Background information
Type 2 diabetes is one of the killer conditions according to the World Health Organization statistics. This condition is a component of an array of dysfunction which has a hypoglycemia as its primary character and is a product of combined resistivity to inappropriate glucose secretion, insulin actions and the less secretion of insulin. The neuropathic complication, macrovascular and microvascular are the well-known arrays associated with poorly controlled type 2 diabetes. There are some complications which are related to microvascular which are associate of the type 2 diabetes. These are inclusive of the possibility of neuropathic disorder, retinal complication and the renal disorders. On the other hand, the difficulty brought about by the macrovascular is inclusive of the peripheral vascular condition as well as coronary artery disease. Diabetic neuropathy is a condition which is mostly associated with autonomic and peripheral nerve disorders.
One issue worth noting is that the patient with diabetes type 2 is much different from the patient who has diabetes type 1. In the case of the patient who has the diabetes type 2, they are not dependent on insulin for life like the patient suffering from diabetes type 1 does. In fact, this dependency brought about the distinction of terms that is the type 1 and type 2 of diabetes, which refers to insulin dependents and none insulin dependents. However, the main approaches to treatments of diabetes type 2 remain to be insulin. The rationale is that the patients still have the ability to secret some endogenous insulin, these means that they require the insulin but does not entirely depend on it. The older terms for the diabetes type 1 and type 2 were abandoned due to confusion based on treatment classification rather than etiological classification. There were other words which were given to the diabetes type 2. One such term was the adult- onset diabetes (Morris et al., 2012). These terms were granted to the condition after Epidemiology revealed that it was inactive in children. There was a concern also for this name since, the condition is known for affecting mostly adults especially those above the forty years mark, however, in some circumstances, and children have been diagnosed with the diabetes type 2. In fact, the latest epidemiology data from the center for disease and control put the diabetes type 2 above that of debates type 1 among children in regards to diagnosis.
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The management of the diabetes mellitus type 2 is very critical since it is a chronic infection and it requires a long term attention in order to reduce its complication and development impulse. Moreover, the management and treatment of this disease are not a chicken feed; it is costly to manage and to inhibit its development and the devastating complication which is associated with it. This article focuses on the Pathophysiology and the basics of the diabetes type 2. The cause, as well as the treatment of this condition, will be put under the microscope. This article will rely heavily on the peer review research on the same condition.
Pathophysiology
The type 2 diabetes is components of the combination of the inadequate insulin secretion by some cells known as the beta cells and the peripheral insulin resistivity. The insulin resistivity is attributed to increased fatty acids and the plasma proinflammatory cytokines; it is this resistivity which reduces the transport of the glucose to the cells. Moreover, it enhances the breakdown of the fats and also increases or improves the production of the hepatic glucose. On the other hand, glucagon plays a critical role in these situations, for instance, this condition is the paracrinopathy islet where the reciprocal relationship between the insulin secreting beta cells and the alpha cells of the glucagon secretion are lost ( Nolan et al., 2011). The loss of this reciprocal relationship results to a condition known as the hyperglucagonemia which is a consequent of the hyperglycemia. There must be an existence of both insulin resistances a well as the less secretion of the insulin for the type 2 diabetes to be in existence. A good example to illustrate this point is that the overweight individuals in the world have insulin resistance, however; those who are unable to sufficiently increase insulin secretion to compensate for the resistance of insulin develop diabetes. The rationale is that these individuals may have high insulin concentration in their body; however, it can be inappropriately low for the glycemia level. The image below depicts simplified scheme of the Pathophysiology of the diabetes mellitus type 2.
It has been noted that the persistence of the diabetes type 2 may cause a condition in the pancreases called atrophy.
Beta cell dysfunction
One of the major factors across the spectrum of diabetes' pre diabetes is the beta cell malfunctions. The research has confirmed that for both adults and children, beta cells dysfunctions do not follow the insulin resistance stage as they develop in the early stages of the pathologic process. There is always a term which has been used to refer to the insulin resistance as the "be all and end all", this term is seems to be on a declining trend, and there is a hope that soon or later, the better approach of addressing the better cell pathology will emerge.
Insulin resistance
The postprandial blood level of the blood glucose is normal increased first in the progression from normal to the glucose intolerance abnormalities. As it progresses, there is a development of the fasting hyperglycemia as a failure of the suppression of the herpetic gluconeogenesis is noted. During the insulin resistance induction, for instance, the occurrence of the high-calorie diet, steroid administration and others, there is an increase in glucagon levels. Alternatively, there is an increase in the insulineotropic polypeptides which are all glucose dependents, and it accompanies glucose intolerance ( Kahn et al., 2014). However, it is worth noting that during this entire process, there is no alteration of the postprandial glucagon like a peptide-1 response.
