Diabetes mellitus type 2 is often caused by obesity. The disease can often be controlled by consistent behavioral measures.
What is diabetes mellitus type 2?
Infographic on the anatomy and cause of diabetes mellitus type 2. Click image to enlarge. Diabetes mellitus type 2 is a form, colloquially known as diabetes, of chronic disease that affects metabolism. Characteristic of forms of diabetes such as diabetes mellitus type 2 is an elevated blood glucose level in affected individuals. The name diabetes for forms of diabetes such as diabetes mellitus type 2 is derived from the fact that sugar can be detected in the urine of people suffering from diabetes. Diabetes mellitus type 2 mainly affects older people. For this reason, diabetes mellitus type 2 was also called adult-onset diabetes in the past. Increasingly, however, diabetes mellitus type 2 is also found in younger people. Scientists believe this is due to the fact that more and more children and adolescents are eating unhealthy diets rich in sugar. In addition, many children suffer from a lack of exercise. Both components then usually lead to obesity and subsequently to diabetes. Type 2 diabetes mellitus accounts for by far the largest proportion of diabetes cases worldwide. The trend in the number of people affected by diabetes mellitus type 2 is increasing.
Causes
Diabetes mellitus type 2 is due to impaired formation of insulin by the pancreas and impaired action of insulin in the body. Due to impaired insulin formation in diabetes mellitus type 2, affected individuals experience inadequate release of insulin after ingestion of food; this can then trigger acutely elevated blood glucose levels. Insulin resistance in type 2 diabetes mellitus means that the body’s cells respond only to a limited extent or not at all to the insulin that is secreted, thus impairing the breakdown of glucose in the blood. Diabetes mellitus type 2 is therefore characterized by a so-called relative insulin deficiency: Despite insulin production, insulin does not elicit sufficient responses from the body’s cells. A majority of people suffering from diabetes mellitus type 2 have risk factors such as high blood pressure and severe obesity.
Symptoms, complaints, and signs
Unlike type 1 diabetes, in which symptoms appear within a few weeks, type 2 can creep up unnoticed for years. Although some of the symptoms are similar, they are often delayed and less severe or are not immediately attributed to diabetes mellitus. Not infrequently, only blood glucose measurement contributes to the final diagnosis. Nevertheless, frequent urination and increased thirst are typical symptoms of type 2 diabetes as well, which occur when the body wants to get rid of too much sugar in the blood via the kidneys. Tiredness, fatigue and poor concentration become noticeable. If the disturbed energy and fluid balance continues to progress, the skin dries out. In addition, weight changes, headaches, muscle cramps, impaired vision and erectile dysfunction, as well as tingling and numbness in the hands and feet may occur. The immune system is also affected. For example, recurring infections such as bladder and gum infections, fungal infections or colds, and poor wound healing are among the typical symptoms of diabetes. If type 2 diabetes is not treated, other acute symptoms occur. Increased urine output can lead to dehydration and kidney failure. Nausea, vomiting and impaired consciousness eventually herald a diabetic coma – a life-threatening hyperglycemia. If type 2 diabetes is already recognized and treated with insulin or medication, dangerous hypoglycemia can result from an overdose or during vigorous exercise.
Diagnosis and course
The presence of type 2 diabetes mellitus can be determined by blood glucose levels. In addition, a urine sample may reveal glucose in the urine in diabetes mellitus type 2. Indications of diabetes mellitus type 2 are given if, for example, blood glucose values of more than 110 mg/dl are found in whole blood in a fasting state; in healthy people, this value is usually below 90 mg/dl. The course of diabetes mellitus type 2 depends above all on consistent therapy.With appropriate medical treatment and active cooperation of the patient, the prognosis for diabetes mellitus type 2 can be very good. However, if diabetes mellitus type 2 is not treated appropriately, there may be limitations in quality and duration of life due to sequelae.
Complications
Acute and long-term complications may develop during the course of diabetes with type 2 diabetes mellitus. Acutely, elevated blood glucose levels cause a derailment of sugar metabolism. This can lead to diabetic coma with circulatory collapse and unconsciousness. Hypoglycemia can cause hypoglycemic shock, which is manifested by typical symptoms such as sweating, tremors, and palpitations. If left untreated, thought blockage and eventually circulatory collapse follow. As a result of a chronic disease, secondary diseases of the organs can develop. Affected organs include the kidneys, the nervous system, the heart and blood vessels, and the eyes. Sexual disorders, amputations and mental illnesses are also possible late effects of diabetes with type 2 diabetes mellitus. In addition, many diabetics are overweight, have high blood pressure and poor blood lipid levels, which in turn are associated with serious complications. Over the years, this can lead to calcification of the arteries and subsequently to a heart attack or stroke. If the kidneys are affected, diabetic nephropathy with increasing protein deficiency and malignant kidney changes can occur. In addition, severe nerve damage to the sensory and autonomic nervous systems may occur.
When should you see a doctor?
