Type II Diabetes Mellitus Vodcast Questions

This article discusses Type II Diabetes Mellitus through vodcast questions. It covers patient criteria, response to questions, and treatment options. The patient is a 54-year-old female with a sedentary lifestyle and prescribed medication of Metformin, Dapagliflozin, and Insulin. The article also provides references for further reading.

Running head: TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Type II Diabetes Mellitus Vodcast Questions
Name of the student
Name of the university
Author note

1TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Patient criteria
Name: Emily Roberts
Gender: Female
Age: 54
Condition: Type II Diabetes Mellitus
Weight range: Overweight
Exercise: Sedentary lifestyle
Occupation: Housewife
Living Status: Lives with husband and has no children
Medical History of family: Nothing relevant.
Pregnant: NA
Smoker: No
Alcohol: No
Prescribed medication: Metformin, Dapagliflozin and Insulin.

2TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Response to question 1.
In a healthy and non-diabetic individual insulin functions by binding to the target
tissues and enabling them to uptake glucose present in the blood. In absence of insulin the
blood glucose level increases. Therefore, synthesis and release of insulin is as important as its
binding to the target tissues (American Diabetes Association 2014). Insulin is produced and
secreted by the beta cells of pancreas. This hormone maintains the blood sugar level and
prevents development of hyperglycaemia or hypoglycaemia. Insulin keeps the BGL in check
by activating the target cell receptors that are used to uptake the glucose from the blood. If
insulin is not produced adequately, the glucose metabolized from carbohydrates remains in
the blood and elevates the blood glucose levels markedly. Moreover, if insulin is produced,
but is unable to act on the target cells it can also lead to increased BGL. In Type II Diabetes
the affected person starts to show insulin resistance where the body does not effectively
respond to insulin. Therefore the tissues refuse to take up glucose from blood and thereby the
blood glucose level increases. If the disease is left untreated, the increasing pressure on the
pancreas results in complete abolishment of the insulin producing pancreatic beta cells
(Kahn, Cooper and Del Prato 2014). Insulin plays a major role in regulating the glucose level
in blood. Insufficient amount of insulin or the inability to respond to the insulin action,
develops diabetic symptoms in people. Insulin plays several key roles in the body. One of its
major functions include regulation of glucose and fat storage in the body. Multiple tissues in
human body relies on insulin to take up glucose from the blood for utilizing that glucose later
for energy production. Insulin signals the liver, muscles and adipose tissues to take up
glucose from the blood. With the help of insulin hepatic tissues take up glucose and turn it
into glycogen.

3TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Response to question 2.
Diabetes can be treated with proper care, but if the BGL is left uncontrolled then it
can increase the risk of heart diseases such as myocardial infarction (Courcoulas et al. 2015).
People who are suffering from Type II diabetes can develop cardiovascular diseases if their
risk factors are not addressed. Increased level of blood glucose triggers the condition of MI as
it favors the fatal occurrence of arrhythmia. Acute hyperglycaemia induces ischaemic
conditions in heart and thereby results in worse myocardial functions. Increased platelet
activation in non-diabetic patients is related with hyperglycaemia. If hyperglycaemia results
in increased stress, it amplifies the immune responses and worsens the cardiac functions
(Scheen 2015). Acute hyperglycaemia resulting from diabetes, leads to an increase in
inflammatory markers, resulting in a detrimental effect in case of MI. Endothelial dysfunction
is common with MI and plays a major role in cardiovascular diseases. Increased
hyperglycaemia induces the endothelial dysfunction thereby leading to myocardial infarction.
Along with this, if the patient is overweight they may tend to have an increased level of
unhealthy blood cholesterol (high LDL and low HDL) they can easily develop heart diseases.
Such blood lipid imbalances can be caused by insulin resistance which is known as diabetes
dyslipidemia. Therefore, obesity and overweight increases the chances of MI in patients with
T2DM (Ozougwu et al. 2013). Obesity has strong associations with insulin resistance.
Another major risk factor of T2DM associated cardiovascular diseases is lack of physical
activity. Mrs. Roberts does not exercise at all and leads an extremely sedentary lifestyle.
Regular exercise and thereby maintaining to lose weight in a healthy way can delay the onset
of diabetes and helps in effectively manage the disease. Physical activity manages the blood
pressure in patients suffering from hypertension and reduces the chances of myocardial
infarction.

4TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Response to question 3.
The drug that is used in treating type II diabetes mellitus in the patient Mrs. Emily
Roberts is Metformin. Metformin is a hypoglycaemic medication that improves the blood
glucose status of the individuals. This drug acts on the glucose utilization rather than the
glucose absorption. It has been reported that metformin induces the insulin- induced glucose
uptake action of the skeletal muscle cells and the adipose tissues (Zaccardi et al. 2015). In the
hyperglycaemic state the action of the drug is enhanced. It acts on the insulin receptors and
the glucose transporters, increases the insulin binding capacity of the cells, and stimulates
glucose uptake. Metformin also acts as a stimulator for uptake of glucose. It mostly works on
the skeletal muscles and increases the glucose transport across the muscle membrane.
Metformin reduces the glucose production level of liver cells, decreases the absorption of
glucose through the intestines and promotes the insulin sensitivity of target cells by
maintaining a normal level of glucose uptake by the peripheral tissues. Therefore, the primary
action of Metformin is lessening glucose release from liver, and its secondary action is that it
increases the insulin sensitivity and stimulates the absorption of glucose by target cells (Lee
et al. 2016). Along with this, researches have proved that Metformin can help the individuals
lose weight. Metformin reduces the appetite, and thereby combats the symptom of frequent
hunger of the affected persons. Thus, it can lead to weight loss. It has been reported that
people who exercise regularly and follow a healthy diet and lifestyle tend to lose the most
weight while taking Metformin. The patient is overweight and does not exercise. Therefore, if
Metformin can help her lose weight while addressing her hyperglycaemic condition, it will be
helpful for her.

5TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Response to question 4a.
Abdominal adiposity is classified as a condition that results in excessive fat deposition
in the abdominal region. Abdominal adiposity poses a greater implication for diabetes.
Abdominal adiposity has a greater chance of developing diabetes and other metabolic
syndromes rather than obesity. The excessive fat deposition in the abdominal cavity of
individuals is classified as visceral adiposity or subcutaneous adiposity according to the place
of fat deposition. Women are more prone to abdominal adiposity than men (Singh et al.
2013). However, the differences in the sexes of the individuals do not affect the degree of
adiposity. There are three measures of adiposity such as BMI, percent fat and the waist
circumference of the individuals. These are the best predictors of insulin sensitivity. If
adiposity is controlled in aged patients, insulin sensitivity tends not to get affected by the
patient’s age. Contribution of abdominal adiposity to increasing the risks of diabetes has also
been reported.
Response to question 4b.
Haemoglobin A1c test or the glycated hemoglobin test is used to assess the blood
glucose level of a patient over the past 2-3 months. This test helps determine the average
blood glucose levels in the patients who are suffering from diabetes (Kautzky-Willer,
Harreiter and Pacini 2016). Sometimes the test is also used for diagnosis of diabetes. This test
is based on the fact that when glucose levels increase in blood, the glucose binds to the red
blood cells present in the blood. With the help of this test the amount of glucose bound to
RBCs can be measured. If the BGL has increased in the patient over the last few days the
result of the HbA1c test will be higher. In case of the non-diabetic patients, the normal range
of HbA1c test ranges between 4-5.6% (Scirica et al. 2013). If the percentage gets higher than
6.5% it means that the individual is suffering from diabetes.

6TYPE II DIABETES MELLITUS VODCAST QUESTIONS
References
American Diabetes Association, 2014. Diagnosis and classification of diabetes
mellitus. Diabetes care, 37(Supplement 1), pp.S81-S90.
Courcoulas, A.P., Belle, S.H., Neiberg, R.H., Pierson, S.K., Eagleton, J.K., Kalarchian, M.A.,
DeLany, J.P., Lang, W. and Jakicic, J.M., 2015. Three-year outcomes of bariatric surgery vs
lifestyle intervention for type 2 diabetes mellitus treatment: a randomized clinical trial. JAMA
surgery, 150(10), pp.931-940.
Kahn, S.E., Cooper, M.E. and Del Prato, S., 2014. Pathophysiology and treatment of type 2
diabetes: perspectives on the past, present, and future. The Lancet, 383(9922), pp.1068-1083.
Kautzky-Willer, A., Harreiter, J. and Pacini, G., 2016. Sex and gender differences in risk,
pathophysiology and complications of type 2 diabetes mellitus. Endocrine reviews, 37(3),
pp.278-316.
Lee, A.L., Chen, B.C., Mou, C.H., Sun, M.F. and Yen, H.R., 2016. Association of traditional
Chinese medicine therapy and the risk of vascular complications in patients with type II
diabetes mellitus: a nationwide, retrospective, Taiwanese-registry, cohort
study. Medicine, 95(3).
Ozougwu, J.C., Obimba, K.C., Belonwu, C.D. and Unakalamba, C.B., 2013. The
pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. Journal of
Physiology and Pathophysiology, 4(4), pp.46-57.

7TYPE II DIABETES MELLITUS VODCAST QUESTIONS
Scheen, A.J., 2015. Pharmacodynamics, efficacy and safety of sodium–glucose co-transporter
type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Drugs, 75(1), pp.33-
59.
Scirica, B.M., Bhatt, D.L., Braunwald, E., Steg, P.G., Davidson, J., Hirshberg, B., Ohman, P.,
Frederich, R., Wiviott, S.D., Hoffman, E.B. and Cavender, M.A., 2013. Saxagliptin and
cardiovascular outcomes in patients with type 2 diabetes mellitus. New England Journal of
Medicine, 369(14), pp.1317-1326.
Singh, S., Chang, H.Y., Richards, T.M., Weiner, J.P., Clark, J.M. and Segal, J.B., 2013.
Glucagonlike peptide 1–based therapies and risk of hospitalization for acute pancreatitis in
type 2 diabetes mellitus: a population-based matched case-control study. JAMA internal
medicine, 173(7), pp.534-539.
Zaccardi, F., Webb, D.R., Yates, T. and Davies, M.J., 2015. Pathophysiology of type 1 and
type 2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal,
pp.postgradmedj-2015.