Genomic factors
There are a wide variety of the genetic variants which have been identified by the Genome –Wide association studies of the single nucleotide polymorphisms, which they claim are associated with the beta cell functions and the insulin resistance. Within the variants identified, there are genomes which are suspected to be increasing the risk to the disease. Alternatively, there are over forty loci which have been turned towards demonstrating the risk, and the result shown is always positive. Examples are as follows. First, there is decreased in responsiveness of the beta cells. This leads to impaired insulin processing as well as reduced in the insulin production. Alternatively, there is a little early release of the insulin which is stimulated by the glucose. The third is the unsaturated fatty acid metabolism alteration, deregulation of the metabolism of the fat and the inhibition of the serum glucose release. The fourth is the increased adiposity and increase resistivity in insulin; also, there is control of the pancreatic structure developments which are inclusive of the beta cells islet. Lastly, there are beta cells functions and the survival as well as the transport of the zinc onto the beta cells islet. This influences insulin production as well as the secretions.
The incretin hormone genetic variant is also pointed out to be factors which affect the susceptibility of the type 2 diabetes. This hormone is released from the endocrine cells which are located in the gut system, and it is responsible for the stimulation of the secretion of insulin in response to the food digestions. A good example is that the variant of the in the genes which are associated with coding for the receptor of the gastric inhibitory peptides has been linked the reductions of the of the beta cell functions ( D’Adamo & Caprio, 2011). The group A1 proteins have a mobility character. This makes them become fundamental regulators of the insulin gene raptors. This function variant of the gene has been associated with the enhancement of the type 2 diabetes.
Diabetes mellitus type 2: The basics
The causes of the condition
The cause the type 2 diabetes is tied to a hormone called insulin which is produced by small organs in the body called the pancreases this hormone functions to aid in the conversation of food to energy in the body. There is what is known as the insulin resistance, and this is what responsible for the cause of the type 2 diabetes. It means that a patient diagnosed with the type 2 diabetes has insulin, and their bodies make the hormones. However, there don't use it appropriately or the way it is supposed to be used. Firstly, the pancreases make a lot of insulin hormones to be utilized in the body. The more the insulin in the body, the more glucose circulation, the insulin then tries to force the glucose into the cells for its proper function. However, those who suffer from the disease have a way of resisting to this force or the hormones, this leads to the accumulation of the unused sugar in the body hence leading to the diabetes. There are several causes of this condition. In this part of the paper, some of the causes are discussed.
The first cause of the diabetes type 2 is the Genes. There is scientific evidence which shows that there are some genome replications which inhibits or increases the functions of the insulin hormones and hence causes the type 2 diabetes. Another causation factor for the diseases is the increased weight. There has been researching which has shown that insulin resistance is caused by the increased weight or obesity mostly for those who have a large pound of weight in their middle. There is a condition known as the child hood obesity which is the increased weight of on children; this is the sole cause of the type 2 diabetes among the kids. There is also a condition which is known as the metabolic syndrome. This is some of the conditions which individuals who experience what is called the insulin resistance face. They are inclusive of high blood glucose level, high blood pressure; there is also an extra fat around the waist, high cholesterol and there is called the triglyceride. Another cause of the condition is the inadequate communication between the cells. In many occasion, cells send wrong signals or receive false information from others. The scientist has sensed that in case the cells which control the insulin hormones send or receive bad signal, it may cause the type 2 diabetes. Alternatively, high glucose concentration in the liver is also a cause of the diabetes type 2. In case the blood sugar is low, the liver functions to aid also of the glucose in the blood. After having a meal, the blood sugar level increases. It is the role of the liver to have this condition, or the sugar slowed down to normality. However, in some individuals, the liver fails to perform this standard function, this means that such people accumulate a lot of sugar in their body hence lead to diabetes. The last cause of this condition is the damaged beta cells. The blood sugar is frequently thrown off in case the cells which are responsible for the insulin hormones control sends out or receive a wrong signal or wrong amount of the hormone at incorrect time or duration. High blood glucose is often associated with the damage of the beta cells and hence can cause the condition called the diabetes type 2.
Risk factors and the prevention of diabetes type 2
There are issues which make an individual be in apposition of getting the type 2 diabetes. This element cannot be controlled by any means. They are inclusive of age factors that are being at the age which is vulnerable to the disease; there is also the genetic inheritance from the family and also ethnicity. On the other side, there are factors which relate to the individual health, and they put such person in a position to get the disease. These factors can be controlled and hence can help in preventing the condition. These factors are inclusive of the heart and blood vessels conditions; there is pre diabetes, and here is also low cholesterol. Others are the control and monitoring of the treated high blood pressures, an increased amount of the triglycerides, prevention of the obesity or overweight both adults and children, depression, and many others. There are other risk factors which are pointed out to be the principal associates of the diabetes type 2 conditions. These risk factors are associated with the individual habits and the lifestyle of the person. This condition can be controlled and if well put under control; they can help in preventing this disease. The state is inclusive but not limited to sleeping too little or too much, there is the stress, there is smoking and lastly, getting little or no exercise. In art shell, there are conditions which can be put in action or under control to help in preventing this disease. The first one is the weight loss. An individual should try to drop weight to prevent the type 2 diabetes. The second is to get active. The scientific research has shown that insulin is used when muscles are moved. People should get active and involve in a lot of exercises to help in the utilization of the insulin. Alternatively, the eating habit is very paramount when it comes to the diabetes control. One should avoid drinking or eat sugary substances. This will only put one in more risky position than enhancing solutions.