Type 2 diabetes mellitus is often discovered during routine physical examinations. Very often, the disorder affects people who are considerably overweight and have other diseases due to this circumstance. If diabetes mellitus is suspected after a routine examination, the patient should consult a specialist, preferably a diabetologist, to clarify the suspicion and find out about treatment options. Once the best possible therapy for the patient has been determined, ongoing care of the patient can also be provided by the primary care physician. In addition, individuals who belong to an at-risk group or notice certain symptoms in themselves should have their blood glucose levels tested. Type 2 diabetes mellitus is noticeable through a number of signs. Typical symptoms include weight changes that do not result from lifestyle changes, severe thirst and frequent urination, and constant itching. Many patients also suffer from general weakness, loss of appetite as well as headaches, nausea and dizziness. Anyone who observes several of these symptoms at the same time and this over a period of several days or recurrently should consult a doctor promptly. If type 2 diabetes mellitus is not treated properly, the disease is not only associated with a loss of quality of life; as a rule, life expectancy is also reduced. Medical care is therefore essential for diabetes, even in the less dangerous type 2, and should be provided promptly.
Treatment and therapy
Possible therapeutic steps in diabetes mellitus type 2 can be presented as a so-called stepwise therapy: If diabetes mellitus type 2 is diagnosed in time, therapy at stage 1 is often still possible without the administration of medication; interventions here can include, for example, a healthy diet, weight loss, and physical exercise. If therapy goals of stage 1 cannot be achieved or are not sufficiently effective, medication may be necessary at stage 2 of the therapy of diabetes mellitus type 2; the medication of overweight patients with diabetes mellitus type 2 usually differs from the medication of normal-weight patients. If therapy level 2 for diabetes mellitus type 2 does not show sufficient success, additional medication can be prescribed at level 3. At stage 4 of the therapy for diabetes mellitus type 2, the previous medication is supplemented by insulin administration. Finally, at the last stage of treatment of diabetes mellitus type 2, therapy focuses on the administration of insulin.
Outlook and prognosis
Diabetes mellitus type 2 is a non-curable disease and therefore has an unfavorable prognosis. Nevertheless, it can be arrested under optimal conditions.Without medical treatment, numerous unpleasant and debilitating side effects occur. In addition, the general life expectancy is significantly shortened. Medical progress and the cooperation of the patient can mitigate any complications that occur. Avoiding certain risk factors can also prevent the occurrence of concomitant symptoms or significantly reduce their intensity. Adequate exercise and a healthy diet can have a significant positive impact on the patient’s quality of life. Monitoring blood glucose levels, blood lipid levels and blood pressure helps to intervene as quickly as possible in the event of changes. Overweight patients can achieve an increase in their average life expectancy by losing weight. With a special diet suitable for diabetics, the progress of the disease can be slowed down. Patients achieve better mobility sets in as a result of weight loss. In addition, the blood glucose level automatically decreases. In favorable cases, diabetes mellitus type 2 can stagnate through proper behavior in everyday life. A relapse and in this case a progression of the disease is possible at any time with an unhealthy diet, weight gain or discontinuation of medication.
Prevention
Diabetes mellitus type 2 can be prevented in many cases by a healthy lifestyle; this includes, for example, a balanced diet (low in fat, sugar, and sufficient vegetables or fruit and whole grains), regular physical exercise, and, above all, avoiding excess weight. If support is desired in avoiding type 2 diabetes mellitus, a visit to the doctor may be helpful.
Follow-up
Type 2 diabetes mellitus does not require traditional follow-up care, but rather lifelong medical support. After diagnosis and adjustment of medication and/or injections, the patient must see his or her doctor at regular intervals. The doctor will check the values again and again, both those taken in the doctor’s office and those taken by the patient himself in the time between the visits. Furthermore, nutritional training is indispensable for most diabetics. This is where education is given on proper nutrition as well as the benefits of exercise. Often, a doctor’s office that specializes in diabetology will also have a nutritionist. The patient should also meet with this person on a regular basis. The rhythm could look like this, for example: every three months, alternating between an appointment with the doctor and with the nutritionist. If the disease is already more advanced, the visit to the doctor will probably be more frequent. Annual checkups with an ophthalmologist and a podiatrist (specialist in feet) should also be part of the patient’s preventive care program. Because diabetes can affect vision, seeing an ophthalmologist is essential. Diabetes is a progressive disease that cannot yet be cured. Screenings, along with proper lifestyle choices, are an important component in slowing the process.
Here’s what you can do yourself
If type 2 diabetes mellitus is accompanied by obesity, the most important contribution to self-help that affected individuals can make is a change in their lifestyle and dietary habits. Remission can very often be achieved by losing as little as ten kilograms of weight. Affected persons who have already carried out several reduction diets in the past, which did not show any lasting success, should definitely seek professional support. In preparation for a reduction diet, it is helpful to note down over a period of at least two weeks what was eaten when and in what quantities. The diet diary makes it easier for an ecotrophologist to identify counterproductive foods and harmful eating habits. During the diet, such a diary is a good tool for self-monitoring. Very often, those affected lack the motivation for a comprehensive change in lifestyle and eating habits. Diabetics should then join forces with other sufferers and join a self-help group. Many people are also motivated by aspects that are not primarily health-related but focus on higher goals, such as animal welfare and environmental protection or global nutritional justice. Those who are motivated by idealistic goals should consider the benefits of a plant-based vegetarian or vegan diet.Regular exercise is also important. If there is a lack of motivation, it is worthwhile to join a gym, where individual exercise plans are drawn up and monitored by trainers.
