Diabetes Mellitus Type 2 - Pathogenesis, Symptoms, Causes, Contributing Factors, and Related Diseases - Essay Example

Diabetes Mellitus Type 2 Key Words: Impaired Glucose Tolerance (IGT), Type 2 diabetes mellitus, insulin, BMI, Sugar and Glucose levels, Type 2 diabetes mellitus, formerly known as non-insulin dependent diabetes (NIDD) is a metabolic disease that hinders the body from generating energy (Braham, 2011). The disease normally affects how the body handles blood sugar levels, which are the main source of body energy (Dunning 2014). The disease normally affects insulin, whereby not enough insulin is produced to handle blood sugar level (Braham, 2011). This disease commonly affects adults but recently there has been increase in the number of children being infected with it (Goldstein, 2013). This is the most common type of diabetes mostly evident among adults. This is when blood cells not only ignore insulin but also prevent glucose absorption in to the body, hence resulting to its build up in the blood (Braham, 2011). The initial symptoms of type 2 diabetes mellitus are the emission of a faint smell, normally fruit or vegetable order, in his breath or urine. This urine is commonly known as sweet urine (Braham, 2011). The essay will shed more light on diabetes mellitus type 2, its symptoms, diagnosis, treatment and patient education. Pathogenesis of Disease Diabetes mellitus type 2 is the most common type of diabetes. According to studies so far conducted, it is cited to have contributed to about 90-95% of all the complication’s cases (Levenne & Donnelly, 2008). Apart from high blood pressure, other risk factors associated with this malady include genetic factors and high cholesterol levels. In most cases, its occurrence is due to the disruption of sensitive tissues to the extent that they no longer respond properly to insulin, hence graduating to insulin resistance (Poretsky, 2010). This is a state where accumulation of glucose in the blood exceeds the appropriate levels. This condition if not treated earlier, it normally results to failing of peripheral blood tissues. Generally, Type 2 if untreated can be life threatening, especially if not detected earlier. This is because lack of treatment can result to severe complications such as kidney failure, blindness and nerve damage (Braham, 2011). Studies contend type 2 is the main contributing factor in the contraction of strokes and coronary heart diseases. This is due to the narrowing and hardening of blood vessels, which is a problem commonly known as atherosclerosis (Braham, 2011). Disease Symptoms Loss of glucose in urine and elevated blood sugar levels are the earliest symptoms of untreated type 2 condition. Some of type 2 symptoms that follow later on usually vary across persons. The most cited symptoms of this type are usually blurred vision, dehydration, vomiting, nausea and weight loss (Braham 2011). These signs usually call for quick medication least they get worse. Disease Incidence The prevalence of this malady is ever on the rise. Many people affected by the disease are those of the older age group. By 2010, the number of the affected had risen to more than 215 million (Dunning, 2013). Researches contend approximately 35% of people in US aged between 20 and above are already in the pre-diabetes stage of the disease (Sheehan & Ulchaker, 2012). Type 2 is usually recorded most in minority populations due to glycemic poor control (Sheehan & Ulchaker, 2012). Causes, Contributing Factors, and Related disease The malady is usually associated with obesity and insulin inefficiencies (Poretsky, 2010). Although the main cause of insulin resistance is yet to be known, both environmental and genetic factors play a significant role (Poretsky, 2010). Some of the common factors that contribute to the contraction of type 2 include, Age A person’s age has been identified as one of the causes of type 2. According to research, many people who diagnosed with this complication are usually above 40 years (Levenne & Donnelly, 2008). Although in some cases the disease has been detected in people of a much younger age. Gender Research shows type 2 nominally affects more women than men (Braham, 2011). This is according to a research conducted by PBS in 2001 (Braham, 2011). Obesity Based on numerous studies, obese people normally stand a greater chance of contracting type two diabetes mellitus. Obesity is usually defined according to body mass index (BMI), whereby a higher BMI is usually directly promotional to the individual’s insulin resistance. Obesity occurs mostly because of frequent consumption of a wrong diet and lack of physical exercise usually leads to a higher BMI, which increases the chances of contracting the disease (Levenne & Donnelly, 2008).This is usually preventable if the person changes his diet and starts eating nutritious foods and performing more exercises. Disease Complications and Risks