Diabetes is estimated to affect approximately 530 million adults worldwide. Type 2 diabetes represents 98% of global diabetes diagnosis, it develops in people with age 45or older, but recently it can be developed in children and teens.

‍What causes type 2 diabetes?

Insulin is a hormone synthesized by your pancreas, it lets your body use the glucose in a good way to be used as a source of energy, in type 2 diabetes, cells don’t respond normally to insulin so the pancreas makes more insulin until your pancreas can’t keep up to synthesize more insulin, this stage is called insulin resistance, eventually called Prediabetes and it can lead to type 2 diabetes.

Symptoms:

Symptoms of type 2 diabetes are most commonly the same as type 1 diabetes, some patients don’t notice any symptoms until it leads to a very serious condition. The most important is to realize the risk factors of type 2 diabetes and how to prevent it.

Symptoms are including:

·       Polydipsia: feeling thirsty
·       Polyphagia: feeling hungry
·       Frequent urination, especially at night
·       General fatigue
·       Blurred vision
·       Slow healing wounds and skin infection
·       Fruity breath: one sign of ketosis
·       Peripheral neuropathy: Numbness and tingling especially at extremities.
·       Urinary tract infections.
·       Erectile dysfunction.

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When to see the doctor?

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To book an appointment with us, you are kindly requested to visit the website  FUH.OKADOC.COM

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If you experience one or more of the symptoms of diabetes, you should check with your endocrinologist at once, also follow up and close monitoring of your treatment plan is very important to manage type 2 diabetes.

Diagnosis:

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·       Glycated hemoglobin(HbA1c):  which indicates your blood sugar level for the past 2-3 months.
        Below 5.7% is normal, from 5.7% to6.4% is considered as prediabetes, from 6.5% and higher is considered         diabetic. Diabetic patients should aim to target HbA1c level to be 6.5% or less.

·       Random Blood sugar test: Regardless of what or when you ate,  a level of 200mg/dl or higher suggests         diabetes.

·       Fasting blood sugar test: a blood sample is withdrawn when you fast overnight, less than 100mg/dl is          considered healthy, from 100-125mg/dl is considered as prediabetes, more than 125mg/dl is diabetes.

·       Oral glucose tolerance test: this test is less commonly used than the other tests

 If you are diagnosed with prediabetes, age more than 35 years old, overweight or obese, having one of the risk factors of type 2 diabetes, you must routinely screen to avoid any complications and monitor your treatment.

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Risk Factors:

You are at risk for type 2 diabetes if you:

·       Had prediabetes.
·       Are overweight or obese.
·       Are at the age of 45 years or older.
·       Have any close relatives with type 2 diabetes.
·       Physically inactive or don’t exercise properly.
·       Had gestational diabetes before.

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Complications:

·       Periodontitis
·       Gastroparesis: the doctor may prescribe domperidone, which is effective for diabetic patients having         gastroparesis
·       Peripheral neuropathy and nerve damage which causes numbness and tingling
·       Heart diseases and stroke
·       Kidney disease
·       Diabetic foot
·       Gestational diabetes during pregnancy
·       Eye diseases: as retinal detachment and blindness

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Treatment options:

Your doctor will discuss the perfect option for you especially if you have any other co-morbidities as Hypertension, Meanwhile please take a closer look at the treatment options:

·       Biguanide: which includes metformin.
·       Sulfonylurea: which tell your pancreas to make more insulin
·       DPP-4 inhibitor: as Sitagliptin, Saxagliptin which can be used to lower our blood glucose level after taking your         meals.
·       Glitazones: as pioglitazone which lowers the insulin resistance.
·       SGLT2 inhibitors: as empagliflozin and dapagliflozin which activate the kidneys to remove extra sugars.
·       GLP-1 receptor agonists: these are injectable drugs which help your pancreas to make more insulin, it’s either to         be taken once daily or once weekly.
·       Insulin: please check type 1 diabetes blog.

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Lifestyle and Self-care:

• Follow a healthy eating plan as discussed in type 1 diabetes blog, don’t follow a special meal plan.
• Be physically active for at least 150 minutes a week.
• Manage your ABCs:
  

         A: Get a regular A1C test to measure your average blood sugar.
            B: Try to keep your blood pressure below 140/90 mm Hg (as per the doctor’s recommendations).
            C: Control your cholesterol levels.
            s: Stop smoking.

• Lose weight if you’re overweight—just a 5% to 7% weight loss lowers the risk for complications.
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• Take medicine as instructed and talk to your doctor if you have questions about or problems with your medicine.
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• Make and keep appointments with your health care team (primary care doctor, dentist, foot doctor, Ophthalmologist, and dietitian).

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Patient Support:

We offer at Fakeeh University Hospital a wide range of support for our patients, from glucose monitoring devises, insulin pumps, supplements (multi-vitamins and diabetic supports) for more details, don’t hesitate to check our website below.

References:

https://www.cdc.gov/diabetes/library/features/prevent-complications.html

https://www.uptodate.com/contents/type-2-diabetes-treatment-beyond-the-basics/print

https://www.nice.org.uk/guidance/ng28/resources/type-2-diabetes-in-adults-management-pdf-1837338615493

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