essay diabetes type 2

Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

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Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

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Type 2 Diabetes as a Public Health Issue Essay

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Introduction

Lessons learned.

Diabetes mellitus is one of the critical issues of world medicine as a disease associated with a high level of human and economic costs. According to the World Health Organization (WHO) experts, type 2 diabetes is a problem of all ages and populations, which is due to its wide geographic prevalence and an exceptionally rapid increase in morbidity (Unnikrishnan, Pradeepa, Joshi, & Mohan, 2017). High mortality rates are caused by the disease complications that gradually progress, significantly reducing the quality and duration of one’s life. This paper aims to examine type 2 diabetes, including the related problems, potential solutions, and recommendations.

In recent years, a steady increase in the incidence and prevalence of diabetes is observed in almost all countries of the world. This allows for qualifying these processes as a new non-communicable epidemic of the end of the 21st century. As stated by the WHO, there are currently 160 million people with diabetes in the world, which represents 2-3 percent of the total population of the planet. It is anticipated that by 2025, their number will reach 330 million (Unnikrishnan et al., 2017). The most problematic point of diabetes is that it includes a range of issues, which affect human health. Namely, the comorbid diseases and high prevalence, care costs, and underreporting should be mentioned.

Speaking of diabetes as of the global epidemic, it should be stressed that with regard to age, the data show that after 40 years, the risk of developing this disease increases. The prevalence rate among people aged between 65 and 74 is almost 20 percent (World Health Organization, 2016). Type 2 diabetes is more common among ethnic group minorities. Compared to six percent of the disease prevalence among White people, it is about ten percent among people of African-American and Asian-American origin.

For the Hispanic population, 12.5 percent are likely to develop the mentioned chronic condition (Schneiderman et al., 2014). In certain communities of the indigenous American population, diabetes is likely to be developed by 20-50 percent of the population. In general, diabetes is more common in women who have already had diabetes in the family. This data points to the need to implement an immediate action to reduce diabetes morbidity.

Another critical aspect is that there are a lot of comorbid states that worsen health outcomes of patients. The majority of people with type 2 diabetes develop cardiovascular problems, including chronic heart failure, cerebrovascular accident, and heart attack myocardium (Krug, 2016). The second place among the related states is occupied by the terminal stage of renal failure and oncological diseases (World Health Organization, 2016). However, it is also noted that the mentioned issues lead to death, but many cases remain unknown to the doctors. Among other aggravating factors, there are obesity, unhealthy lifestyles, unawareness of one’s disease, and the failure to start treatment timely.

The proportion of comatose states, both hyperglycemic and hypoglycemic, among the causes of death is small: it does not exceed 0.5 percent (Krug, 2016). The specificity of the formation of the epidemiological situation with regard to diabetes is that understating the importance of diabetes among public health problems is affected by underreporting the actual number of patients. In addition, the associated symptoms of the disease can be misinterpreted.

In turn, the combination of these factors leads to underfunding of the diabetes problem, insufficient information programs for groups at risk of diabetes, low and late accessibility of medical care (Merlotti, Morabito, & Pontiroli, 2014). The decrease in care affordability is likely to cause a decrease in the number of registered cases.

Diabetes is a great economic burden for health systems, especially in developed countries such as the US. In most countries, the cost of treating patients with diabetes ranges from five to twenty percent of the total health budget, which depends on interventions and policies that regulate care processes and procedures. According to estimates of Seuring, Archangelidi, and Suhrcke (2015), based on the fact that the cost of treating patients with diabetes is 2-3 times higher than that of people without diabetes, the cost of treating diabetes in the US surpassed those in all countries of the world and amounted to $ 320 billion.

To compare, in China and Germany, occupying the second and third places in the cost of treatment of diabetes – $51 and $35 billion, respectively (Seuring et al., 2015). To reduce the costs, a comprehensive plan is required to join forces of care providers, patients, and governments.

Physicians, nutritionists, cardiac care specialists, nurses, and other care providers should be aware of the diabetes epidemic. Their actions need to be coordinated and properly managed by leaders to ensure that they have the necessary skills and knowledge. The role of patients in managing their disease lies in self-assessment and timely reporting to care providers. The study by Jaacks, Siegel, Gujral, and Narayan (2016) shows that a significant underestimation of the actual number of patients and complications compromise the importance of diabetes among public health problems.

The improvement in the effectiveness of preventing the progression of diabetes and the development of avoidance strategies are important. The increase in quality and life expectancy is associated with the efforts of the patients who should monitor their condition and follow medical recommendations.

Representing a significant public health issue, diabetes is one of the priority non-communicable diseases. The measures to combat it can also be planned at the highest level of public health. The international organizations noted that over the past few decades, the incidence and prevalence of diabetes have steadily increased. This first WHO Global Diabetes Report highlights the enormity of the problem of diabetes and the potential to change the current situation (World Health Organization, 2016).

Namely, a political framework has already been formed for concerted action on diabetes. It is identified in the Sustainable Development Goals by the United Nations’ Political Declaration on non-communicable diseases and the WHO’s Global NCD Action Plan. It is proposed to introduce education and assistance with self-monitoring as well as qualified care from experienced professionals.

A National Diabetes Prevention Program (National DPP) prepared by the Centers for Disease Control and Prevention (CDC) is the most relevant solution that integrates the efforts of all the mentioned stakeholders. The DPP promotes the cooperation of the governmental bodies, clinics, care providers, and communities to combat diabetes. In the course of the experimental trials, it was revealed that such an approach is useful to reduce the negative impacts of this non-communicable illness (Diabetes Prevention Program Research Group, 2015).

This solution also presents the recommendations associated with the pharmacological aspect of this health problem based on Metformin. It increases insulin sensitivity in peripheral tissues by up to 50 percent and inhibits glucose production by the liver (Dunkley et al., 2017). The synthesis of glucose in the liver in patients with pre-diabetes is significantly increased compared with that in healthy people, Metformin helps in normalizing fasting glucose. The advantage of using metformin for the prevention of diabetes is its high safety, which is confirmed by the years of experience and the results of randomized-controlled studies (Diabetes Prevention Program Research Group, 2015).

The serious lifestyle interventions can be recommended to lessen the threat of developing diabetes mellitus. Metformin had the greatest effect in young patients with more pronounced glucose disorders and obesity. In combination, lifestyle changes and pharmacological therapy can decrease the incidence of diabetes in people at high risk (Dunkley et al., 2017). Adults with overweight and obesity should consider the ways to balance their weight by engaging in adequate physical activity (Merlotti, et al., 2014).

Moreover, moderately intense physical exertion is accompanied by the growth in the rate of proliferation of capillaries in the muscles, the volume of muscle tissue, and the sensitivity of peripheral tissues and muscles to insulin. Food should be healthy and balances, including high-grade proteins, lean meat, fish, milk, dairy products, and so on (Ley, Hamdy, Mohan, & Hu, 2014).

The public health issue of diabetes requires the attention of a greater number of people since there are a lot of factors that can cause it. In this connection, it seems important to think about the need for early detection of diabetes. Often, insurance does not include screening and blood tests for diabetes, and people fail to reveal the onset of their disease, which leads to complications (Seuring et al., 2015). One may suggest that a special fund should be organized to support and promote a diabetes prevention program. It was learned that money should be spent not only on improving diagnostics but also on working with patients to ensure their adherence to treatment.

It is significant that a patient follows the rules of nutrition, actively moves, constantly independently monitors the level of glucose in the blood, and regularly passes examinations, following a doctor’s prescriptions. If the disease is diagnosed on time, there is an opportunity to stop it without medical treatment. It was clarified that the prevention of diabetes can reduce the risk of this dangerous disease. Learning to control his or her diabetes and keeping blood glucose levels at optimum levels. A patient achieves the main goal of treatment. While it requires high awareness and motivation from the patient, preventative measures allow saving funds and improving care quality.

