Question

Describe diabetes type II. Be sure to include pathophysiology, etiology, manifestations, and treatment.

Answer 1

Describe diabetes type-11, Include Pathophysiology, aetiology, manifestations and treatment?

WHO describes Diabetes as a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. It is considered the leading cause of death to humankind and about 422 mllion people are suffering from this worldwide.

Primarily there are three type of Diabetes. Type 1 diabetes, previously called insulin-dependent diabetes mellitus (IDDM) or juvenile onset diabetes, may account for 5 percent to 10 percent of all diagnosed cases of diabetes. Gestational diabetes develops in 2 percent to 5 percent of all pregnancies but usually disappears when a pregnancy is over

Type –II Diabetes.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90 percent to 95 percent of all diagnosed cases of diabetes. Risk factors for Type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high. People living with type 2 DM are more vulnerable to various forms of both short- and long-term complications, which often lead to their premature death.

Etiology

Type 2 diabetes is caused by a combination of genetic factors related to impaired insulin secretion and insulin resistance and environmental factors such as obesity, overeating, lack of exercise, and stress, as well as aging. It is typically a multi-factorial disease involving multiple genes and environmental factors to varying extents. The development of type 2 diabetes is clearly associated with a family history of diabetes

Environmental factors, aging, obesity, insufficient energy consumption, alcohol drinking, smoking, etc. are independent risk factors of pathogenesis. Obesity (particularly visceral fat obesity) due to a lack of exercise is accompanied by a decrease in muscle mass, induces insulin resistance, and is closely associated with the rapid increase in the number of middle- and high-aged patients. The changes in dietary energy sources, particularly the increase in fat intake, the decrease in starch intake, the increase in the consumption of simple sugars, and the decrease in dietary fibre intake, contribute to obesity and cause deterioration of glucose tolerance.

Pathophysiology

Impaired insulin secretion and insulin resistance contribute more or less jointly to the development of pathophysiological conditions. Impaired insulin secretion is a decrease in glucose responsiveness, which is observed before the clinical onset of disease. More specifically, impaired glucose tolerance (IGT) is induced by a decrease in glucose-responsive early-phase insulin secretion, and a decrease in additional insulin secretion after meals causes postprandial hyperglycaemia. Impaired insulin secretion is generally progressive, and its progression involves glucose toxicity and lipo-toxicity. When untreated, these are known to cause a decrease in pancreatic cell mass in animal experiments. The progression of the impairment of pancreatic cell function greatly affects the long-term control of blood glucose. The progression of the deterioration of pancreatic cell function subsequently causes permanent elevation of blood glucose.

Insulin resistance is a condition in which insulin in the body does not exert sufficient action proportional to its blood concentration. The impairment of insulin action in major target organs such as liver and muscles is a common pathophysiological feature of type 2 diabetes. Insulin resistance develops and expands prior to disease onset.

Clinical manifestations

The major early clinical manifestations of type two diabetes are

• Frequent urination
• Increase theist and Hunger
• Blurred vision
• Feeling very tired
• Slow healing cuts and wounds
• Tingling, numbness and pain in hands or feet
• Patches of dark skin

Diagnosis

Random blood sugar test. Blood sugar values are expressed in milligrams per decilitre (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a blood sample showing that your blood sugar level is 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst.

Fasting blood sugar test. A blood sample is taken after an overnight fast. A reading of less than 100 mg/dL (5.6 mmol/L) is normal. A level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes.

Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. Normal levels are below 5.7 percent, and a result between 5.7 and 6.4 percent is considered prediabetes. An A1C level of 6.5 percent or higher on two separate tests means diabetes.

TREATMENT

Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes.

Sulfonylureas. These medications help the body secrete more insulin. Examples include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain.

Insulin Therapy- Insulin. Some people who have type 2 diabetes need insulin therapy. In the past, insulin therapy was used as a last resort, but today it's often prescribed sooner because of its benefits. Low blood sugar (hypoglycemia) is a possible side effect of insulin.

Healthy eating

• Fewer calories
• Fewer refined carbohydrates, especially sweets
• Fewer foods containing saturated fats
• More vegetables and fruits
• More foods with fiber

Weight loss

Losing weight can lower your blood sugar levels. Losing just 5 to 10 percent of your body weight can make a difference, although a sustained weight loss of 7 percent or more of your initial weight seems to be ideal. That means someone who weighs 180 pounds (82 kilograms) would need to lose a little less than 13 pounds (5.9 kilograms) to make an impact on blood sugar levels.

Exercises and physical activity are highly beneficial