Which Of The Following Describes Type 2 Diabetes Mellitus

What’s It Like For Teens With Type 2 Diabetes

Sometimes people who have diabetes feel different from their friends because they need to think about how they eat and how to control their blood sugar levels every day.

Some teens with diabetes want to deny that they even have it. They might hope that if they ignore diabetes, it will just go away. They may feel angry, depressed, or helpless, or think that their parents are constantly worrying about their diabetes management.

If you’ve been diagnosed with type 2 diabetes, it’s normal to feel like your world has been turned upside down. Your diabetes care team is there to provide answers and support. Don’t hesitate to ask your doctors, dietitian, and other treatment professionals for advice and tips. It also can help to find support groups where you can talk about your feelings and find out how other teens cope.

Diabetes brings challenges, but teens who have it play sports, travel, date, go to school, and work just like their friends.

Type 1 And Type 2 Differences

Below is a guide to some of the main differences between type 1 and type 2.

Diet Weight Control And Physical Activity

• Diet. What you eat is absolutely central to your blood glucose control, as well as your general health. Please read our separate leaflet called Type 2 Diabetes Diet for more information. Your practice nurse or dietician can give you more information and support.
• Lose weight if you are overweight. Getting to a perfect weight is unrealistic for many people. However, losing some weight if you are obese or overweight will help to reduce your blood glucose and blood pressure levels . Recent evidence from Professor Taylor, Newcastle University, has shown that weight loss alone can put diabetes into drug-free remission in at least a third of patients.
• Do some physical activity regularly. If you are able, a minimum of 30 minutes’ brisk walking at least five times a week is advised. Anything more vigorous and more often is even better – for example, swimming, cycling, jogging, dancing. Ideally, you should do an activity that gets you at least mildly out of breath and mildly sweaty. You can spread the activity over the day – for example, two fifteen-minute spells per day of brisk walking, cycling, dancing, etc. Regular physical activity also reduces your risk of having a heart attack or stroke.

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Impaired Endothelial Function And Atherosclerosis Development

Endothelium plays an important role in the regulation of vascular tone and structure through a balanced release of endothelial-derived relaxing and contracting factors. This balance is altered in T2DM leading to alteration of the physicochemical properties of the vascular wall via endothelial dysfunction, oxidative stress, platelet hyperreactivity, and inflammation . These abnormalities lead to enhanced vasoconstriction, development of atherosclerosis, and favored thrombus formation .

6.2.1. Mechanisms Leading to Endothelial Dysfunction in T2DM

Vascular endothelial cells are particularly susceptible to developing intracellular hyperglycemia because glucose diffuses passively through their plasma membrane. In T2DM, the excess of glucose can be metabolized in the sorbitol pathway to sorbitol and fructose by aldose reductase, which activates the aldose reductase secondary metabolic pathway, with concomitant oxidation of NADPH to NADP+ and reduction of NAD+ to NADH. NADPH depletion and an increased NADH/NAD+ cytosolic ratio leads to a change in redox potential that accelerates glycolysis and increases de novo synthesis of DAG . As a result, protein kinase C is activated, nitric oxide is reduced. These effects cause vascular permeability and increase contractility. Simultaneously, the increased NADH/NAD+ ratio also results in higher production of O2, LDL oxidation, cytotoxic effects on endothelial cells and reduced NO availability, leading to endothelial dysfunction .

Managing And Treating Type 1 And Type 2

Managing and treating your diabetes is so important. This is because itll help you avoid serious health complications. And itll play a big part in your daily life regardless of if you have type 1 or type 2.

If you have type 1 diabetes, youll need to take insulin to control your blood sugar levels. Youll also need to test your blood glucose levels regularly. And count how many carbs you eat and drink. Counting carbs will help you work out how much insulin you should take when you inject with your meals.

And generally you should be trying to have a healthy lifestyle. That includes regular physical activity and a healthy balanced diet. These will help you reduce your risk of diabetes complications.

If you have type 2 diabetes, you also need to eat a healthy diet and be active. These things will help you manage your weight and diabetes.

But quite often people with type 2 also need to take medication. Such as tablets and insulin, or other treatments too. Whether you need to test your blood glucose level like someone with type 1, depends on the treatment you take. Your GP can tell you what you should do at home.

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T2dm Outcomes/complications: Cardiovascular Risk

As described in the previous sections, T2DM is a multisystem disease with a strong correlation with CVD development . T2DM leads to a two- to four-fold increase in the mortality rate of adults from heart disease and stroke and is associated with both micro- and macro-vascular complications, the latter consisting of accelerated atherosclerosis leading to severe peripheral vascular disease, premature coronary artery disease and increased risk of cerebrovascular diseases . These factors lead to T2DM being considered a significant risk factor for CVD , likely through the involvement of several molecular mechanisms and pathological pathways. These include the role of IR in atherosclerosis, vascular function, oxidative stress, hypertension, macrophage accumulation and inflammation . The following sections describe in detail the main factors implicated in cardiovascular risk outcomes from T2DM and the interactions between them .