To conclude, it should be stressed that type 2 diabetes is a public health concern that turned out to become an epidemic in recent years. People of different ages and cultures across the globe struggle to prevent and combat it. The evidence shows that the prevalence of the disease tends to increase, and many comorbid diseases complicate the situation. The national DPP initiative introduced in the US is expected to contribute to the early recognition of diabetes through patient and care provider education. While nurses and physicians can diagnose and prescribe treatment options, the patients should also participate through self-monitoring and timely reporting if any changes. More people should pay attention to this public health issue to make a significant step towards protecting their health from diabetes impact.

Diabetes Prevention Program Research Group. (2015). Long-term effects of lifestyle intervention or Metformin on diabetes development and microvascular complications over 15-year follow-up: The Diabetes Prevention Program outcomes study. The Lancet Diabetes & Endocrinology, 3 (11), 866-875.

Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, K. (2014). Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: A systematic review and meta-analysis. Diabetes Care , 37 (4), 922-933.

Jaacks, L. M., Siegel, K. R., Gujral, U. P., & Narayan, K. V. (2016). Type 2 diabetes: A 21st century epidemic. Best Practice & Research Clinical Endocrinology & Metabolism , 30 (3), 331-343.

Krug, E. G. (2016). Trends in diabetes: Sounding the alarm. The Lancet , 387 (10027), 1485-1486.

Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. The Lancet , 383 (9933), 1999-2007.

Merlotti, C., Morabito, A., & Pontiroli, A. E. (2014). Prevention of type 2 diabetes; A systematic review and meta‐analysis of different intervention strategies. Diabetes, Obesity and Metabolism , 16 (8), 719-727.

Schneiderman, N., Llabre, M., Cowie, C. C., Barnhart, J., Carnethon, M., Gallo, L. C.,… Teng, Y. (2014). Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: The Hispanic community health study/study of Latinos (HCHS/SOL). Diabetes Care , 37 (8), 2233-2239.

Seuring, T., Archangelidi, O., & Suhrcke, M. (2015). The economic costs of type 2 diabetes: A global systematic review. Pharmacoeconomics , 33 (8), 811-831.

Unnikrishnan, R., Pradeepa, R., Joshi, S. R., & Mohan, V. (2017). Type 2 diabetes: Demystifying the global epidemic. Diabetes , 66 (6), 1432-1442.

World Health Organization. (2016). Global report on diabetes . Web.

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Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a metabolic disorder characterized by dysregulation of blood glucose caused by relative insulin deficiency and insulin resistance. 1 It is a progressive condition that have serious adverse effects on multiple organs and body functions, but it can be successfully managed with treatment that usually includes lifestyle changes and pharmacotherapy. 2 This article summarizes the risk factors, symptoms, diagnostic workup, and treatment of type 2 diabetes mellitus.

Epidemiology

According to the Centers for Disease Control and Prevention, in 2021 an estimated 38.4 million people in the United States (US) had diabetes. 3 Approximately 90% to 95% of all cases of diabetes are type 2. 1 An estimated 22.8% of people with diabetes are undiagnosed. 3  

Type 2 diabetes mellitus is common among older adults in the US, affecting an estimated 29% to 33% of adults age 65 years or older, and is projected to become even more prevalent in this age group. 3,4 In recent years, the incidence of type 2 diabetes mellitus among children and adolescents has also increased, corresponding to increases in obesity rates in the US. 3

Type 2 Diabetes Etiology & Risk Factors 

The precise etiology of type 2 diabetes mellitus is not clear. 1 The pathophysiology this type of diabetes involves insulin resistance, relative insulin deficiency, and glucagon dysregulation. 2 Excess body fat or an abnormally high abdominal fat percentage contributes to insulin resistance. 1  

Aging has direct effects on metabolic regulation, and advanced age is a risk factor for type 2 diabetes mellitus. 1,4 Other risk factors include the following 1 :

• Obesity or overweight;
• Lack of physical activity;
• Prediabetes or a history of gestational diabetes;
• Polycystic ovarian syndrome;
• Hypertension;
• Having a first-degree relative with type 2 diabetes mellitus; and
• Certain medications, including glucocorticoids, statins, thiazide diuretics, second-generation antipsychotics, and antiretroviral therapy.

The life expectancy of a patient with type 2 diabetes mellitus who is older than age 50 years is decreased by 6 years compared to individuals without diabetes. 5 Achieving treatment goals related to weight, blood sugar, blood cholesterol, and blood pressure can improve that prognosis by 3 to 10 years. 5

In addition to age, the prognosis for type 2 diabetes mellitus varies based on the presence of co-existing conditions or complications. 2 Patients with type 2 diabetes mellitus and heart failure have an especially poor prognosis, with a high risk of debilitating symptoms, hospitalization, and death. 2 Co-occurring stroke, ischemic heart disease, chronic kidney disease, and peripheral artery disease also decrease the life expectancy of patients with type 2 diabetes mellitus. 6  

Presentation & Diagnosis of Type 2 Diabetes 

The most common symptoms of type 2 diabetes mellitus are the following 7 : 

• Increased thirst and hunger; 
• Increased urination; 
• Fatigue; 
• Blurred vision; 
• Numbness and tingling in the feet and hands; 
• Unexplained weight loss; and 
• Delayed wound healing. 

Because symptoms of type 2 diabetes mellitus develop gradually, they may be difficult to detect, which can lead to a delayed or missed diagnosis. 1,7

According to guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinology (AACE), the diagnostic criteria for type 2 diabetes mellitus (for people who are not pregnant) are as follows 1,2 :

• A1C greater than or equal to 6.5%; or
• Fasting plasma glucose (FPG) greater than or equal to 126 mg/dL (at least 8 hours with no food); or
• Postprandial plasma glucose (PPG) greater than or equal to 200 mg/dL during a 2-hour oral glucose tolerance test; or
• Random plasma glucose greater than or equal to 200 mg/dL or greater than or equal to 11.1 mmol/L in a person with symptoms of hyperglycemia.

Due to the progressive nature of the disease, patients with early stages of type 2 diabetes mellitus may have normal blood glucose levels. 1 Therefore, the diagnosis requires 2 abnormal test results, measured from a single sample or from 2 samples taken at different times, unless a person with clear hyperglycemic symptoms has a random plasma glucose level greater than or equal to 200 mg/dL. 2  

Diagnostic Workup

Because patients with type 2 diabetes mellitus often are asymptomatic, systematic screening is necessary. 2 Although there is no evidence-based consensus on the ideal screening frequency, the ADA recommends screening every 3 years starting at age 35 years for most adults. 1 Adults with overweight or obesity should be screened more frequently if they have an additional risk factor, such as prediabetes (A1C 5.7% to 6.4%, FPG 100 mg/dL to 125 mg/dL, or PPG 140 mg/dL to 199 mg/dL), hypertension, high cholesterol, polycystic ovarian syndrome, or a family history of diabetes. 1  

The diagnostic workup is largely based on blood tests. 2 Random glucose and A1C levels can be assessed at any time. The FPG test requires the patient to not consume any food for at least 8 hours or overnight. For the PPG test, patients should fast for 8 hours or overnight, ingest 75 g of oral glucose, and wait 2 hours before a blood draw. 2  

A clinical history and physical examination should also be conducted to investigate common symptoms affecting the eyes and extremities (such as retinopathy and neuropathy). 2

Differential Diagnosis of Type 2 Diabetes

Developing an appropriate treatment plan requires distinguishing type 2 diabetes mellitus from other types of diabetes. Type 1 diabetes can be identified via autoantibody testing. 1 Specifically, blood tests should assess for the presence of autoantibodies for insulin, glutamic acid decarboxylase, pancreas islet b cells (tyrosine phosphatase IA-2), and IA-2b zinc transporter 8. 2 A positive result on any of these tests would indicate type 1 diabetes. 2  

The diagnostic criteria for gestational diabetes are distinct from those of type 1 diabetes and type 2 diabetes mellitus. 1 Pregnant individuals should be assessed according to the recommendations from the ADA and AACE. 1,2

