WELCOME TO OUR WEBSITE

Selamat Datang Di Website Resmi Obat Dewa Red Kank, Web Ini Menyediakan informasi Mengenai Produk Red Kank, Artikel Kesehatan serta Layanan Informasi Dan Lain-lain Yang Berkaitan Dengan Kesehatan Serta Menyediakan Wadah Untuk Berkonsultasi Mengenai Keluhan Penyakit Dari Pelanggan Red Kank Secara Gratis Via e-Clinic.

LOGIN

Diabetes - Type II Diabetes

In This Article

Aetiology

  • Underactivity, overeating and obesity are all factors in the formation of this disease.
  • It is thought that the presence of excess triglyceride within the cell has some effect in causing the insulin resistance.
  • The genetic link is type 2 diabetes is stronger than that in type 1 – monozygotic twins have a greater than 50% chance of developing the disease (compared to 30-50% in type 1).
  • MODY – maturity onset diabetes of the young – this is a rare type of type 2 diabetes. It will present in young people who have a family history of type 2 diabetes. It is dominantly inherited. The diabetes will be relatively easy to control.
  • There is evidence to suggest that low birth weight and low weight at 12 years of age predisposes to type two diabetes, as well as cardiovascular disease and hypertension. The theory is that low weight is related to malnutrition, and poor nutrition can impair beta cell development, thus putting you at greater risk of type 2 diabetes later in life.
  • There is no evidence that type 2 diabetes is related to autoimmunity. However, there is some evidence that inflammatory markers (CRP) and cytokines are raised in obesity, and as a result some people believe this plays a role in the development of diabetes.
  • Whether or not a person will develop type 2 diabetes is generally due to genetics. When it will occur is generally due to lifestyle.
  • Diabetes diagnosed in a man aged 40-59 will cause a reduction in life expectancy of 5-10 years. Therefore, preventing the onset of type 2 diabetes can have a significant impact on life expectancy. Diabetes diagnosed after the age of 70 has little effect on life expectancy.
 
Back to top

Epidemiology

  • The four main determining factors are; age, obesity, family history and ethnicity.
  • The overall prevalence of this disease in the UK is about 2%. This rises to 10% by the age of 70.
  • The disease is relatively common in all populations enjoying an affluent lifestyle.
  • ‘In poor countries, diabetes in a disease of the rich, but in rich countries, diabetes is a disease of the poor’
  • The disease may be present in a subclinical form for many years before it is detected.
  • The onset of the disease can be accelerated by stress, pregnancy, illness or certain drugs.
  • In western societies, adults of the age 25-55 gain about 1 gram of weight a day. This is due to an excess of just 90 calories a day (one chocolate coated digestive!), but is not due to overeating, more likely due to sedentary lifestyles.
  • The insulin resistant state associated with type two diabetes often presents with other risk factors that put someone at greater risk of cardiovascular disease. These include things like;      
  • Hypertension, obesity, hypertriglyceridaemia, decreased HDL cholesterol and acanthosis nigricans;
  • This is a condition where there is hyperpigmentation of the skin, particularly in the neck, axilla, groin and umbilicus. It results from excess insulin (which tends to be present in those with insulin resistance), which in turn causes excess growth of melanocytes. There are many causes of this, but the most common is type 2 diabetes.
  • The insulin resistant state, often combined with the symptoms above has been called syndrome X, metabolic syndrome, or insulin resistance syndrome.  The syndrome is basically a product of genetically susceptibility combined with a sedentary lifestyle, and obesity. It is not strictly a true syndrome, as alterations in the above factors can remove the aetiology, and thus mean you are no longer a sufferer of syndrome X.  Syndrome X is basically a state which puts you at much greater risk of cardiovascular disease and diabetes (i.e. you are on the road to developing these diseases), but by modifying lifestyle and body weight, you can ‘revert’ to being normal again.
  • About 1/3 of the adult population have some of these symptoms, not necessarily associated with type 2 diabetes.
  • Do not confuse this with ‘Cardiac syndrome X’.
 
Back to top

Pathology

  • This involves a combination of insulin resistance and relative secretory failure of insulin. . Insulin is still released normally, and will still bind to its receptor, but it will not cause the normal physiological changes in a cell that you would normally expect. This occurs for reasons unknown. Type-2 diabetes results when a person cannot secrete enough insulin to overcome this ‘resistance’ factor. You have fewer beta cells (so they are under strain) trying to produce more insulin than a normal person requires.
  • Not only does this mean that there is a high blood glucose due to the fact you can’t remove normal digested glucose, but it has a secondary effect on the liver; there is less glucose entering liver cells, and so the liver reacts as if blood glucose were low, and begins glycogenolysis, and raises blood glucose even more.
  • Patients will have up to 50% of their beta cell mass at diagnosis. However, this destruction of beta cells is nowhere near as extensive as in type 1 diabetes. Most patients will also show amyloid deposition around the islets at autopsy. Amylin is a product secreted with insulin by the beta cells. it is not known if the amylin is a cause or a consequence of beta cell failure.
 
 
 
Back to top

Diagnosing diabetes by glucose levels

This graph shows the development of type two diabetes in relation to insulin secretion and sensitivity.
At first there will be compensatory secretion of insulin to counteract the reduced insulin sensitivity, however as the disease develops more, the amount of insulin secreted will also reduce.
 
 
Often the same patient will show IGT and IFG. These stages are important because they show the first signs of the disease, and these patients should be followed up.