What You Need To Know About Type 2 Diabetes Mellitus Management

Written by Chinonso Dimgba | Published on August 31, 2021
Medically reviewed by Ajidahun Olusina, MD


Imagine life before insulin injection and pills. Imagine what it would be like to have your life depend on a glimmer of hope that the sugar level in your blood would return to normal.

In this article, we'll examine what causes type 2 diabetes mellitus, how it affects your health in general and your vision in particular, how you can prevent it from developing, and lastly, what you can do if you've already been diagnosed. You can read more on the general overview of diabetes from our previous topics.

What Is Type 2 Diabetes Mellitus? 

Type 2 diabetes mellitus is different from type 1 diabetes and it's one of the oldest diseases known to man. It is the most common form of diabetes, accounting for nearly 90 per cent of all cases. It is a progressive disorder; this means -  it does not happen suddenly. The causes are not clear, but it is thought that genetics, being overweight, obesity and lifestyle, are factors that may cause type 2 diabetes.

 

Symptoms Of Type 2 Diabetes Mellitus

Type 2 diabetes mellitus symptoms may differ from the common signs of diabetes, and in some cases; diabetes may be present with no symptoms yet. However, the common signs include;

  • weight gain (obesity)
  • Feeling thirsty,
  • Foaming urine like soap
  • The unusual odour of urine
  • Increased urination,
  • Excessive hunger, and
  • Blurry vision.
  • A wound that refuses to heal
  • Fatigue and numbness
  • Tingling in the hands or feet as if you cannot feel your leg or hands
  • Excessive darkening of the armpit and back of the neck
  • Increase in skin tag all over a different part of the body
  • High blood pressure (Hypertension)

They can be different in younger people with type 2 diabetes, particularly in women. People with type 2 diabetes are also more likely to develop heart problems and eye problems.

 

How Type 2 Diabetes Occurs

Although type 2 diabetes can be prevented or delayed, no medications can cure it. Type 2 diabetes occurs as the body does not respond to insulin properly, as the disease continues there might be a reduction in insulin production. The pancreas becomes less able to make the hormone due to a problem with the β-cells in the pancreas.

A change in the way the body uses insulin can also be due to the body's failure to use insulin effectively, or Insulin resistance, also known as increased insulin resistance (IR). Many factors culminate in the progressive deterioration of pancreatic functions or decrease in the body's response to insulin.

Genetics and environmental factor play a huge factor in the development of type 2 diabetes. If you noticed you are at higher risk of having this disease, kindly talk to your health care professional for proper counselling and possible lifestyle modifications.

 

Risk Factors Of Type 2 Diabetes

About 1 in 3 adults over the age of 20 in the United States has been diagnosed with Type 2 diabetes. The majority of those people were diagnosed with Type 2 diabetes after the age of 60. However, up to 20% of those diagnosed with Type 2 diabetes before 40 will develop the condition.

The risk factors for type 2 diabetes include:

  • Age (older age being from 45 and above)
  • Those that are overweight or obese
  • A family history of diabetes
  • If you've had diabetes while pregnant (gestational diabetes)
  • People with hypertension (high blood pressure)
  • Being Black (higher among Africans)
  • Cigarette smoking
  • Chronic alcohol consumption

 

Causes Of Type 2 Diabetes Mellitus

According to a recent study conducted at the Medical College of Georgia at Augusta University[4], the leading causes of Type 2 diabetes mellitus include:

Genetic predisposition (family history of diabetes):It is essential to know your family history. About 35-50% of patients with diabetes have someone in their family with diabetes in comparison to someone from a healthy family.

It has been published that the hereditary factor is more vital than the environmental factor in contributing to type 2 diabetes mellitus. Ask about your family background, as this can serve as a guide in preventing a sedentary lifestyle.

Obesity: Generally, 80% of patients with type 2 diabetes are obese. And this is the most contributory environmental factor to the development of type 2 diabetes.

Ageing: The influence of age on the development of type 2 diabetes cannot be ignored. The universal prevalence of this disease shows a progressive increment of its prevalence rates as you grow old.

The ability of the body to maintain average glucose levels decreases as we increase in age, which has been attributed to the loss of muscle mass and increase in adipose tissue, especially in sedentary individuals.

