Diabetes Mellitus Type 2 is often misunderstood when it comes to Diabetes.

It is important to understand that there are a few different forms of Diabetes.

When it comes to Type II – this is where the body has a problem with how insulin is absorbed into the cells of the body.  As a result, the body might be producing enough insulin, from the Pancreas, but it is not using it as it should.

Over time, the pancreas might stop producing Insulin altogether. But, treatment success and other issues make it fundamentally different then Diabetes Type 1 .

Type II has also been called or referred to as “adult-onset diabetes“.  This means, that most patients develops this when they are older. However, younger and younger patients are developing symptoms because of weight gain, inactivity, and other causes.

On a medical standpoint, Type II  is where there is a resistance to insulin or a decrease in sensitivity to glucose. Type 1 Diabetes is a result of beta cell destruction in the Pancreas.

Diabetes Type 2 is often initially managed by changing diet and increasing exercise. Not all patients with Type 2 will require medications. If the condition progresses, medications may be needed. This condition often affects obese or overweight but not always.

Type II By the Numbers:

In the United States, almost 24 million people suffer from Diabetes and almost 90% of those have been diagnosed with Type 2

Worldwide – Diabetes is seen in almost 150 million persons and that number is believed to double in the next 1-2 decades.

Initially the large majority of those diagnosed with Type 2 were adults, however, recently there has been a large increase of children who are diagnoses – and it is often paralleled to the increasing number of obese children.

Potential Causes:

–  Obesity
–  Inactivity
–  Age
–  Genetics
–  Environmental exposures

Potential Symptoms:

–  Glucose in urine  [Glycosuria]
–  Increased frequency to urinate
–  Increased thirst
–  Fatigue
–  Decreased or blurred Vision

Potential Complications

1.)  Hypoglycemia – can be seen following medication
2.)  Hyperglycemia
3.)  Cardiovascular Disease
4.)  Chronic Renal Failure
5.)  Blindness or retinal damage
6.)  Diabetic Ketoacidosis
7.)  Nerve Damage
8.)  Difficulty for wound healing
9.)  Amputation
10.)  Erectile Dysfunction
11.)  Coma
12.)  Death

Blood Sugar Testing:

1.)  Diagnosis is often seen on a fasting blood draw
2.)  Glucose Tolerance Test [GTT] – this test checks the plasma glucose after 2 hours of oral glucose.
3.)  Continued and routine checking of blood sugars
4.)  HA1c is often routinely checked to evaluate the progression of the condition.

Prevention:

1.)  Proper Nutrition
2.)  Regular Exercise
3.)  Routine Screening

Treatment:

1.)  Self-Monitoring by Blood Glucose Monitoring
2.)  Diabetic Diet
3.)  Limit Carbohydrates
4.)  Limit Calories
5.)  Medications
6.)  Weight loss

Medications:

Biguanide

  • Metformin

Sulfonylurea

First Generation

  –  Acetohexamide
  –  Chlorpropamide
  –  Tolbutamide
  –  Tolazamide

Second Generation

  –  Glipizide
  –  Gliclazide
  –  Glibenclamide  [Glyburide]
  –  Gliquidone
  –  Glyclopyramide

Third Generation

  –  Glimepiride

Thiazolidinediones (TZDs)

  –  Rosiglitazine (Avandia)
  –  Pioglitazone (Actos)

Meglitinide

  –  Repaglinide  [Prandin].
  –  Nateglinide  [Starlix]

Alpha-Glucosidase Inhibitors

  –  Acarbose
  –  Miglitol

Insulin

ACE Inhibitors

–  This medications is recommended by the HOPE study
–  Does not specifically decrease blood sugars
–  Can help protect against kidney kidney and other problems often associated with diabetes.

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