Definition
Type 2 diabetes which is a medical condition that is cause due to metabolic disorder which results in the elevation of blood glucose level in the body. It is characterised by insulin resistance, high blood sugar level and insufficient production of insulin in the body (Tan et al., 2019). Some of the key characteristics of type 2 diabetes includes frequent urination, increased hunger, blurred vision, unintended weight loss, fatigue and increased thirst.
According to a report published by international diabetes federation, it has been estimated that approximately 537 million people a surviving with diabetes in the world. Among them, about 90 to 95% of the cases has been reported to be type 2 diabetes. Diabetes is one of the most prevalent disorders in both developing and developed countries although it is uncommon in underdeveloped countries (Chatterjee, Khunti and Davis, 2017).. Since diabetes has been prevalent in every part of the world, most of the International Health Organization including World Health Organization have recognised type 2 diabetes as global epidemic (Lascar et al. 2018). According to the Irish Longitudinal Study on Ageing (TILDA), in 2015, there are about 10% of adults who are aged over 50 and have type 2 diabetes. Over the years, the number has significantly increased to 16% among those who are 80 years old and over. Based on recent research, one in ten people with diabetes among the stated population are undiagnosed. It is projected that there will be an increase in type 2 diabetes from about 15% to 18% in 2030 and an increase by 23% in 2050.
The progress of the type 2 diabetes is due to the combination of genetic factors and lifestyle. Obesity has been observed to be more common among women than that of the men worldwide.
The factors related to lifestyle of an individual have been observed to be essential for the progress of type 2 diabetes. These lifestyle factors include deficiency of physical activities. The less active one is, the greater their risks. Physical activities assists in controlling weight since it converts glucose as energy and further makes the cells more subtle to insulin. Another factor is obesity. Being overweight or obese increases one’s risks of getting type 2 diabetes. It is related with storing fat in the abdomen instead of the hips and thighs are an indication of increased risks of diabetes. Besides, the risks increase if one is a man who has waist circumferences of over 40 inches or females with measurements above 35 inches. The third factor is prediabetes also increases one’s risks to type 2 diabetes. It is an illness where blood sugar levels are high than normal. If it is not managed and treated, it often develops to type 2 diabetes. The forth factor is poor diet. Junk foods are often high in saturated fats.
Type 2 type test develops due to insufficient production of insulin from the beta cells of the pancreas. This results in the development of insulin resistance in the body that is regarded as the inability of the body cells to respond properly to the normal level of the insulin hormone present in the bloodstream. It usually occurs in the liver, muscles and fats tissue. The insulin usually suppresses the release of glucose in liver if the amount of glucose is higher in the bloodstream then the normal range (Barron et al., 2020) However, during insulin resistance the liver releases the glucose in bloodstream inappropriately. Several studies have established that the relationship between proportion of the resistance of insulin and dysfunction of the beta cells varies among the individuals. In most of the cases it has been observed that insulin resistance is the primary incident which is associated with some minor defects in the secretion of the insulin. However, in few cases the insulin resistance is much lower which is associated with lack of secretion of insulin in the body (Berbudi et al. 2020).
Epidemiology
Some other mechanisms that have been observed to be associated with type 2 diabetes and resistance of insulin includes elevated levels of glucagon in blood, increment of the degradation of lipids in fat cells, resistance and lack of incretin, unsuitable regulation of the metabolism that is associated with central nervous system and increased in the retention of the water and the salt by kidneys. In the initial stages the insulin resistance, beta cells expand which increases output of the insulin for compensating the insensitivity of insulin in the body (Khan et al. 2020). When the beta cell dysfunction, the secretion of insulin is impaired. The insulin may still be secreted however, its insensitivity manifests in the targeted tissues. When this happens, the hyperglycaemia amplifies resulting in the progression of type 2 diabetes. However, during the manifestation of type 2 diabetes major portion of the beta cells would be last. The fatty acids present in the beta cells would activate FOXO1 which results in the apoptosis of beta cells (Oguntibeju, 2019).