Young patients who meet the criteria for diabetes but do not have obesity or overweight should be assessed for maturity-onset diabetes of the young (MODY), which is monogenic and can be tested for with a gene panel of 14 implicated genes. 2

Type 2 Diabetes Treatment 

The first step in managing type 2 diabetes mellitus is to develop patient-specific treatment goals. 8 Glycemic targets should be individualized based on the patient’s age, weight loss goals, risk factors, and complications. 8,9 The AACE suggests a target A1C of less than or equal to 6.5% for most people who are not pregnant, while the ADA suggests less than 7%. 2,10 To achieve the target A1C, patients generally need an FPG less than 110 mg/dL and a 2-hour PPG less than 140 mg/dL. 2 Treatment goals should be less stringent in patients with advanced and severe diabetes or in those with extensive comorbidities. 2 The glucose goal for patients who are hospitalized is generally 140 to 180 mg/dL. 2

Monitoring glucose levels is an important component of the management strategy because it allows therapy to be adjusted based on glucose levels over time. 2 Although all individuals with type 2 diabetes mellitus can benefit from daily monitoring, the AACE recommends semiannual or quarterly A1C monitoring for people with type 2 diabetes mellitus who are not being treated with insulin. 2 Continuous glucose monitoring or at least twice daily blood glucose monitoring is recommended for patients receiving insulin or those with a high risk for hypoglycemia. 2

Pharmacotherapy for Type 2 Diabetes 

The ADA and AACE have established algorithms for determining the appropriate treatment course for type 2 diabetes mellitus based on complications, glycemic targets, and risk factors. 8,9 In general, the first-line pharmacologic treatment is metformin, a glucagon-like peptide-1 (GLP-1) receptor agonist, or a sodium-glucose cotransporter (SGLT) inhibitor. 8,9  

Within the same drug class, some agents may be more effective in preventing type 2 diabetes mellitus complications than others. 9 Patients with risk factors for the following complications should consider the following agents 9 :

• Cardiovascular event: Canagliflozin, empagliflozin, dulaglutide, liraglutide, semaglutide;
• Heart failure: Canagliflozin, dapagliflozin, empagliflozin, ertugliflozin (avoid saxagliptin and thiazolidinediones); and
• Diabetic kidney disease: canagliflozin, dapagliflozin, empagliflozin, dulaglutide, liraglutide, semaglutide.

The pharmacotherapy treatment plan should be reassessed every 3 to 6 months. If glycemic goals are not met with monotherapy, combining metformin, injectable or oral GLP-1 receptor agonists, and insulin should be considered. 9 Dulaglutide, semaglutide, and tirzepatide are the most effective in combination therapies. 9 Other GLP-1 receptor agonists, metformin, SGLT inhibitors, sulfonylureas, and thiazolidinediones are also highly effective. 9 Metformin, thiazolidinediones, sulfonylureas, and glinides may be preferred due to their relatively lower cost. 8,9

For patients with overweight or obesity, therapies that are effective at both glucose control and weight loss should be prioritized. 9 Semaglutide and tirzepatide are very highly effective for weight loss; dulaglutide and liraglutide are highly effective. 9

For older adults with type 2 diabetes mellitus, metformin should be the initial treatment. 4 If treatment goals are not met, other oral or injectable therapies or insulin may be added to metformin. 4  

Nonpharmacologic Treatments for Type 2 Diabetes 

For individuals with type 2 diabetes mellitus with obesity and overweight, healthy lifestyle behaviors that include nutritional interventions, increased physical activity, and behavioral therapy to achieve and maintain a weight loss of 5% or greater of body weight are recommended. 11 Some evidence suggests that patients with type 2 diabetes mellitus who engage in intensive exercise and diet or surgical weight loss can achieve remission of type 2 diabetes mellitus. 11 The ADA recommends frequent patient counseling (at least 16 sessions in 6 months) to facilitate changes in nutrition and physical activity. 11 For many individuals with overweight or obesity, a 500 to 750 kcal/d deficit may be appropriate. 11

Adverse Effects of Treatments 

Some medications used to treat type 2 diabetes mellitus, particularly insulin, sulfonylureas, or meglitinides, carry the risk of hypoglycemia, defined as a plasma glucose less than 70 mg/dL. 10 This can generally be prevented with patient education and vigilant blood glucose monitoring. 10 Fast-acting carbohydrates or glucagon can restore glucose levels in patients experiencing hypoglycemia. 10 Due to their propensity to cause hypoglycemia, sulfonylureas or glinides should be avoided in older adults. 4

Metformin, GLP-1 receptor agonists, sulfonylureas, and thiazolidinediones can cause gastrointestinal adverse effects such as bloating, abdominal discomfort, and diarrhea. 9,12 The use of SGLT inhibitors increases the risk for genital mycotic infections. 12 Insulin therapy, sulfonylureas, and thiazolidinediones can result in weight gain. 2 All of these effects can be managed by adjusting the dose or changing medications based on individual circumstances. 9

The risk of cancer is increased in individuals with diabetes and/or obesity. 2 However, an AACE review found no strong evidence that type 2 diabetes mellitus therapies increase the risk of cancer. 2 

Complications of Type 2 Diabetes 

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes characterized by an overproduction of ketones. 1 Spontaneous DKA is not common in type 2 diabetes mellitus. 2 Usually, DKA presents in patients with type 2 diabetes mellitus who are taking insulin and miss a dose or receive an inadequate dose; after the stress of another illness such as an infection or myocardial infarction, or after using certain illicit drugs (such as cocaine) and certain medications (such as glucocorticoids or second-generation antipsychotics). 1  

Individuals with type 2 diabetes mellitus are at a high risk for cardiovascular disease. 2 According to the AACE, patients should undergo annual assessments for dyslipidemia and receive lipid-lowering therapy (high-intensity statins) as necessary. 2  

Hypertension is common in patients with type 2 diabetes mellitus. For most patients, the blood pressure goal should be 130/80 mm Hg or lower. 2 Individuals with type 2 diabetes mellitus who developed hypertension should be treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). 2  

Untreated hypertension can increase the risk of diabetic kidney disease and chronic kidney disease. 2 The estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio should be assessed annually in people with type 2 diabetes mellitus. The recommended treatment options for concomitant kidney disease and type 2 diabetes mellitus generally include ACE inhibitors, ARBs, SGLT inhibitors, and GLP-1 receptor agonists. 2  

Retinopathy is a potential complication of type 2 diabetes mellitus, and patients should be screened for this once every 2 to 3 years. 2 The treatment for retinopathy is pan-retinal laser photocoagulation and/or anti-vascular endothelial growth factor antibodies. 2

Diabetic peripheral neuropathy and cardiovascular autonomic neuropathy can also occur in individuals with diabetes. 2 Foot examinations and reflex tests should be used to assess for neuropathy. 2 Treatments for neuropathic pain include pregabalin, duloxetine, and capsaicin. 2  

The ADA has published extensive guidelines for treating and managing the risk of cardiovascular disease, chronic kidney disease, and retinopathy and neuropathy in patients with diabetes. 13-15 In general, a greater duration of glycemic burden increases the risk of these complications, while meeting glucose targets decreases the risk. 1

Type 2 Diabetes Guidelines

Several organizations offer recommendations on the diagnosis and treatment of type 2 diabetes mellitus:

