Type 2 Diabetes

Awareness and prevention

Reshmi Nair

Objectives
The objectives of nursing education should focus

providing information on disease process and mechanism

Recognize the signs and symptoms

Explore treatment options

Nutritional plan and dietary modification

Exercise plan and monitoring physical activity

Self-blood glucose monitoring and knowledge of abnormal levels

Promote knowledge on complications of DM

Adequate knowledge of prescribed diabetic medication

Addressing psychosocial issues and stress management

Finding out individual strategies to promote optimal health

What is type 2 diabetes

Group of physiological dysfunction characterized by hyperglycemia

resulting from insulin resistance, inadequate insulin secretion or
excessive glucagon secretion (Blair, 2016).

Much more common than type I diabetes.

Impaired glucose regulation due to insulin resistance and dysfunctional

pancreatic beta cells.

How is it diagnosed?
Short term glucose level measurements:
Fasting blood glucose
Glucose tolerance test
Random blood test (diagnostic >200 mg/dL)
Long term glucose level measurements:
Hemoglobin A1C
Short term values have to be confirmed by a repeat test.

Risk factors
Non modifiable:
Genetics (family history)
Race
Age >35

Risk factors contd

Modifiable:
Excess adiposity, increased waist circumference.
BMI or waist circumference overweight (>25 kg/m2 and
obesity>30kg/m2)
steady weight changes during adulthood /cyclical weight changes.
Physical inactivity/ sedentary life style.
Active and passive smoking.
Polycystic ovarian syndrome
Excessive consumption of processed meat and sugar-sweetened and
carbonated beverages.

Symptoms

Fatigue

Weight gain

Frequent infections

Slow wound healing

vaginal yeast infections

Change in vision

Complications
Microvascular:
Damage of small blood vessels (nephropathy, retinopathy, neuropathy)
Macrovascular:
Damage of large blood vessels ( cardiovascular diseases, strokes, heart
attack and insufficient blood flow to legs)

Statistics

The report by Center for Disease Control and Prevention (CDC) shows that DM
affects about 25.8 million people in the US in 2010 with 90% to 95% are type
2 DM and the common age group is between 45 and 64 years. (Olokoba,
Obateru, & Olokoba,2012)

The total number of people with DM worldwide is estimated to rise from 171
million in 2000 to 366 million in 2030(Gupta et al.,2016).

The DM is on the rise in all the countries and 80% of people live in low- and
middle-income countries. (Olokoba, Obateru, & Olokoba,2012)

In the United States, 9.3 % of all adults, age 20 or over and 25.9 % of adults
65 or over has diabetes.

Web link to CDC

https://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

Prevention

Can be prevented or delayed.

Important to know self-care measures

Good understanding of blood glucose monitoring, nutrition, physical

activity and sick day management.

Reduce stress, sleep well and drink plenty of water.

Recommendations

More than 90% of T2DM cases are potentially preventable by following a

healthful diet, having a BMI of 25 m2 and exercising for at least 30
minutes a day.

avoid smoking, and consume alcohol in moderation.

Test fasting and 2 hour postprandial blood sugar levels.

Results
Reduction in the development of type 2 diabetes by 58 percent.
Losing five to seven percent of body weight through exercise and
healthy eating may prevent the onset of type 2 diabetes.
Regular testing of blood sugar, cholesterol and blood pressure
significantly reduced the risk of diabetes.

Are you at risk for type 2 diabetes?

References
Blair, M. (2016). Diabetes mellitus review. Urologic Nursing, 36 (1),
27-36. http://doi:10.7257/1053-816X.2016.36.1.27
Gupta, N., Kishore, J., Ray, P. C., Kohli, C., & Kumar, N. (2016).
Determination of
prevalence of type 2 diabetes mellitus by screening tests using a
mathematical formula in place of invasive blood tests. Journal of Clinical
and Diagnostic Research: JCDR, 10(1), LC05LC09.
http://doi.org/10.7860/JCDR/2016/14812.7039
Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 diabetes
mellitus: A review of current trends. Oman Medical Journal, 27(4), 269
273.
http://doi.org/10.5001/omj.2012.68