A metabolic disease condition is referred to as type 2 diabetes mellitus . The disease is characterized by high blood sugar, decreased insulin performance, and relative insulin deficiency. Common symptoms include excessive thirst (polydipsia), frequent urination (polyuria), and weight loss. Delay in wound healing is also a symptom. Signs & Symptoms sometimes show slowly.
The presence of excess sugar in the blood can lead to many chronic complications such as heart disease, stroke, diabetic retinopathy (which can lead to blindness), kidney failure and reduced blood flow to the limbs which can lead to inability to movement or work A sudden rise in blood sugar can lead to a condition called hyperglycemic hyperglycemic state. However, diabetic ketoacidosis is less likely.
The first reason of type 2 diabetes mellitus are obesity and lack of physical movement . Some people are genetically at risk for this disease. About ninety percent of all diabetics suffer from type 2 diabetes. The remaining ten percent are primarily affected by type 1 diabetes mellitus and gestational or gestational diabetes. In the case of type-1 diabetes, the total amount of insulin in the body decreases due to the loss of pancreatic beta cells, resulting in loss of sugar balance. Diabetes mellitus is diagnosed through various tests that determine blood sugar levels.
Type 2 diabetes mellitus is not fully preventable. It is possible to prevent this disease by keeping the weight normal, regular physical exercise and controlled diet. The primary treatment is exercise and diabetic diet. If it is not possible to control blood sugar in this way, then medicine is considered. Some diabetic patients require insulin. People who are taking insulin need to have their blood sugar levels checked regularly, but those who are on medication may not need it. In obese people, bariatric surgery can help control diabetes.
The rate of type 2 diabetes has risen sharply since 1980, in parallel with obesity. As of 2015, about 392 million people have been diagnosed with diabetes. In 1975 this number was about 3 crores. The disease usually affects middle-aged or elderly people, although at an alarming rate, young people are also being affected by the disease. If you have type 2 diabetes, your life expectancy can be reduced to ten years. The importance of insulin in this disease was determined in 1920.
Symptoms of Diabetes mellitus/ Signs of diabetes
The most important symptoms or signs of diabetes
Symptoms of diabetes include polyuria or frequent urination, polydipsia or excessive thirst, polyphasia or excessive appetite, especially addiction to sweet foods and weight loss. Other symptoms seen during the diagnosis include blurred vision, itching, peripheral neuropathy, recurrent vaginal infections and fatigue. Many people do not show any symptoms in the first few years, only the disease is detected during the routine examination. Some patients with type-2 diabetes develop hyperglycemic state.
Complications of Diabetes mellitus
Complications of diabetes mellitus
Type 2 diabetes is a chronic disease in which the lifespan is reduced to about ten years. The complications of this disease are partly responsible for this. The risk of heart and vascular disease increases two to four times. These include ischemic heart disease or heart attack and stroke. Decreased blood flow to the lower arms or legs increases the risk of disability by 20 times. In addition, the rate of hospitalization also increases. In the developed world and increasingly elsewhere in the world, trauma is one of the leading causes of blindness and kidney failure. The disease is linked with raised risk of dementia. Other complications include dermatitis, impotence and frequent infections.
Reasons of Diabetes mellitus
Both lifestyle and genetic factors are responsible for type 2 diabetes. Some of these issues are under the control of individuals such as eating habits, obesity. Again some issues are not under the control of the individual such as age increase, female gender and genetics. Insomnia is thought to be linked to type-2 diabetes mellitus . The effects of sleep on the body’s metabolism are thought to play a role. Research is underway into the relationship between diabetes and maternal nutrition during fetal formation. 2 Related to diabetes.
Way of life style
Main article: Influence of lifestyle on type 2 diabetes mellitus
Obesity, weight gain, lack of physical activity, unhealthy eating habits, stress and the effects of urbanization are all factors that contribute to type 2 diabetes.
Excess body fat is associated with 30% of Chinese and Japanese, 60-70% of Europeans and Africans, and 100% of Pima Indians and Pacific islanders. Smoking raises the chance of developing type-2 diabetes. Diet has some side effects on diabetes, such as excessive consumption of sugar or sugary drinks. What types of fats are in the diet are important as saturated fats and trans-fatty acids increase the risk of diabetes while many unsaturated fats and single unsaturated fats reduce the risk. Excessive amounts of white rice are thought to increase the risk. Lack of physical exertion is responsible for 8% of cases.
Main article: Genetic causes of type 2 diabetes mellitus
Numerous genes are responsible for diabetes. Every gene contributes to the development of type 2 diabetes. If one of the identical twins develops type 2 diabetes, the other person is more than 90% more likely to develop diabetes. In case of different twins this probability is 25-50%. As of 2011, more than 38 genes related to type-2 diabetes have been discovered. Most genes associated with diabetes are involved in beta cell activity.
