Diabetes Mellitus Type II
Also known as non-insulin dependent diabetes mellitus, Diabetes mellitus type 2 (DM II) is a life-long disease characterized by high blood sugar levels. Unlike type 1 diabetes or juvenile onset diabetes where the body does not produce insulin at all, DM II usually starts in adulthood and is marked by the presence of insulin in the body. However, the amount of insulin, a hormone produced by the pancreas, may be inadequate to control blood sugar levels, or the cells may be resistant to the effects of insulin, thus preventing metabolism of sugar.
Sugar or glucose is an important substrate in the blood which the body needs as food of the cells for energy and function. However, abnormalities in metabolism can cause glucose levels to be in excess, producing symptoms that put the body at risk for complications.
Factors That Affect Blood Glucose Levels
In people with normal metabolism blood sugar levels increase with food intake, but decrease shortly after when insulin facilitates entry of the sugar molecules into the cells to be used as sources of energy. However, sugar levels in type 2 diabetes usually do not decrease as expected because (a) of the lack of the amount of insulin produced by the pancreas, or (b) the muscle, fat and liver cells which are supposed to absorb the sugar molecules are resistant to the effects of the insulin or (c) both.
Aside from hormones, blood glucose levels are controlled by many factors like diet, exercise and medications. A diet rich in carbohydrates, especially simple sugars, can increase blood sugar levels immediately after eating. Lack of exercise and a sedentary lifestyle can also hinder the body’s ability to utilize the existing sugar molecules in excess of the body’s needs. Often, blood sugar levels may be reduced just by controlling the amount of sugar consumed in the diet and by doing enough exercise. However, some people may need anti-diabetic medications to decrease blood glucose levels that put them at risk for complications.
Other factors that may influence an increase in sugar levels in type 2 diabetes are:
- Family history of diabetes
- Age over 45 years, although younger people are now being diagnosed with the disease
- Obesity and high blood cholesterol levels
- Heart disease
- Polycystic ovaries in women
- Increased blood sugar levels related to pregnancy
- Previous experience of impaired glucose tolerance
- Ethnicity is also associated with increased risk for DM II, particularly for African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans
Symptoms Related to Increased Blood Sugar Levels
Many people who are pre-diabetic or with slightly increased blood sugar levels are not symptomatic. However, in those with full-blown disease symptoms such as these may bring them to clinics for consultation:
- Excessive thirst, followed by increase in drinking of fluids
- Increase in the frequency of urination
- Constant hunger, increase in appetite
- Weight loss
Diagnosis and Treatment
Increases in blood sugar levels are usually discovered first in routine urinalysis. Further confirmation of the disease is best done by obtaining fasting blood sugar levels and by doing the glycated hemoglobin (A1C) test which demonstrates the average levels of blood sugar in the past 3 months. An oral glucose tolerance test may also be done to challenge a patient’s ability to decrease blood sugar levels after the intake of sugar.
Blood sugar levels to diagnose diabetes are:
- Fasting blood glucose levels higher than 126 mg/dL on two occasions
- Hemoglobin A1c level of 6.5% or higher
- Oral glucose tolerance test yields glucose levels higher than 200 mg/dL after 2 hours.
The principles of treatment for type 2 diabetes are anchored on a life-long commitment to:
- A healthy diet with less sugar and fat to maintain an ideal body weight –should consist of more fruits, vegetables and whole grain foods; avoid alcohol and beverages that have high sugar content.
- Regular exercise to burn calories, maintain weight and prevent other complications like heart disease.
- Use of proper medications to control blood sugar levels – may consist of oral hypoglycemic or insulin
- Regular blood sugar monitoring, as advised by a physician to remain within a target range and avoid complications
It is important for patients to have early diagnosis and treatment of the disease because type 2 diabetes sugar levels that are uncontrolled can predispose them to complications like heart and kidney disease, blindness, non-healing ulcers and death.
Medline Plus, “Diabetes”, https://www.nlm.nih.gov/medlineplus/ency/article/001214.htm
Mayo Clinic, “Type 2 Diabetes”, https://www.mayoclinic.com/health/type-2-diabetes/DS00585/DSECTION=treatments-and-drugs