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Diabetes type 2

Updated on November 18, 2009

Control type 2 diabetes

Insulin resistance is detectable before the onset of diabetes type 2.

Together with other signs such as accumulation of abdominal fat and increased lipid deposits in muscle tissue you may be able to slow down the onset of the disease or even avoid it altogether.

Before the onset of diabetes type 2 the body will be releasing increased amounts of insulin into the bloodstream literally to mop up the overload coming from an increased level of blood sugars.

Did you know that about 100 million people in the world are being treated for type 2 diabetes and this number is on the increase.

Insulin resistance in itself is not responsible for the onset of type 2 diabetes. Both insulin resistance and impaired secretion of insulin within the body are two factors that are required for type 2 diabetes to manifest.

Type 2 diabetes is characterized by three defects;

  • Insulin resistance
  • Failure of beta cells to secrete insulin
  • Elevated hepatic glucose production

Type 2 diabetes is also known as non insulin type diabetes.

This type of diabetes does not usually appear until adulthood but unfortunately in recent years children as young as 12 have been diagnosed due to obesity problems.

METABOLISM

Blood glucose is the fuel for human energy. The food that we eat is eventually changed into blood glucose which is transported by the bloodstream to skeletal muscle cells for storage. Once there it is readily available for the working muscle. Sometimes we provide too much energy through eating much larger portions than we need. Regardless of this it is still processed and sent in the bloodstream for storage.  We can say that two thirds of normal energy expenditure within the body is used while at rest the rest is used in more strenuous action .

Energy is produced for the body through the oxidation of fats, carbohydrates and  proteins. In our bodies energy is stored as glycogen in skeletal muscles and as triglycerides in fat cells.

After a meal insulin levels in the blood increases.

We also store glucose converted in to glycogen in the liver. When the bloods glucose levels are high the release from the liver is suppressed.   Also when blood sugar is elevated insulin will be released to assist it into appropriate cells.

What happens to metabolism in type 2 diabetes?

Over time the insulin releasing cells get tired producing to compensate for the constant rush of elevated blood sugar levels. This is called hyperglycemia. At the onset of diabetes type 2 the insulin levels in the blood are severely impaired, they are in a constant high level.

Levels that are much higher than the body can cope with. The increased level of blood sugar is also sometimes known as glucose toxicity.

INSULIN RESISTANCE

When you become resistant to the effect of insulin it affects both the skeletal muscle and liver.

Suppression of glucose from the liver means that the skeletal muscle needs much higher insulin levels in order to take up glucose into the muscle for normal functioning.

I would like to mention that Insulin resistance is not always caused by obesity it can be caused by several conditions such as  pregnancy, ageing and some infections.  However, there is a strong correlation between abdominal obesity and the total body glucose uptake.

Diabetes is a serious disease, it is subject to the development of many complications.

These complications affect large vessels such as in the heart, cerebral and those found in the peripheral circulation. In addition to this the small vessels found in the kidneys and eyes can also be affected. If this is not bad enough it can also be hazardous for nerves and other organs.

It is a bad attitude that contributes to the idea that it is ok to get diabetes nowadays because it can be treated.

Although treatment can be found and it is getting better every year I would like to say that there is no better treatment than PREVENTION.

IS IT POSSIBLE TO PREVENT DIABETES TYPE2 ?

In some cases it may be genetic but if it is related to insulin resistance which is being compensated by insulin hypersecretion with signs that beta cells are gradually being exhausted there may be a chance that the damage can be reduced. In some cases the onset of diabetes can be delayed or even prevented.

The known preventions include lifestyle changes where calorie controlled diets are followed  for reduction of weight and exercise.

A new type of oral  anti-hyperglycaemic medication is improving insulin sensitivity for many type 2 diabetic patients. This medication has also shown a positive reduction in systolic and mean arterial blood pressure. They also show vasculo- and reno-protective effects.

This once a day administered medication significantly improves glucose and lipid metabolism. With decreased proteinuria glomerular injury is prevented and this protects against diseases such as arteriosclerosis of the kidneys.

The following should be monitored on a regular basis when diabetes type 2 is diagnosed.

  • Micro-albumin levels
  • Blood pressure
  • Eye examination
  • Feet examinations
  • Lipid profiles

Your doctor will from time to time do an  test HbA1c. Ideally, every 3 months.

This test measures what your average blood glucose level (bg) has been for the last few months.

In your blood a hemoglobin molecule contains iron and carries oxygen around the body, delivering it to cells. The molecule is made in your bones, in the bone marrow, and lives for about 3 months. During it's life, glucose molecules one by one "stick" to the hemoglobin molecules. The more glucose that's in the bloodstream, the more sticks to the hemoglobin. If you remove the hemoglobin from the blood, and measure how much glucose is stuck to it, you can find out roughly how much glucose has been in the blood during the life of the molecule.

The aim is normally to get your figure near the upper end of that range. If your HbA1c is too low, near the bottom end of the reference range, it may be that your control is very good, but it's more likely that you're having far too many hypos.

A typical normal range might be 4.3%-5.9%
At this reference range, if your HbA1c is above 10%, there's plenty of room for improvement.
If it's 6.5% that's pretty good.
5.9% would be classed as excellent.

Be aware that a low HbA1c is not necessarily good. If you are having highs and lows which swing from the one to the other It may disguise the fact that you are having a lot of highs and a lot of hypos . To get best results it is also important to check blood glucose levels.

Working to have a steady blood glucose level is in the long run much healthier.

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