Several studies have reported that people suffering from type 2 diabetes does not show clinical symptoms in the initial phase and therefore it is usually undiagnosed for many years. However, there are several classic symptoms which would help to indicate the occurrence of type 2 diabetes in a patient. These classical symptoms include polyuria, a condition that is characterised by frequent urination, polydipsia, which is a condition that is characterised by increased thirst, weight loss and polyphagia, the condition in which the patient feels increased hunger in most of the time. Some other symptoms related to type 2 diabetes are previous history of blurry vision, peripheral neuropathy, itchiness, vaginal infection that relapse frequently and fatigue . In several cases it has been observed that the patient reported about loss of taste (Kaiser, Zhang and Der Pluijm 2018). By analysing these symptoms routine checker is instructed which would help to detect type 2 diabetes in the initial stage. However, if the symptoms are overlooked the prevalence of type 2 diabetes would not be detected since the initial stage of the manifestation of type 2 diabetes is mostly symptomless. In few cases it has been observed and recorded that a patient suffering from type 2 diabetes might develop hyperosmolar hyperglycaemic state which is a condition characterised by excessive increase of blood sugar level which is usually associated with the decreased consciousness level and lower blood pressure (Sacerdote et al., 2019).
The first sign is blurred vision. It is defined as the loss of sight which cannot be corrected by prescription eyeglasses or surgery. The vision loss does not consist of complete blindness since there may be still some sights and can be at times be improved with the use of normal visual aids. Excess sugar in the blood damages the blood vessels in the eyes leading to blurry vision (Frydrych et al., 2018). The second sign is fatigue. It is more than being sleepy or tired. Individuals who are fatigued also feel drained in a level where their exhaustions affects their day to day activities. Type 2 diabetes is associated with fatigue. The third sign is increased urge to urinate especially during the night. When the levels of the blood sugar are high, the kidneys often try to eliminate the excess sugars. It does this by filtering it out of the blood (Frydrych et al., 2018). Such aspects may result in the individual feeling the urge to urinate more frequently especially at night. The fourth sign is slow healing of both cuts and sores. The high levels of sugar in the blood may negatively affect the circulation of blood and further damage the nerves in the body. Due to this, the cuts and wounds may take time to heal. The slow healing wounds in return increase the risk of infections among individuals.
Aetiology
There are various differential diagnosis of type 2 diabetes. The first one is metabolic syndrome. It is a group of risk factors that is believed to be connected to resistance of insulin. It may occur when patients who have normal glucose tolerance, diabetes or prediabetes. The presentation of the patient may be an indication of metabolic syndrome. It is mainly characterized by low levels of high-density lipoprotein, abdominal obesity, and elevated blood pressure. The second differential diagnosis is hyperthyroidism. It is caused by the over activity of the thyroid gland caused by an overproduction of thyroxin. It is characterized by weight loss and tiredness, which are the same symptoms as type 2diabetes. Other symptoms include fatigue, muscle weakness and insomnia. Thyroid test often confirms the diagnosis. The existence of autoantibodies tends to exclude hyperthyroid. Thyroid imaging also eliminates other causes. The third differential diagnosis is a condition that negatively impacts the digestive system. It is characterized by symptoms like bloating, cramps and diarrhoea. The symptoms often appear and disappear over time and may further last for days, weeks and months.
Type 2 diabetes can be analysed based on the clinical manifestations of the disease among the patient. There are several guidelines that are used for diagnosing type 2 diabetes which are published by American Diabetes Association. However, there are several laboratory findings that would help to ensure the prevalence of type 2 diabetes among the patient. One of the most commonly used laboratory testing for diagnosing type 2 diabetes is glycated hemoglobin test. This test helps to detect the average level of blood sugar for past 3 months. The random test for detecting blood sugar level helps to measure the diabetic level at random periods of time. The fasting blood sugar examination is performed for analysing the stage of the prevalence of diabetes in the patient.
There are several medicines that are considered to be orthodox for the treatment of type 2 diabetes in the present world. Among these orthodox medicines insulin is regarded as one of the most important and common mode of treatment for type 2 diabetes.. There are several side effects that has been observed in insulin therapy which includes unusual ocular disturbance at the initial phase of the therapy that causes bloody vision, several dermatologic reactions have been observed during the insulin therapy which results in lipohypertrophy and lipoatrophy. Hypersensitivity reaction due to insulin therapy has been recorded in most of the cases although the rate of such reaction a decreasing with the advancement of the insulin production. The insulin from the external source helps to breakdown the glucose in the blood stream thus reducing the level of it in the blood (Sattar et al. 2019).
