Understanding Diabetes Mellitus Type 2: Risk Factors, Prevention, And Burdens

What Is Diabetes Mellitus Type 2?

Discuss about the Epidemiology of Diabetes Mellitus Type for Insulin Resistance.

Diabetes mellitus type 2 is also referred to as non-insulin dependent, type 2 diabetes or adult onset of diabetes. It presents with high blood sugar, insulin resistance or lack of insulin production by the pancreas. Diabetes mellitus type two contributes to 90% of cases of diabetes; type 1 diabetes contributes to the remaining 10% of the disease burden to the population. Chances of developing this condition are attributed to obesity, unhealthy lifestyle, and inactivity which may cause obesity. There has been a positive genetic link to the development of type 2 diabetes mellitus; therefore, the risk to developing this condition is associated with increased age, obesity, inactivity, unhealthy lifestyle practices and a positive genetic link (1).

Diabetes mellitus present with unexplained weight loss, frequent urination and increased thirst. Diabetes mellitus type 2 leads to so many complications if not controlled (2). The complications result from a long-term hyperglycemic state which leads to diabetic retinopathy resulting to blindness, diabetic nephropathy; leading to kidney failure, and diabetic neuropathy. In amputations the hyperglycemic state makes it impossible for wounds to heal. A state of hyperglycemia results to the alteration of the normal glycemic state and this alteration may result to a number of complications. Diabetes mellitus type 2 is diagnosed after a series of random blood sugar check-ups; a random blood sugar is taken to determine the resting blood sugar levels of a person and fasting blood sugar to determine the patency of the pancreas to produce enough insulin to breakdown glucose in blood after a meal.

Diabetes mellitus type 2 sets in gradually, such that a person may be predisposed to the risks, but the condition sets in later in life. The rate of onset of diabetes mellitus has been on the rise. Typically; diabetes type 2 is mostly described in the old adult, but research shows that currently the rate of diabetes in young adults has been on the rise. In 2015 392 million people were diagnosed with diabetes as opposed to 30 million people diagnosed with the same condition in 1985. The rate of developing diabetes mellitus has been on the rise, diabetes mellitus type 2 is not only restricted to the old people, but young adults too (3).

Diabetes mellitus type 2 is a preventable chronic condition. It can be prevented through regular exercise, and eating nutritionally health food, these two factors helps a person maintain a normal basal mass index; therefore decreasing the chances of developing obesity which is a major contributory factor to obesity (3). Obesity can be successfully prevented even in the people who are genetically exposed; however, if a person develops diabetes mellitus type 2 regardless of taking the preventive measures to normalize their blood sugar levels, they are treated with artificial insulin to help normalize their blood sugar levels (2). 

Complications of Diabetes Mellitus Type 2

Diabetes mellitus type 2 is associated with many other morbidities, this has led to aggressive campaigns promoting the prevention of diabetes. Most of the mortality associated with diabetes is attributed to its complications and not the high blood sugar state. This implies that a high blood sugar results in an altered homeostatic state which leads to the complications associated with diabetes mellitus and the morbidity and mortality that result from high blood sugar (3). Numerous studies have been conducted about diabetes mellitus type two, its etiology, risk factors, prevention approach. Prevention of this condition is the best option in preventing the morbidity and mortality associated with diabetes mellitus type 2 (1). 

Type 2 diabetes mellitus has become a major public health burden because of the increased incidence rate. In Australia type 2 diabetes mellitus is linked to a reduced life expectancy. Analysis conducted between the year 2009 and 2014 shows an increased rate of mortality by 10% for people suffering from type 2 diabetes mellitus. This condition is also attributed to major health concerns because of the increased complication that results from type 2 diabetes mellitus. Diabetic neuropathy, diabetic foot ulcer, amputation of the lower limps and vision impairments are the major morbidities caused by; diabetes mellitus type 2 in Australia (4).

His condition is a burden which not only affects Australians, but also other regions of the world; therefore, making it a major public health concern to the whole world because of the debilitating complications associated with diabetes mellitus type 2. Lower limp amputations associated with diabetes have resulted to a major health problem because of the disability caused by the amputations. This creates extra financial burdens to families and the government at large because the number of disabled people goes high. Such statistics show that there is an increased financial burden caused by diabetes mellitus type 2 to the government and increased physical burden to caregivers.

In Australia; the impact of type 2 diabetes mellitus on kidney disease is on the rise. Type 2 diabetes mellitus is risk factor for developing chronic kidney disease; same applies to lower limb amputation whereby 1.7% of the patients with amputated legs are diabetic patients with more patients suffering from type 2 diabetes mellitus. In Australia the highest number of insulin consumers and other blood glucose lowering agents are patients suffering from type 2 diabetes mellitus.

