Wednesday, February 09, 2011

Type 2 diabetes

Let's talk about Type 2 Diabetes.  It used to be called non insulin dependent diabetes, late onset diabetes, or adult onset diabetes, but the one thing that is sure, it is the inability of the body to metabolize sugar or glucose which is the body's main source of fuel.
The body requires insulin to regulate the sugar into your cells.  When this regulation is disrupted, one needs treatment to correct it, or life threatening results can occur over time.
At the moment, there is no cure for Type 2 diabetes, but it can be treated and managed so that it does not progress causing complications.  Eating healthy foods, exercising, and weight control are critical in that management.
When I was in nursing school, they taught us the 3 cardinal symptoms of diabetes;
1. Polydipsia- excessive thirst~ as excess sugar is released into the bloodstream, it pulls fluids out of the tissues triggering thirst.
2. Polyuria- elimination of large amounts of urine
3. Polyphagia- excessive hunger.~Muscles and organs are depleted of glucose since it's not being absorbed into cells, causing the body to want to consume food to correct it.  But the foods aren't able to get there because of the misregulation of insulin.
There are other symptoms-
*Some people lose weight as glucose is eliminated from the body in urine.
* When cells are deprived of sugar, the body becomes very tired and many times irritable.
*Because fluid is being drawn out of organs and into the bloodstream, the eyes are affected and blurring of vision can occur.
* Sores don't heal and become infected more easily than the normal person . 
*Acanthosis nigricans is the term given to the brownish velvety skin discoloration usually found in the armpit and neck areas- it's a sign of insulin resistance.
Type 2 diabetes occurs when the body developes insulin resistance or when the pancreas stops producing insulin.  It is not known why this occurs, but contributing factors may be overweight and inactivity.
Insulin is produced by the pancreas.  When you eat, the pancreas releases insulin to open the cells to permit glucose to enter.  As the blood levels of sugar drops, so does the amount of insulin secreted by the pancreas.
Glucose is the main source of energy for body cells.  It comes from either food you eat or the liver produces it.
There are certain factors that increase the risk of developing Type 2 diabetes:
*Obesity- the more fat cells you have, the more resistant to insulin you become
*Family history
*Prediabetes-a condition where blood sugars rise, but not enough to diagnose as diabetes- it often leads to it however.
* Gestational diabetics carry more risk later in life.

Complications if left untreated even in the early stage of Type 2 diabetes can be life threatening.  Many organ systems are involved including eyes, heart, blood vessels, nerves, and kidneys.  Skin and mouth fungal infections can occur as well as osteoporosis and hearing problems.   Recently it has been connected to Alzheimers.

Testing to make the diagnosis or follow the treatment :
*Glycohemoglobin or A1c is a test done that averages your blood sugar for the past 2-3 months.  It measures the amount of glucose attached to hemoglobin on your red blood cells.  6.5 or higher indicates type 2 diabetes.
* Random glucose levels of 200 or more indicate diabetes.
*Fasting glucose levels should be 100 or below.  Up to 125 is diagnosed as prediabetes.  Over 125 fasting is Type 2 diabetes.
* Glucose Tolerance Test can also be done

What can be done?  What treatments are available?
Daily glucose monitoring with a glucometer at home to follow the levels on a daily basis.
Healthy eating including low glycemic index foods, fruits, veggies, and whole grains.
Increase physical activity daily

I'll talk about medications in another post.

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