Type 2 Diabetes - Weebly



Type 2 Diabetes

Tammy Fontana

Salt Lake Community College-Nutrition 1020

Diabetes is a very common condition that affects approximately 29.1 million people in the United States with an additional 86 million adults having prediabetes (National Diabetes Month, 2015, p. 1). Diabetes is becoming more and more prevalent in adults and children. In fact, from 1980 through 2014, the number of Americans with diagnosed diabetes has increased from 5.5 million to 29.1 million. In adults, type 2 diabetes accounts for about 90-95 percent of all diagnosed cases of diabetes in North America (Wardlaw, 147). Type 2 diabetes risk increases with age, however, the number of children diagnosed is also increasing due to a growing number of overweight youth. In adults 20 and older, more than one in ten people suffer from diabetes, and in seniors (65 and older), that figure rises to more than one in four people (Pietrangelo, 2016, pg 1). While some of the risk factors are genetic, you can help prevent and manage type 2 diabetes by incorporating healthy lifestyle behaviors into your daily life.

Description

According to the Mayo Clinic, “Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose), your body’s important source of fuel. With type 2 diabetes, your body either resists the effects of insulin-a hormone that regulates the movement of sugar into your cells- or doesn’t produce enough insulin to maintain a normal glucose level” (Mayo Clinic Staff, 2016, p.1). When you eat your body breaks food down into glucose and sends it into the blood. Insulin then helps move the glucose from the blood into your cells. Once the glucose enters the cells, it can be used as fuel for energy right away and can also be stored to use later. When a person has type 2 diabetes, the body does not use insulin properly. At first, the pancreas makes extra insulin to combat the insulin resistance. Soon it will no longer be able to keep up and cannot make enough insulin to keep the blood glucose levels normal (American Diabetes Association, 2013. p. 1.). Because type 2 diabetes can be genetic, those who have a family history of the disease should get regular blood glucose tests done and also practice a healthy lifestyle. There is no cure for type 2 diabetes, but you can help manage it by eating well, exercising and maintaining a healthy body weight. There are also several medications available that can help manage blood sugar levels.

Risk Factors

It is unclear why some people develop type 2 diabetes and some don’t. Researchers have found that there are certain factors that increase the risk, including:

Family history. The risk is increased it you have a parent or sibling that has type 2 diabetes. Some studies have shown that a child’s risk of developing type 2 diabetes is greater if the mother has it. If both parents have diabetes, the child’s risk of developing it is approximately 50 percent. In most cases, if a child has one parent that was diagnosed with type 2 diabetes before age, 50, the child has a 1 in 7 chance of developing the disease. (Pietrangelo, pg 1)

Race. Studies have shown that people of certain races are more susceptible than others. Blacks, Hispanics, American Indians, and Asian-Americans are all more likely to develop type 2 diabetes than Caucasians. While type 2 diabetes is rare among children, it has been found that Asian/Pacific Islanders ages 10-19 are diagnosed at a higher rate than most other ethnic groups (Mayo Clinic Staff, 2016, p.1).

Age. The risk of type 2 diabetes increases with age. It is most likely because people tend to exercise less, lose muscle mass, and gain weight as they get older. It is alarming that many children, teens, and young adults are also being diagnosed with type 2 diabetes. This is most likely due to being overweight. “In the United States, as of 2012, 9.3 percent of all adults 20 or over have diabetes. Among adults 65 or over, 25.9 percent have diabetes. In comparison, children 19 and under have a rate of only 0.26 percent.” (Pietrangelo, 2016, pg 1)

Weight. Being overweight is a primary risk factor. The more fatty tissue in your body, the more resistant your cells become to insulin. Not all individuals diagnosed with type 2 diabetes are overweight. Most cases of type 2 diabetes (about 80%) are linked to obesity (Wardlaw, 2015, p. 150).

Fat distribution. It has been found that people who store excess fat primarily in the abdominal area or more at risk for type 2 diabetes than those who store fat elsewhere, such as in the hips and thighs (Wardlaw, 2015, p. 150).

Inactivity. Because physical activity helps control weight, uses up glucose as energy and make cells more sensitive to insulin, it makes sense that activity levels are directly related to the risk for developing type 2 diabetes. The less active a person is, the greater the risk.

Prediabetes. A person with prediabetes has a blood sugar level higher than normal, but not high enough to be considered diabetic. If this is left untreated, it often progresses to type 2 diabetes. For some people with prediabetes, early treatment can actually return blood glucose levels back to the normal range. You can prevent or delay type 2 diabetes from developing by cutting back on calories and saturated fats, losing weight, and increasing your daily physical activity. Research has shown that if you have prediabetes, you can lower your risk for type 2 diabetes by 58% by exercising moderately 30 minutes a day, five days a week and by losing 7% of your body weight (American Diabetes Association, 2014, p.1).