• American Diabetes Association Standards of Care in Diabetes—2024
• American Association of Clinical Endocrinology Comprehensive Type 2 Diabetes Management Algorithm (2023 Update)
• American Association of Clinical Endocrinology Clinical Practice Guideline (2022 Update)
• Endocrine Society Treatment of Diabetes in Older Adults (2019)
• American College of Physicians Oral Pharmacological Treatment of Type 2 Diabetes Mellitus (2017)
• American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of care in diabetes—2024. Diabetes Care . 2024;47 (Suppl 1):S20-S42. doi:10.2337/dc24-S002
• Blonde L, Umpierrez GE, Reddy SS, et al. American Association of Clinical Endocrinology clinical practice guideline: Developing a diabetes mellitus comprehensive care plan—2022 update. Endocr Pract . 2022;28(10):923-1049. doi:10.1016/j.eprac.2022.08.002
• National Diabetes Statistics Report. Centers for Disease Control and Prevention. Updated May 15, 2024. Accessed September 16, 2024. https://www.cdc.gov/diabetes/php/data-research/index.html
• LeRoith D, Biessels GJ, Braithwaite SS, et al. Treatment of diabetes in older adults: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab . 2019;104(5):1520-1574. doi:10.1210/jc.2019-00198
• How people with type 2 diabetes can live longer. Centers for Disease Control and Prevention. Updated May 15, 2024. Accessed September 12, 2024. https://www.cdc.gov/diabetes/data-research/research/treatment-goals.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/resources-publications/research-summaries/reaching-treatment-goals.html
• Zareini B, Blanche P, D’Souza M, et al. Type 2 diabetes mellitus and impact of heart failure on prognosis compared to other cardiovascular diseases: A nationwide study. Circ Cardiovasc Qual Outcomes . 2020;13(7):e006260. doi:10.1161/CIRCOUTCOMES.119.006260
• Type 2 diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. Updated May 2017. Accessed March 13, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes
• Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology consensus statement: Comprehensive type 2 diabetes management algorithm – 2023 update. Endocr Pract . 2023;29(5):305-340. doi:10.1016/j.eprac.2023.02.001
• American Diabetes Association Professional Practice Committee. 9. Pharmacologic approaches to glycemic treatment: Standards of care in diabetes—2024. Diabetes Care . 2024;47(Suppl 1):S158-S178. doi:10.2337/dc24-S009
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• Published: 18 September 2024

Reply to: Milk intake, lactase non-persistence and type 2 diabetes risk in Chinese adults

• Kai Luo   ORCID: orcid.org/0000-0001-6453-3699 1 ,
• Yanbo Zhang   ORCID: orcid.org/0000-0003-1054-9657 1 ,
• Robert C. Kaplan 1 , 2 &
• Qibin Qi   ORCID: orcid.org/0000-0002-2687-1758 1 , 3  

Nature Metabolism ( 2024 ) Cite this article

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• Endocrine system and metabolic diseases
• Epidemiology
• Risk factors

The Original Article was published on 18 September 2024

replying to M. G. Kakkoura et al. Nature Metabolism https://doi.org/10.1038/s42255-024-01128-2 (2024)

We thank Kakkoura and colleagues 1 for their commentary on our recent study, which reported an inverse association between milk intake and incident type 2 diabetes (T2D) in lactase non-persistent (LNP) individuals with a potential mediating role of gut microbiota and related metabolites 2 .

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Data availability

The data in our original article 2 were used to generate results in this paper. In brief, the genetics data of HCHS/SOL used in this paper are archived at the NIH repositories dbGap (accession no. phs000810.v1.p1 ) and BioLINCC (accession no. HLB01141418a ), and gut microbiome sequence data in this study are deposited in QIITA (study ID 11666). HCHS/SOL has established a process for the scientific community to apply for access to participant data and materials, with such requests reviewed by the project’s Steering Committee. These policies are described at https://sites.cscc.unc.edu/hchs/ (accessed December 2022). Original data from the UKB used in the present study are available at https://www.ukbiobank.ac.uk/ . Source data are provided with this paper.

Code availability

No custom codes or functions were generated for this manuscript. All codes regarding the main analyses or data visualization can be made available upon reasonable request to the corresponding author.

Kakkoura, M. G., Walters, R. G., Clarke, R., Chen, Z. & Du, H. Milk intake, lactase non-persistance and type 2 diabetes risk in Chinese adults. Nat. Metab. https://doi.org/10.1038/s42255-024-01128-2 (2024).

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Acknowledgements

The present work is supported by R01-DK119268 (to Q.Q.) and R01-DK126698 (to Q.Q.) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and R01-MD011389 (to R.C.K.) from the National Institute on Minority Health and Health Disparities. K.L. is supported by an AHA postdoctoral fellowship award (23POST1020455). Other funding sources for this study include UM1-HG008898 from the National Human Genome Research Institute; R01-HL060712, R01-HL140976 and R01-HL136266 from the National Heart, Lung, and Blood Institute (NHLBI); and R01-DK120870 and the New York Regional Center for Diabetes Translation Research (P30-DK111022) from the NIDDK. Support for metabolomics data was graciously provided by the JLH Foundation (Houston, Texas). The HCHS/SOL is a collaborative study supported by contracts from the NHLBI to the University of North Carolina (HHSN268201300001I/N01-HC-65233), University of Miami (HHSN268201300004I/N01-HC-65234), Albert Einstein College of Medicine (HHSN268201300002I/N01-HC-65235), University of Illinois at Chicago (HHSN268201300003I/N01-HC-65236 Northwestern University) and San Diego State University (HHSN268201300005I/N01-HC-65237). The following institutes/centres/offices have contributed to the HCHS/SOL through a transfer of funds to the NHLBI: National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, NIDDK, National Institute of Neurological Disorders and Stroke and National Institutes of Health (NIH) Institution-Office of Dietary Supplements. We thank the staff and participants of HCHS/SOL for their important contributions. A complete list of staff and investigators is available on the study website at https://sites.cscc.unc.edu/cscc/ . The funding agencies had no role in the data analyses and results interpretation.

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K.L. and Y.Z. conducted the analyses. K.L. prepared the tables and figures and drafted the manuscript. R.C.K. and Q.Q. critically revised the manuscript.

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Luo, K., Zhang, Y., Kaplan, R.C. et al. Reply to: Milk intake, lactase non-persistence and type 2 diabetes risk in Chinese adults. Nat Metab (2024). https://doi.org/10.1038/s42255-024-01129-1

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Diabetes Type 2

Diabetes mellitus, normal physiology of the pancreas, case in point.

Type 2 diabetes results from the body failing to effectively utilize the insulin produced by the pancreas. The malfunction is referred is known as insulin resistance. The result is hyperglycaemia that is associated with the presenting symptoms of diabetes (Stoian et al., 2015; Lazo et al., 2014)

The alpha cells comprise about 20% of all the islet’s cells. They secrete the hormone named glucagon which increases blood sugar to maintain normal levels so that glucose can get broken down once sugar levels drop (Waters, 2014; TAO, 2014). The making and release of glucagon in the pancreas is controlled by chemoreceptors through the body that are sensitive to the levels of sugar in the blood. When the blood sugar levels drop too low, the chemoreceptors signal the alpha cells in the pancreas to release the hormone glucagon which is transported via blood to the liver. Glucagon acts on hepatocytes hepatocytes to break down glycogen into the glucose through a process referred to as glycogenesis (Barron, 2010; DeWit, Stromberg & Dallred, 2017).

Low amount of insulin coupled with insulin resistance of cells lead to high blood glucose levels. The result is poor protein synthesis, and other metabolic derangements, such as acidosis (TAO, 2014). Persistent high glucose levels outrun the kidneys ability for reabsorption and glucose is excreted in urine (DeWit, Stromberg & Dallred, 2017). Osmotic pressure of urine increases impairing the ability of the kidneys to reabsorb water. More water is lost leading to excessive polyuria and fluid from the cells is lost to replace lost volume. The result is polydipsia (TAO, 2014; HINKLE, & CHEEVER, 2014).

1. Barron, J., 2010. The Endocrine System: The Pancreas & Diabetes. [Online] Available at: https://jonbarron.org/diabetes-blood-sugar-levels/endocrine-system-pancreas-diabetes. [Accessed 21 October 2016].

2. Chin, Y, Huang, T, & Hsu, BR 2013, ‘Impact of action cues, self-efficacy and perceived barriers on daily foot exam practice in type 2 diabetes mellitus patients with peripheral neuropathy’, Journal of Clinical Nursing, vol. 22, no. 1/2, pp. 61-68. Available from: 10.1111/j.1365-2702.2012.04291.x. [8 February 2017].

