Public Health

Type 2 Diabetes

Epidemiology and Background

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Type 2 diabetes is a condition that emerges due to the body’s inability to produce enough insulin. Alternatively, type 2 diabetes can also be a result of the body becoming insensitive to insulin. Adults are at more risk of developing diabetes than children. There are also ethnic differences where African and Asian ancestry people are at a higher risk as young adults. A primary risk factor for diabetes is genetics. Individuals with a close family member who has diabetes are at an increased risk of developing the disease. The importance of family history is because specific gene mutations make an individual at risk of diabetes.

Lifestyle plays a prominent role in the onset of the condition. Everything from diet to exercise routine can put individuals at high risk. There is an excellent correlation between a sedentary lifestyle and type 2 diabetes. A recurrent theme is that obesity is a significant indicator of people with diabetes or at risk (1). However, apart from genetics, certain factors are better predictors for the onset of type 2 diabetes. These include body mass index, high blood pressure, and history of gestational diabetes.

In the world, Western countries have the highest prevalence rates of diabetes because they have higher living standards. However, prevalence rates in the world are increasing more so in Asia. Currently, China leads the world in the number of confirmed cases (1). An indication that higher standards of living and shifting to a sedentary lifestyle increases cases. Approximations indicate that there are currently 400 million people living with type 2 diabetes; the figure will rise to about 600 million in 2040 as poor nations develop and improve standards of living (1).

I would explain this different than being due to higher living standards.

You need to explain the link: does having money in the bank and a warm house cause diabetes.

Pathophysiology

In a normal functioning system, insulin from the pancreas can regulate the glucose level in the blood. After eating, there is a buildup of glucose; the pancreas’ beta cells produce insulin which stimulates cells to assimilate glucose as a source of energy (2). The liver is also stimulated to absorb unutilized glucose in the blood. The process also leads to the uptake and synthesis of fat. On the other hand, low insulin will prompt the release of glucose and the breakdown of protein. Type 2 diabetes primarily affects insulin sensitivity of the beta cells and adjacent tissues; it causes a defect in insulin receptors responsible for insulin’s effects. (2) As a result, the body can no longer produce insulin to adjust glucose levels in the blood. Therefore, cells cannot adequately utilize glucose. A person with type 2 diabetes will experience an increase in blood sugar after eating; however, their bodies will not appropriately respond, leading to the symptoms of type 2 diabetes such as excessive hunger or thirst.

You should also talk about how physical inactivity contributes to development of diabetes and how a lack of PA worsens condition post diagnosis.

References:

1. Galicia-Garcia, U, Benito-Vicente, A, Jebari, S, Larrea-Sebal, A, Siddiqi, H, Uribe, KB, et al. Pathophysiology of Type 2 Diabetes.

2. Zimmet, PZ and Alberti, KGMM. Epidemiology of Diabetes—Status of a Pandemic and Issues Around Metabolic Surgery.

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