TYPE 2 DIABETES MELLITUS

DEFINITION:
 Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of
diabetes that is characterized by high blood sugar, insulin resistance, and
relative lack of insulin. Common symptoms include increased thirst,
frequent urination, and unexplained weight loss.

CAUSES:

 Genes. Scientists have found different bits of DNA that affect how your
body makes insulin.
 Extra weight . Being overweight or obese can cause insulin resistance,
especially if you carry your extra pounds around your middle.
 Metabolic syndrome . People with insulin resistance often have a group of
conditions including high blood sugar, extra fat around the waist, high blood
pressure, and high cholesterol and triglycerides.
 Too much glucose from your liver . When your blood sugar is low, your
liver makes and sends out glucose. After you eat, your blood sugar goes up,
and your liver will usually slow down and store its glucose for later. But
some people's livers don't. They keep cranking out sugar.
 Bad communication between cells. Sometimes, cells send the wrong signals
or don't pick up messages correctly. When these problems affect how your
cells make and use insulin or glucose, a chain reaction can lead to diabetes.
 Broken beta cells. If the cells that make insulin send out the wrong amount
of insulin at the wrong time, your blood sugar gets thrown off. High blood
sugar can damage these cells, too.

COMMON MEDICATION:

 Biguanides. This group includes metformin, one of the most commonly used
drugs to treat diabetes. It tells your liver to hang on to some of the glucose it
Meglitinides and sulfonylureas. These medications tell your pancreas to
make more insulin makes.
  Alpha-glucosidase inhibitors slow the digestion of food with complex
carbohydrates like bread, pasta, rice, potatoes, and corn. This keeps your
blood sugar from shooting up after you eat.
 SGLT2 inhibitors work by letting your kidneys pee out extra sugar.
 Bile acid sequestrants lower your cholesterol and can also help lower your
blood glucose.

CLASSIFICATION :

Type 2 diabetes (due to a progressive insulin secretory defect on the

background of insulin resistance.

Normalize insulin activity. This is the main goal of diabetes treatment —

normalization of blood glucose levels to reduce the development of vascular
and neuropathic complications.
Intensive treatment. Intensive treatment is three to four insulin injections per
day or continuous subcutaneous insulin infusion, insulin pump therapy plus
frequent blood glucose monitoring and weekly contacts with diabetes
educators.
Exercise caution with intensive treatment. Intensive therapy must be done
with caution and must be accompanied by thorough education of the patient
and family and by responsible behavior of patient.
Diabetes management has five components and involves constant
assessment and modification of the treatment plan by healthcare
professionals and daily adjustments in therapy by the patient.

Nutritional Management:

 The foundations. Nutrition, meal planning, and weight control are the
foundations of diabetes management.

 Consult professional . A registered dietitian who understands diabetes

management has the major responsibility for designing and teaching this
aspect of the therapeutic plan.
 Consult a professional. A registered dietitian who understands diabetes
management has the major responsibility for designing and teaching this
aspect of the therapeutic plan.
 Meal Planning
 Criteria in meal planning. The meal plan must consider the patient’s food
preferences, lifestyle, usual eating times, and ethnic and cultural
background.
 Managing hypoglycemia through meals. To help prevent hypoglycemic
reactions and maintain overall blood glucose control, there should be
consistency in the approximate time intervals between meals with the
addition of snacks as needed.

 Educate the patient. Health education should include the importance of

consistent eating habits, the relationship of food and insulin, and the
provision of an individualized meal plan.

 The nurse‘s role. The nurse plays an important role in communicating

pertinent information to the dietitian and reinforcing the patients for better
understanding.