Diabetes Mellitus Type 2

Introduction 

Type 2 diabetes is a disease characterized by chronic hyperglycemia resulting from peripheral tissue resistance to insulin action, deficient amount of insulin secretion, and excessive glucagon secretion. Mostly, increase blood glucose level can be resulting from increased carbohydrate intake, decrease peripheral tissue glucose intake(insulin resistance), and decrease insulin secretion. 
IF fasting blood glucose level more than 126mg/dl or random blood glucose level more than 200mg/dl; usually diagnose as diabetes 


Causes 

Inheritance factors; several genes variant involve beta-cell function and insulin resistance.some of these genes have a risk for type 2 diabetes. 
Environmental factors; low weight birth, impair glucose intolerance in later life, impair beta-cell development in early life, because of these reasons predisposing to diabetes in later life. 
Beta-cell dysfunction; when there is no adequate insulin secretion from beta cells to meet its requirement that leads to developing the diabetes 
Insulin resistance; normally in the body, insulin is needed for peripheral tissues to uptake glucose if peripheral tissues show resistance for the insulin blood glucose level elevated. Lead to hyperglycemia and diabetes. 


Clinical presentation 

Polyuria,polydipsia,polyphagia,weight loss,blurred vision,lowe extremity tingling and numbness,erectile dysfunction,peripheral gangrean.

Complications 

macrovascular 

 Atherosclerosis 
 Stroke(cerebrovascular disease) 
 Coronary heart disease 
 Peripheral vascular diseases 
  

microvascular 

 Retinopathy;non-proliferative/proliferative maculopathy. 
 Neuropathy; peripheral sensory neuropathy, autonomic neuropathy, mononeuropathy, proximal            motor neuropathy. 
 nephropathy 

 Management 

Microvascular complications are reduction through control of hyperglycemia and blood pressure. macrovascular risk reduction through control of lipids and hypertension prevent from smoking.metabolic and neurologic risk reduction through control of hyperglycemia.


Treatment 

Diet controlling, Oral hypoglycemic medication, Insulin therapy. 


Risk factors 

Over weight,demography(age,gender..),alcohol use,family histry,physical inactive,high blood pressure(hypertension),history of gestational diabetes,uncontrol eating.

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