A healthy body is important to live a quality life. To regulate the normal functioning of the body one must take care of a healthy diet, body weight, and daily exercise.Due to stress, poor diet, and physiological conditions, the body stops functioning normally. As a consequence one suffers from a variety of diseases. Diabetes mellitus is one of them.A metabolic disorder associated with high blood glucose, insulin resistance, and insufficient insulin production is termed as diabetes mellitus. It has been estimated that about 336 million DM cases have been reported in 2011 which would have increased to 552 million by 2030. (1)Diabetes mellitus is of two types; diabetes mellitus type 1 and diabetes mellitus type 2.

Diabetes mellitus type 2.

This type of diabetes is also termed non-insulin-dependent diabetes. It alters the body’s normal way of using insulin to decrease blood glucose levels.

People suffering from diabetes type 2 show resistance to insulin. Unlike diabetes type 1, insulin is synthesized by the body but due to some reasons it does not function properly or one does not respond to the produced insulin. This leads to an increased blood glucose level.In some cases, this condition becomes worst causing the exhaustion of the pancreas leading to continuous hyperglycaemic conditions this type of diabetes is also known as adult-onset diabetes or juvenile diabetes as it is more likely to happen in people of middle age or older. It accounts for about 90% of all diabetes cases and hence becomes the most common type of diabetes.

Causes.

Several root causes make the body resistant to insulin leading to diabetes type 2.

  1. Family history.

This disorder runs from generation to generation. One may suffer from diabetes type 2 if relatives especially from the first degree show any case.

  1. Genes

Genetic mutation is one of the main causes of diabetes. DNA decides how the pancreas will synthesize insulin so any mutation in the nucleotide bases of DNA may cause a disturbance in insulin production.

  1. Obesity.

Overweight and obesity is another cause of diabetes. Obesity causes insulin resistance. People carrying extra weight at an early age are more likely to have diabetes type 2.Obesity accounts for about 55% of DM 2. (2)

  1. Other physiological conditions.

Diabetes type 2 is directly or indirectly correlated with other physiological conditions. People reported with this type are also found to have groups of other metabolic syndromes such as hypertension, hypercholesterolemia, and hyperlipidemia.

  1. Impaired glucose intolerance (IGT)

It is a condition in which the body builds up more than normal blood glucose levels yet below the threshold. This higher blood glucose level eventually leads to a condition known as hyperglycemia.

  1. Liver impairment

Besides detoxification, the liver also releases stored glucose in the blood when the body falls short of glucose in the fasting condition.After eating food liver usually uptakes the extra glucose and stores it. But in abnormal conditions, the liver keeps releasing out sugar.

  1. Miscommunication between cells

Sometimes cells don’t communicate properly. Receiving or sending wrong signals by the cells causes decreased insulin production and increased blood glucose level.

  1. Damaged beta cells

Insulin is produced by the beta cells of the pancreas. Damaged beta cells produce less insulin causing hyperglycaemic conditions.

  1. Cigarette smoking
  2. Sedentary lifestyle. A weak but positive connection has been seen between the concentrations of bisphenol A (a type of plastic) and the incidence of DM 2.
  3. Alcohol consumption

Signs and symptoms.

A patient suffering from diabetes mellitus type 2,  shows various signs and symptoms.  Symptoms are mild and sometimes absent and people live several years without being diagnosed.

  1. Patient feels dryness in the mouth and excessive thirst.
  2. Frequent urination is another symptom shown by the Type 2 diabetics
  3. Prolong diabetes affects the vision of the eye by causing cataracts or glaucoma. These conditions lead to blurred vision.
  4. Diabetes indirectly influences the neurons and causes numbness and tingling in the hands and feet.
  5. Type 2 diabetics worn out orget tired after doing a little amount of work. Fatigue and laziness are one of the major signs and symptoms.
  6. Comparative to a normal person, wounds of type 2 diabetics take more time to heal up.
  7. Once get a yeast infection, the patient is more likely to have it again and again with time.
  8. Due to impaired functioning of the body and metabolic disorder, the patient feels more hunger in a day.
  9. Type 2 patients keep on losing weight unwantedly.
  10. Patient becomes vulnerable and least resistant to other infections.

Diagnosis.

Different tests are done for the diagnosis of DM type 2. Sometimes due to higher glucose concentration and prominent symptoms, one test may be all the patient needs.

  1. This test determines the average blood glucose concentration for the last 2 to 3 months. Patients showing a percentage greater than 6.5 are diagnosed with DM 2.
  2. Fasting plasma glucose (FPG). A patient has to.fast for about 8 hours prior to.that test. The glucose in the fasting state is then checked.
  3. Oral glucose tolerance test (OGTT). In this test, the glucose is measured two hours after eating.

Management and treatment.

One can minimize the chances of DM 2 by modifying the lifestyle. Consumption of dietary fibers, less fatty food, maintained body mass index, daily exercise, no smoking, and no alcohol intake have reduced the incidence rate of DM 2.

Medications. 

Medications aids in regulating the blood glucose concentration but do not eradicate DM 2.

Biguanides such as metformin reduce hepatic glucose release, enhances the insulin sensitivity, increases glucose uptake from the blood.

Sulfonylureas such as glipizide trigger the endogenous insulin secretion. But it carries the risk of hypoglycemia.

Nateglinideand repaglinide belong to the class meglitinides. These pharmacological agents stimulate insulin production by acting on the ATP-dependent potassium channel in beta cells of the pancreas.

Dipeptidyl-peptidase IV inhibitors inhibit dipeptidyl peptidase IV, modifies islet function, and controls hyperglycemia.

Thiazolidinediones such as pioglitazone is an insulin sensitizer.  It enhances body sensitivity towards insulin secretion.  (3)

References

  1. Global burden of diabetes. International Diabetes federation. Diabetic atlas fifth edition 2011, Brussels. Available at http://www.idf.org/diabetesatlas(Accessed 18th December 2011).
  2. Hossain, P., Kawar, B., & El Nahas, M. (2007). Obesity and diabetes in the developing world—a growing challenge. New England journal of medicine356(3), 213-215.
  3. Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 diabetes mellitus: a review of current trends. Oman medical journal27(4), 269.