Type 2 Diabetes: Management and Complications

This assignment delves into the multifaceted aspects of type 2 diabetes. It examines dietary components and nutritional strategies for prevention and management. The document also explores the increased risks of pancreatitis, biliary disease, and neuropathy associated with type 2 diabetes. Furthermore, it discusses the impact of blood pressure control and glucose management on patient outcomes and outlines treatment algorithms for initiating and adjusting therapy. The assignment highlights the significance of epigenetic dysregulation in pancreatic islets from diabetic patients and analyzes the effects of medications like metformin and empagliflozin on cardiovascular outcomes and mortality.

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Introduction
Chronic condition or illness is a prolonged illness or condition to a human health that cannot be
cured. Chronic diseases are persisting and their effects come with time (DeCensi et al 2010).
Human beings have to live with chronic condition by managing it. The common chronic diseases
are cancer, diabetes, HIV/Aid, Arthritis, stroke, and Asthma. Chronic diseases are the leading
cause of deaths in the World accounting for 60% total death per year (Green et al., 2015).
Chronic diseases are common and costly to human beings that impacts people economically and
socially. They make patients vulnerable to other infections. Many chronic illnesses are both
manageable and preventable. Chronic diseases are highly linked to an individual lifestyle (Owen,
Bauman, & Brown, 2009). Chronic diseases can be prevented by avoiding tobacco, regular
undertaking physical exercises, and eating nutritious foods. On the other side, chronic diseases
can be managed by eating healthy food, exercising and taking medications to prolong one’s life.
The following write up discusses a case study of Ann Nobis who has diabetes for the past ten
years. Ann Nobis is an Australian citizen and was diagnosed with diabetes in 2007. Ann is 45
years old and has been working as a hotel manager for the past 20 years. Diabetes is a complex
condition and affects the entire body. Diabetes is condition that occurs as a results abnormal high
level of glucose in a person’s blood. Ann suffers from Diabetes type 2 that is a condition as a
result of the body not making or using insulin. Ann is also obese. The write up will involve
discussing Pathophysiology of diabetes, the impact of the disease to the patient and her family
and recommendation on diabetic prevention and pharmacological management.
Pathophysiology of Diabetes
Ann had the following symptoms; first, Ann experienced frequent urination and increase thirst.
The excess sugar in the bloodstream builds up causing fluid in tissue to be pulled off leading to
dehydration. The tissues get dehydrated that leads to Ann drinking more water and consequently
urinating more. Ann was urinating more times per day than a normal person and felt thirsty
throughout the day (Noto et al., 2012). Secondly, Ann has increased hunger. Ann confessed that
she felt hunger even after immediately taking a meal. This symptom was as a result of her body
organs and muscles becoming depleted of energy. This is because there is no enough insulin in
the body to move sugar to her cells that triggers hungers. Thirdly, Ann lost weight. Even with

increased eating to reduce hunger, Ann lost weight. She recorded 5% weight loss (Chiuve et al.,
2012). Ann’s body with type 2 diabetes has no ability to metabolize glucose leading to the body
opting for alternative fuels that is stored in the muscles and fat. The calories that can be used in
the body are released as excess glucose from the body in form of urine. This leads to the body
losing weight despite increased food intake (Esser et al., 2014). Fourth, the Ann’s body is
fatigue. She gets tired walking around or undertaking easy chores at home. She feels tired and
irritable. The body cells are deprived of glucose that energizes the body cells to work. The
fatigue in her body cells cause her to fell tired ad be unable to carry out her duties in her daily
life. Fifth, Ann said that she was experiencing blurred vision. She could hardly clearly see
objects especially from a short distance. This was caused by high blood sugar in the body that
pulled the fuel from her eyes lens (Noel et al., 2009). This led to her eyes being affected hence
losing ability to focus on objects. Lastly, Ann confessed that she had slow healing sores. The
sores took longer than expected and she was forced to visit her doctor even with minor cuts.
Type 2 diabetes has caused serious health complication to Ann. Type 2 diabetes is as a result of
insulin resistance which is likely to be a combination with reduced insulin secretion (Dabelea et
al., 2014). This has become a lifelong disease and has affected how her body handles glucose in
the blood. The pancreas produces insulin but Ann’s cells do not use the insulin as it is supposed
to. The pancreas produces more insulin than normal to get all glucose into the cells which it not
able to keep up leading to sugar building up the blood instead. This is a result of insulin
resistance by the body. The overproduction of insulin happens for a long period until the cells
producing insulin in the pancreas wear out. In this case, an individual loses 50-70% of the cells
producing insulin for the disease to be diagnosed (Bunck et al., 2009). Therefore Ann’s illness
was a progressive condition on destruction of cells producing insulin in her pancreas.
Type 2 diabetes condition is caused by ineffectiveness of insulin. Insulin is produced by pancreas
gland. It is the pancreas that secretes insulin to the blood stream. The insulin then circulates in
the whole body enabling glucose to enter to the body cells. This process lowers the amount of
glucose in the bloodstream. The production of insulin is stimulated by the amount of sugar in the
blood. Glucose (sugar) is an important source of energy for body cells. The human body muscles
and tissues require glucose to function normally through provision of energy. Glucose in the