3. DeWit, S. C., Stromberg, H., & Dallred, C. (2017). Medical-surgical nursing: Concepts & practice.

4. Habtewold, TD, Tsega, WD, & Wale, BY 2016, ‘Diabetes Mellitus in Outpatients in Debre Berhan Referral Hospital, Ethiopia’, Disease Markers, pp. 1-6. Available from: 10.1155/2016/3571368. [8 February 2017].

5. HINKLE, J. L., & CHEEVER, K. H. (2014). Brunner & Suddarth’s textbook of medical-surgical nursing.

6. Lazo, MA, Bernabé-Ortiz, A, Pinto, ME, Ticse, R, Malaga, G, Sacksteder, K, Miranda, JJ, & Gilman, RH 2014, ‘Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study’, PLoS ONE, vol. 9, no. 5, pp. 1-5. Available from: 10.1371/journal.pone.0095403. [7 February 2017].

7. Li, G, Sun, C, Wang, Y, Liu, Y, Gang, X, Gao, Y, Li, F, Xiao, X, & Wang, G 2014, ‘A Clinical and Neuropathological Study of Chinese Patients with Diabetic Peripheral Neuropathy’, PLoS ONE, vol. 9, no. 3, pp. 1-5. Available from: 10.1371/journal.pone.0091772. [8 February 2017].

8. Park, H, Park, C, Quinn, L, & Fritschi, C 2015, ‘Glucose control and fatigue in type 2 diabetes: the mediating roles of diabetes symptoms and distress’, Journal of Advanced Nursing, vol. 71, no. 7, pp. 1650-1660. Available from: 10.1111/jan.12632. [8 February 2017].

9. Stoian, A, Bănescu, C, Bălaşa, RI, Moţăţăianu, A, Stoian, M, Moldovan, VG, Voidăzan, S, & Dobreanu, M 2015, ‘Influence of GSTM1, GSTT1, and GSTP1 Polymorphisms on Type 2 Diabetes Mellitus and Diabetic Sensorimotor Peripheral Neuropathy Risk’, Disease Markers, vol. 2015, pp. 1-10. Available from: 10.1155/2015/638693. [6 February 2017].

10. Syngle, A, Verma, I, Krishan, P, Garg, N, & Syngle, V 2014, ‘Minocycline improves peripheral and autonomic neuropathy in type 2 diabetes: MIND study’, Neurological Sciences, vol. 35, no. 7, pp. 1067-1073. Available from: 10.1007/s10072-014-1647-2. [7 February 2017].

11. TAO, Y.-X. (2014). Glucose homeostatis and the pathogenesis of diabetes mellitus.

12. Won, JC, Kwon, HS, Kim, CH, Lee, JH, Park, TS, Ko, KS, & Cha, BY 2012, ‘Prevalence and clinical characteristics of diabetic peripheral neuropathy in hospital patients with Type 2 diabetes in Korea’, Diabetic Medicine: A Journal Of The British Diabetic Association, vol. 29, no. 9, pp. e290-e296. Available from: 10.1111/j.1464-5491.2012.03697.x. [8 February 2017].

13. Yorek, MS, Obrosov, A, Shevalye, H, Holmes, A, Harper, MM, Kardon, RH, & Yorek, MA 2015, ‘Effect of diet-induced obesity or type 1 or type 2 diabetes on corneal nerves and peripheral neuropathy in C57Bl/ 6J mice’, Journal of the Peripheral Nervous System, vol. 20, no. 1, pp. 24-31. Available from: 10.1111/jns.12111. [6 February 2017].

• Alzheimer Disease
• Anger Management

Type 2 Diabetes

This paper aims to examine type 2 diabetes from both a scientific and an analytical/mathematical viewpoint, with particular attention paid to the effects of the illness on various organs and systems and the financial burdens it places on society. The paper details the intricate physiological processes—involving the endocrine, cardiovascular, neurological, and immunological systems—that contribute to these effects. Financial repercussions of type 2 diabetes are also examined in this paper. This includes medical care and treatment expenditures, diabetes-related consumables, and lost productivity, both direct and direct costs. The paper stresses the significance of maintaining frequent medical checkups and stable blood sugar levels in avoiding or delaying the onset of problems associated with type 2 diabetes. It further aims to scrutinize the disease from an ethical and cultural vantage point, with particular attention paid to the rules that regulate the disease and their effect on a patient’s ability to get care and treatment. The paper explains how the ACA and the Americans with Disabilities Act (ADA) are helping to expand access to medical care for individuals with Type 2 diabetes. The report also analyzes state-level efforts, and legislation passed intending to expand access to treatment for persons who suffer from the illness. The paper describes some of the challenges people face when trying to get healthcare, including the high cost of treatment and a lack of qualified medical professionals, as well as some of the programs and policies already in place to address these issues. The Veteran Association is also mentioned as a support system for veterans ailing from the condition. The paper discusses the societal and cultural effects of Type 2 diabetes, emphasizing the Western world and low- and middle-income nations. This paper mentions how certain civilizations are more likely to contract type 2 diabetes due to cultural and lifestyle variables. Finally, the paper discusses potential approaches to treating and controlling the disease.

Introduction

Hyperglycemia, or preeminent blood glucose intensities, is a cause of type 2 diabetes, a long-term illness. It happens when the pancreas cannot generate enough of the hormone insulin, which controls blood sugar, or when the body develops insulin resistance. Being overweight, having a diabetes-related family history, and living a sedentary lifestyle are all risk factors. Increased thirst and hunger, urine frequency, weariness, and impaired wound healing are among the symptoms. Diet, exercise, and medication changes may help control the condition. Heart disease, stroke, renal failure, and nerve damage are some consequences that may result from untreated type 2 diabetes. Diabetic retinopathy and diabetic neuropathy are just a few products that may arise from the disease’s effects on the body’s numerous systems. The endocrine, circulatory, neurological, and immunological systems all play a role in these effects. The direct expenses of medical care and treatment, diabetes-related consumables, and the indirect costs of lost work and lower productivity significantly impact people, families, and society due to type 2 diabetes. Several legislation and guidelines have been implemented to guarantee that people with Type 2 diabetes may get the treatment they need. Healthcare access for all Americans has been expanded by passing laws like the Americans with Disabilities Act (ADA) and the Affordable Care Act (ACA). Medicare’s Diabetes Prevention Program (MDPP) and Social Security Disability Insurance (SSDI) are examples of federal and state programs that try to improve patient’s access to care for the disease. However, despite these regulations and programs, there are still obstacles to receiving care and treatment, especially for low-income persons in rural regions. Middle- and low-income countries, as well as Western and Middle Eastern people, are disproportionately afflicted by Type 2 diabetes. Metformin is widely used as a medication for this disease. Thiazolidinediones or glitazones are another class of medications used to treat type 2 diabetes. These medications aid blood sugar regulation by increasing insulin sensitivity and lowering insulin resistance. However, they can raise blood pressure and water retention risks.

Scientific Inquiry

Body parts affected by type 2 diabetes.

The inability to properly use glucose, the body’s primary source of cellular metabolism, lies at the heart of type 2 diabetes, a chronic disease with far-reaching consequences. High blood sugar levels are associated with a wide range of health problems because of the harm they may do to the body over time. Individuals who have type 2 diabetes often have complications related to their eyes. Diabetic retinopathy occurs when blood capillaries in the retina are damaged due to high blood sugar levels. If neglected, this may result in impaired eyesight or total blindness, according to Daryabor et al. (2020). The course of diabetic retinopathy may be halted or at least slowed with regular eye examinations and good blood sugar management.

Moreover, type 2 diabetes may damage the kidneys, another vital organ. Diabetic nephropathy develops when capillaries in the kidneys are damaged due to high blood sugar. Because of this, dialysis or a kidney transplant may become necessary. Diabetic nephropathy may be avoided, or its development slowed with strict blood sugar management and routine monitoring of kidney function. Type 2 diabetes may potentially damage the nerves. Diabetic neuropathy is a disorder in which impairment of the nerves is caused by high blood sugar levels (Daryabor et al., 2020). Symptoms include tingling, numbness, and discomfort in the limbs. Because patients with diabetic neuropathy might not be able to experience pain or other impulses in their feet, this may increase the likelihood of foot injuries and illnesses. Diabetic neuropathy may be prevented or slowed by regular foot examinations and good blood sugar management.

