Type 2 Diabetes

  • Also known as non-insulin dependent diabetes
  • Represents 85 to 90% of all cases of diabetes in Antigua and Barbuda
  • Type 2 Diabetes is more common than people realize and many cases go undiagnosed (between 30% and 50% depending on estimates)
    • Type 2 Diabetes was once considered a disease of older individuals but is now being diagnosed in children and adolescents
  • There are several risk factors for Type 2 Diabetes:

What is Type 2 Diabetes?

  • Type 2 Diabetes is characterized by the inability of the body to use available insulin, also known as insulin resistance
*Image from Nationwide Children’s Hospital
  • For most individuals, Type 2 Diabetes follows a trend of increasing insulin resistance and increasing blood glucose levels. Initially, the beta cells attempt to compensate for the insulin resistance by increasing their production of insulin. However, over time the beta cells start to become dysfunctional or decrease in number. They can no longer produce enough insulin to meet the growing insulin resistance and at this point many of the symptoms of diabetes start to show (excessive thirst, excessive urination, frequent infections, blurred vision, weight changes, etc.)
  • It is very important to note that many people do not recognize or notice the symptoms of diagnosis. This is the reason why 30 to 50% of the population is undiagnosed!
  • The high levels of sugar in the blood of those with Type 2 Diabetes leads to a number of complications (the complications are similar to Type I)
    • The most dangerous acute complication in poorly controlled individuals is diabetic ketoacidosis (DKA)
  • In DKA, the body’s cells cannot access the sugar that is all around them because of insulin resistance (or deficiency). Without sugar, they begin to starve. When this occurs, the body starts to convert fats and protein to sources of energy. Fat breakdown results in the formation of ketones or keto-acids which increase the acidity of the blood. This condition can be dangerous and may lead to hospitalization.
  • Chronic complications include:
  • The best approach to reducing your risk of having Type 2 Diabetes is exercise and dietary management.
    • Exercise, for example, increases insulin sensitivity and improves glucose metabolism.

Managing Your Diabetes

  • Lifestyle management is very important for diabetes management (see section)
    • Body weight reduction, exercise, and maintaining a healthy diet are 3 interlinked targets which can have a major impact on improving your quality of life (and reducing potential complications of diabetes)
    • Similar to Type 1 Diabetes, there are also a number of other lifestyle interventions that should be considered:
  • In addition to lifestyle style modifications, medications play a key role in managing Type 2 Diabetes (see section)
    • In Antigua, the most common therapeutic interventions are insulin therapy and oral medications (metformin and sulfonylureas)
    • Oral medications can be used in Type 2 Diabetes because individuals with this condition still have functioning beta cells. Sulfonylureas, for example, increase the secretion of insulin by the beta cells.

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