Diabetes mellitus Type 2
Unlike patients with type 1 diabetes mellitus, patients with type 2 are not absolutely dependent upon insulin for life. This distinction was the basis for the older terms for types 1 and 2, insulin dependent and non–insulin dependent diabetes. However, many patients with type 2 diabetes are ultimately treated with insulin. Because they retain the ability to secrete some endogenous insulin, they are considered to require insulin but not to depend on insulin. Nevertheless, given the potential for confusion due to classification based on treatment rather than etiology, these terms have been abandoned.[1] (See Treatment and Management and Medication.)
Another older term for type 2 diabetes mellitus was adult-onset diabetes. Currently, because of the epidemic of obesity and inactivity in children, type 2 diabetes mellitus is occurring at younger and younger ages. Although type 2 diabetes mellitus typically affects individuals older than 40 years, it has been diagnosed in children as young as 2 years of age who have a family history of diabetes. (See Epidemiology.)
Diabetes mellitus is a chronic disease that requires long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur. It is a disproportionately expensive disease; in the United States in 2002, the per-capita cost of health care was $13,243 for people with diabetes, while it was $2560 for those without diabetes. The emergency department utilization rate by people with diabetes is twice that of the unaffected population.[2]
This article focuses on the diagnosis and treatment of type 2 diabetes and its acute and chronic complications, other than those directly associated with hypoglycemia and severe metabolic disturbances, such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Genetic susceptibility to diabetes mellitus type 2
Today, you know that diabetes mellitus type 2 a much larger genetic basis exists for, than previously assumed. For example, both parents have diabetes mellitus type 2, the probability that children also diabetes susceptible to this type 70-80% is located. One parent is affected, the risk of the child is up to 60%.
Diabetes mellitus type 2 - lack of exercise and obesity make sick
First of all no insulin is available in the diabetes mellitus type 2. There may be an increase in the concentration of insulin in the blood due to lack of exercise and excess weight. Be resistant to the insulin receptors on the cell wall and the Islands have to produce more insulin to keep blood sugar levels still normal. This preliminary stage of diabetes mellitus type 2 is called an impaired glucose tolerance.
Because these patients often continue to increase with increasing age and move even less, the insulin production at some point no longer sufficient, to keep the blood sugar levels normal. Then, the blood sugar goes up even though the patient has a very high insulin levels.
The treatment of diabetes is type 2 therefore, first change the way of life, i.e. a healthy diet and more exercise. If this goal is a normal setting not reached, drugs are required in addition in the form of tablets or insulin. Here too the consequential occur otherwise after about 10 years, which greatly affect the quality of life and life expectancy.
Targets a modified diet for diabetes mellitus type 2
• calorie-friendly diet, thus the BMI below 25 will be held
• Avoid a high blood sugar
• Antiatherogene effect (directed against the emergence of an atherosclerosis)
• Nephroprotektive effect (end of renal protection effect).
Metabolic syndrome and type 2 diabetes
Diabetes type 2 is usually part of a complex disorder of the regulation and of the processes in various body cells. This disorder is summarized with the term "Metabolic syndrome". Heart attack, stroke and other diseases, which related to changes of arteries in context, are usually consequences of metabolic syndrome.General characteristics of the metabolic syndrome are a specific type of fat distribution, the "Apple type" (much belly fat, low in fat in the field of buttocks and thighs) with an insulin resistance.
The tendency to the metabolic syndrome is inherited. More than a third of the population in Germany has this hereditary. With increasing body weight and age show the various facets of the metabolic syndrome, which are mutually reinforcing.
In recent years, the idea of the origin and meaning of type 2 diabetes has changed fundamentally. In contrast to the type 1 diabetes, not the insulin is the primary problem in the type 2 diabetes. The pancreas is even more insulin at the beginning and through long stages of the disease.
A major problem in the type 2 diabetes is that insulin can have its effect on the target organs of skeletal muscle, adipose tissue and liver not properly, this is called insulin resistance. (For many body cells, insulin is the signal, to record the energy source glucose and continue to process.)
This leads to an increase in blood sugar but not alone, but to a variety of changes of Ernergiestoffwechsels. So, the increased blood sugar level is only the tip of the iceberg. In the Centre of the action is the "metabolic syndrome".
Metabolism means metabolism, a syndrome is the simultaneous presence of several health problems, which partly mutually influence and shape a clinical picture. The metabolic syndrome disorders of lipid metabolism, the coagulation system and the blood pressure regulation include in addition to a disorder of glucose metabolism.
A key feature of the metabolic syndrome is the waist circumference. According to the current provisions, the limit value for the waist circumference is located in European men at 94 cm in women at 80 cm. An increase of Bauchung fishing means an increase in the probability of the formation and the development of metabolic syndrome.
Number and extent of the components of metabolic syndrome are more likely to get a heart attack, stroke or a vascular disease of the legs. Therefore must in the diabetes patients of not only the blood sugar level, but also the other components of the "metabolic syndrome" be registered and, as far as it goes, sought a normalization.
The interweaving of risk factors is so complex, the most important recommendation to tackle this complex disorder is so easy: regular physical activity (depending on the age and physical condition sport or even walking) is the best and most natural way to affect almost all components of the metabolic syndrome. Try it!
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