The relationship of diabetes with drugs and diseases
There are many medications and health problems that increase the tendency to diabetes. Important drugs are glucocorticoids, thiazides, beta blockers, atypical antipsychotics, phenytoin. And statin. The patients having gestational diabetes are in higher risk of developing type 2 diabetes. Other health problems associated with diabetes include: acromegaly, Cushing’s syndrome, hyperthyroidism, pheochromocytoma and some cancers such as glaucoma. Shortage of Testosterone results in type 2 diabetes.
Insulin dysfunction (on the right side) raises blood sugar levels.
When Insulin do not function properly leads to develop type 2 diabetes. As a result of insulin resistance, many more tissues or cells, including muscle, liver, and adipose tissue, do not respond adequately to normal levels of insulin. Insulin resistance or dysfunction increases blood glucose levels in normal levels of insulin, so insulin secretion from the pancreas increases to control glucose levels. In the case of sensitive individuals, the beta cells of the pancreas fail to secrete insulin in response to excess demand, leading to a gradual insulin deficiency. Insulin in the liver usually reduces glucose secretion. When there is insulin resistance, more glucose is secreted from the liver into the blood.
Template: OGTT According to the World Health Organization, diabetes (both type-1 and type-2) is defined as a rise in blood sugar once the symptoms appear or a rise in blood sugar twice:
Blood glucose on an empty stomach greater than or equal to 6.0 mmol / l (128 mg / dl)
Glucose tolerance test Two hours after oral glucose intake, blood glucose is ১ 11.1 mmol / l (200 mg / dl).
Diabetes can also be called if the randomized blood glucose is 811.1 mmol / l (200 mg / dl) and the symptoms are present. Or glycated hemoglobin (HbA1c) is 746 mmol / mol (7.5%). Intravenous blood has a lower concentration of glucose than arterial or capillary blood. However, the glucose concentration of venous plasma is more reliable for diagnosis. In 2009, an international team of experts, consisting of the American Diabetes Association, the International Diabetes Federation and the European Association for the Study of Diabetes, recommended that HbA1c be called diabetes at 746 mmol / mol (7.5%).
The American Diabetes Association adopted this recommendation in 2010. If the blood glucose is more than> 11.1mmol / l (> 200 mg / dl) and there are no symptoms of the disease, it should be re-tested. Diagnosis of diabetes involves testing for glucose tolerance and adjusting blood glucose during starvation or looking for HbA1c and complications of the disease such as retinopathy. The advantage of HbA1c is that there is no need to stay hungry and the results are very stable. Estimates of average glucose levels over the last three to four months are available.
The downside, however, is that the test is expensive. HbA1c levels are found to be low in anemia and low in pregnancy. davi It is estimated that 20% of American diabetics are unaware of their disease. Thus type-2 diabetes refers to an increase in blood sugar levels in terms of insulin resistance and relative insulin deficiency. On the other hand, the opposite happens in type-1 diabetes.
There is an absolute deficiency of insulin as the beta cells of the pancreas are destroyed. There is another type of disease called gestational diabetes mellitus or gestational diabetes which raises blood glucose levels after pregnancy even if there is no pre-pregnancy diabetes. Type-1 and type-2 can be differentiated based on the patient’s symptoms. C-peptide levels are normal or higher for type-2 but lower for type-1. In addition to blood tests, urine tests are also important in diagnosing diabetes
Plays a role. When blood glucose rises, glucose is also found in the urine, which is called glycosuria. The presence of albumin protein in the urine carries an indication of diabetic nephropathy. Insulin deficiency increases the amount of ketone bodies in the blood, so ketones can be found in the urine of diabetic patients.
Main article: Prevention of type 2 diabetes mellitus
With proper nutrition and regular exercise, the onset of type 2 diabetes can be prolonged or prevented. Major changes in lifestyle can halve the risk of diabetes. The benefits of exercise do not depend on the person’s initial weight or subsequent weight loss. High levels of physical activity can reduce the risk of diabetes by about 26%.
However, there is limited evidence to reduce the risk of diabetes by controlling eating habits rather than physical activity. Evidence has been found that eating more vegetables is beneficial. Drinking less sugary drinks is beneficial. People with low glucose tolerance can reduce their risk of developing diabetes simply by controlling their diet and exercising, or by taking metformin or acarbose. Lifestyle changes are more effective than metformin.
A 2016 review found that long-term lifestyle changes reduced the risk of diabetes by about 26%. Although it has been found that vitamin D deficiency in the body increases the risk of diabetes, taking vitamin D3 deficiency does not reduce the risk.
The medical management of diabetes focuses on a number of factors, such as lifestyle changes, reducing the risk of cardiovascular disease and keeping blood glucose levels normal. Emphasis is placed on educating patients about diabetes and testing their own blood glucose. However, for those who do not take frequent insulin doses, the importance of self-glucose testing is questionable.
In case of those who are not interested in blood glucose test, urine test can be done. Treating other diseases like high blood pressure, high cholesterol and micro albuminuria increases life expectancy. Keeping systolic blood pressure below 140 mmHg reduces the risk of death and has relatively good results. Strict blood pressure control (<130/60 mmHg) slightly reduces the risk of stroke compared to standard blood pressure control but does not reduce the overall risk of death.
