The cause of the common form of type II diabetes mellitus isunknown. The genetic of type II are complex and not clearly defined.Autoimmune mechanisms are not involved. Individuals with
maturity onset diabetes of youth
(MODY), a subset o type II, are normal weightto underweight. MODY is thought to be auto somal dominant because itaffects 50 % of first-degree relatives.Cellular resistance is a factor for 60% to 80% of individuals withtype II DM. Insulin resistance is increase in obesity. Decrease beta cellsresponsiveness to the plasma glucose level is noted, along withabnormal glucagons secretion. Levels of insulin may increase tocompensate or insulin resistance in peripheral tissues, but there is stilla relative deficiency of insulin.Pancreatic changes in individuals with type II DM are non-specificand have been observed to a lesser degree in persons without DM.Liver changes are related to elevated serum lipid levels.Risk for developing diabetes after age 40 years old in general,incidence increases with the age into the 70’s. Diseases results fromgenetic susceptibility combined with environmental determinants andother risk factors. It is associated with long duration obesity. Islet cellantibodies are not present. Increased insulin resistance caused byaltered cellular metabolism and an intracellular post receptor defect. Typically increased at time of diagnosis; may be normal or decreased. The goal of treatment is restoration of euglycemia and correctionof related metabolic disorders. Dietary measures, including therestriction of the total caloric intake, are of primary importance in theoverweight individual.
13 AREAS OF ASSESSMENT
1. SOCIAL STATUS