Type II Diabetes: Diagnosis and Prevention

Type 2 diabetes, a type of diabetes mellitus, is the most common form of diabetes and also the most common endocrine disorder (Tortora, 2005). Diabetes mellitus harms the cardiovascular system and is consequentially the fourth leading cause of death by disease in the United States. Diabetes is caused by an inability to produce or use insulin. In a healthy human being, insulin is used to transport glucose into body cells. Those affected by diabetes mellitus have high levels of blood glucose and some of this glucose ends up being deposited in the urine.

There are three common ways of identifying diabetes mellitus, which are called the three “polys.” Polyuria may indicate diabetes mellitus, which is when the body produces excessive urine due to the kidneys’ inability to reabsorb water. A diabetic person may also experience excessive thirst (polydipsia) and excessive eating (polyphagia) (Tortora, 2005). Symptoms specific to type 2 diabetes are increased thirst, increased hunger, increase urination (especially at night), fatigue, weight loss, blurred vision, and sores that do not heal (American Heart Association, 2007). Type 2 diabetes symptoms are milder than type 1 diabetes and can be controlled in many patients by exercising, eating the proper diet, and losing weight (Tortora, 2005). Type 2 diabetes is diagnosed by analyzing blood glucose levels in a fasting environment where glucose levels are greater than 125mg/dL (Toth, 2007). Levels must exceed 200mg/dL in a random blood test to indicate type 2 diabetes.

Type 2 diabetes is also known as non-insulin-dependent diabetes mellitus and is more common than type 1 diabetes (Tortora, 2005). While diabetes is caused by both environmental and genetic factors, type 2 diabetes generally affects people who are obese and over the age of 35. While this is true in most cases, none of the relatives in my family who were diagnosed with diabetes were obese. The American Heart Association states that about 50% of men and 70% of women who have diabetes are obese. Type 2 diabetes is also more common among those who have chronic high blood pressure and live a sedentary lifestyle (American Heart Association, 07/22/07). Certain ethnic groups are more prone to type 2 diabetes, such as African Americans, Latino/Hispanic Americans, Native Americans, Asian Americans and Pacific Islanders.

Most type 2 diabetics have a sufficient amount of insulin in their blood, unlike type 1 diabetics that just do not produce enough insulin (Tortora, 2005). Insulin is a hormone and is produced my pancreatic beta cells. Secretion is stimulated by the increased blood level of glucose and its presence in the blood normally lowers blood glucose by accelerating the transport of glucose into the cells. Insulin also acts to convert glucose into glycogen and stimulate protein synthesis. In a diabetic person, this process is inhibited. Target cells can become desensitized to insulin and insulin receptors are down regulated. This results in excess glucose in the blood and a paucity of glucose in the cells.

Aside from environmental causes of type 2 diabetes, such as lack of physical exercise and overeating, individuals may experience a genetic predisposition. These defects can be broken down into genetic defects associated with a beta islet-cell dysfunction and genetic defects associated with insulin resistance. One may have a genetic mutation in the insulin receptor gene that causes diabetes. There are also several genetic diseases that are associated with diabetes such as Down syndrome, Klinefelter's syndrome, Turner's syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Friedreich's ataxia, Huntington's chorea, Hemochromatosis, and Porphyria. Clearly, there is a large genetic component that predisposes individuals to type 2 diabetes.

Treatment of type 2 diabetes ranges from lifestyle changes to drug therapy. The American Diabetes Association suggests that Metformin should be administered immediately upon diagnosis (Toth, 2007). This medication is given to reduce HbA1c levels to less than 7%. HbA1c is a test that measures the amount of glycosylated hemoglobin in your blood (Hurd, 2007). Glycosylated hemoglobin is a molecule in red blood cells that attaches to glucose and high prevalence of this protein may indicate that insulin is not doing its job properly. Complementary therapies include biotin, chromium, and essential fatty acid supplements (Toth, 2007). Once diagnosed, doctors will generally recommend an aerobic exercise program that is 20-60 minutes three to five times per week and daily blood glucose testing. Doctors will also educate patients about proper foot hygiene and footwear to prevent swelling.

There are many ways to prevent type 2 diabetes. Avoiding the specified behaviors that are linked with type 2 diabetes is the most accepted way of preventing this disease, including maintaining an active lifestyle, following a proper diet that is not too high in carbohydrates, and keeping a low blood pressure. More specifically, foods rich in nonstarch polysaccharides and carbohydrate foods with a low glycemic index appear to protect against the development of type 2 diabetes (Toth, 2007).

References:

Hurd, Robert, MD. “HbAc1.” US National Library of Medicine. Updated 04/26/2007. Accessed 02/15/2008. http://www.nlm.nih.gov/medlineplus/ency/article/003640.htm

Tortora, J. (2005). Principles of Human Anatomy. Hoboken, NJ: John Wiley & Sons,Inc.

Toth, David W., MD. “Diabetes mellitus type 2 in adults.”

MD Consult.Updated August 24, 2007. Accessed 02/15/2008. http://www.mdconsult.com/das/pdxmd/body/880694953/674267989?type=med&eid=9-u1.0-_1_mt_1014721#Contributors

“Type 2 Diabetes.” American Heart Association. Updated 07/22/2007. Accessed 02/15/2008. http://www.americanheart.org/presenter.jhtml?identifier=3044759

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