As our lifestyle has become so advanced that we don’t care about the basic necessities which are required to the body for a healthy life. Today almost everyone on the globe has some sufferings which can be in any form. Type 2 diabetes mellitus or Type two diabetes mellitus is one of them. Read this article to know Type 2 diabetes mellitus symptoms, causes, and diet.
Diabetes mellitus is one of them. In 2017, it was estimated that about 425 million people around worldwide have been diagnosed with diabetes mellitus in which about 90% of people are diagnosed with type 2 diabetes mellitus.
When coming upon the ratio, men and women both share equal rates. The death rate due to diabetes mellitus in early age has now also increased. In 2017, about 3.2 to 5.0 million death has been recorded worldwide due to diabetes mellitus.
What Is Diabetes Mellitus?
Diabetes mellitus (DM) is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Hyperglycaemia has many causes but is most commonly due to type 1 or type 2 diabetes.
People with hyperglycemia usually have disturbed metabolism of carbohydrate, fat, and protein due to lack of insulin secreted by β-cell of the pancreas. Along with this, hyperglycemia also disturbs normal water and electrolyte balance; as a result, death may take place due to acute metabolic decompensation.
As the diabetes mellitus progresses, irreversible pathological changes can be seen in the form of:-
- Blindness (due to glaucoma)
- Nephropathy which can progress to renal failure
- Neuropathy (loss of nerve sensation)
- Foot ulcers (due to neuropathy)
- Amputation due to gangrene
- Charcot’s joints
- Sexual dysfunctions in both sexes (impotency in male and loss of libido in female)
If this condition still progresses than the prognosis of the patient can go to the worse with the high-risk cardiovascular diseases, peripheral vascular disease and cerebrovascular diseases (in the form of diabetic coma).
Diagnostic Value of Diabetes Mellitus (in mg/dl)
|Diabetes Mellitus||Venous plasma||Whole venous plasma||Whole blood capillaries|
|2-hours PG||>= 200||>= 180||>= 200|
|Impaired Glucose Tolerance (IGT)|
|Fasting (if measured)||<126||<110||<110|
|2-hours PG||>= 140 to <200||>= 120 to <180||>= 140 to <200|
|Impaired Fasting Glucose|
|Fasting||>= 110 to <126||>= 100 to <110||100 to <110|
Classification of Diabetes Mellitus
DM is generally classified under four groups:-
1.Type 1 diabetes
2. Type 2 diabetes
Other specific types
- Genetic defects of β-cell function
- Genetic defects of insulin action (e.g. leprechaunism, lipodystrophies)
- Diseases of pancreas
- Excess amount of counter-regulatory hormones
- Drug-induced (e.g. corticosteroids, thiazide diuretics, phenytoin)
- Viral infections (e.g. congenital rubella, mumps, Coxsackievirus B)
- Uncommon forms of immune-mediated diabetes
- Associated with genetic syndromes (e.g. Down’s syndrome; Klinefelter’s syndrome; Turner’s syndrome; DIDMOAD (Wolfram’s syndrome) —diabetes insipidus, diabetes mellitus, optic atrophy, nerve deafness; Friedreich’s ataxia; myotonic dystrophy)
3. Gestational diabetes
WHAT IS TYPE 1 DIABETES MELLITUS DIABETES?
Type 1 diabetes, formerly called juvenile diabetes, is usually diagnosed in children, teenagers, and young adults. Type 1 diabetes may develop in adults also.
This is an autoimmune disease causing specific destruction of β-cells of the pancreas which results in an absolute insulinopenia.
WHAT IS TYPE 2 DIABETES MELLITUS DIABETES?
Type 2 diabetes, formerly called adult-onset diabetes. It is the most common form and has an insidious onset.
Type 2 diabetes is a more complex condition than type 1 diabetes because there is a combination of resistance to the actions of insulin in liver and muscle together with impaired pancreatic β-cell function leading to ‘relative’ insulin deficiency.
Causes for Type 2 Diabetes Mellitus
In type 2 DM patients, the pancreatic β-cells are unable to sustain the increased demand for insulin and slowly progressive insulin deficiency develops. It can be understood in two ways:-
- Insulin resistance:- In these patients, excessive production of glucose in the liver takes place and under-utilization of glucose in skeletal muscle occurs which results from the resistance to the action of insulin.
- Pancreatic β-cell failure:- At the time of diagnosis of type 2 diabetes, the β-cell appears to be slightly reduced. The functional capacity of the pancreas is impaired out of proportion to its mass. As a result, pathological changes take place which is mostly seen in the form of deposition of amyloid.
Along with this due to lack of insulin level in the body, there is increased plasma glucose and FFA (free fatty acids) levels which produces the toxic effects on β-cell, as a result of which the insulin secretion gets impaired.
As the pathological changes progress, it results in reduced β-cells in the pancreas while α-cell mass in the pancreas remains unchanged. As a result, glucagon secretion goes on increased which results in hyperglycemia.
