Type 2 Diabetes – Causes, Symptoms & Treatment

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Also known as non-insulin-dependent diabetes, Type II Diabetes is the common form of diabetes, affecting about 90% of people [1]. In this disorder, the beta cells in the pancreas produce insulin, but either the amount of insulin produced is insufficient, or the body develops insulin resistance. This inhibits the body cells from being able to actively use up glucose and this ultimately leads to an increased concentration of sugar in the blood stream. Since the body cells are unable to produce energy from glucose, diabetes may cause weakness and muscle wasting.

Type 2 Diabetes

While this type of diabetes is more often seen in adults, it is becoming increasingly common in children as well as cases of child obesity are on the rise. While there is still no complete cure for Type II Diabetes available yet, there are a number of methods for treatment and control of the symptoms and these can greatly help sufferers lead a better and closer to normal lifestyle.

A condition called prediabetes is often considered to be a precursor to Type II Diabetes. Prediabetes is typically characterized by a higher than normal level of sugar present in the blood stream, but this level is not high enough for the condition to be classified as full blown diabetes. While prediabetes is a reversible condition, if left untreated, there is a good chance of individuals developing Type II Diabetes.

Causes of Type II Diabetes

Even though it is the most prevalent form of diabetes, the actual causes of Type II Diabetes are yet to be known. It is most commonly observed to occur in elderly and obese people. Various factors that may trigger Type II Diabetes include the diet, the lifestyle and the genetic susceptibility of an individual.

What is Type 2 Diabetes?

Some of the risk factors have been identified, which may lead to individuals contracting the disorder. People are more likely to get Type II Diabetes at some point of time in their life if they face some specific risk factors including:

  • Presence of an excess amount of fatty tissue in the body
  • An uneven distribution of fat in the body, concentrated in the hips and the thighs
  • A lesser amount of physical activity
  • Elderly people who are over 45 years of age
  • Obese or overweight individuals including children
  • Females who had episode of gestational diabetes during pregnancy
  • Persons having family members with Type II Diabetes
  • People suffering from pre-diabetes conditions
  • Those who consume low HDL cholesterol or high triglycerides with less amounts of physical activity
  • Hypertensive patients
  • Members of specific racial or ethnic groups
  • Women who suffer from polycystic ovary syndrome

Causes of diabetes

Signs and symptoms of Type II Diabetes

Some of the common symptoms of Type II Diabetes include:

  • Increased hunger due to a depletion of energy in the body cells
  • Increased thirst due to excessive loss of fluids by urination
  • Dryness of the mouth
  • A feeling of nausea and occasional vomiting
  • Frequent urination, amounting to over 2.5 liters excreted each day
  • Fatigue and a general feeling of weakness
  • Blurring of vision
  • Numbness or tingling sensation in hands or feet
  • Infections of the skin, urinary tract, the gums and the vagina
  • Slow healing of wounds
  • Appearance of patches of darkened skin

Diabetes signs

Complications associated with Type II Diabetes

If left uncontrolled, Type II Diabetes may lead to certain life threatening complications like [2]:

  • The increased level of sugar in blood results in an increase in urinating frequency, causing dehydration.
  • High blood glucose levels may damage blood vessels and nerves of the kidneys, eyes, and heart leading to atherosclerosis, or hardening of the arteries that can further lead to heart attack or stroke. There is a greater risk to becoming more susceptible to various infections, skin ulcerations and gangrene in limbs due to poor blood circulation. This may also result in the need for amputation of limbs.
  • Retinopathy: Increased blood sugar levels may damage the nerves and blood vessels of eyes leading to retinopathy. Thus it is important to control blood sugar as well as blood pressure and cholesterol to prevent eye diseases. Severe diabetes may also lead to loss of eyesight.
  • Hyperosmolar non-ketone diabetic coma or Diabetic coma: It is a situation where a person with type II diabetes is severely dehydrated and is not able to make up for the fluid losses.
  • Other complications that can be associated with Type II Diabetes include a susceptibility of Alzheimer’s disease, development of skin conditions and also hearing impairment.

Diagnosis of Type II Diabetes

In order to diagnose Type II Diabetes, blood is examined for abnormalities in blood glucose level through a random fasting blood test or through a 2-hour glucose tolerance test [1]. A hemoglobin A1C test may also be done to show average blood sugar for the past 2 to 3 months. One may even look for glucose or ketones in urine.

Diabetes OGT test Diabetes HbA1c test

Some other alternatives to the A1C test may be resorted to under some certain conditions such as pregnant women and individuals with hemoglobin variants in the blood. In such cases, the tests for diagnosing Type II Diabetes include:

  • A blood sugar test taken at a random point in time
  • A blood sugar test taken specifically after fasting
  • A tolerance test for glucose which is administered orally

Another test named zinc transporter 8 autoantibody (ZnT8Ab) test is another blood test that helps to determine the type of diabetes. The advantage of the ZnT8Ab test is that it gives a prompt and an accurate diagnosis of diabetes which can lead to timely treatment.

Screening tests for people who are suspected to be at a risk of diabetes should also be carried out. In case of prediabetes, a screening test can greatly help in determining the presence of the condition and necessary measure can be taken before the condition develops fully into Type II Diabetes.

After the presence of diabetes is confirmed in an individual, additional tests need to be carried out in order to distinguish Type I diabetes from Type II. This is required as the treatment procedures for the disorders are quite different from each other.

Along with the normal diagnostic measures, blood samples and urine samples are also analyzed to check for other complications which are related to diabetes. These analyses check for the levels of cholesterol, the functioning of the thyroid gland and also the functioning of other major organs such as the kidneys and the liver. Blood pressure, eye check-ups and checking of the foot through physical examinations are also common diagnostic procedures that are included in the diagnosis of Type II Diabetes.

