Continued from part - I...............
Identification of diabetes mellitus type 2
Unlike diabetes type 1, where the problem in the metabolic system with insulin production, in case of diabetes type 2, it is the response to insulin by body cells what is defective. It may go undetected for years, since the symptoms are sporadic and not acute. However, it may prove fatal if not managed properly. The major factors contributing to this problem are (Robbins & Cotran, 2004).
• Higher level of hepatic glucose production.
• Reduction of insulin-mediated transport of glucose to adipose tissue and primary muscles.
• Beta-cell malfunction.
The early detection of the disease helps to manage it better. There are some symptoms identified with diabetes like increased thirst, more urination, recurrent infection, weight loss and tiredness. The World Health Organization defined diabetes as raised glucose level in blood on two occasions. On fasting the level of glucose in blood should be > 7.0 mmol/l i.d 126mg/dl and/ or the tolerance test of glucose that is two hours after oral dose plasma glucose >11.1 mmol/l i.e 200mg/dl (WHO 2007).
Risk factors
Diabetic patients especially who are suffering from type 2, may have strong genetic connection. Type 2 diabetes is also associated with obesity, high cholesterol level and a condition termed as metabolic syndrome (Chiasson 2002; Torgerson, 2004). Further type 2 diabetes associates with cushing’s syndrome, acromegaly, endrinological problems. Obesity caused by type 2 diabetes changes metabolism and turn it insulin resistance (Camastra, Bonora , Del Prato, Rett, Weck & Ferrannini 1999).
Diabetic hypoglycemia is another risk associated with all type of diabetic patients (Cryer PE1997). It is sudden fall of blood glucose level and is seen as emergency. Because as fall out of hypoglycemia; patient collapses usually losing sense. It should be treated as emergency and prompt treatment with the recognition should be started lest brain or organ damage may occur. It may be reversed initially with the small intake of carbohydrate in solid or liquid form. In extreme cases patients losing consciences are called to be in diabetic coma. Hypoglycemia symptoms can be severe, moderate or mild depending upon the level of glucose fall in the blood (Diabetes Control and Complications (DCCT) Research Group 1993; Inzucchi & Sherwin 2005).
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