Nursing Continue Education

Diabetes Mellitus Type 2 (DMT2) 糖尿病 (Reading & Sharing Part 2)

The main source of energy in your body cells that make up muscles and other tissue is Glucose, a sugar.

  • Glucose is derived from foods you ingest and is stored in your liver as glycogen.
  • Glucose is absorbed into the bloodstream and with the assistance of insulin, enters cells
  • Your liver also makes glucose
  • To keep your glucose levels within normal range, your liver will break down glycogen to glucose and send it into the bloodstream.  This might occur if you haven’t eaten for a while, for instance, overnight.

This process in the normal way in which your body maintains a normal blood sugar level (Mayo Clinic, 2018)

If this is impaired, your sugar will stay in your bloodstream instead of moving into your cells to provide energy.  “As blood sugar levels increase, the insulin-producing beta-cells of the pancreas release more insulin, but eventually these cells become impaired and can’t make enough insulin to meet the body’s demands” (Mayo Clinic. 2018. p.2.).

When this occurs, your blood sugar may remain elevated and a diagnosis of Type2 Diabetes can be made.  This may require changes in life style and the addition of medicines taken by mouth, or if your sugar levels are high, may even include insulin to maintain a normal blood sugar.

In the beginning, type 2 DM may cause you little concern.  But if untreated, many body organs and functions may be influenced. These could include:

  • Heart
  • Blood vessels
  • Eyes
  • Kidneys
  • Nerves

Here are some of the potential complications that can occur over time.

  • Heart and Blood vessels ~ type 2 DM can cause coronary heart disease that can cause a heart attack or congestive heart failure.  It can affect the arteries in your neck and brain and cause a stroke. It can narrow the arteries in your legs causing decreased blood flow to the legs and feet.  This might cause pain, swelling and leg ulcers. High blood pressure is very common in Type 2 DM.
  • Kidney damage ~ Just as DM can narrow other vessels in the body, the kidney is even more vulnerable.  The kidney houses millions of tiny blood vessels to filter impurities in our blood.  If these vessels are impaired, significant damage and even irreversible damage can occur.  This often results in a need for dialysis or even kidney transplant.
  • Eye damage ~ DM can cause premature cataracts, high pressures within the eye (glaucoma) and importantly damage to the all-important retina. The retina also contains hundreds of tiny vessels that if injured can lead to blindness.
  • Nerve damage ~ Tiny blood vessels, capillaries surround and nourish your nerves, mainly in your legs.  Excess blood sugar can injure the walls of these vessels, causing numbness, tingling and pain in your extremities.  This can become so severe that you might loose all feeling in your feet and legs.  A concern with this is that you can more easily injure your foot and not even realize it.  Wounds that are bleeding could be a significant problem if not recognized.
  • Foot damage ~ As we noted above, DM decrease blood flow to vessels of the legs.  This can cause ulcers or sores to occur. If left untreated, hard to treat infections and poor healing can occur and can even lead to the necessity of amputation.
  • Decreased hearing, skin conditions and increased risk for Alzheimer’s disease are also more common in patients with type2 DM.

(Mayo Clinic, 2018).

 

Here are some of the ways your physician may treat your newly diagnosed type 2 DM.

These may include some life style changes.

  • Your blood sugar control will benefit by maintaining a healthy weight.  Your physician might suggest proper weight management, nutritional planning and an increased exercise program
  • Smoking cessation is encouraged if needed
  • Educational Sessions

(American Diabetic Association, 2014)

The more common Oral medications to lower your blood sugar (glycemic agents) might include:

  • Metformin
  • Glipizide
  • Glyburide
  • Glimepiride
  • Miglitol

If your blood sugars are not controlled on oral medications, your physician may order insulin injections to be given daily or when self-testing shows your blood sugar to be high (Braun, C.A., and Anderson, C.M., 2017).

 

References:

Braun, C.A. and Anderson, C.M., (2017) Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease. (3rd. Edition) Baltimore: Wolters Kluwer.

Diabetes Mellitus Type II.   American Diabetes Association, 2014.

Type @ Diabetes.  Mayo Clinic. 2018.

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