The type 2 diabetes mellitus accounts for 80-90 percent of diabetes cases and is becoming more common: approximately 150 million people worldwide.
What is it?
The type 2 diabetes mellitus or non-insulin-dependent, Accounts for 80-90% of cases of diabetes. The frequency of diabetes mellitus is increasing worldwide at an accelerated rate. In this type of diabetes occur metabolic disorders characterized by an inappropriate elevation of blood glucose (Hyperglycemia) resulting in chronic complications due to involvement of large and small vessels and nerves. The underlying disorder in this disease is the difficulty of the action of insulin (as a loss of tissue sensitivity to insulin) we call insulin and an inadequate insulin secretion by the cells responsible for production in pancreas. In addition to increasing glucose concentration action of insulin deficient frequently results in elevated levels of cholesterol and / or triglycerides. Most cases of diabetes mellitus type 2 occur in the context of what is called Metabolic Syndrome. This syndrome is associated Diabetes, hypertension pressure, increased levels of cholesterol, Triglycerides and / or uric acid and overweight probably also due to insulin resistance. Metabolic syndrome significantly raises cardiovascular risk and is a major cause of death in developed countries.
Why there is diabetes mellitus type 2?
It is well known to be more frequency of Type 2 diabetes in individuals with family history of diabetes. In recent years have uncovered many genes related to later presentation of diabetes although the genetic component is complex and possibly should be accompanied by environmental factors involved in this case primarily to lifestyle: sedentary lifestyle and poor diet. 80% of people with Type 2 diabetes are Obese.
* In Type 2 diabetes, the pancreas cells still produce insulin, but may have lost their ability to replenish the supply of insulin quickly, when necessary.
* If the number of insulin receptors on the cell surface is too small or not functioning properly, blood sugar can not enter freely into cells. This situation is called insulin resistance or insensitivity to insulin.
* When sugar enters a cell, is conducted to the place where necessary, by a conveyor system. A defect in this system is another possible cause of insulin resistance.
What are your initial symptoms?
Diabetes mellitus type 2 is characterized precisely because it is virtually asymptomatic in its early stages. This is really the big problem, we diagnose diabetes and late (often several years) and it is estimated that up to 50% of people with type 2 diabetes remain undiagnosed at this time. This makes with frequency (Up to 20%) people with this type of diabetes have signs of complications at diagnosis. This cause's type 2 diabetes mellitus must be sought specifically in the persons at risk:
* Anyone from age 45
* Under 45 with:
o Family history DM
o Diabetes during previous pregnancies or children with birth weight greater than 4 kg
o Hypertension arterial
o Cholesterol or triglycerides
o Background abnormalities of blood glucose
How is it diagnosed?
Diagnosis is made initially by determining fasting glucose. Is now considered a pathological repeat value of glucose greater than 126 mg / dl. In a random glucose test (non-fasting) is suspected of diabetes if levels are above 180 mg / dl. In doubtful cases resort to making a glucose curve (Determination of glucose in blood serially) after taking a preparation with 75 g of glucose.
What is the initial treatment?
It is important to understand that Type 2 diabetes requires careful attention although there are few or no symptoms. Type 2 diabetes, untreated can have a gradual and subtle. There is also the risk of developing complications more serious Called late complications of diabetes it may take years to appear. They are essentially nervous and circulatory problems and are much more common in diabetics than in non-diabetics. Include:
* Increased risk of heart attacks and thrombosis
* Poor blood circulation and loss of sensation in the legs and feet
* Eye Injuries and kidney disease.
Treatment of Type 2 diabetes is based on three pillars: monitoring a balanced eating plan, physical exercise regular and personalized drug treatment. As mentioned above, a number of people with this type of diabetes present a variable degree of obesity Therefore a primary objective in these cases is the Weight reduction. This treatment must be individualized in each of its aspects and appropriate to the patient's lifestyle.
What progress has been made in recent years in the treatment?
If your weight is normal, it will probably be necessary to make only small changes in your eating habits. If you are overweight, your doctor will help you change your diet to achieve a weight loss of safe, long term. The exercise increases the body's sensitivity to insulin, so it tends to decrease the level of blood sugar. It is preferable to exercise regular because phase's sudden strenuous exercise can cause problems with control of blood sugar. At present we have several groups drugs (stimulating the secretion of insulin sensitizers tissues to insulin absorption inhibitors carbohydrates or fat …) That allow you to select the most suitable treatment for each patient according to their characteristics: obesity, Amount of insulin produced by your pancreas … The patient should control their sugar levels Whether you're treating your diabetes with tablets, insulin or only diet and exercise.