Type 2 diabetes has additional effects on the cardiovascular system, particularly the heart and the blood arteries. Damage to the blood arteries caused by high blood sugar levels is associated with improved cardiovascular illness and stroke risk. The danger of heart disease increases in individuals with type 2 diabetes because of their heightened susceptibility to hypertension. Carpenter et al. (2019) posit that individuals with the disease may lower their danger of cardiac disease and stroke by sustaining a healthy weight, exercising regularly, and consuming a balanced diet.

The Specific Physiological Mechanisms and Processes That Lead to The Effects on the Different Body Systems in Individuals Having Type 2 Diabetes

High blood glucose intensities are related to a wide range of health issues because of the wear and tear they place on the body over time. It is difficult and time-consuming to isolate the specific physiological processes and systems contributing to these effects. The endocrine system is a significant contributor to the adverse effects of type 2 diabetes on the body. Humans’ ability to produce and regulate hormones like insulin is a function of the endocrine system (Eizirik et al., 2020). Over time, increased blood glucose levels may harm the blood vessels and organs, resulting in various problems such as diabetic retinopathy and diabetic neuropathy.

Type 2 diabetes affects the body in several ways, and the cardiovascular system is a significant contributor. Atherosclerosis, or hardening of the arteries, is a disorder caused by damage to the blood vessels brought on by high blood sugar levels. Heart disease, stroke, and other cardiovascular issues may be more likely due to this, as Khan et al. (2020) claim.

Type 2 diabetes has adverse effects on the neurological system as well. Damage to the nerves, known as diabetic neuropathy, is a known complication of uncontrolled high blood sugar. Symptoms include tingling, numbness, and discomfort in the extremities. However, oxidative stress, inflammation, and alterations in nerve function are all speculated to have a role in diabetic neuropathy, while the exact roles remain unclear. The immune system is another critical physiological system that contributes to the impacts of type 2 diabetes on the body. The disease may lower the body’s defenses, making those with type 2 diabetes more vulnerable to illness. Some autoimmune disorders, such as autoimmune thyroiditis and celiac disease, may be more likely in people with type 2 diabetes (Galicia-Garcia et al., 2020). It is unclear what exact physiological mechanisms contribute to these elevated risks, although alterations in immune system function and oxidative stress are two likely candidates.

Mathematical/Analytical Inquiry

Economic issues involved with type 2 diabetes.

Affecting one in ten American grownups, type 2 diabetes is costly for people, families, and the economy. Type 2 diabetes may have severe repercussions on a person’s financial security due to various direct and indirect charges. The expense of treatment and medical care is a direct cost associated with having the condition. Most individuals with the disease need continuing medical treatment, such as follow-up appointments with their doctor, blood work, and medication. Those without insurance or with inadequate coverage may find the expense of these procedures prohibitive. Medical costs may skyrocket for those with type 2 diabetes because of the increased likelihood that they will also acquire illnesses like heart disease and renal disease. Blood glucose monitors, test strips, and insulin are just a few examples of diabetes-related equipment and supplies, all of which add up to a significant financial burden for people with type 2 diabetes (Younossi et al., 2020). These expenditures may add up quickly for people who need numerous injections of insulin daily. Diabetic shoes and wound care kits are just a few examples of the specialized equipment that some persons with type 2 diabetes may need to invest in.

However, the actual financial burden of type 2 diabetes often lies in its indirect expenses. Loss of income and diminished earning potential may occur when a person with type 2 diabetes has to miss work or is unable to work because of their disease. Type 2 diabetics have a greater chance of being disabled, which may lead to higher disability insurance premiums and less money put up for retirement. Adverse economic effects of type 2 diabetes on the community are also possible. According to O’Connell et al. (2019), estimates place the annual cost of treating and caring for people with type 2 diabetes in the billions of dollars. Since customers ultimately bear healthcare costs and missed productivity in the form of progressive taxation and the prices of goods and services, this may burden healthcare systems and the economy.

Several monetary issues also arise from having type 2 diabetes. One significant difficulty is that people with type 2 diabetes may experience a decline in their quality of life, which may have repercussions on their social and economic security. The inability to engage in strenuous physical activity may hinder a person’s ability to work and enjoy life while living with type 2 diabetes. Quality of life might suffer due to the resulting decline in social and emotional functioning. The high price tag of treating diabetes-related consequences, including amputations, blindness, and renal failure, is a further financial burden for those with type 2 diabetes. Medical costs and time away from work are only two ways these difficulties add up to a hefty price tag. Additionally, they may lower one’s quality of life, which has repercussions for one’s emotional and material well-being.

Furthermore, depression and other psychological health disorders are more prevalent in people with type 2 diabetes, which may have severe consequences for both physical health and financial security. Due to their deteriorating psychological and physical health, individuals with type 2 diabetes may incur higher expenditures for mental health care and have less earning capacity. Furthermore, the expenses of medical treatment and missed productivity might make it hard for those with type 2 diabetes to break the cycle of poverty. The chance of acquiring type 2 diabetes and other health disorders is increased, which may lead to losing access to good food and secure housing. Costs associated with caring for the anticipated 30 million Americans with type 2 diabetes each year are expected to exceed $200 billion (Alzaid et al., 2021). Both direct and indirect costs are included here.

How Do Direct and Indirect Costs of Type 2 Diabetes Vary by Geography, Demographic, and Healthcare Access

Dependent on factors including population size, healthcare availability, and location, the direct and indirect costs of type 2 diabetes may range widely. Because of these disparities, certain areas and groups may bear a disproportionate share of the cost of caring for people with type 2 diabetes. The direct and indirect financial burdens of type 2 diabetes might vary widely by geography. Individuals who have type 2 diabetes, for instance, may have to pay more for healthcare and diabetes-related supplies and equipment if they live in an area with restricted access to excellent healthcare. They may also have difficulties gaining access to specialists like endocrinologists, which may raise the likelihood of problems and the expense of treatment (O’Connell et al., 2019). Type 2 diabetes is associated with more extraordinary healthcare expenses over time. It may be more prevalent in areas with high air pollution levels or restricted access to good dietary alternatives.

Furthermore, the direct and indirect expenses of type 2 diabetes may be affected by demographic variables. For example, persons living in low-income areas are more likely to acquire type 2 diabetes because they have less access to nutritious food and less chance of participating in risky physical exercise. The quality of life, ability to generate money, and overall cost of care might all take a hit. Type 2 diabetes and its consequences are more common among people of color, which poses a heftier financial burden on communities struggling to recover from other social and economic issues.

The availability of healthcare significantly impacts the direct and indirect expenses of type 2 diabetes. Healthcare and diabetes-related supplies and equipment may be more expensive for those who cannot quickly get high-quality medical care (Alzaid et al., 2021). Complications and additional expenses may be magnified because they may not have ready access to specialists like endocrinologists. The danger of getting the disease and its consequences is greater among those who lack adequate access to health insurance, who may also face increased expenses for medical treatment and lower access to preventative care. Moreover, some groups may have difficulty gaining entry to high-quality healthcare due to language and cultural barriers, leading to increased healthcare expenses and a lack of preventative programs. A person’s capacity to avoid and treat type 2 diabetes may be hindered if they lack access to knowledge on the illness and its management techniques due to low levels of education or literacy.

