Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency, leading to high blood sugar levels (hyperglycemia). Unlike Type 1 Diabetes, the pancreas still produces insulin, but the body's cells do not respond effectively to it.
Causes & Risk Factors
- Insulin Resistance: Body cells (muscle, fat, liver) do not respond effectively to insulin.
- Genetics & Family History: Strong genetic component; family history significantly elevates risk.
- Obesity & Sedentary Lifestyle: Excess body fat (especially visceral belly fat) and lack of physical activity.
- Unhealthy Diet: Diets high in refined carbohydrates, sugary beverages, and processed foods.
- Age: More common in individuals over 45, though increasingly diagnosed in younger adults and teenagers.
- Hypertension & High Cholesterol: High blood pressure and abnormal lipid profiles increase metabolic risk.
- Gestational Diabetes History: Prior history of elevated blood sugar during pregnancy.
- Polycystic Ovary Syndrome (PCOS): Hormonal imbalance associated with elevated insulin resistance.
Symptoms
- Increased thirst (polydipsia) & frequent urination (polyuria)
- Increased hunger (polyphagia) & chronic fatigue
- Blurred vision & slow-healing cuts or sores
- Numbness or tingling in hands and feet (peripheral nerve involvement)
- Frequent infections (e.g., skin, gum, or urinary tract infections)
Diagnostic Criteria
- Fasting Blood Sugar: ≥ 126 mg/dL (7.0 mmol/L)
- Random Blood Sugar: ≥ 200 mg/dL (11.1 mmol/L)
- HbA1c (Glycated Hemoglobin): ≥ 6.5%
- Oral Glucose Tolerance Test (OGTT): ≥ 200 mg/dL after 2 hours
Treatment & Management Protocol
1. Lifestyle Changes (First-Line Treatment)
- Healthy Diet: Low-carb, high-fiber diet rich in vegetables, legumes, and lean proteins.
- Regular Exercise: At least 150 minutes per week of moderate aerobic exercise (brisk walking, cycling) and strength training.
- Weight Loss: Losing even 5–10% of body weight significantly improves insulin sensitivity and blood sugar control.
- Smoking Cessation & Alcohol Limitation: Protects cardiovascular and microvascular health.
2. Medications (When Lifestyle Modifications Are Insufficient)
- Metformin: First-line oral drug; decreases hepatic glucose production and improves insulin sensitivity.
- SGLT2 Inhibitors (e.g., Empagliflozin): Promotes urinary excretion of excess glucose and provides renal/cardiac protection.
- GLP-1 Agonists (e.g., Liraglutide): Slows gastric emptying, enhances insulin secretion, and aids weight loss.
- Sulfonylureas (e.g., Glimepiride): Stimulates pancreatic beta cells to produce more insulin.
- Insulin Therapy: Indicated for severe or advanced disease progression.
Complications (If Unmanaged)
- Cardiovascular Disease: Elevated risk of heart attacks, stroke, and peripheral artery disease.
- Diabetic Neuropathy: Nerve damage causing numbness, tingling, and chronic limb pain.
- Diabetic Retinopathy: Microvascular eye damage, potential vision loss and blindness.
- Diabetic Nephropathy: Progressive renal microvascular damage leading to kidney failure.
- Diabetic Foot Ulcers: Impaired healing and circulation leading to non-healing wounds and amputation risk.
- Cognitive Decline: Increased risk of dementia and Alzheimer's disease.
Prevention & Reversal
Healthy diet, portion control, regular exercise, and maintaining an optimal BMI are key. Early intervention in prediabetes can reverse blood sugar elevation and prevent conversion to full T2DM!