According to statistics it shows that, there is an increase in the financial burden, physical burden, and emotional burden of diabetes mellitus type 2 to the population. Financial burden is accrued because of the constant insulin medication which diabetic patients have to purchase. Emotional burden is acquired due to the stigma associated with diabetes and its complications. Physical burden is mostly experienced by care givers especially family members and the diabetic person (3). These different forms of burden as a result of diabetes mellitus type 2 are a clear indicator that diabetes is a public health concern because it affects every person regardless of their age or socioeconomic status; therefore, aggressive campaigns on the preventive measures, blood sugar screening and risk factors associated with; diabetes mellitus is an important step in preventing the morbidity and mortality associated with the condition (5).

Diagnosis of Diabetes Mellitus Type 2

Age above 45 years, an increase in age predisposes a person to the development of this condition..

A positive family history of diabetes mellitus type 2 is another contributing factor to the development of diabetes mellitus type 2 apart from age.

Race; the racial background of a person determines if the person will get diabetes mellitus type 2. The race that is most likely to develop diabetes mellitus type 2 is African- American, Hispanic, Asian-American, Pacific highlanders, Native Hawaiian and American-Indians.

Low levels of high density lipoproteins (HDLs). Low levels of HDLs leads to the accumulation of Low density lipoproteins (LDLs), which may result in obesity and obesity is directly linked to developing diabetes mellitus type 2 (1).

Hypertension; which refers to high blood pressure predisposes a person to the risk of developing diabetes mellitus type 2 (4).

Gestational diabetes; this is another risk factor for developing this condition. Pregnant women who experience gestational diabetes which resolves after pregnancy are at a higher risk of developing diabetes; therefore they are encouraged to go for regular random blood sugar checks.

The risk factors associated with diabetes are modifiable factors with an exception of gestational diabetes and genetics or a positive familiar history. Modifiable factors are factors which can be avoided. It is the duty of the department of public health to create awareness for the risk factors associated with diabetes mellitus type 2 in order to decrease the number of cases reported. 

In a randomized study published in the PMC journals, they studied the treatment and occurrence of diabetes mellitus type 2 in children and young adults. As it is widely known this condition only affects the old people but recent research indicates otherwise. This put great emphasis on the primary prevention of non-insulin dependent diabetes mellitus because of its onset in the young population. Primary prevention implies that lifestyle modification and blood sugar checks should be started at a young age to minimize the risk of the young population developing type 2 diabetes mellitus in adulthood or old age (1).

In another study published in the journal for diabetes care about early and late prevention strategies for diabetes, supported the argument that the adoption of early preventive measures for diabetes mellitus type 2, helps in the prevention of this disease. The study indicated that to successfully prevent the occurrence of chronic conditions such as type 2 diabetes mellitus; the alteration of the modifiable factors that influence the occurrence of chronic diseases should be the prime preventive strategy for this condition is caused by modifiable factors such as unhealthy lifestyle which is made up of unhealthy eating habits and lack of exercise which contributes to the occurrence of obesity (2).

Another study published in the PMC journals also emphasized on the prevention of this condition because of the increasing incidence rate of the condition and the public health burden it is imposing on the population. This study led to the recommendation of a healthier lifestyle and a more active lifestyle which aide with the prevention of such a condition. The study explored different ways of implementing the preventive strategies and taxation was one of the strategies. Tax is levied on alcohol and tobacco which are associated with the development of hypertension. Hypertension is a risk factor for development of the condition under study; alcohol and tobacco are known to increase the chances of developing hypertension, which may result in the development such a disease. eventually. Imposing tax on these items is a strategy to reduce the consumption of alcohol and tobacco, because increased tax results in increased prices making alcohol and tobacco expensive (3).

Effective management and prevention of type 2 diabetes mellitus is necessary for the prevention of morbidity and mortality associated with this disease. 

Most of the studies conducted indicated that there are no arguments against the preventive approach used for type 2 diabetes mellitus. The lack of arguments is attributed to the increasing incidence rate of diabetes mellitus type 2 and the increasing financial burden to the community, the government and the affected individuals. The increasing incidence rate of diabetes mellitus type 2 has prompted research and epidemiologists to conduct more studies with the aim of isolating the risk factors, the most effective preventive measures and the treatments modalities for this illness.

There are no scientifically proven arguments against studies conducted on the risk factors, preventive measures or treatment modality for diabetes mellitus type 2; however there are changes in the treatment regimen, where by there are long acting and short acting blood sugar reducing agents that are used in differently (6).

Conclusion

Diabetes mellitus type 2 is a global burden that can be prevented through lifestyle modification, and frequent blood sugar screening (16). There has been an increasing incidence rate and currently diabetes mellitus type 2 is not restricted to old age because it can affect young adults and children too; therefore sensitization and aggressive campaigns are required to promote primary health education about diabetes mellitus type 2.

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