heart attack and stroke. Diabetic neuropathy is a common complication whereby the nerves that connect the spinal cord to other organs are damaged. The feet are often affected due to poor circulation and nerve damage. Diabetes also affects the kidneys causing nephropathy, where kidneys lose their ability to filter waste products. Diabetes can damage small blood vessels in the retina causing diabetic retinopathy. This may result in loss of vision.

Type 2 diabetes has a strong genetic component. Your risk is higher if you have a parent or sibling with the disease. Age is also a factor. People over 45 are at a greater risk although diabetes is increasingly prevalent in younger people. Certain ethnic groups are at a particularly high risk at an early age. Being overweight or obese dramatically increases your risk of diabetes. Lack of exercise and a poor diet are also linked. High blood pressure and abnormal cholesterol levels contribute to the problem. Heart disease will increase your risk. In women, gestational diabetes, giving birth to a baby weighing more than 9 pounds and polycystic ovary syndrome are additional risk factors.

Symptoms of type 2 diabetes include frequent urination, excessive thirst, hunger, fatigue, slow-healing infections, weight loss and vision problems. However, some people with diabetes may not have any symptoms at all.

A urine analysis may be done to determine the presence of glucose and ketones in urine. If positive, you may be asked to give a blood sample. Blood tests are used to diagnose diabetes. Several different tests are available, some of which require you to fast beforehand. The blood test will need to be repeated on different occasions. A diagnosis of diabetes is made if your blood glucose levels are consistently above a certain level.

Treatment of diabetes aims to reduce the levels of glucose in the blood and limit the risk of long-term complications. Doctors aim to reduce blood glucose levels to as near normal as possible, as this is the best way of reducing risk. You may be prescribed more than one type of treatment, as control of blood glucose tends to get more difficult as time goes on.

Diabetes increases your risk of heart disease. Furthermore, people with diabetes often have other conditions that require treatment. These include high blood pressure, abnormal cholesterol levels and abdominal obesity ' which contribute to the likelihood of cardiovascular problems. You may also be advised to take a low dose of aspirin daily and not smoke.

Your doctor will advise certain changes to your lifestyle. These include losing weight, regular exercise and eating a healthy diet. Such changes help to reduce your blood glucose levels and improve other associated risk factors such as obesity, abnormal cholesterol levels and high blood pressure. You should follow this lifestyle advice even if you go on to receive medication.

Oral antihyperglycemic drugs may be prescribed. There are several different types. Insulin-sensitizing drugs such as biguanides and thiazolidinediones improve the body's response to insulin. Drugs such as sulphonylureas and meglitinides stimulate the pancreas to produce more insulin. Glucosidase inhibitors, such as acarbose, delay the absorption of glucose in the intestine to help limit peaks after a meal.

Some patients require daily injections of insulin. It can be administered using a syringe, insulin pen or jet injector. Your doctor will show you how to administer insulin yourself. Insulin pumps are also available, which deliver a continuous dose of insulin.

Insulin glulisine injection is a new, prandial or mealtime insulin analog to control hyperglycemia in adult patients with type 1 and type 2 diabetes. It is normally to be used in regimens that include longer acting insulin. It controls mealtime blood sugar spikes and is to be taken either before or after a meal. Insulin glargine injection is recommended once a day by subcutaneous administration for adult patients with type 2 diabetes, and adult and paediatric patients with type 1 diabetes who require basal long acting insulin for the control of hyperglycemia. It demonstrates a consistent, slow, prolonged absorption over 24 hours. Insulin inhalation powder, the first diabetes medication that can be inhaled is now available.

It is important for you to monitor your blood glucose levels on a regular basis. A small drop of blood is collected by pricking the finger with a specially designed needle and the drop is collected on a test strip, which is then placed on the meter. Results appear on the meter within several seconds. Blood glucose levels should be 4-7 mmol/L before meals or 8-11 mmol/L after.

If your blood glucose levels fall below 4 mmol/L, you have hypoglycemia. You should eat something sugary immediately and then something more substantial. Tell your doctor if your blood glucose levels are frequently high or frequently low, as you may need your treatment to be changed.

It's important to learn about your disease and how to take care of yourself. For example, it is important to examine your feet regularly for injuries as they may go unnoticed until infection develops. You should also attend your regular clinical visits, so your health can be monitored. Learn the essentials of a good diet: eat plenty of whole-grain foods, fresh vegetables, fruits and a moderate amount of protein, while limiting saturated fats. Eating a healthy diet, exercising regularly and maintaining your weight at normal levels can help you to control your diabetes.