What Is The Medical Term For Type 2 Diabetes

Type 2 diabetes is a prevalent and complex metabolic disorder that affects millions of people worldwide. It is a condition in which the body either does not produce enough insulin or does not use insulin effectively. The medical term for type 2 diabetes is “non-insulin-dependent diabetes mellitus” (NIDDM), also known as “adult-onset diabetes.” However, with the increasing prevalence of this disease in younger populations, the term “adult-onset” has become less accurate. Type 2 diabetes typically develops over time and is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet. Understanding the medical term and the various aspects of type 2 diabetes is crucial for proper diagnosis, treatment, and management.

Etiology and Risk Factors

The development of type 2 diabetes is multifactorial.

Genetic Predisposition: A family history of diabetes significantly increases the risk. Certain genes are associated with abnormal insulin secretion and action. For example, mutations in genes related to pancreatic beta-cell function can lead to impaired insulin production.

Obesity: Excess body fat, especially around the abdomen, is a major risk factor. Adipose tissue releases hormones and cytokines that can interfere with insulin signaling and promote insulin resistance.

Physical Inactivity: Lack of regular exercise reduces muscle mass and decreases the body’s ability to utilize glucose. Sedentary individuals are more likely to develop type 2 diabetes compared to those who are physically active.

Unhealthy Diet: Diets high in refined carbohydrates, sugars, and saturated fats can contribute to weight gain and insulin resistance. A diet lacking in fiber and whole grains may also increase the risk.

Pathophysiology

The pathophysiology of type 2 diabetes involves defects in both insulin secretion and insulin action.

Insulin Resistance: In the early stages, cells in the body, particularly muscle, liver, and adipose tissue, become resistant to the effects of insulin. This means that insulin is less effective in facilitating the uptake of glucose from the bloodstream into cells. As a result, blood glucose levels start to rise.

Beta-Cell Dysfunction: Over time, the pancreatic beta cells, which are responsible for producing insulin, may not be able to compensate for the increased demand due to insulin resistance. They may initially increase insulin secretion, but eventually, beta-cell function declines, leading to a relative insulin deficiency. This combination of insulin resistance and beta-cell dysfunction results in hyperglycemia, the hallmark of type 2 diabetes.

Clinical Manifestations

Type 2 diabetes often presents with a variety of symptoms, although some patients may be asymptomatic in the early stages.

Polydipsia: Excessive thirst is a common symptom. High blood glucose levels cause the kidneys to excrete more urine, leading to dehydration and increased thirst.

Polyuria: Frequent urination occurs as the kidneys try to remove the excess glucose from the blood. This can disrupt normal fluid balance and lead to increased urinary output.

Polyphagia: Despite eating more, patients may experience weight loss or have difficulty maintaining weight. The body’s cells are not getting enough glucose due to insulin resistance, so the body signals for more food intake.

Fatigue: Cells are not able to efficiently use glucose for energy, leading to feelings of tiredness and lack of energy.

Blurred Vision: High blood sugar levels can cause changes in the shape of the lens in the eye, resulting in blurred vision. If left untreated, this can progress to more serious eye problems such as diabetic retinopathy.

Diagnosis

Accurate diagnosis of type 2 diabetes is essential for appropriate management.

Fasting Plasma Glucose Test: A blood sample is taken after an overnight fast. A fasting plasma glucose level of 126 mg/dL or higher on two separate occasions is diagnostic of diabetes.

Oral Glucose Tolerance Test: The patient drinks a glucose solution, and blood samples are taken at specific time intervals. A 2-hour plasma glucose level of 200 mg/dL or higher is indicative of diabetes.

Hemoglobin A1C Test: This test measures the average blood glucose level over the past 2 – 3 months. An A1C level of 6.5% or higher is used to diagnose diabetes. It is also a useful tool for monitoring long-term blood sugar control.

Treatment and Management

The treatment of type 2 diabetes aims to control blood glucose levels, prevent complications, and improve overall health.

Lifestyle Modifications:

Dietary Changes: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins is recommended. Carbohydrate counting and portion control can help manage blood sugar levels. Reducing the intake of sugary beverages and processed foods is crucial.

Regular Exercise: Physical activity helps improve insulin sensitivity and lowers blood glucose levels. At least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming, is advised.

Weight Loss: For overweight or obese patients, losing even a small amount of weight can have a significant impact on blood sugar control and insulin sensitivity.

Medications:

Oral Antidiabetic Agents: These include metformin, which is often the first-line drug. It works by reducing glucose production in the liver and increasing insulin sensitivity. Sulfonylureas stimulate the pancreas to secrete more insulin. Other classes such as thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, and meglitinides are also used depending on the patient’s specific needs.

Injectable Medications: In some cases, injectable drugs like GLP-1 receptor agonists may be prescribed. These medications not only help lower blood sugar but can also promote weight loss and have beneficial effects on cardiovascular risk factors.

Blood Glucose Monitoring: Patients are often advised to monitor their blood glucose levels at home using a glucometer. This helps them understand how different foods, activities, and medications affect their blood sugar and allows for timely adjustments in treatment.

Complications

If left uncontrolled, type 2 diabetes can lead to a range of serious complications.

Microvascular Complications:

Diabetic Retinopathy: This is damage to the blood vessels in the retina of the eye, which can lead to vision loss or blindness. Regular eye examinations are essential for early detection and treatment.

Diabetic Nephropathy: High blood sugar levels can damage the kidneys over time, leading to kidney failure. Monitoring of kidney function through blood and urine tests is important.

Diabetic Neuropathy: Nerve damage can occur, resulting in symptoms such as numbness, tingling, or pain in the extremities. It can also affect the autonomic nervous system, leading to problems with digestion, blood pressure regulation, and sexual function.

Macrovascular Complications:

Cardiovascular Disease: Type 2 diabetes is a major risk factor for heart disease and stroke. It is associated with atherosclerosis, high blood pressure, and abnormal lipid profiles. Aggressive management of cardiovascular risk factors such as blood pressure control, cholesterol management, and smoking cessation is crucial.

Peripheral Arterial Disease: Narrowing of the blood vessels in the legs can lead to poor circulation, pain while walking (claudication), and in severe cases, ulcers and amputations.

Conclusion

Type 2 diabetes, or non-insulin-dependent diabetes mellitus, is a complex and chronic condition with significant implications for health. Understanding its medical term, etiology, pathophysiology, clinical manifestations, diagnosis, treatment, and potential complications is essential for healthcare providers, patients, and their families. With proper management and lifestyle modifications, the progression of the disease and the occurrence of complications can be effectively controlled, improving the quality of life and long-term prognosis for those affected.