Additionally, the direct and indirect expenses of type 2 diabetes may be affected by workplace policies and initiatives. Health and wellness initiatives in the workplace, such as incentives to exercise and access to nutritious food, have been shown to minimize the likelihood of getting the disease and its consequences. However, the threat of acquiring the disease and accompanying problems may rise in workplaces with limited access to nutritious food selections, physical exercise opportunities, and supportive health policies, leading to increased expenses for medical treatment and lower productivity. The direct and indirect costs of type 2 diabetes may be affected by socioeconomic variables such as poverty, lack of secure housing, and restricted access to an excellent education. Higher medical expenses and worse quality of life may arise from the increased chance of having type 2 diabetes and its consequences due to these conditions. The economic and health burdens of type 2 diabetes may be alleviated and health outcomes improved by addressing these socioeconomic factors.

Ethical Perspective of Inquiry

Laws that govern type 2 diabetes and how these laws affect the access to care and treatment for those with the condition.

Several rules and regulations regulate the condition to make sure that individuals who are detected with Type 2 diabetes have access to the treatments and care that they require. The Americans with Disabilities Act is among the most significant legislation relevant to people with type 2 diabetes (ADA). The Americans with Disabilities Act (ADA) is a piece of federal legislation that forbids discrimination against disabled people in all spheres of public life, particularly jobs, housing, and access to medical treatment. The legislation mandates that companies offer reasonable adjustments for workers with impairments, including those with Type 2 diabetes. According to O’Brien & Brown (2018), businesses must provide their workers flexible working arrangements, more breaks, or other accommodations that enable them to manage their diabetes.

The Affordable Care Act (ACA), more often referred to as Obama care, is yet another significant piece of legislation influencing people with type 2 diabetes. The Affordable Care Act (ACA) is a piece of legislation passed into law on the federal level to broaden people’s access to medical care. Persons diagnosed with type 2 diabetes are now qualified for health insurance coverage via the marketplace or Medicaid according to the Affordable Care Act (ACA). In addition, the Affordable Care Act mandates that insurance providers pay for specific preventative care, such as blood sugar monitoring supplies, foot checks, and eye exams, for diabetic patients (Myerson et al., 2019). This makes it more likely that people who have type 2 diabetes will have access to the care and treatment they need to manage their illness effectively.

Additionally, federal and state restrictions may make it more difficult for individuals with the disease to get the care and treatment they need. For instance, “mandated benefits” regulations are prevalent in several jurisdictions. These laws oblige insurance companies to provide coverage for various medical treatments to persons with specified medical conditions, such as type 2 diabetes. The passage of this legislation helps guarantee that individuals who are detected with the disease have access to the therapies necessary to manage their illness. These treatments may include insulin injections, oral drugs, and glucose-tracking devices.

Despite these rules, there are still hurdles that prevent people with Type 2 diabetes from accessing care and treatment. For instance, a significant number of people who have Type 2 Diabetes reside in rural areas or in regions where medical professionals are scarce. Because of this, it is challenging for individuals to get the attention and therapy needed to manage their disease. In addition, a significant number of people who have Type 2 Diabetes have poor incomes, and as a result, they are unable to pay for the necessary medical treatments and supplies (Jia et al., 2019). Diabetes care and treatment may come at a significant financial burden, representing a significant obstacle to access for many individuals.

There are several initiatives now underway that aim to expand access to care and treatment for people who have the disease. These programs are designed to assist people with diabetes in conquering the existing access hurdles. Individuals unable to pay for their medical treatment may take advantage of the diabetes management and education programs provided by many community health clinics. These programs are either provided at a reduced cost or completely free of charge. In addition, a large number of healthcare providers are forming partnerships with groups like the American Diabetes Association and the Juvenile Diabetes Research Foundation that deliver financial support to people living with Type 2 diabetes who have little financial resources. Because of these measures, people who have the condition are more likely to have access to the care and medications they need to manage their illness effectively.

People who are at great threat of developing Type 2 diabetes and have prediabetes are the target population for the Medicare Diabetes Prevention Program (MDPP), which is an effort to avoid the disease’s emergence. Beneficiaries of Medicare are eligible to participate in this program and get preventive therapies that may help reduce the threat of acquiring type 2 diabetes. A systematic intervention to prevent type 2 diabetes in patients who indicate prediabetes is being made available by the Centers for Medicare & Medicaid Services (CMS). This initiative is known as the Medicare Diabetes Prevention Program (MDPP) extended model (Ritchie et al., 2020).

Furthermore, the clinical intervention comprises a minimum of sixteen intensive “core” meetings of a curriculum approved by the Centers for Disease Control and Prevention (CDC). These sessions are delivered over six months in a cohort, classroom-style setting. These sessions offer practical training in long-term nutritional intervention, enhanced physical activity, and behavior modification strategies for weight management. After completing the core sessions, less intense follow-up meetings every month ensure that the participants continue to engage in healthy habits. The reduction of at least 5 percent of total body weight by participants is the primary objective of the enlarged program.

People who are disabled due to type 2 diabetes have another alternative: Social Security Disability Insurance (SSDI). Individuals with impairments, particularly those with severe Type 2 diabetes, can receive financial assistance via this program. The financial strain that comes with managing this chronic ailment could be reduced. Walker & Roessel (2019) posit that people who cannot work due to specific impairments or medical problems, such as chronic type 2 diabetes, are eligible to receive payments from the SSDI.

Furthermore, payroll taxes for FICA Social Security are what finance SSDI. Workers qualify for SSDI if they have accumulated sufficient labor credits during their working lives. An individual must be below the age of 65 and have what the Social Security Administration (SSA) considers a severe qualifying disability to be eligible for the Supplemental Security Income program. The Department of Veterans Affairs (VA), responsible for serving veterans, is also dedicated to assisting those with Type 2 diabetes. Veterans with this illness have access to specialist clinics and programs to help them manage their diabetes as part of the comprehensive care and treatment that the VA provides.

Cultural Perspective of Inquiry

Cultures or societies most affected by type 2 diabetes.

About 80% of people with diabetes live in low and middle-income nations, according to the World Health Organization (WHO). This exemplifies how severely the sickness affects some of the most disadvantaged people on Earth. The Western world is one culture hit hard by the illness, with the United States, the United Kingdom, and Australia among the nations with the highest rates of Type 2 Diabetes. The disease disproportionately impacts the Middle Eastern populace (Sohal et al., 2015). Some nations with the highest rates of diabetes include Egypt, Iran, and Saudi Arabia.

In addition, New Zealand, Australia, and Canada’s indigenous individuals are at a better risk of developing the disease. Rates of obesity and diabetes have skyrocketed in these societies as people have switched to Western diets characterized by their heavy consumption of processed foods. Type 2 diabetes also has a disproportionately large impact on the Pacific Islander population. Heavy rates of the illness may be traced back to cultural activities like feasting and high intake of sugar-rich meals in countries like Fiji, Tonga, and Samoa. Type 2 diabetes is also more prevalent in certain racial groups than in others such as Asian Americans, Hispanics, African Americans, and Native Americans (Omodara et al., 2022).

Cultural Aspects That Lead to the Advanced Incidence of Type 2 Diabetes in Specific Cultures or Societies

In certain civilizations or societies, cultural variables greatly influence the disease’s progressive occurrence. As said earlier, Type 2 Diabetes is quite common in the Western world, which includes nations like the United States, the United Kingdom, and Australia. Numerous cultural influences, such as sedentary lifestyles, unhealthful eating patterns, and large consumption of processed and sugary foods, might be blamed for this. Individuals who live in the West are often more concerned with convenience and efficiency, which leads to a sedentary lifestyle that entails spending much time in front of a computer or TV (Brunetti, 2017). This lack of physical exercise raises the chance of being overweight, a significant danger factor for Type 2 Diabetes when paired with a poor diet.

The extensive accessibility of unhealthy food alternatives is another cultural element contributing to the high disease incidence in the Western world. Fast food, processed meals, and sugary beverages are readily available and often taken in large amounts, which raises calorie consumption and causes weight gain. Huge percentage sizes and excessive food intake are also strongly associated in many Western societies, where they are seen as symbols of success and affluence.

