Diabetes Mellitus [ Type 2]

   Diabetes Mellitus (DM) is a lifelong disorder in which the patient's body cannot regulate the levels of glucose in the blood. There are two types of diabetes mellitus, type 1 and type 2.  Type 2, sometimes called adult-onset or non-insulin-dependent diabetes, is the more common type of Diabetes Mellitus.  It usually develops relatively slowly (McCance, Huether Brashers & Rote, 2010).  This paper will solely focus on Diabetes Mellitus type 2, its causes, symptoms, prognosis, treatments etc.

     Type 2 diabetes is characterized by insulin resistance and a decrease in insulin secretion.  The causes of type 2 diabetes mellitus are unclear; however, there seem to be both complex hereditary (genetic factors passed on in families) and environmental factors involved (McCance, Huether Brashers & Rote, 2010).  It is also more common in blacks, Hispanics, Native Americans, and women, especially women with a history of gestational diabetes.  Genetics and environmental factors are the main contributors to type 2 Diabetes (2010).  Patients with Diabetes type 2 often need a complex set of services and support, ranging from glucose monitoring, insulin, medication management, psychotherapy and social support to physical activity promotion, nutrition counseling and many other aspects.  Type 2 diabetes generally is seen in people of 40yrs and above, and it’s caused by insufficient production of insulin by the pancreas, cells resistance to insulin, excessive hepatic glucose production or inappropriate use of insulin by the body. (Barr, Myslinski, & Scarborough, 2008).

 It is often seen in individuals with hyperlipidemia, high levels of triglycerides, decreased levels of HDL and hypertension. There has been a recent incidence of type 2 in children in recent years. The pancreas usually continues to produce endogenous insulin. This insulin produced is either not sufficient or not properly utilized by the body, over time; the beta cells are destroyed and the pancreas eventually loses its ability to produce insulin.

      Islet autoantibodies are not present. (CDC, 2012). As with every other disease, DM type 2 is identified by symptoms.  These symptoms as increased thirst (polydipsia), increased urination (polyuria), nocturia (the need to get up from sleep to urinate) increased appetite (polyphagia), fatigue, drowsiness, unexplained and unintended weight loss. Other symptoms include blurred vision, frequent infections, wounds that are slow to heal, or a skin discoloration known as acanthosis nigricans (Ismail, Zukri, & Bebakar, 2009).

     A statement by American Diabetes Association (ADA) and the Europe Association for the Study of Diabetes recommends that the first line of an oral hypoglycemic agent is Metformin (Masahiro, Takashi et al 2004).  According to this study by Masahiro, Takashi et al, an increase in the dose of Metformin therapy in DM2 patients reduce serum MDA-LDL (Malondialdehyde-modified Low-density lipoprotein) levels, an oxidized LDL associated with atherosclerosis, unlike the add-on Sitagliptin therapy which showed no effect (2004).  Similarly, another study concluded that Metformin is more effective than other oral pharmacologic agents in reducing glycemic levels, decreasing weight, reducing LDL cholesterol and triglyceride levels.  It is also associated with lowering all-cause mortality and cardiovascular mortality compared with sulfonylureas (Qaseem, Humphrey et al 2012).

      Although the prognosis of Diabetes Mellitus 2 has improved in recent years, it is still the 7^th leading cause of death in the U.S.   Being a disease of micro and macro vessels, it has vast complications. Some of the complications are hypoglycemia, Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNKS), retinopathy, neuropathy, nephropathy, Coronary Artery Disease (CAD), Peripheral Artery Disease (PAD) and Stroke.  According to CDC, “heart disease (stroke) risk is 2-4 times higher among people with diabetes”, “in 2004, heart disease was noted on 68% of diabetic related death certificates among people aged 65years or older” (CDC 2012).  Retinopathy, neuropathy, and nephropathy are termed microvascular complications of diabetes while CAD, PAD, and stroke are termed macrovascular.  If well maintained, People with DM2 can have a normal life expectancy, but will still be at risk of these complications.

     My personal interest in this disease is since it is a disease that runs in my family. My mother currently suffers from Diabetes types 2.  My young cousin who is about 34 years old was pre-diabetic until he was asked to modify his lifestyle and change in diet and exercise regimen. He is on the verge of being diabetic.    Looking at my mom, I have seen firsthand the effects of diabetes and how it affects the life and conditions of people who suffer from it.  The management of diabetes can be very expensive, life changing, time-consuming and scary for the patients and family members of the patient.   Both my grandparents died from diabetes and its complications including an episode of severe hypoglycemia which took the life of my maternal grandmother before we were able to get her medical help; which can be very tasking especially coming from a third world country where health care facilities are not easily reachable and /or accessible.

     Currently, there is no cure for diabetes only management for the disease (Walker, 2013). This is according to all the research made towards this paper as cited and referenced.

Works Cited

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Qaseem, Amir, et al. "Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice                   

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Walker, Tracey. "Bariatric Surgery Can Help, But Not Cure, Diabetes." Formulary 48.1 (2013):

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