Alpha glucosidase inhibitor are also used for the treatment of diabetes. It is an anti-diabetic drug that is usually used for managing type 2 diabetes. Is also used among the patients suffering from glucose intolerance which helps to delay the manifestation of type 2 diabetes among them. This class of drug helps in absorption process of the carbohydrates from small intestine my competitively inhibiting the enzymes which converts complex carbohydrates that are non-absorbable into absorbable carbohydrate. The disturbance of gastrointestinal tract is among the most common and reported site effect of the Alpha glucosidase inhibitor. Flatulence is another commonly reported side effects which has been observed to appear in almost 80% of reported cases. This medicine is contradicted during a condition which is worsen by excessive production of gas in gut. There are several other contradictions like chronic intestinal disease, inflammatory bowel disease, diabetic ketoacidosis and colonic ulceration (Sacerdote et al., 2019).
Pathophysiology
Another drug is Astralagus. It is antidiabetic, antioxidant and antihypersensitive and immune-modulatory activities. The extracts from the plant has been proved in the treatment of diabetes and diabetic impediments. Additionally, treatment using such type of plant leads to better glycemic control by increasing the sensitivity of insulin. The mode of action consists of the Akt activation and the up regulation of the Glut4 and inhibition of the inflammation through the PTP1B pathways. Another herbal medicine that can be used is gastrodia elata. It has been over the years used in the treatment of blood circulation and memory problems. The extract from the plant has also been proved to improve the resistance of insulin in the body. The plant has two main active compounds including vanillin and 4-hydroxybenzaldehyde.
One of the natural medicines for preventing and managing type 2 diabetes is the diet of an individual.. There are different types of diet that has been proven to reduce the chance of developing diabetes and Dietary Approaches to Stop Hypertension. The first is Monitored Carbohydrate Diets. Counting one’s carbohydrates and keeping track of the carbs in all meals, snacks, and drinks may significantly assist to match the activity levels and medicines in the food that is being consumed. Most individuals with diabetes count carbs which helps them manage their blood sugar easily. The second approach is Mediterranean diet. The diet is high in nutritional balanced foods including fruits, vegetables, whole grains and healthy fats which promote the stability of the blood glucose. The last diet is viscous fibre supplements (Sacerdote et al., 2019). It dissolves in water to form a vicious gel in the gut and in the process reduces the rates of the nutrient absorption and insulin response. It also decreases cholesterol absorption and increased satiety.
The use of medicinal herbs when combined with other herbs is believed to be some type of amalgamation therapy because of its convolution of phytochemicals and bioactivities that are found in the plant. The first type of this drug is amorfrutins and licorice. The ethanol extract from the plant reduce the levels of glucose in the blood, fat weight and blood pressure. It has also been discovered to be quandary to and trigger the peroxide proliferator-activated receptor y. the receptor plays a significant role in both the glucose and lipid metabolism (Chang et al., 2013). Such compounds are found to lower blood glucose, fat weight and dyslipedi, an indication that licorice and the active amorfrutins exert their functions thought the receptors pathway. The second medicine is Dioscorea. It is also used as a Chinese traditional medicine for asthma, chronic diarrhea and ulcers. In type 2 diabetes, it can be used to improve the glycemic control and the insulin resistance. The extract plant may also be used to reduce blood glucose when it comes to high fat content in the body. The antidiabetic mechanism of Dioscera excerpt mainly revolves around the decrease of insulin resistance through the reduction of the phosphorylation of the ERK and Ps6k. It also increases the phosphorylation of the AKt and glucose transporter 4 (Frias et al., 2018).
Clinical signs and symptoms
With chronic type 2 diabetes, association of 10 years shorten life is high. In a 55 year old male who has been diagnosed with type 2 diabetes is expected to live for another 13 to 21 years whereas the overall expectancy would be about 24.7 years. Diagnosis of type 2 diabetes at about 15 years of age tends to result in a loss of about 12 years of life. At 45, the life span is drastically decreased by about 6 years whereas at 65, the lifespan is decreased by about 2 years. Some of the complications data links to type 2 diabetes includes cardiovascular disease like stroke and ischaemic heart disease. In most of the developing countries type 2 diabetes have increased the rate of hospitalization among the population. With proper and effective treatment plan, type 2 diabetes can be managed by maintaining proper lifestyle and dietary consumption. In most of the cases it has been observed product type 2 diabetes is the reason for developing kidney failure and nontraumatic blindness among the patient (Chatterjee, Khunti and Davis, 2017).
Type 2 diabetes is linked to augmented atherosclerotic cardiovascular disease and managing blood pressure, regular exercises, and smoking cessation, all of which are significant in increasing the risks of developing type 2 diabetes. The general excess mortality among individuals with type 2 diabetes is about 15% higher. However they vary. The prevalence of the vision-threatening diabetic retinopathy in states like the US is about 4% among adults living with diabetes. In the contemporary society with the pharmacotherapy for the hyperglycemia and decreasing the LDL cholesterol and managing the blood pressure with ARB therapy with aspirin and other ant hypersensitive medication in secondary prevention of the disease.