Type 2 Diabetes prevalence in Middle Eastern nations may be related to various cultural aspects, such as unhealthy fat and sugar-heavy diet. In the typical Middle Eastern diet, fatty foods like oils, nuts, and meats are often consumed, along with sugary pastries and sweets. This eating approach raises the risk of being overweight and having Type 2 Diabetes when paired with a sedentary lifestyle. Additionally, the Middle Eastern area has a large population of sedentary people with little access to physical exercise (Omodara et al., 2022). The substantial value placed on hospitality and generosity in many Middle Eastern cultures has led to the custom of providing visitors with copious amounts of food, which adds to overeating and weight gain.

Some cultural factors that may be at play in the high prevalence of the disease in native people of Canada and New Zealand include the introduction of Western diets high in processed foods and sugar to replace traditional indigenous diets. It is typical for indigenous populations to be economically disadvantaged, leaving them with few choices except unhealthy fast food. There has been a shift in eating habits and a simultaneous decline in bodily exercise, both leading to the rising rates of overweight and obesity-related diabetes in these areas (Al-Sahouri et al., 2022). Fiji, Tonga, and Samoa are just a few Pacific Island countries that feel the effects of Type 2 Diabetes’ widespread prevalence. Perhaps this is due to the widespread practice of feasting in many cultures, which involves ingesting many sugary foods and drinks all at once. Due to the high importance placed on hospitality and generosity in many communities, obesity is a common problem.

However, other factors besides culture may account for the increased incidence of Type 2 Diabetes in specific cultural and community contexts. One of these factors is genetics. Some racial and ethnic groups are biologically susceptible to acquiring Type 2 Diabetes due to factors including family history and genetic makeup. There is also the matter of one’s socioeconomic standing (Wu et al., 2014). People who are impoverished or lack access to adequate medical care and healthy food options are more expected to develop the disease because they are more likely to engage in health-damaging activities, including leading a sedentary lifestyle and eating poorly.

Stress may lead to the development of the disease due to its potential to cause hormonal disruptions and alterations in blood sugar levels. Some populations may be more susceptible to the disease because of cultural factors exacerbating stress, such as a fast-paced way of life, financial insecurity, and discrimination. Furthermore, a lack of education and awareness about maintaining a healthy lifestyle and adopting preventative measures may also be to blame for the increasing incidence of Type 2 Diabetes in certain cultures and groups (Wu et al., 2014). Those with fewer resources may not know how to appropriately manage and prevent illness or the risks associated with particular behaviors.

The solution to Type 2 Diabetes

Modifications to one’s way of life and medical treatment are both necessary components of diabetes management for type 2 patients. The maintenance of a diet that is both balanced and healthful is one of the most critical measures in the management of the condition. This involves reducing the consumption of meals high in sugar, carbs, and unhealthy fats, which may increase blood sugar levels. It is essential to prioritize eating a diet abundant in fiber, protein, and healthy fats to maintain a healthy body. The regulation of sugar levels in the blood and the avoidance of complications are possible benefits of this. In addition, maintaining a regular exercise routine is a crucial component of diabetes management in type 2 patients.

Additionally, regular physical activity boosts insulin sensitivity and has the potential to bring blood sugar levels down. Because cardiovascular illness is a prevalent consequence of type 2 diabetes, this may help lower the chance of developing the disease (McGill et al., 2017). Monitoring one’s blood sugar levels consistently and maintaining a good relationship with one’s primary care physician are both essential components of a successful management strategy for type 2 diabetes. Other alterations to one’s way of life, such as giving up smoking and finding healthy ways to cope with stress, are also encouraged. A patient and their healthcare practitioner may collaborate to establish an individualized treatment strategy tailored to the patient’s preferences and way of life.

Metformin, sulfonylureas, and DPP-4 inhibitors may aid in decreasing blood glucose levels by either enhancing insulin sensitivity or stimulating insulin secretion. These effects can be achieved by oral administration. Insulin therapy is another alternative, and it may either be administered by injectable or an insulin pump (C Thomas, 2016). People unable to regulate their blood sugar levels with oral drugs or lifestyle modifications alone are often advised to consider this a possible option. Other treatments, for instance, sodium-glucose cotransporter 2 (SGLT2) blockers and glucagon-like peptide-1 (GLP-1) receptor injectors, are also accessible in addition to these drugs. The most effective course of action for someone with type 2 diabetes will rely on their particular medical requirements and circumstances and how they react to various treatments. In addition, it is essential to have routine checkups with the doctor to monitor blood sugar, cholesterol levels, and blood pressure and to look for any warning indications of issues. One’s healthcare practitioner may also suggest checking their eyes and feet and getting blood tests regularly to monitor overall health.

Type 2 diabetes is a long-term illness that affects various body components and systems, such as the eyes, adrenal glands, nerves, heart and blood vessels, cardiovascular system, nervous system, and immune system. It can have significant consequences on an individual’s financial situation. The inability of the body to create enough insulin or react effectively to the insulin produced causes this disorder, which ultimately results in elevated blood sugar levels. Type 2 diabetes may lead to several complications, such as retinopathy, diabetic nephropathy, chronic neuropathy, improved danger of cardiovascular ailment and stroke, and autoimmune illnesses. It is possible for the costs of medical care, therapy, supplies, and equipment to be very high, which may have a considerable effect on a person’s ability to maintain financial stability. Diabetes type 2 is a severe illness, but it is possible to maintain reasonable disease control with the appropriate care and treatment. Thus, it is advised that frequent visits to the doctor, laboratory testing, adequate blood sugar management, a balanced diet, and regular exercise be undertaken to treat type 2 diabetes and its associated effects. People who are diagnosed with Type 2 diabetes are eligible for insurance coverage, preventive care, and financial support due to a variety of pieces of legislation, including the Americans with Disabilities Act (ADA) and the Affordable Care Act (ACA). However, obstacles still prevent people from getting the necessary care, such as a lack of medical professionals in specific regions and expensive treatment options. People with type 2 diabetes may get assistance through initiatives such as the Medicare Diabetes Prevention Program, Social Security Disability Insurance (SSDI), and the Department of Veterans Affairs. These services are designed to help people overcome the obstacles listed above. The illness is more common in nations with a moderate income and a poor income, as well as in the inhabitants of the Western world and the Middle East, as well as African Americans and Hispanics. To solve this issue that affects the public’s health, it is essential to maintain efforts to expand access to medical care and treatment for those with type 2 diabetes. Some cultures and communities have an advanced threat of contracting type 2 diabetes than others due to causes including hereditary factors, environmental factors, and lifestyle factors such as leading a sedentary lifestyle, being overweight, and consuming nutritious foods.

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Home — Essay Samples — Nursing & Health — Diabetes — Diabetes: Type 1 and Type 2

Diabetes: Type 1 and Type 2

• Categories: Diabetes

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Words: 440 |

Published: Dec 18, 2018

Words: 440 | Page: 1 | 3 min read

• A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating.
• An oral glucose tolerance test measures your blood sugar after you have gone at least eight hours without eating and two hours after you drink a glucose-containing beverage
• A random plasma glucose test, your doctor checks your blood sugar without regard to when you ate your last meal. This test, along with an assessment of symptoms Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day. This blood test -- along with other information and test results - can help determine if a person has type 1 diabetes and not another type.

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Type 2 Diabetes Essay

Info: 1550 words (6 pages) Nursing Essay Published: 23rd Apr 2021

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Tagged: diabetes

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• Construction of the definition problem.
• Setting of a collaborative goal.
• Collaborating to solve the problem.
• Contracting changes
• Continuing support.
• Identification of the causes of T2D.
• Educating people on the causes and impacts of T2D.
• Encouraging the medical screening of employees
• Offering counseling sessions to anyone suffering from T2D.
• Prevention of food substances that can make it riskier for employees to acquire T2D.
• Offering to treat anybody suffering from T2D, and this should be a motivational policy.

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The term “Diabetes” is known widely as a disease which affects people who are overweight; although this disease is a common side effect which comes with being unhealthy, there are many other types of this disease that affect people who have no control over it. Diabetes is a condition with a group of different sub-conditions where the body cannot regulate blood glucose.

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