Difference between Type 1 and Type 2 diabetes

Treatment of Type II Diabetes

Type II Diabetes can be controlled with exercise, weight reduction and by following a diabetic diet [3] [4]. Weight reduction and exercise are important treatments for diabetes. Weight reduction and exercise increase the body’s sensitivity to insulin, thus helping to control blood sugar elevations.

When these measures fail, oral hypoglycemic drugs may be prescribed to sufferers. These may include:

  • Metformin drugs including Glumetza and Glucophage
  • Megalitinide drugs including Prandin and Starlix
  • Sulfonylurea drugs including Amaryl, Glucotrol and Glynase
  • Thiazolidinedione drugs including Avandia and pioglitazone
  • DPP4 inhibitor drugs including Januvia, Onglyza and Tradjenta
  • GLP1 receptor agnostic drugs including Victoza and Byetta
  • SGLT2 inhibitor drugs including Invokana and Farxiga

If oral medications for diabetes are still insufficient, treatment with insulin or insulin is considered to be useful. Insulin therapy may include injecting the patient with various forms of insulin such as:

  • Insulin Glulisine
  • Insulin Lispro
  • Insulin Aspart
  • Insulin Glargin
  • Insulin Detemir
  • Insulin Isophane

Sufferers must also ensure to monitor the levels of sugar present in the blood on a periodic basis. Not only will this help in setting and achieving target, but it is also a wonderful indicator of whether medication or treatment therapy is proving to be effective.

Diabetes reduce risks

While Type II Diabetes is a chronic condition and there is not much that individuals can do to prevent onset of the disease, especially if there is a history of the disease in the family. However, there are a few accepted measures which need to be followed by people who consider themselves at risk to the disease. These include:

  • People should always eat healthy foods which are lower in calories and fats and higher in fiber
  • Individuals should resort to an active physical lifestyle involving at least half an hour of rigorous exercise each day
  • People should always maintain a healthy weight and keep checking the weight regularly to notice unexplained irregularities at the earliest
  • Individuals who suspect themselves at risk should always undergo screening tests for diabetes
  • Individuals should also make sure to monitor the glucose levels in the blood on a frequent basis

In some specific cases, medication such as Metformin and other orally administered diabetic medications may help in reducing the risk of contracting the disorder. However, the most essential thing in order to prevent Type II Diabetes is maintaining an active and healthy lifestyle. Cessation of smoking must be done at the earliest and people are also advised to drink alcohol more responsibly as drink mixers and alcohols can dramatically affect the blood sugar levels.

Some of the vital things that diabetics should always remember are to regularly conduct health checkups and to follow as healthy and as active a lifestyle as possible. While it may not be entirely possible for a diabetic to lead a completely normal life, careful measures can help sufferers lead a somewhat closer to normal life.

 

References


[1] Diagnosis and Classification of Diabetes Mellitus, Silvio Inzucchi, MD; Richard Bergenstal, MD; Vivian Fonseca, MD; Edward Gregg, PhD; Beth Mayer-Davis, MSPH, PhD, RD; Geralyn Spollett, MSN, CDE, ANP, Richard Wender, MD; 33(Suppl 1): S62–S69 – Jan 2010 – DOI: 10.2337/dc10-S062, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797383/


[2] Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes, William Duckworth, M.D., Carlos Abraira, M.D., Thomas Moritz, M.S., Domenic Reda, Ph.D., Nicholas Emanuele, M.D., Peter D. Reaven, M.D., Franklin J. Zieve, M.D., Ph.D., Jennifer Marks, M.D., Stephen N. Davis, M.D., Rodney Hayward, M.D., Stuart R. Warren, J.D., Pharm.D., Steven Goldman, M.D., Madeline McCarren, Ph.D., M.P.H., Mary Ellen Vitek, William G. Henderson, Ph.D., and Grant D. Huang, M.P.H., Ph.D.; 360:129-139 – January 8, 2009 – DOI: 10.1056/NEJMoa0808431, http://www.nejm.org/doi/full/10.1056/nejmoa0808431


[3] Epidemiology of Diabetes and Diabetes-Related Complications, Anjali D Deshpande, Marcie Harris-Hayes, Mario Schootman; vol. 88 no. 11 1254-1264 – September 18, 2008 – DOI: 10.2522/​ptj.20080020, http://ptjournal.apta.org/content/88/11/1254.short


[4] REDUCTION IN THE INCIDENCE OF TYPE 2 DIABETES WITH LIFESTYLE INTERVENTION OR METFORMIN, I.W. Culbert, D.A. Ehrmann, P.G. Watson, H. Miettinen, R.F. Hamman,; 346(6): 393–403 – Feb 7, 2002 – DOI: 10.1056/NEJMoa012512, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1370926/


[5] The Cost-Effectiveness of Lifestyle Modification or Metformin in Preventing Type 2 Diabetes in Adults with Impaired Glucose Tolerance, William H. Herman, MD, MPH; Thomas J. Hoerger, PhD; Michael Brandle, MD, MS; Katherine Hicks, MS; Stephen Sorensen, PhD; Ping Zhang, PhD; Richard F. Hamman, MD, DrPH; Ronald T. Ackermann, MD, MPH; Michael M. Engelgau, MD, MS; Robert E. Ratner, MD; 142(5):323-332 – March 1, 2005 – DOI: 10.7326/0003-4819-142-5-200503010-00007, http://annals.org/article.aspx?articleid=718240

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