There are many different types of diabetes mellitus with the two major being Type 1 and Type 2. Whereas Type 1 commonly presents in children and is due to insulin deficiency, Type 2 diabetes is usually a lifestyle disease and presents later in life. However, nowadays more and more younger children are being diagnosed with Type 2 diabetes as a result of unhealthy lifestyle. This has led to rapid increase in numbers worldwide.
Type 2 diabetes mellitus is a chronic medical illness with potential to affect multiple internal organ systems over a period of time. Although diabetes is related to metabolism, it is primarily a vascular disease. If not proper properly managed it can lead to two major vascular complications - macrovascular and microvascular.
Macrovascular complications affect large blood vessels such as major arteries and lead to involvement of heart (myocardial infarction), brain (stroke) and extremities (peripheral vascular disease). The microvascular effects of diabetes leads to involvement of eyes (retinopathy), kidneys (nephropathy) and nerves of feet and hand (peripheral neuropathy). There is enough evidence that good control of diabetes leads to prevention of both of these complications.
The three main risk factors for development of Type 2 diabetes mellitus are physical inactivity, being overweight/obese and intake of excess calories. Therefore, lifestyle interventions are known to help people control their diabetes. Other risk factors are age, family history and previous gestational (pregnancy related) diabetes. The common symptoms of diabetes are dry mouth and increased thirst, frequent urination, unexplained weight loss, weakness and fatigue, increased hunger and poor wound healing.
The following blood tests help in establishing a diagnosis of Type 2 Diabetes: fasting blood glucose (FBS > 126 mgs/dl), two-hour postprandial blood glucose (PPBS > 200 mgs/dl) and HbA1c test (> 6.5 per cent). Patients however, remain in the state of impaired glucose tolerance otherwise known as borderline diabetes (FBS 100 - 125 mgs/dl, PPBS 140 - 199 mgs/dl and HbA1c 5.7 - 6.4 per cent) for many years before the development of full blown diabetes mellitus.
Management of Diabetes involves: lifestyle changes, medications and treatment of associated risk factors and complications. Healthy eating, regular physical activity and weight loss if overweight are key for better control of diabetes. Medications under physician supervision will be required if blood sugars are not manageable with life style interventions only.
It is essential to understand that Type 2 diabetes is a lifestyle disease with tremendous potential for prevention. Healthy lifestyle adopted from childhood is likely the key strategy for future prevention.