Type 2 Diabetes Mellitus Symptoms
- Thirst, dry mouth
- Tiredness, fatigue, lethargy
- A noticeable change in weight (usually weight loss)
- Blurring of vision
- Pruritus vulvae, balanitis (genital candidiasis)
- Nausea; headache
- Hyperphagia; a predilection for sweet foods
- Mood change, irritability, difficulty in concentrating, apathy
Type 2 Diabetes Mellitus Risk Factors
- Central (visceral) obesity
- Dyslipidaemia (increased level of small dense LDL)
- Increased cholesterol level and triglycerides
- Low level of HDL
- History of cardiovascular diseases
- Sedentary life
- Decrease physical activity
- Unhealthy diet
- Positive family history type 2 DM.
- Medications including NSAIDs, anti-seizures, for HIV
- Low level of Vitamin D
- History of PCOD (Polycystic ovarian disease)
- History of GDM (gestation diabetes mellitus)
- Delivery of a baby >9lb
These are the common risk factors for type 2 DM. There may be other factors that can be responsible for it depending upon the circumstances and environmental factors.
Diagnosis of Type 2 Diabetes Mellitus
The diagnosis of diabetes should be made in the early stage of the development of the hyperglycaemic state.
Glucose:- Testing the urine for glucose is a common procedure for detecting diabetes, using a sensitive glucose-specific dipstick. If possible, testing should be performed on urine passed 1-2 hours after a meal, since this will detect more cases of diabetes than a fasting specimen.
Glycosuria always warrants further assessment by blood testing. Due to individuality, measurement of urinary glucose varies between diabetic patients, this occurs due to variation in the renal threshold for glucose. This can be considered as a disadvantage of this test.
Normally a low renal threshold can be seen in pregnancy. Some drugs also interfere with the result of urinary glucose test due to low renal threshold caused due to intake of drugs.
Ketone bodies can be identified by the nitroprusside reaction, which measures acetoacetate, using either tablets or dipsticks.
Ketonuria may be found in normal people who have been fasting or exercising strenuously for long periods, who have been vomiting repeatedly, or who have been eating a diet high in fat and low in carbohydrate.
Ketonuria is therefore not pathognomonic of diabetes but, if associated with glycosuria, the diagnosis of diabetes is highly likely. In diabetic ketoacidosis, ketones can also be detected in plasma using dipsticks.
Glucose:- Laboratory glucose testing in blood relies upon an enzymatic reaction (glucose oxidase) and is cheap, usually automated and highly reliable.
However, variation in blood glucose depends on whether the patient has eaten recently, so it is important to consider the circumstances in which the blood sample was taken.
Blood glucose can also be measured with colorimetric or other testing sticks, which are often read with a portable electronic meter.
Type 2 Diabetes Mellitus Treatments
Treatment with insulin
- Regular BG observance ought to be performed by all patients to regulate the hypoglycemic agent dose and sight symptom.
- Daily pre-prandial and time of day measurements square measure typically suggested.
- Target BG levels are typically 5–8 mmol/L (∼90–144 mg/dL), although target ranges may be lower (e.g. in gestational diabetes) or higher (e.g. in impaired awareness of hypoglycemia).
Treatment with anti-diabetic drugs
- BG monitoring is optional in many patients with stable type 2 diabetes; patient preference usually decides.
- BG monitoring is most useful in patients taking sulphonylureas (risk of hypoglycemia), during intercurrent illness and prescription of corticosteroids, and during changes in therapy.
BG is usually measured before breakfast (typical target 4–7 mmol/L (∼72–126 mg/dL)) and 2 hrs. after food (typical target 4–10 mmol/L (∼72–180 mg/dL)).
Type 2 Diabetes Mellitus Diet
The goal of dietary medical aid is to supply a nutritional diet to keep up the perfect weight (IBW) of the patient to attain sensible glycaemic management besides the correction of dyslipidemia.
The dietary coming up with relies on the sort of polygenic disorder, the weight of the patient, activity profile, and presence of co-morbid conditions. Dietary macronutrient composition is one of the important considerations for dietary therapy in diabetes.
Diet to prevent diabetes.
- Studies have shown that higher intakes of saturated and trans fats are associated with an increased risk of diabetes, whereas a higher intake of monounsaturated and polyunsaturated fats is associated with decreased risk of diabetes.
- The importance of consuming minimally processed foods with low glycaemic index and glycaemic load is recommended in the management of diabetes.
- Whole grain products such as whole-wheat bread, brown unpolished rice, oats, and barley tend to produce lower glycaemic and insulinemic responses than highly processed refined grains.
- Such unprocessed whole grains are also rich in fiber, antioxidants, vitamins, and phytochemicals.
- How many calories given to diabetic patients are first calculated? This calculation is based on the individual’s weight and physical activity. According to which the calories are divided into three principal meals and two snacks.
- The diet for the diabetic patient should include carbohydrate, fat, and protein with the proportion of 60:20:20.
- Consuming the whole fruit is better than the fruit juice which needs to be avoided. Ideal fruits are citrus fruits, orange sweet lime, guava, apple, papaya, and pomegranate.
Please review this article “Type 2 diabetes mellitus symptoms, causes, and diet”.
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