Type 2 is a life threatening complication because it has adverse effects on mortality and morbidity (Levenne & Donnelly, 2008). Studies have shown that whereas people with Impaired Glucose Tolerance (IGT), who normally stand greater risks of contracting diabetes usually, reduce their rate of contracting the disease by 60% through lifestyle changing while those who seek medication from pharmacies normally reduce their chances by 25-60 % (Serrano-Rios & Gutierrez-Fuentes, 2010). The identification of risk factors is usually essential for proper medication, management and implementation of prevention measures. Disease Diagnosis There are several ways of diagnosing type 2 but the most common include, 1. Hemoglobin AIC Measurement (AIC) test. In the body, sugar sticks particularly to proteins. Red blood cells circulate in the body for about three months before dying off. When a sugar sticks to these cells, it enables one gain have idea of how much sugar is available for the preceding three months (Serrano-Rios & Gutierrez-Fuentes, 2010). In poorly controlled diabetes, it is 8% or above while in well-controlled patients less than 7%. The benefit of measuring AIC is that it gives a more reasonable and stable view of what is happening over the course of time ,which is usually three months besides the value does not fluctuate like in other methods(Serrano-Rios & Gutierrez-Fuentes, 2010). 2. Fasting of Plasma Glucose Test (FPG). This is the mostly preferred way, which numerous physicians use it. The reason why many health practitioners use the method is that the method is not only easy but also convenient (Sheehan & Ulchaker, 2012). The method entails a patient to fast overnight for at least eight hours. After eight hours, a blood sample is drawn and sent to the laboratory for analysis (Sheehan & Ulchaker, 2012). This process can also be done in a doctor’s office by using a glucose meter. For a normal person, the glucose level ought to be less than 100 mg/dl (Sheehan & Ulchaker, 2012). Therefore, if the blood test result shows a glucose level of more than 126 mg/dl, this confirms the presence of diabetes mellitus. 3. Random Plasma Glucose Test. In this method, a blood glucose level of 200 mg/dl or higher indicates the presence of diabetes mellitus (Nathan, 2009). When blood glucose level is above 100 mg/dl or higher but in the 100-126 mg/dl, this is known as Impaired fasting Glucose (IFG). 4. Oral Glucose Tolerance Test(OGTT) In this test, a person ought to fast overnight, at least eight hours but not more than 16 hours. The glucose level is then tested. After the test, the person receives 75g of glucose but a pregnant woman is normally given 100g (Nathan, 2009). The glucose is usually in liquid form that the person drinks. Blood samples are then taken to measure glucose, which is usually done in specific intervals. For this test to have reliable results, several measures are to be observed; a) The person ought to be healthy; hence he or she should not have any other illness. b) The person should be normally active meaning he or she should not be an in-patient. c) One should not be under any form of medication because some drugs usually affect blood glucose. d) One should consume at least 2*300 g carbohydrates per day three days b4 the test. e) On the test day, one is neither supposed to smoke nor take coffee. The classical oral glucose tolerance test is the most used because of its ability to measure blood glucose level five times in three hours (Nathan, 2009). For a non-diabetic person, glucose level normally rises and falls quickly but in someone with diabetes, the level of glucose usually rises but stagnates or comes down very slowly (Serrano-Rios & Gutierrez-Fuentes, 2010). People whose glucose levels are in-between normal and diabetic usually have an impaired glucose tolerance (IGT) (Nathan, 2009). Such people do not have diabetes but are at a high risk of progressing to diabetes (Nathan 2009). Each year, 1-5% of people tested with impaired glucose tolerance usually contract diabetes mellitus type 2. Being active commonly associated with decrease of one’s weight loss is essential in aiding the ailing to stabilize one’s IGT to the expected conditions (Nathan 2009). In most cases, Glucose tolerance test usually results to one of these diagnoses: a) Normal response: This is when a person’s two-hour glucose level is less than 140 mg/dl (Sheehan & Ulchaker, 2012). All values between 0-2 hours are less than 200 mg/dl (Sheehan & Ulchaker, 2012) b) Impaired Glucose Tolerance: when one’s glucose during fasting is less than 126mg/dl and the two-hour glucose level is between 140-199mg/dl (Sheehan & Ulchaker, 2012). c) Diabetes: A person normally contracts diabetes when the outcome of two diagnostic tests performed on different days show a high blood glucose level (Sheehan & Ulchaker, 2012). d) Gestational diabetes- A woman has Gestational diabetes when she has 100g