Diabetes Mellitus | Type 2 | Sign & Symptoms | Investigation | Treatment | Prevention |By Dr Tuqeer
In type 2 diabetes, there are primarily two problems. The pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into the cells. And cells respond poorly to insulin and take in less sugar.
Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults. But the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.
There's no cure for type 2 diabetes. Losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to control blood sugar, diabetes medications or insulin therapy may be recommended.
Symptoms
Symptoms of type 2 diabetes often develop slowly. In fact, you can be living with type 2 diabetes for years and not know it. When symptoms are present, they may include:
Increased thirst.
Frequent urination.
Increased hunger.
Unintended weight loss.
Fatigue.
Blurred vision.
Slow-healing sores.
Frequent infections.
Numbness or tingling in the hands or feet.
Areas of darkened skin, usually in the armpits and neck.
Causes
Type 2 diabetes is mainly the result of two problems:
Cells in muscle, fat and the liver become resistant to insulin As a result, the cells don't take in enough sugar.
The pancreas can't make enough insulin to keep blood sugar levels within a healthy range.
Exactly why this happens is not known. Being overweight and inactive are key contributing factors.
How insulin works
Insulin is a hormone that comes from the pancreas — a gland located behind and below the stomach. Insulin controls how the body uses sugar in the following ways:
Sugar in the bloodstream triggers the pancreas to release insulin.
Insulin circulates in the bloodstream, enabling sugar to enter the cells.
The amount of sugar in the bloodstream drops.
In response to this drop, the pancreas releases less insulin.
The role of glucose
Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues. The use and regulation of glucose includes the following:
Glucose comes from two major sources: food and the liver.
Glucose is absorbed into the bloodstream, where it enters cells with the help of insulin.
The liver stores and makes glucose.
When glucose levels are low, the liver breaks down stored glycogen into glucose to keep the body's glucose level within a healthy range.
In type 2 diabetes, this process doesn't work well. Instead of moving into the cells, sugar builds up in the blood. As blood sugar levels rise, the pancreas releases more insulin. Eventually the cells in the pancreas that make insulin become damaged and can't make enough insulin to meet the body's needs.
Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels, a condition called atherosclerosis.
Nerve damage in limbs. This condition is called neuropathy. High blood sugar over time can damage or destroy nerves. That may result in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.
Other nerve damage. Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. Nerve damage also may cause erectile dysfunction.
Kidney disease. Diabetes may lead to chronic kidney disease or end-stage kidney disease that can't be reversed. That may require dialysis or a kidney transplant.
Eye damage. Diabetes increases the risk of serious eye diseases, such as cataracts and glaucoma, and may damage the blood vessels of the retina, potentially leading to blindness.
Skin conditions. Diabetes may raise the risk of some skin problems, including bacterial and fungal infections.
Slow healing. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation.
Hearing impairment. Hearing problems are more common in people with diabetes.
Sleep apnea. Obstructive sleep apnea is common in people living with type 2 diabetes. Obesity may be the main contributing factor to both conditions.
Dementia. Type 2 diabetes seems to increase the risk of Alzheimer's disease and other disorders that cause dementia. Poor control of blood sugar is linked to a more rapid decline in memory and other thinking skills.
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