Psychological stress: according to some research findings, it has been confirmed that acute psychological stress has been linked as a factor that favours the onset of diabetes. The psychological stress increases sympathetic activation, which reduces the functionality of the pancreatic β-cell (the organ that produces insulin), resulting in a decline in insulin production.

At the same time, in the muscle, there is a decline in insulin sensitivity, glucose uptake, and glycogen deposition, all of which elevates glucose in the blood and clinically favours the development of type 2 diabetes mellitus

Race: it is known that type 2 diabetes is commoner among the blacks

Unhealthy Diet

Lack of exercise or physical inactivity(sedentary lifestyle): Obesity and inactivity (sedentary lifestyle) appear to be the most critical risk factors for the development of type-2 diabetes. Obesity is when the body accumulates too much fat and can't control how the fat is distributed throughout the body.

Obesity is a global pandemic. One in three adults, 9 billion people globally, are overweight, and one in ten of them are obese. A body mass index (BMI) of 30 kg/m2 or more can increase the risk for type 2 diabetes by up to 75%.

The American Diabetes Association reports that patients with Type 2 diabetes and insulin resistance will show symptoms that do not meet the conventional diagnostic criteria for either condition, such as experiencing generalized fatigue or elevated liver enzymes.

 

Prevention Of Type 2 Diabetes

Definitely, a healthy lifestyle can prevent almost all cases of type 2 diabetes. Diabetes is a common condition in both adults and children. And the good news is that you can prevent type 2 diabetes by doing the following:

  • Increasing your physical activity- by regular exercise,
  • Maintain your blood glucose within the normal range by periodic checking of your blood sugar
  • Maintaining a healthy weight, and
  • Eating a healthy, well-balanced diet.
  • Avoiding sugary drinks such as soda drinks.
  • Choosing to eat a diet low in saturated fat and cholesterol and high in fibre, fruit, vegetables, and dairy products
  • Stop smoking cigarettes, shisha, etc
  • Consider cutting back on or quitting alcohol consumption

 

Control Of Type 2 Diabetes

In controlling type 2 diabetes, it is vital to follow these life-saving guidelines:

  • Ensure that blood sugar levels are maintained within the recommended ranges by regularly checking your blood sugar with a glucometer and informing your doctor if you get a value above the recommended range. The doctor may recommend a monthly check of HbA1c (glycosylated haemoglobin to monitor glucose control) for up to six months.
  • Diabetes medication and lifestyle changes may help people with type 2 diabetes to manage this condition. People with type 2 diabetes may need to monitor their blood sugar levels regularly. They may have to take some medicines such as Metformin and insulin, which control blood sugar levels.

Lifestyle modification, such as:

  • Exercising frequently: the importance of exercise on our body cannot be overemphasized because the body uses blood glucose to generate energy. Depending on the duration and intensity of the exercise, physical activities reduce blood sugar. It will also increase the sensitivity of the body cells to insulin which was primarily defective in a diabetic patient.
  • Drink enough water, and
  • Eating fruits of different colours, such as apple, grape, oranges, strawberry, etc.

 

Complications Of Type 2 Diabetes Mellitus

Diabetes puts you at risk of many significant health diseases. The good news is that many people with diabetes can avoid or prevent the early onset of these complications if they present themselves early, receive proper treatment and make appropriate lifestyle changes.

Some of the possible complications of type 2 diabetes include:

  • Hypoglycemia: this is one of the most common complications. Characterized by drop in blood glucose level below the acceptable level, and this can be life-threatening. It can lead to shaking (tremor), sweating profusely, feeling dizzy and unbalanced, having headaches, hunger, and anxiety.
  • Tooth decay, especially in poorly managed diabetes
  • High blood pressure (Hypertension)
  • Cardiovascular diseases
  • Stroke and hyperglycemic emergencies.
  • Visual abnormalities such as blurry vision
  • None healing wound, also known as Diabetic foot ulcer
  • Renal damage
  • Mental health; people with diabetes are more prone to develop mental health problems such as anxiety, depression, etc.

