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Type 2 diabetes – overview


Type 2 diabetes, the most common type of diabetes, is a disease that occurs when your blood glucose (a.k.a. blood sugar) levels build up in your bloodstream. Blood glucose is a sugar that the bloodstream carries to all cells in the body to supply energy. This sugar usually is obtained from the diet, and glucose can only enter cells if enough insulin is also circulating in the bloodstream. Without insulin, glucose cannot enter cells and thus builds up in the bloodstream, leading to the development of diabetes (1).


Source: BBC News


In the early stage of type 2 diabetes, the cells of the body become less sensitive to insulin, known as insulin resistance. The pancreas usually would produce more insulin, however, in the situation when insulin resistance grows, the pancreas cannot make enough insulin and thus the cells no longer can take in glucose and begin to starve. When the blood sugar levels rise, it damages the nerves, blood vessels and organs (2).


Source: BBC News


What causes diabetes?

Type 2 diabetes can be developed at any age, even during childhood. However, type 2 diabetes usually occur in middle aged and older people, especially those 45 and older. Some people are more likely to develop type 2 diabetes based on the genes they inherited from their parents. People with family history of diabetes, or those who have the ancestry of African, Asian, Native American, Pacific Islander, have an increased risk for developing type 2 diabetes (3).


Lifestyle and health factors also play a major role in the development of type 2 diabetes. Obesity, diet, lack of physical activity has a huge amount of influence over who develops type 2 diabetes. Researchers have found out that 80 – 85% of type 2 diabetes was due to obesity. Obesity can lead to changes in body’s metabolism, such as insulin resistance and impaired glucose tolerance (4).


Lack of exercise also contribute to the development of insulin resistance. Studies have proven that sufficient amount of exercise can reduce the risk for developing type 2 diabetes. Consuming beverages with high sugar content, such as energy drinks, sweet tea can promote obesity, leading to the development of type 2 obesity.


How common is diabetes?

In 2019, approximately 463 million adults were living with diabetes, and the number will continue to rise to 700 million by 2045. In Malaysia, the prevalence of type 2 diabetes has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. Not everyone with diabetes has been diagnosed, it is estimated that one-third of those with diabetes do not realize they have it. This might be due to the fact that early warning signs such as fatigue or increased thirst are often misdiagnosed as signs of aging or other conditions (5).


Malaysia has the highest rate of diabetes in Asia. The risk of getting heart disease and kidney disease caused by diabetes is also very commonly listed as a contributing factor on death. Type 2 diabetes was found to shorted one’s life expectancy by as much as 10 years (6).


Common symptoms of Type 2 diabetes

People with type 2 diabetes may have the following symptoms, which include:

  • Intense hunger

  • Intense thirst

  • Fatigue

  • Frequent urination

  • Blurry vision

  • Slowed healing

  • Peripheral neuropathy

People with type 2 diabetes may experience additional health problems, including high blood pressure, chronic kidney disease and heart failure (7).


Treatments for Type 2 diabetes

Although type 2 diabetes cannot be cured, however, there are some effective treatments that have been proven to help control blood glucose levels, slowing the progression of the disease and prevent serious complications from developing.


Lifestyle changes, including losing weight, eating healthier, and getting more exercise, are considered first line therapy for type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, then you will need to take medication.


Many people with diabetes or prediabetes have improved their health with dietary changes. Making these changes may allow you to reduce or eliminate diabetes medication, helping you to lose weight as well. Some people with type 2 diabetes also incorporate natural or holistic treatments, such as acupuncture, herbal or nutritional supplements. Cinnamon, turmeric, vitamin D or fish oil supplements have shown to reduce inflammation in people with type 2 diabetes (7).


Prevention is often better than treatment. Thus, maintaining a healthy weight, following a healthy diet, exercising regularly can reduce the risk of getting type 2 diabetes.


References:

1. Ahrén B. Type 2 diabetes, insulin secretion and beta-cell mass. Curr Mol Med. 2005 May;5(3):275-86. doi: 10.2174/1566524053766004. PMID: 15892647.

2. Feldman EL, Callaghan BC, Pop-Busui R, Zochodne DW, Wright DE, Bennett DL, Bril V, Russell JW, Viswanathan V. Diabetic neuropathy. Nat Rev Dis Primers. 2019 Jun 13;5(1):42. doi: 10.1038/s41572-019-0097-9. PMID: 31197183; PMCID: PMC7096070.

3. Spanakis EK, Golden SH. Race/ethnic difference in diabetes and diabetic complications. Curr Diab Rep. 2013 Dec;13(6):814-23. doi: 10.1007/s11892-013-0421-9. PMID: 24037313; PMCID: PMC3830901.

4. Shah R. Assessing the risk of diabetes BMJ2015; 351:h4525 doi:10.1136/bmj.h4525

5. Hussein Z, Taher SW, Gilcharan Singh HK, Chee Siew Swee W. Diabetes Care in Malaysia: Problems, New Models, and Solutions. Ann Glob Health. 2015 Nov-Dec;81(6):851-62. doi: 10.1016/j.aogh.2015.12.016. PMID: 27108152.

6. Malaysia has highest rate of diabetes in Asia, says Nadi chairman, 2018. Retrieved from: https://www.thestar.com.my/news/nation/2018/07/25/malaysia-has-highest-rate-of-diabetes-in-asia-says-nadi-chairman/

7. Type 2 diabetes, 2019. Retrieved from: https://www.cdc.gov/diabetes/basics/type2.html

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