Factors implicated in cardiovascular risk outcomes from T2DM and the interactions between them. T2DM derived hyperglycemia, hyperinsulinemia and IR causes endothelial dysfunction, diabetic dyslipidemia and inflammation leading to CVD. The flowchart illustrates the multiple interactions among the implicated factors.

How Are Type 1 And Type 2 Diabetes Treated

Theres no cure for type 1 diabetes. People with type 1 diabetes dont produce insulin, so it must be regularly injected into the body.

Some people take injections into soft tissue, such as the stomach, arm, or buttocks, several times per day. Other people use insulin pumps. Insulin pumps supply a steady amount of insulin into the body through a small tube.

Blood sugar testing is an essential part of managing type 1 diabetes, because levels can go up and down quickly.

Type 2 diabetes can be managed and even reversed with diet and exercise alone, but many people need extra support. If lifestyle changes arent enough, your doctor may prescribe medications that help your body use insulin more effectively.

Monitoring your blood sugar is an essential part of type 2 diabetes management too. Its the only way to know if youre meeting your target levels.

Your doctor may recommend testing your blood sugar occasionally or more frequently. If your blood sugar levels are high, your doctor may recommend insulin injections.

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How Is Gestational Diabetes Mellitus Diagnosed

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation.

In addition, women with diagnosed GDM should be screened for persistent diabetes 6 to 12 weeks postpartum. It is also recommended that women with a history of GDM undergo lifelong screening for the development of diabetes or prediabetes at least every three years.

Calculations And Statistical Analyses

Implementation was calculated as the proportion of days with sufficient supply while being persistent. It is inherent in the algorithm that the size of the implementation degree depends on both the maximum acceptable length of a supply gap and the prescribed amount of medicine, which at Steno is typically 3 months at a time. Persistence was calculated as the proportion of days in persistence of all days prescribed with the medicine in question.

Rate-ratios of incidence of the different events representing the different behavioural elements of adherence to medication over time were analysed through Poisson regression, where the follow-up time for each individual was split in intervals of 3 months, and one record for each time interval entered the Poisson model.

For the five time-varying covariates

we used the current value of the covariates at the time of the left endpoints of the follow-up time intervals. Thus, age and duration of T2DM diagnosis increased by 3 months for each follow-up time interval related to the same individual.

Calculations and analyses were performed using SAS, version 9.3 . Graphs were done in R, version 3.0.2 .

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What Medicines Do I Need To Treat My Type 2 Diabetes

Along with following your diabetes care plan, you may need diabetes medicines, which may include pills or medicines you inject under your skin, such as insulin. Over time, you may need more than one diabetes medicine to manage your blood glucose. Even if you dont take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital. You also may need medicines for high blood pressure, high cholesterol, or other conditions.

Learn more about medicines, insulin, and other diabetes treatments.

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Its important to maintain a healthy body weight. You should also make sure that you drink plenty of water, and limit your intake of sugary drinks. In addition, make sure that you get regular exercise. You should also avoid alcoholic beverages. Lastly, you should avoid alcohol. These beverages contain high amounts of sugar. If you dont drink enough, youre not doing anything to prevent diabetes. Besides, drinking alcohol can be harmful to your health.

The most important thing to do is to follow the recommended diet. Eat more healthy foods that have low amounts of fat and high amounts of fiber. The best way to lose weight is to lose 7 percent of your body weight. If youre overweight, you should try to lose 14 pounds to reduce your risk of developing type 2 diabetes. However, you should not attempt to lose weight while pregnant. Talk to your doctor about what kind of weight is safe for you.

Besides high blood glucose, diabetes can also affect the nerves and skin. It may affect your sexual response and your nervous system. It can also affect your fertility. Women with diabetes are more likely to miscarry or have a baby with a birth defect. It can cause a person to have difficulty hearing and sleep. If the condition is left untreated, it can lead to type 1 diabetes and can even lead to amputation.

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Causes Of Type 1 Diabetes

The bodys immune system is responsible for fighting off foreign invaders, such as harmful viruses and bacteria.

In people with type 1 diabetes, the immune system mistakes the bodys own healthy cells for foreign invaders. The immune system attacks and destroys the insulin-producing beta cells in the pancreas. After these beta cells are destroyed, the body is unable to produce insulin.