Gestational diabetes. Women who develop gestational diabetes during pregnancy have a 35 to 60 percent chance of developing type 2 diabetes within 10 to 20 years of the pregnancy.

Health Complications

Type 2 diabetes is progressive, and in most cases is present long before it is diagnosed. The symptoms can develop slowly and are not always noticed in the early stages of the disease (Wardlaw, 2015, p. 150). Some common signs and symptoms of type 2 diabetes include heart disease, stroke, hypertension, blindness and eye problems, kidney disease, nervous system complications, amputations, dental disease, pregnancy complications, and mental health problems (Pietrangelo, pg 1). There are many factors that can affect your blood sugars levels and problems can arise quickly and will require immediate care. Some of these include:

High blood sugar. You should check your blood glucose level often because the levels can rise for many reasons. Some of these reasons might include eating too much, being sick, or not taking the correct amount of medication. Some common sign or symptoms of hyperglycemia could be frequent urination, increased thirst, dry mouth, blurred vision, fatigue, and nausea (Mayo Clinic Staff, 2016, p.1).

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). This is a life threatening disease that is caused by very high blood sugar that turns the blood thick and syrupy. It usually develops over days or weeks and is most common in older people with type 2 diabetes. Symptoms can include a blood sugar reading over 600mg/dl, dry mouth, extreme thirst, fever, drowsiness, confusion, vision loss, hallucinations and dark urine (Mayo Clinic Staff, 2016, p.1).

Increased ketones in your urine (diabetic ketoacidosis). DKA is a serious condition that can lead to a diabetic coma or even death. If your cells are starved for energy, your body may start to break down fat. The toxic acids that this produces are called ketones. When ketones build up in the blood, they make it more acidic. When levels get too high, ketones can poison the body. Possible signs of increased ketones could include a very dry mouth, frequent urination, vomiting shortness of breath, fatigue, and breath that has a fruity odor (American Diabetes Association, 2015, p.1).

Low blood sugar. When your blood sugar level drops lower than your target for whatever reason. Some causes could be skipping a meal, getting more physical activity than normal, or taking too much medication. Some signs of hypoglycemia could be sweating, shakiness, weakness hunger, headache, heart palpitations, slurred speech, confusion, and seizures. It is possible to develop hypoglycemia during the night. You might wake up with a pillow wet with sweat or a headache. If you have signs of low blood sugar, you should eat or drink something that will raise your level quickly like candy, fruit juice, or another form of sugar (American Diabetes Association, 2015, p.1).

Prevention

Often times, type 2 diabetes and its side effects can be prevented or delayed. Research has found that exercising regularly and eating a healthy diet will dramatically decrease the onset of diabetes and its accompanying complications. Other preventative measures can include regular visits to a healthcare provider and maintaining a healthy body weight. If you have a high risk for diabetes, your health care provider might use medicine to help prevent or delay diabetes. For most people, eating less, being more active, and losing weight work better than taking medicine. Talk with your doctor and make a plan. Another option is to meet with a registered dietitian and discuss what to eat and how to lose weight (American Diabetes Association, 2013. p. 1.).

In order for your doctor to diagnose type 2 diabetes, they will take a look at your medical history and risk factors, review your symptoms and perform a physical examination. Your doctor will then give you one or more blood tests. The most common test used to diagnose type 2 diabetes is the glycated hemoglobin (A1C) test. This test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, which is the oxygen carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. If this test isn’t available, there are several others that your doctor may use to diagnose type 2 diabetes. Other options include random blood sugar tests, fasting blood sugar tests, and oral glucose tolerance tests (Mayo Clinic Staff, 2016, p.1). The American Diabetes Association recommends routine screening beginning at age 45, especially if you are obese. Screening is also important for people under 45 who are overweight, live a sedentary lifestyle, have a family history of diabetes, or have blood pressure of 140/90 (American Diabetes Association, 2013. p. 1.).

Treatment Options

The two main goals of type 2 diabetes treatment are to make sure you feel good day to day and to prevent or delay long-term health problems. The most common ways to manage type 2 diabetes include healthy eating, regular exercise, diabetes medication or insulin therapy and blood sugar monitoring. By doing these things, you are able to keep your blood sugar levels closer to normal, which can help prevent, or delay complications (Pietrangelo, pg 1)

Some people with type 2 diabetes may be able to achieve their target blood sugar levels with diet and exercise alone, but there are many who also need medication or insulin therapy. Your doctor will consider your blood sugar levels and any other health problems you may have before prescribing a medication. Some of the possible treatments include Metformin (improves the sensitivity of your body tissues to insulin so that your body uses insulin more effectively), Sulfonylureas (help your body secrete more insulin), Meglitinides (stimulates pancreas to secrete more insulin), Thiazolidinediones (make the body’s tissues more sensitive to insulin), DPP-4 inhibitors (help reduce blood sugar levels), GLP-1 receptor agonists (slow digestion and help lower blood sugar levels), SGLT2 inhibitors (prevents kidneys from reabsorbing sugar into the blood-the sugar is excreted in the urine), and insulin therapy (American Diabetes Association, 2013. p. 1.).