OGTT, a food starving glucose level of more than 95mg/d, one hour glucose level of more than 180mg/dl, two hour glucose level of more than 155mg/dl or a three hour glucose level of more than140mg/dl (Sheehan & Ulchaker, 2012). Disease Treatment Treatment usually requires one to have a long-term commitment by ensuring that they oversee certain factors and ensure to follow them to the letter. Diabetic patients ought to ensure that apart from monitoring their blood sugar level, they also need to eat healthy and nutritious food (Levenne & Donnelly, 2008). The food should be enriched with high fiber besides having low fat content, for instance, vegetables, whole grains and other fruits (Levenne & Donnelly, 2008). Patients ought to embrace active lifestyle coupled with ding exercises on daily basis besides frequently visiting a medical practitioner for insulin therapy (Levenne & Donnelly, 2008). Just like any other disease, type 2 by adherence of proper measures is a preventable complication. Most common ways of preventing the disease is through medical prescriptions and change of lifestyle from sedentary to active. Nursing Diagnoses People experiencing type 2 are vulnerable; hence they require intensive nursing attention (Dunning, 2013). Earlier diagnosis is usually of great benefit both to the patient and the nurse because there will have higher chances of understanding the disease, which leads to proper care by the nurse (Dunning, 2013). Earlier diagnosis usually helps the patient obtain more information about diabetes and ways in which it can be self-managed.it also helps avoid other expenses such as further hospitalization due to complications related to diabetes (Dunning, 2013). Patient Education This is the integral part in the move to manage diabetes. Through regular support and guidance, the diabetes support team usually plays a significant role in assisting diabetic patients (Serrano-Rios & Gutierrez-Fuentes, 2010). This not only helps diabetic patients to properly manage their diabetes, but also gives them hope of getting well (Dunning, 2014). This is one of the main pillars towards the move to curb and eradicate this complication. The method is both effective and essential because the patient is educated on how to identify the disease and what needs to be done in case the situation worsens (Dunning, 2013). Conclusion Type 2 commonly known as non-insulin dependent diabetes is a chronic complication mostly results from the body failing to produce enough insulin to regulate the amount of sugar level in the body (Braham, 2011). The disease, if not detected at an earlier stage could lead to blindness, kidney failure and nerve damage which are usually fatal (Braham, 2011). Research shows that older men above 40 years normally contract type 2 although in some cases, the disease has also been detected in children and youths (Levenne & Donnelly, 2008). Some of the main factors that contribute to the contraction to this predicament include age, obesity and gender (Braham, 2011). Obesity is normally defined in relation to the BMI whereby a higher BMI usually directly proportional to a person’s insulin resistance (Braham, 2011). There are several methods that are used by physicians to diagnose the presence of this complication including Hemoglobin AIC measurement, fasting of plasma glucose, random plasma glucose and oral glucose tolerance tests (Braham, 2011). Just like any other disease, type 2 can be controlled. Controlling the disease requires long-term commitments (Levenne & Donnelly, 2008). For instance, apart from frequently monitoring their blood sugar level, they should ensure they consume healthy, nutritious food and conduct lots of physical exercise in addition to visiting medical care for progressive checkups and insulin therapy. Diabetic patients are very vulnerable hence, they require lots of education on diabetes mellitus type 2 (Dunning, 2013). Through education, patients will not only be able to acquire more knowledge on the disease but also will be in a better position to medicate themselves at their homes in case they do not have somebody to oversee them. References Dunning, T. (2013). Care of People with Diabetes: A Manual of Nursing Practice. Chichester, West Sussex: John Wiley & Sons. Goldstein, J.B. & Wieland, M. D. (2013). Type 2 Diabetes: Principles and Practice, Second Edition. Florida: CRC Press. Levene, S. L. & Donnelly, R.(2008).Management of Type 2 Diabetes Mellitus : A Practical Guide. Edinburgh: Elsevier. Nathan, M. D. & Harvard medical School. (2009). Diabetes: a plan for living. Boston, MA: Harvard Health Publications. Poretsky, L. (2010). Principles of Diabetes Mellitus. New York: Springer Serrano-Rios, M. & Fuentes, G. A. J. (2010). Diabetes mellitus: type 2. Amsterdam; Barcelona: Elsevier, cop. Sheehan, J. & Ulchacker, M. M. (2012).Obesity and type 2 diabetes mellitus. 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