Researchers dont know why the immune system sometimes attacks the bodys own cells. It may have something to do with genetic and environmental factors, such as exposure to viruses. Research into autoimmune diseases is ongoing.

What Types Of Healthcare Professionals Might Be Part Of My Diabetes Treatment Team

Most people with diabetes see their primary healthcare provider first. Your provider might refer you to an endocrinologist/pediatric endocrinologist, a physician who specializes in diabetes care. Other members of your healthcare team may include an ophthalmologist , nephrologist , cardiologist , podiatrist , neurologist , gastroenterologist , registered dietician, nurse practitioners/physician assistants, diabetes educator, pharmacist, personal trainer, social worker, mental health professional, transplant team and others.

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Who Is Most At Risk From Type 2 Diabetes

As already mentioned, type 2 diabetes symptoms often come on gradually and can be quite vague at first. Many people have type 2 diabetes for a long period of time before their diagnosis is made.

The most common type 2 diabetes symptoms are:

• Being thirsty a lot of the time.
• Passing large amounts of urine.
• Tiredness, which may be worse after meals.

The reason why you make a lot of urine and become thirsty is that if your blood sugar rises too high the excess sugar leaks into your urine. This pulls out extra water through the kidneys.

As the type 2 diabetes symptoms may develop gradually, you can become used to being thirsty and tired and you may not recognise for some time that you are ill. Some people also develop blurred vision and frequent infections, such as recurring thrush. However, some people with type 2 diabetes do not have any symptoms if the glucose level is not too high. But, even if you do not have symptoms, you should still have treatment to reduce the risk of developing complications.

Type 2 Diabetes

A simple dipstick test may detect sugar in a sample of urine. However, this is not enough to make a definite diagnosis of type 2 diabetes. Therefore, a blood test called HbA1c is needed to make the diagnosis. The blood test detects the level of glucose in your blood. If the glucose level is high then it will confirm that you have type 2 diabetes.

Some people have to have two samples of blood taken and may be asked to fast.

What Is Diabetes Mellitus

Diabetes mellitus, also called diabetes, is a term for several conditions involving how your body turns food into energy.

When you eat a carbohydrate, your body turns it into a sugar called glucose and sends that to your bloodstream. Your pancreas releases insulin, a hormone that helps move glucose from your blood into your cells, which use it for energy.

When you have diabetes and donât get treatment, your body doesnât use insulin like it should. Too much glucose stays in your blood, a condition usually called high blood sugar. This can cause health problems that may be serious or even life-threatening.

Thereâs no cure for diabetes. But with treatment and lifestyle changes, you can live a long, healthy life.

Diabetes comes in different forms, depending on the cause.

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Possible Complications For The Baby

Unlike type 1 diabetes, gestational diabetes generally occurs too late to cause birth defects. Birth defects usually originate sometime during the first trimester of pregnancy. The insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week. Women with gestational diabetes mellitus generally have normal blood sugar levels during the critical first trimester.

The complications of GDM are usually manageable and preventable. The key to prevention is careful control of blood sugar levels just as soon as the diagnosis of diabetes is made.

Infants of mothers with gestational diabetes are vulnerable to several chemical imbalances, such as low serum calcium and low serum magnesium levels, but, in general, there are two major problems of gestational diabetes: macrosomia and hypoglycemia:

Blood glucose is monitored very closely during labor. Insulin may be given to keep the mother’s blood sugar in a normal range to prevent the baby’s blood sugar from dropping excessively after delivery.

What Are The Complications Of Diabetes

If your blood glucose level remains high over a long period of time, your bodys tissues and organs can be seriously damaged. Some complications can be life-threatening over time.

Complications include:

• Dental problems.

Complications of gestational diabetes:

In the mother:Preeclampsia , risk of gestational diabetes during future pregnancies and risk of diabetes later in life.

In the newborn: Higher-than-normal birth weight, low blood sugar , higher risk of developing Type 2 diabetes over time and death shortly after birth.

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What Are The Different Types Of Diabetes

The types of diabetes are:

• Type 1 diabetes: This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who have diabetes have Type 1. Its usually diagnosed in children and young adults . It was once better known as juvenile diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes.
• Type 2 diabetes: With this type, your body either doesnt make enough insulin or your bodys cells dont respond normally to the insulin. This is the most common type of diabetes. Up to 95% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it having a touch of sugar.
• Prediabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
• Gestational diabetes: This type develops in some women during their pregnancy. Gestational diabetes usually goes away after pregnancy. However, if you have gestational diabetes you’re at higher risk of developing Type 2 diabetes later on in life.

Less common types of diabetes include:

Diabetes insipidus is a distinct rare condition that causes your kidneys to produce a large amount of urine.