 

Diagnosis Of Type 2 Diabetes

Whether you have diabetes or not, it is always good to be aware of your blood glucose. Checking your blood sugar assists you in knowing when your glucose level is normal or when it is abnormal. According to WHO guidelines[3], for most people, normal blood sugar levels are:

  • 70-100 mg/dl (3.9-5.6 mmol/L) before eating (fasting blood sugar)
  • Below 180 mg/dl (<10 mmol/L) 2 hours after eating (Postprandial glucose level)
  • HbA1C should be less than 6.5%: A haemoglobin A1C above 6.5% is diagnostic of type 2 diabetes mellitus

When fasting blood glucose is between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) changes in lifestyle and monitoring glycemia are recommended. If fasting blood glucose is 126 mg/dL (7 mmol/L) or higher on two separate tests, diabetes is diagnosed.

An individual with low fasting blood glucose concentration (hypoglycemia) – below 70 mg/dL (3.9 mmol/L) – will experience dizziness, sweating, palpitations, blurred vision and other symptoms that have to be monitored.

 Increased fasting blood glucose concentration (hyperglycemia) is an indicator of a higher risk to diabetes. An individual’s fasting blood plasma glucose (FPG) may be in the normal range because the individual is not diabetic or because of effective treatment with glucose-lowering medication in diabetics.

Making the diagnosis is usually clinical. Your doctor might want to ask about excessive weight gain, excessive eating, increase water intake, and frequent urination. He will check your blood glucose either by checking your fasting glucose level or by carrying out Oral Glucose Tolerance Test (OGTT). If the value obtained is above the recommended above, the diagnosis can be made and commencement of appropriate treatment.

 

How To Check Blood Sugar Level

When it comes to self-monitoring of blood glucose, there are many options that you can use to know your sugar level. One of the popular options is the use of a glucometer with a test strip and lancet. It is effortless and straightforward with no or minimal discomfort. Testing your glucose allows you to learn how to manage your blood glucose no matter the time of the day or wherever you are.

Guidelines in checking your blood sugar:

  • To check your blood glucose, you need the following materials: a glucometer, a lancet device (small needle for pricking), 60% alcohol and cotton wool, a test strip, a pen, and paper for documenting your glucose value.
  • Wash your hands or sterilize your hands with 60% alcohol and cotton wool.
  • Insert the new test strip into the glucometer
  • Prick the sterilized finger with the lancet and allow the blood to form a
  • Gently place the drop of blood on the test strip and wait for 10-15 seconds for the result. Then, Safely cap the lancet and dispose properly in a sharp box.

 

How To Maintain Blood Sugar Level

As stated earlier, type 2 diabetes mellitus can be controlled through lifestyle changes, diet, and exercise. If the levels remain high, insulin injections can be used to manage the blood sugar levels. 

  1. Eat a healthy, balanced diet. It is essential to consume a diet rich in low-fat or non-fat dairy products, legumes, cereals, vegetables, fruits, and lean meat.
  2. Inclination towards physical activity. The WHO recommends that people engage in moderate to vigorous-intensity aerobic activities that include 150 minutes of moderate-intensity physical activity per week. Aerobic exercises like walking, swimming, cycling, running, aerobics, and dancing are good to control blood sugar levels.
  3. Drinking enough water and staying hydrated.
  4. Work with a dietitian or nutritionist to formulate an adequate meal plan
  5. Get quality sleep

Before making any lifestyle changes or taking new supplements, consult with your healthcare practitioner. This is especially essential if you have trouble managing your blood sugar or are on blood glucose-lowering medication such as Metformin

 

A Word From HealthCabal

While Type 2 Diabetes Mellitus is an ailment that can be managed with proper diet and exercise, it is essential to understand that Type 2 Diabetes Mellitus is a life-long condition. It should not be confused with the other types of diabetes.

The symptoms of diabetes are non-specific and do not correspond to a specific cause.  If you have diabetes or are having trouble managing your blood sugar, you should collaborate with your healthcare practitioner to develop and implement a treatment plan as soon as feasible.

 

References:

https://www.diabetes.org/diabetes/type-2

https://www.nhs.uk/conditions/type-2-diabetes/

https://www.who.int/data[3]

https://www.openaccessjournals.com/articles/[4]