References
Barron, E., Bakhai, C., Kar, P., Weaver, A., Bradley, D., Ismail, H., Knighton, P., Holman, N., Khunti, K., Sattar, N., Wareham, N., Young, B. and Valabhji, J., 2020. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. The Lancet Diabetes & Endocrinology, 8(10), pp.813-822.
Berbudi, A., Rahmadika, N., Tjahjadi, A.I. and Ruslami, R., 2020. Type 2 diabetes and its impact on the immune system. Current diabetes reviews, 16(5), p.442.
Chatterjee, S., Khunti, K., & Davies, M. J. 2017. Type 2 diabetes. The lancet, 389(10085), 2239-2251.
Foretz, M., Guigas, B. and Viollet, B., 2019. Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus. Nature Reviews Endocrinology, 15(10), pp.569-589.
Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K.B., Ostolaza, H. and Martín, C., 2020. Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences, 21(17), p.6275.
Gurung, M., Li, Z., You, H., Rodrigues, R., Jump, D.B., Morgun, A. and Shulzhenko, N., 2020. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine, 51, p.102590.
Kaiser, A.B., Zhang, N. and DER PLUIJM, W.V., 2018. Global prevalence of type 2 diabetes over the next ten years (2018-2028). Diabetes, 67(Supplement_1).
Khan, M.A.B., Hashim, M.J., King, J.K., Govender, R.D., Mustafa, H. and Al Kaabi, J., 2020. Epidemiology of type 2 diabetes–global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), p.107.
Lascar, N., Brown, J., Pattison, H., Barnett, A. H., Bailey, C. J., & Bellary, S. 2018 Type 2 diabetes in adolescents and young adults. The lancet Diabetes & endocrinology, 6(1), 69-80.
Melson, E., Davitadze, M., Aftab, M., Ng, C. Y., Ooi, E., Blaggan, P., … & Kempegowda, P. 2020. Simulation via instant messaging-Birmingham advance (SIMBA) model helped improve clinicians’ confidence to manage cases in diabetes and endocrinology. BMC medical education, 20(1), 1-10.
Monteiro?Soares, M., Boyko, E. J., Jeffcoate, W., Mills, J. L., Russell, D., Morbach, S., & Game, F. 2020. Diabetic foot ulcer classifications: a critical review. Diabetes/metabolism research and reviews, 36, e3272.
Oguntibeju, O.O., 2019. Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. International journal of physiology, pathophysiology and pharmacology, 11(3), p.45.
Roden, M. and Shulman, G.I., 2019. The integrative biology of type 2 diabetes. Nature, 576(7785), pp.51-60.
Sacerdote, A., Dave, P., Lokshin, V. and Bahtiyar, G., 2019. Type 2 diabetes mellitus, insulin resistance, and vitamin D. Current diabetes reports, 19(10), pp.1-12.
Sami, W., Ansari, T., Butt, N. S., & Ab Hamid, M. R. 2017. Effect of diet on type 2 diabetes mellitus: A review. International journal of health sciences, 11(2), 65.
Sattar, N., Rawshani, A., Franzén, S., Rawshani, A., Svensson, A.M., Rosengren, A., McGuire, D.K., Eliasson, B. and Gudbjörnsdottir, S., 2019. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks: findings from the Swedish National Diabetes Registry. Circulation, 139(19), pp.2228-2237.
Tan, S. Y., Wong, J. L. M., Sim, Y. J., Wong, S. S., Elhassan, S. A. M., Tan, S. H., … & Candasamy, M. 2019. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes & metabolic syndrome: clinical research & reviews, 13(1), 364-372.
Wagner, R., Heni, M., Tabak, A.G., Machann, J., Schick, F., Randrianarisoa, E., Hrab? de Angelis, M., Birkenfeld, A.L., Stefan, N., Peter, A. and Häring, H.U., 2021. Pathophysiology-based subphenotyping of individuals at elevated risk for type 2 diabetes. Nature medicine, 27(1), pp.49-57.
Xu, H., & Verre, M. C. 2018. Type 2 diabetes mellitus in children. American Family Physician, 98(9), 590-594.
Zheng, Y., Ley, S.H. and Hu, F.B., 2018. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature reviews endocrinology, 14(2), pp.88-98.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