body comes from either the liver or food. The condition of Type 2 diabetes occurs when this
process does not work as expected. This leads to glucose instead of being absorbed in the body
cells, it remains in the bloodstream (Ferrannini et al., 2010). This accumulates sugar in the blood
cells lending to increased insulin. The insulin producing cells becomes impaired and is unable to
produce more insulin that can meet the demand of the body.
Type 2 diabetes is contributed by several factors; first, it the genes of an individual body.
Scientists have established that different bits on one’s DNA do affect how the body makes
insulin (Volkmar et al., 2012). This means that the illness can be genetically transferred from one
generation to another. If one person in the family has type 2 disabilities, the other members from
the same family are likely to have the same condition at a certain period of their life. Secondly,
type 2 diabetes can be contributed by extra weight of one’s body. Being obese causes insulin
resistance. This is more likely when the weight is around the waist of an individual. Thirdly,
diabetic condition can be contributed by metabolic syndrome. People who suffer from other
conditions such as high blood pressure, high blood glucose, high cholesterol, extra fat, or
triglycerides are at more risk to getting insulin resistance (Forslund et al., 2015). Fourth, having
too much glucose produced by the liver. When the liver produces glucose even when there is
glucose from food, put an individual to a risk of having high blood sugar that can damage the
insulin producing cells (Dunkley et al., 2014). Lastly, type 2 diabetes can be contributed by bad
communication between cells or broken beta cells. This leads to cells sending wrong signals that
cause insulin to be sent on the wrong time increasing the blood sugar. The high blood sugar then
damages the cells producing the insulin leading to type 2 diabetics.
Ann also had several comorbities as a result of type 2 diabetes. She was diagnosed with one
kidney failure. Ann’s one kidney was damage in 2015 and it was removed. This was a as a result
of damages caused by diabetes in the kidney tiny blood vessels. Secondly, Ann eyes got
damaged that led to seeing problems. Diabetes damages the retina blood vessel. The blood
vessels are dehydrated and lack supply of energy that lead to dysfunction. Thirdly, Ann had foot
damage. Her feet nerves were damaged together with poor blood flow that led to foot
complications. Lastly, Ann developed a skin conditions. Her skin developed black spots around
specific area. These infections were as a result of insulin resistance in the body causing dark
patches (Lewis et al., 2011).

Impact of Type 2 Diabetes to Ann and Her Family
Type 2 diabetes is a lifelong condition that has no cure (Ley, Hamdy, Mohan, 2014). The
condition has adversely affected Ann’s life and her family. First, the condition has impacted
Ann’s ability to work. Ann used to work as a manager in a hotel in town where she lost her job
two years ago. She was unable to meet targets as a result of stagnated and decreasing
performance in the workplace. Secondly, type 2 diabetes has led to Ann losing her one kidney.
The condition damaged her left side kidney leading to it removal. Thirdly, Ann has developed
eyes problems where she has to use a pair of glasses and attend regular checkups to her optician.
Lastly, Ann cannot walk without external support. She needs to be supported or use a wheelchair
to move. Her foot has been damaged by type 2 diabetes condition (Hayward et al., 2015). On the
other side, Ann’s condition has affected her family in several ways; first, her family has incurred
high budgets to maintain her condition and attend medications. The family takes the
responsibility of paying hospital bills for Ann. Secondly the family has been stressed over Ann’s
condition. The family at first did not understand her condition. This caused anxiety in the family
that led to stress (Vijan et al., 2014). Lastly, the family lost a bread winner. Ann was a bread
winner in the family who turned to a dependant in her family. This situation has exposed the
family to financial constrains.
Type 2 Diabetes Prevention
Type 2 Diabetes is a condition of a patient’s pancreas not working effectively. The pancreas does
not produce optimum insulin to enable absorption of glucose top cells leading to high blood
sugar (Bauer et al., 2014). The following strategies can be used to prevent and manage type 2
diabetes;
Healthy eating: This involves eating a healthy diet that maintains or reduces one’s blood
sugar for patients (Van Acker et al., 2009). Diabetes can be prevented by eating balanced diet
and avoiding food with high levels of calories. It is also important for an individual to avoid
tobacco because it stimulates diabetes. Eating well enables manage blood glucose level and body
weight (Zinman et al., 2015).
Undertake exercises regularly: This involves engaging in physical activities that increase
metabolic activities of the body. Exercising enables patient insulin to work more effectively.

Exercising also reduces the risk of heart disease and lowers the blood pressure (Zoungas et al.,
2014).
Monitoring blood glucose regularly: This involves taking blood sugar test regularly to
monitor it level. This strategy enables one to know if the treatment followed is adequate in
controlling the condition. Monitoring enables making of informed decision on managing blood
sugar (Matthews, 2012).
Pharmacological management of Type 2 Diabetes
Type 2 Diabetes can be managed in several ways and each case is different. The following are
pharmacological recommendation to Ann condition;
Metformin: This medication helps the body to use insulin produced effectively.
Sulfonylureas: This medicine enables the body to produce more insulin to enhance
absorption of glucose by the muscles and tissues (Kahn, Cooper, & Del Prato, 2014).
DPP-4 Inhibitors: This enable reduce blood glucose level.
SGLT2 Inhibitors: It prevents kidney from reabsorbing glucose from the blood.
Insulin Therapy: These are injected to control blood sugar. They include; insulin
glulisine, insulin aspart, insulin isophane, and insulin lispro (Nathan et al., 2009).
Conclusion
From Ann’s case study, type 2 diabetes is a lifelong condition without a cure. The illness is a
condition where there is insulin ineffectiveness causing high blood sugar. This condition can be
contributed by genes, metabolic syndrome, liver producing glucose, overweight, and
miscommunication between insulin producing cells. Type 2 diabetes damages the kidneys, eyes,
foot, and the heart. The condition symptoms are impaired healing, weight loss, increased thirst
and urination, fatigue, and inability to see clearly. Type 2 diabetes causes other complications
such has foot, kidney, eyes, and heart diseases. The condition can be managed or prevented by
eating healthy diet, monitoring blood sugar level and regularly exercising.

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