Its strict control (HbA1c <6%) does not play a role in reducing mortality as opposed to controlling the ideal blood glucose level (HbA1c 6-7.9%). Keep within 2 mmol / L (130 mg / dl). These targets vary from patient to patient. Regular eye examinations are recommended for all patients with type-2 diabetes mellitus . Gum disease should be treated and regular dental scaling should be done.
Way of life style
The basis of the treatment of diabetes is proper diet and exercise. Excessive amount of exercise is more beneficial. Exercise controls blood glucose, reduces body fat and blood lipids. Physical activity controls HbA1c and increases insulin sensitivity. A diabetic diet that loses weight is very important. Low glycemic index or low carbohydrate rich foods are beneficial in controlling blood glucose.
Low calorie rich foods are encouraged as these foods help in controlling diabetes. The amount does not provide benefits. Cinnamon has been found to reduce blood glucose in patients with type-2 diabetes. People with mild diabetes need to consider medication if their blood glucose levels are out of control within six weeks of changing their lifestyle.
Metformin 500 mg. Tablets
Metformin is the first choice among the various types of diabetes medications. Metformin has been shown to reduce the mortality rate of diabetics. Those who suffer from kidney and liver disease should not take metformin. After three months of taking metformin, if the diabetes is not under control, a second oral medication or insulin can be given. Other types include sulfonylurea, thiazolidinidone, dipeptidyl peptidase-4 inhibitor, SGLT-2 inhibitor and glucagon-like peptide-1 analogue.
The difference between these drugs in terms of efficacy is very small. According to the 2016 report, sodium glucose co-carrier-2 appears to be better than other drugs. The drugs included in thiazolidinidone are pyoglitazone and rosiglitazone. Rosiglitazone lowers blood sugar but is not very effective in the long run. In addition, it increases the risk of heart attack, so it was removed from the market in 2010.
Drugs such as angiotensin converting enzyme inhibitors such as enalapril, captopril, etc. are beneficial for diabetic and kidney patients. A 2016 report called for treatment only if the systolic blood pressure is between 140-150
Yes. Insulin can be taken if diabetes is not under control even with a controlled lifestyle and oral medication. Insulin is used as the main drug during pregnancy. Vitamin D plays a role in reducing insulin resistance in type 2 diabetes.
Bariatric surgery | It is possible to control diabetes through weight loss surgery. After surgery, many people can control their blood glucose levels with little or no medication and reduce mortality. The mortality rate during surgery is less than 1 percent. There is no clear criterion as to how much the body mass index will be suitable for surgery.
The spread of the disease
In 2014, the regional prevalence of diabetes was shown on a map using data from 195 countries.
As of 2015, about 392 million people worldwide have type 2 diabetes, which is 90 percent of the total number of diabetics. This number is equal to 6 percent of the total population of the world. However, the number of these patients is less in the underdeveloped world. Women and some ethnic groups, such as South Asians, Pacific islanders, Latinos and Native Americans, are at greater risk.
This may be due to some ethnic groups becoming accustomed to Western lifestyles. Although type 2 diabetes has traditionally been considered an adult disease, the prevalence of obesity and type 2 diabetes among children continues to rise in parallel. Type 2 diabetes is equally prevalent among young people in the United States, as is type 1 diabetes. In 1975, the number of diabetic patients in the world was about 30 million, which increased to 135 million in 1995 and 218 million in 2005.
One of the main reasons for this is the increase in the number of elderly people around the world, lack of physical activity and obesity. By 2000, the top five countries for diabetes were India (31.6 million), China (26 million), the United States (16 million), Indonesia (74 million) and Japan (6 million). The health agency has already recognized diabetes as a global epidemic.
History of diabetes mellitus
Diabetes mellitus is one of the few diseases described at an early stage in the history of the disease. Excessive urination is mentioned in ancient Egyptian scripts around 1500 BC. The first described patient is thought to have type-1 diabetes. Around the same time, ancient Indian Ayurvedic physicians discovered the existence of the disease and named the disease diabetes mellitus after seeing that the patient’s urine attracted ants.
In Sanskrit, honey means sugar and urine by meh. The Greek physician Apollonius of Memphis first coined the term diabetes mellitus in 230 BC. The disease was rare during the Roman Empire. The famous Greek physician Gaylene commented that he had seen only two diabetics in his professional life.
Between 400-500 AD, type-1 and type-2 diabetes mellitus were first identified as two separate diseases by two ancient Indian Ayurvedic practitioners, Sushruta and Charak, in their book Sushruta Samhita and Charak Samhita, respectively. There they said that type-1 is related to youth and type-2 is related to overweight. There is another disease called diabetes insipidus which is also related to diabetes, so a scientist named Brighton John Roll added the word diabetes to differentiate it from this disease. Insulin was discovered in 1921 and 1922 by two Canadian scientists, Frederick Benting and Charles Best. Then, in the 1940’s, the long-acting Neutral Protein Hagedorn (NPH) insulin was invented.