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Understanding Type 2 Diabetes
Diabetes doesn’t rhyme with chronic. But once the condition grabs you, it lasts for a long time, often for someone’s whole life. There are over 30 million people diagnosed with diabetes in India and an estimated 10 million people who have the condition but don’t know it. Diabetes is a condition in which the body cannot properly store and use glucose. Glucose enters the blood and is used by cells for energy. To use glucose, the human body needs a hormone called insulin that is secreted by the pancreas. Insulin is important because it allows glucose to leave the blood and enter the human body cells.
In type 2 diabetes, insulin is produced, but either it is not enough or the body cannot use the insulin adequately. This is called insulin resistance. When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells and there is high level of glucose in the blood (hyperglycemia). When glucose builds up in the blood instead of going into cells, the body’s cells are not able to function properly..
There are two main types of diabetes: type 1 diabetes and type 2 diabetes. About 90% of people with diabetes have type 2 diabetes, which used to be known as adult onset diabetes.
Some people do not have diabetes but also do not handle glucose normally. This is called impaired glucose tolerance (IGT). Up to 40% of people with IGT will eventually develop type 2 diabetes.
Why the pancreas does not make enough insulin and/or the body does not use insulin properly is still unknown. However, it is more likely to occur in people who:
- are over 45 years of age.
- are obese.
- have a family history of diabetes.
- developed gestational diabetes during a pregnancy.
- have given birth to a baby that is more than 4 kg (9 lbs).
- have high blood pressure.
- have low HDL cholesterol or high triglyceride levels.
- have IGT or impaired fasting glucose.
- are descendants from certain ethnic groups like Hispanic, Asian, South Asian, or South African.
Symptoms and Complications
Type 2 diabetes, most of the time, go undiagnosed for years or decades in many people. But as the blood sugar levels rises and the disease progresses, symptoms develop. People with type 2 diabetes may have the following signs and symptoms:
- Blurred vision.
- Decreased sensation or numbness in the hands and feet.
- Dry, itchy skin.
- Frequent bladder and vaginal infections.
- Frequent need to urinate.
- Increased thirst and hunger.
- Male impotence (erectile dysfunction).
- Sores that are slow to heal.
Problems Associated with Hyperglycemia
- Damage to the body. Over time, the high glucose levels in blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke. Damage to eyes, specifically the retina, is called diabetic retinopathy and is the leading cause of blindness. Damage to the kidneys, called diabetic nephropathy, can lead to kidney failure and the need for dialysis. Damage to the nerves that supply the legs and arms and gastrointestinal tract is called diabetic neuropathy. Some people with diabetes who develop peripheral neuropathy (damage to the nerves in the legs) and have poor blood flow to the legs may eventually need an amputation.
- Dehydration. The buildup of sugar in the blood can cause an increase in urination. When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration.
- Diabetic coma. When a person with type 2 diabetes becomes very ill or severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication. They become confused, dizzy, and have seizures. This can lead to a condition called non-ketonic hyperosmolar coma and requires immediate medical attention.
Fortunately, the complications of diabetes can be prevented, delayed, or slowed by controlling blood glucose levels to as close to the normal range as possible.
Diagnosing Type 2 Diabetes
Your doctor will check for abnormalities in your blood (high blood glucose level) during a random fasting blood test or through a screening test known as the 2-hour glucose tolerance test. Or you may get a blood test called a hemoglobin A1C that reflects your average blood sugar for the past 2 to 3 days. In addition, he or she may look for glucose or ketone bodies in your urine.
Treatment & Prevention
Though weight control, diet, and exercise are all important components of management of type 2 diabetes, the most important treatment is nutritional.
An overwhelming 90% of people with type 2 diabetes are obese. So, losing weight, even 2 kg to 5 kg (5 lbs to 10 lbs) can help lower blood glucose levels. For many, lifestyle changes like following a healthy diet and an exercise program can help control glucose levels.
Others may need to take medications in order to keep glucose levels within a healthy range. Medications for type 2 diabetes are usually taken by mouth in the form of tablets and should always be taken around meal times as prescribed by the doctor. If it is not controlled by oral medications, a doctor may recommend insulin injections also.
- Diet: It is important to eat regularly three times a day. Special diabetic foods aren’t necessary for a healthy diet; you just need to eat a balanced diet that is low in saturated fat, sugar and salt, and high in fiber, vegetables and fruits. Include carbohydrates, such as pasta, potatoes or sugary foods such as fruit in each meal. A dietitian can help you design a healthy eating plan.
- Exercise: Exercise promotes good circulation and will help you stay at an optimal weight. At least half an hour of moderate activity for five days a week can help you lose weight.
- Smoking: Smoking is unhealthy for everyone, but quitting is especially important for people with diabetes. This is because you already have an increased chance of developing cardiovascular disease or circulatory problems. Smoking makes the chances of developing these diseases even greater.
- Alcohol: There is no need to give up alcohol completely, but it’s important to drink sensibly. It is recommended to drink no more than two standard drinks each day. However, don’t drink on an empty stomach – eat food containing carbohydrate before and after drinking and monitor your blood glucose levels regularly.
- Care your Foot: Poor circulation and nerve damage caused by diabetes reduce sensitivity in the feet. It is important to check your feet regularly, looking for any blisters, cuts, or sores. Always keep your feet clean and dry and protect them by wearing socks and comfortable shoes.
- Care your Eye: Eye problems due to diabetes can lead to blindness. Therefore, have your eyes checked by an eye doctor at least once a year.
- Care your Skin: Hyperglycemia lead to skin problems such as slow healing after an injury or frequent infections. Make sure to wash every day with a mild soap and warm water, protect your skin by using sunscreen, take good care of any cuts or scrapes with proper cleansing and bandaging, and see your doctor when cuts heal slowly or if an infection develops.
Stay healthy, adopt an active lifestyle, and stay away from long-term complications.
Image courtesy : page2anesthesiology.org