Symptoms of the condition
There is one issue which many scientist and scholars are pointing out on the type 2 diabetes. This issue is that this disease often goes unnoticed by many people. This has to lead to it’s under diagnosis is since its signs and symptoms are mild. The research from the Centre for disease control has it that almost eight million individuals have this disease yet they are not aware. There this part of the paper will major on some of the symptoms to help those who may not know the signs of the disease as well as those who suffer from it. The first sign of this disease is extreme thirst and urge to drink a lot of water. This is due to o high concentration of the sugar level in the body. The second symptom is the sensation of peeing. Another well-known sign of the diseases is the blurry vision. Extreme irritation is also another sign which many people who suffer from this disease have confessed to having experience. Moreover, these individuals often experience tingling or numbness of feet and hands. There is also the yeast infection which is perennial, and also wounds which don't heal are some of its signs. Lastly, these individuals are often tied and feel worn out most of the time.
Diagnosis of the type 2 diabetes
The doctors often test the blood for the signs of this condition. There is always a confirmation test in case the first taste reveals less sugar concentration in the blood. In case one has high blood level, or in case, the same person shows a lot of signs of diabetes, then one test is enough. These are some of the key terms during the diagnosis. The first one is the oral glucose tolerance test, fasting plasma glucose and others.
Medication, treatment option, management and follow-up for the diabetes type 2
There are many options for treating this condition. The first option is a healthy eating habit. Many people have been told that there is a particular diet they should follow; however, this is not true according to some scientist perceptions. However, individuals who suffer from this condition should eat of fabric food and food with low fat content. These are inclusive of the fruits, vegetables and whole grains. Alternative food is the low glycemia index food. The glycemia is the measure of the rate at which food causes the rise of sugar in the blood. For this reason, low glycemia index diet help in reducing the small
Another treatment option for this disease is the physical activity. Every individual need to exercises and those individual who have type 2 diabetes are a necessity for this since it is one of the medication for the disease. In this case, the doctors’ attention should be sought then one should involve in physical activates they enjoy most. These are inclusive of swimming, walking, stretching, and biking. The combination of exercises such as walking, weightlifting, acrobatic is all geared towards treatment of this condition. The combination is very effective since they help in putting blood sugar level under control more than if it is used singly.
The next treatment option is the control of the blood sugar level. This very effective mostly in monitoring and managing this disease .constant surveillance of the blood sugar level is very efficient follow-up treatment, and it can be used in combination with the treatment plan. This help in ensuring that the blood sugar level remains within the target.
The last medication option in the list is the using the pharmacological drugs and the insulin therapy. These are inclusive of the utilization of the Metformin which is often the first prescription for this disease. It acts to lower the glucose production in the liver. Another drug is the sulfonylurea which is a medication which will boost the insulin hormone secretion in the body. An example is the DiaBeta as asserted by Herder and Roden (2011). An alternative drug is the Meglitinides, DPP-4 inhibitors and others. This is the best approach in my perspective is it is not only good for the those who have mild type 2 diabetes, but it is also important for those who have severe or acute type 2 diabetes. The follow-up treatment or management is often done by the doctors and the physical therapist that help the patients to manage their conditions.
Conclusion
The paper has majored on the diabetes type 2. The condition has been majored on in regards to its Pathophysiology, cause as well as treatment options. The paper has used a variety of the peer reviewed scholar articles from well-known scholars and hence has provided a comprehensive analysis of this disease.
References
D’Adamo, E., & Caprio, S. (2011). Type 2 diabetes in youth: epidemiology and pathophysiology. Diabetes care , 34 (Supplement 2), S161-S165.
Herder, C., & Roden, M. (2011). Genetics of type 2 diabetes: pathophysiologic and clinical relevance. European journal of clinical investigation , 41 (6), 679-692.
Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. The Lancet , 383 (9922), 1068-1083.
Morris, A. P., Voight, B. F., Teslovich, T. M., Ferreira, T., Segre, A. V., Steinthorsdottir, V., ... & Prokopenko, I. (2012). Large-scale association analysis provides insights into the genetic architecture and pathophysiology of type 2 diabetes. Nature genetics , 44 (9), 981.
Nolan, C. J., Damm, P., & Prentki, M. (2011). Type 2 diabetes across generations: from pathophysiology to prevention and management. The Lancet , 378 (9786), 169-181.
