Understanding Diabetes Mellitus Type 2

Diabetes is a problem in the way your body makes or uses insulin. Insulin is needed to move glucose (blood sugar) into the cells where it is used for energy. Usually obesity related, Diabetes Mellitus Type 2, is a metabolic disorder which is incurable and is characterized by insulin resistance, relative insulin deficiency and hyperglycemia. It is a very common illness in America, with an estimated 15.7 million people, or 5.9 percent of the population being stricken.

What are the causes and risk factors?
Type 2 Diabetes occurs gradually, striking mostly the obese and the elderly. Family history and genetics play a larger role. Increasing a person's risk for the onset of Type 2 Diabetes is low activity, poor diet and excess body weight around the waist. High blood pressure and high cholesterol are other common risk factors.
People who are overweight have a higher risk of insulin resistance, which means the insulin produced by your pancreas cannot get fat and muscle cells to produce energy. When the cells are not getting the insulin they need more and more over time, hyperglycemia, or abnormally high levels of sugar build up in the blood.

What are the symptoms of Type 2 Diabetes?
-Increased thirst
-Increased urination
-Increased appetite
-Fatigue
-Blurred vision
-Frequent or slow-healing infections
-General dysfunction

How can a person be tested for Type 2 Diabetes?
The most common way to be tested is a fasting blood glucose level test. You are diagnosed if your level is higher than 126 mg/dl on two occasions.
Random (non-fasting) blood glucose level testing is when patients experience symptoms of increased thirst, urination and fatigue. Diabetes is suspected when the glucose level is higher than 200 mg/dl.

How is Type 2 Diabetes treated?
The primary treatment is exercise and diet, with the first goals being to eliminate and stabilize blood glucose levels. Ongoing goals are to prevent long-term complications and prolong life. How well your combination of diet, exercise and medication is working can be measured by regular self-testing. Tests should be done before meals and at bedtime, with more frequent testing needed when sick or under stress. A glucometer provides an exact blood sugar reading. Usually a person pricks their finger with a lancet, which gives a tiny drop of blood. The blood is placed on a test strip and put into the device, with results available in 30 to 45 seconds.
The results of testing can be used to adjust a person's lifestyle to keep blood sugar near the appropriate range. Accurate testing will help guide your health care provider with an idea of how to plan for your care.

How does a person regulate their diet?
Choosing healthy foods, eating the right amount and eating at the right time are all part of healthy meal planning. It is important to work with your health care provider to find out how much fat, protein and carbohydrates are needed in a diet. Make sure to point out the foods you like or dislike, that way you are more likely to stick to the plan provided.
Eating a variety of foods is very important, and you should be sure to include high-fiber choices, such as fruits, vegetables and whole grains. Foods with fiber do help regulate blood sugar levels.
Meals should be eaten about every four to five hours, and no meals should be skipped. Portions of meals should be controlled. You should eat only the amount of food in your plan and the same amount of food each day. Salt should be limited, as it can affect your blood pressure. Avoid saturated fats, such as butter, fatty meats and cheese, as these boost bad LDL cholesterol levels. Good fats, like Omega-3 fats in fish and oils made from plants are better substitutes.

How can a person stick to a regulated diet while dining out?
You should avoid choices with lots of calories, such as any items labeled jumbo, giant, deluxe or super-sized. Grilled or broiled sandwiches with lean meats, like turkey or chicken are good choices. Avoid creamy toppings, like mayonnaise. Flavor can be added with lettuce, tomato and onion. Salads are good choices, as long you avoid high fat toppings like dressings, bacon bits, cheeses and crutons.
When eating Mexican, stick to soft tacos and other non-fried foods. Choose chicken over beef. Go easy on refried beans, sour cream and cheese. Lettuce, tomatoes and salsa can be limitless.
When eating pizza, choose a thin crust with vegetable toppings. Be sure to limit yourself to one or two slices. Meat and extra cheese can add unnecessary calories, fat and sodium.

Can regular physical activity help?
Yes, regular exercise is important, as it helps control the amount of glucose in the blood and helps burn excess calories and fat. Exercise also imporves blood flow and blood pressure, which helps decrease insulin resistance. You will also feel an increased energy level, a lower tension level, and you will have a better ability to handle stress.
Consult with your health care provider before beginning an exercise regimen, as extra precautionary measures may need to be followed.

What happens when diet and exercise fail to help?
When proper diet and exercise fail to help maintain normal or near normal blood glucose levels, your health care provider may prescribe medication to regulate production of insulin or decrease the production of glucose. If medication fails, then insulin injections will be prescribed.

What kind of continuing care is needed?
People who suffer from Type 2 Diabetes should visit their health care provider every three months. A thorough examination includes a blood pressure check, neurological examination, opthalmoscopy exam, a foot and skin exam and glysosylated hemoglobin, a three month average of your blood glucose level and how much glucose has been sticking to red blood cells and other cells.

What kind of prognosis can be expected?
The risk of long-term complications from Type 2 Diabetes can be reduced, if you control your blood glucose and blood pressure.
Call your health care provider immediately if you experience trembling, weakness, drowsiness, headache, confusion, dizziness, double vision or lack of coordination.

How do you prevent developing Type 2 Diabetes?
People age 45 and over should have their glucose level checked every three years. Regular testing should begin at a younger age and be more frequent, if you are at risk. Maintaining a healthy body weight and an active lifestyle goes a long way.