Mediora

Overview

Type 2 diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from insulin resistance and relative insulin deficiency.
Accounts for 90-95% of all diabetes cases worldwide, affecting over 537 million adults globally with numbers projected to reach 783 million by 2045.
Unlike Type 1 diabetes, the pancreas continues producing insulin but body cells become resistant to its effects, requiring progressively higher insulin levels to maintain normal glucose metabolism.

Classic Type 2 Diabetes: Most common form occurring primarily in overweight or obese adults with gradual onset of symptoms and strong genetic predisposition.
Lean Type 2 Diabetes: Occurs in individuals with normal BMI, more common in Asian populations, often related to visceral adiposity and genetic factors.
Latent Autoimmune Diabetes in Adults (LADA): Slow-progressing autoimmune diabetes initially resembling Type 2 but eventually requiring insulin therapy.
Prediabetes: Intermediate hyperglycemic state (impaired fasting glucose or impaired glucose tolerance) preceding overt diabetes with high conversion risk.
Gestational Diabetes: Glucose intolerance first recognized during pregnancy; significantly increases risk of developing Type 2 diabetes later in life.

Polyuria (Excessive Urination): Frequent urination especially at night as kidneys attempt to eliminate excess glucose through urine production.
Polydipsia (Increased Thirst): Persistent excessive thirst resulting from fluid loss through frequent urination and body's attempt to dilute high blood glucose.
Polyphagia (Increased Hunger): Despite eating, cells cannot access glucose for energy leading to persistent hunger and cravings.
Unexplained Weight Loss: Despite increased appetite, body breaks down muscle and fat for energy when cells cannot utilize glucose effectively.
Fatigue and Weakness: Inadequate glucose utilization by cells results in persistent tiredness, reduced physical stamina, and mental fatigue.
Blurred Vision: Fluctuating blood glucose levels cause lens swelling affecting ability to focus clearly; usually reversible with glucose control.
Slow Wound Healing: High blood sugar impairs immune function and blood circulation delaying healing process and increasing infection risk.
Recurrent Infections: Frequent urinary tract infections, yeast infections, skin infections due to impaired immune response in hyperglycemic environment.
Numbness and Tingling: Peripheral neuropathy causing tingling, numbness, pain in hands and feet from nerve damage due to prolonged hyperglycemia.
Darkened Skin Patches: Acanthosis nigricans appearing as velvety darkened skin in body folds (neck, armpits, groin) indicating insulin resistance.

Insulin Resistance: Primary defect where muscle, fat, and liver cells fail to respond normally to insulin, requiring higher insulin levels to facilitate glucose uptake.
Beta Cell Dysfunction: Progressive decline in pancreatic beta cell function reducing insulin secretion over time, eventually leading to insulin deficiency.
Genetic Predisposition: Strong hereditary component with 40% risk if one parent has diabetes, 70% if both parents affected; multiple gene variants contribute.
Obesity and Visceral Fat: Excess adipose tissue, particularly abdominal fat, releases inflammatory cytokines and free fatty acids promoting insulin resistance.
Physical Inactivity: Sedentary lifestyle reduces insulin sensitivity in muscles, decreases glucose utilization, and promotes weight gain accelerating disease development.
Abnormal Glucose Production: Liver continues producing glucose even when blood sugar is high due to hepatic insulin resistance contributing to fasting hyperglycemia.
Incretin Deficiency: Reduced or impaired secretion of gut hormones (GLP-1, GIP) that normally stimulate insulin release after meals.

Cardiovascular Disease: Two to three times higher risk of heart attacks, strokes, and peripheral artery disease; leading cause of death in diabetic patients.
Diabetic Neuropathy: Nerve damage affecting peripheral nerves causing pain, numbness, digestive problems, sexual dysfunction, and autonomic nervous system disorders.
Diabetic Nephropathy: Progressive kidney damage potentially leading to chronic kidney disease, end-stage renal disease requiring dialysis or transplantation.
Diabetic Retinopathy: Blood vessel damage in retina causing vision problems, potentially leading to blindness if untreated; screening essential for early detection.
Diabetic Foot Complications: Combination of neuropathy and poor circulation increases risk of ulcers, infections, and amputations requiring meticulous foot care.
Hyperosmolar Hyperglycemic State: Life-threatening complication with extremely high blood sugar, severe dehydration, altered consciousness requiring immediate hospitalization.
Increased Infection Risk: Impaired immune function and high glucose levels create favorable environment for bacterial and fungal infections.
Cognitive Impairment: Increased risk of dementia, Alzheimer's disease, and cognitive decline associated with chronic hyperglycemia and vascular damage.

Overweight and Obesity: BMI ≥25 kg/m² significantly increases risk; excess weight, especially abdominal obesity, is strongest modifiable risk factor.
Age: Risk increases after age 45, though growing prevalence in younger adults and children due to obesity epidemic.
Family History: Having parent or sibling with Type 2 diabetes substantially elevates personal risk due to shared genetic and environmental factors.
Ethnicity: Higher prevalence in African Americans, Hispanic/Latino Americans, Native Americans, Asian Americans, Pacific Islanders compared to Caucasians.
Gestational Diabetes History: Women who developed diabetes during pregnancy have 50% chance of developing Type 2 diabetes within 10 years.
Polycystic Ovary Syndrome: Women with PCOS have significant insulin resistance increasing diabetes risk requiring screening and preventive interventions.
Hypertension: Blood pressure ≥140/90 mmHg associated with insulin resistance and increased cardiovascular disease risk in diabetic patients.
Dyslipidemia: Low HDL cholesterol (<40 mg/dL in men, <50 mg/dL in women) or high triglycerides (>250 mg/dL) indicate metabolic syndrome.

Weight Management: Losing 5-10% of body weight significantly reduces diabetes risk; prevents or delays disease onset in high-risk individuals.
Regular Physical Activity: Minimum 150 minutes moderate aerobic exercise weekly plus strength training improves insulin sensitivity and glucose metabolism.
Healthy Dietary Patterns: Mediterranean or DASH diet emphasizing vegetables, fruits, whole grains, lean proteins, healthy fats; limiting processed foods and added sugars.
Smoking Cessation: Smoking increases diabetes risk by 30-40%; quitting reduces risk and improves overall cardiovascular health outcomes.
Regular Screening: Adults ≥35 years or younger with risk factors should undergo blood glucose testing every 3 years for early detection.
Metformin for Prevention: Consider for individuals with prediabetes, especially those with BMI ≥35, age <60, or history of gestational diabetes.
Adequate Sleep: Maintain 7-9 hours quality sleep; sleep deprivation increases insulin resistance and appetite-regulating hormones disruption.
Stress Management: Chronic stress elevates cortisol levels promoting insulin resistance; mindfulness, relaxation techniques benefit glucose control.