Definition
Type 2 diabetes is a chronic (lasting) disease with
the condition of hyperglycemia (high level of glucose in the blood). It results
from insulin resistance and relative insulin deficiency. The body is unable to respond to either endogenous or
exogenous insulin to reduce blood glucose level. This condition causes the body
cells cannot able to take up the glucose and utilize it.
Pathophysiology
The level of insulin that arising
from the body or derived within the body (endogenous insulin) may be normal,
decreased or even elevated. Nevertheless, this insulin production usually is
not sufficient to overcome the insulin resistance.
Increased blood glucose level first appears after meal
(postprandial) and then followed by an elevation in
fasting glucose concentration. This condition happens because of the decreased
insulin secretion accompanied by increased glucose production by the liver.
Besides that, insulin resistance
which happens on fat cells can causes high amount of lipids in the blood. At
this time, lipolysis (the process of breaking down of lipid, particularly
triglycerides into fatty acids and glycerol) will take place frequently. This
free fatty acid (FFA) will be transported to the liver. This influx of FFA to the
liver will further increase in insulin resistance. High level of free fatty
acids will impair the function of pancreas to secrete insulin and increase the
glucose production by the liver.
Risk factor
- Age greater than 45 years
- Experience previous diabetes during pregnancy
- Excessive body weight especially around the waist.
- Born a baby weighing more than 9 pounds (4.1kg).
- HDL cholesterol (good cholesterol help in transportation of bad cholesterols) which is under 35 mg/dL.
- High blood levels of triglycerides, a type of fat molecule (250 mg/dL or more)
- High blood pressure (greater than or equal to 140/90 mmHg)
- Impaired glucose tolerance (IGT) - High blood glucose level but is below the level of diabetic patient. This is associated with the insulin resistance and abnormal insulin secretion.
- Low activity level (exercising less than 3 times a week)
- Metabolic syndrome (a group of risk factors that increases the risk for heart disease, diabetes, stroke and other diseases.)
- Polycystic ovarian syndrome - a condition in which a woman has an imbalance sex hormones regulation which causes difficulty to get pregnant. It happens mostly among obese people.
- Acanthosis nigricans (presence of dark and thickened skin around the neck or armpits.)
- Ethnic background including African Americans, Hispanic Americans, Asian Americans, and Native Americans.
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