Effects of Diet

Diet plays a major role in the prevention and treatment of type 2 diabetes and many other diseases. According the American Diabetes Association, “Eating well-balanced meals is an essential part of taking better care of yourself and managing diabetes” (American Diabetes Association, 2013). Diet is an important tool to keep your body healthy and your blood sugar levels in a safe range. In the past, diabetic diets have been really restrictive. Luckily, things are different now. Even though you may have to make some changes in what and how much you eat, with a little bit of planning you can still enjoy your favorite foods.

Some important things to remember when you have type 2 diabetes are to eat meals and snacks on schedule and to not skip meals. It is vital to maintain your blood sugar levels throughout the day. You should choose a variety of foods that are nutrient dense and low in empty calories. You should also be careful not to overeat as this can cause hyperglycemia. Your diet should emphasize overall calorie control, increased intakes of fiber-rich foods and fish, and reduced intakes of added sugars and solid fats (Wardlaw, 150). Low glycemic index foods are also a good choice as they help achieve a more stable blood sugar and are typically higher in fiber.

A healthy diabetic diet should include a variety of different foods, including vegetables, whole grains, fruits, non-fat dairy foods, healthy fats, and lean meats. The American Diabetic Association has provided a list of the top 10 diabetes superfoods. These foods need to be worked into your individualized meal plan, but do offer a low glycemic index and provide key nutrients including calcium, potassium, fiber, magnesium and vitamins A, C, and E. The superfoods recommended are beans, dark green leafy vegetables, citrus fruit, sweet potatoes, berries, tomatoes, fish high in omega-3 fatty acids, whole grains, nuts, and fat-free milk and yogurt (American Diabetes Association, 2013).

There are also certain foods that you should limit or avoid completely. Examples of these include foods heavy in saturated fats, hoods heavy in trans fats, beef, processed meats, shellfish, organ meats, stick margarine, shortening, baked goods, processed snacks, sugary drinks, high-fat dairy products, salty foods, and fried foods.

A registered dietitian can help you develop a meal plan that fits your health needs, food preferences and lifestyle. Together, you can come up with a diet plan full of foods you enjoy that also suits your lifestyle and health needs.

Effects of Activity and Exercise

Physical activity and exercise are extremely beneficial and essential to overall health and is also essential in managing type 2 diabetes. According to the New York Times, “Exercise has positive benefits for those who have diabetes. It can lower blood sugar levels, improve insulin sensitivity, and strengthen the heart. Strength training, which increases muscle and reduces fat, may be particularly helpful for people with diabetes” (A.D.A.M., 2016).

It is important to make exercise a part of your daily routine. You can easily incorporate physical activity by choosing things that you enjoy doing. Some examples are swimming, walking, biking, or yoga.

“For improving glycemic control, the American Diabetes Association recommends at least 150 minutes per week of moderate-intensity physical activity or at least 90 minutes per week of vigorous aerobic exercise. Exercise at least 3 days a week, and do not go more than 2 consecutive days without physical activity” (A.D.A.M., 2016).

Conclusion

Although type 2 diabetes can be genetic, it can also be prevented and managed with a healthy lifestyle. By eating a healthy diet, being physically active and maintaining a healthy body weight, you can dramatically reduce your risk for type 2 diabetes and the complications that accompany it.

References

1. National Diabetes Month. (2015, November 20). Morbidity and Mortality Weekly Report. Retrieved from

2. Pietrangelo, Ann. (2016 March 31). Type 2 Diabetes Statistics and Facts. Retrieved from

3. Wardlaw, G., Smith, A., & Collene, A. (2015). Foundations of Nutrition. United States

4. American Diabetes Association. (2013, August 1). Facts about Type 2. Retrieved from

5. Mayo Clinic Staff. (2016, January 13). Type 2 Diabetes. Retrieved from

6. American Diabetes Association. (2014, December 9). Diagnosing Diabetes and Learning about Prediabetes. Retrieved from

7. American Diabetes Association. (2015, July 1). Living with Diabetes. Retrieved from

8. A.D.A.M. (2016, July 10). The New York Times Health Guide. Retrieved from 's-effects-on-diabetes.html

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