{"id":5213,"date":"2025-12-06T23:50:02","date_gmt":"2025-12-07T04:50:02","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5213"},"modified":"2025-12-07T21:47:23","modified_gmt":"2025-12-08T02:47:23","slug":"type-ii-diabetes-mellitus","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/type-ii-diabetes-mellitus\/","title":{"raw":"9p10 Type II Diabetes Mellitus","rendered":"9p10 Type II Diabetes Mellitus"},"content":{"raw":"<h1><strong>Overview<\/strong><\/h1>\r\n<ul>\r\n \t<li>Typically\u00a0<strong>older<\/strong>\u00a0in onset but increasingly affecting\u00a0<strong>children and teenagers<\/strong>\u00a0due to rising obesity.<\/li>\r\n \t<li>Onset is\u00a0<strong>insidious<\/strong>\u00a0(gradual) rather than sudden.<\/li>\r\n \t<li><span style=\"font-size: 1em\">More common than Type I, accounting for about <\/span><strong style=\"font-size: 1em\">90%<\/strong><span style=\"font-size: 1em\">\u00a0of diabetes cases.<\/span><\/li>\r\n \t<li>Often leads to <strong>chronic complications,<\/strong> and sometimes <strong>acute complications,<\/strong>\u00a0if blood glucose is not well-controlled.<\/li>\r\n<\/ul>\r\n<h1><strong>Causes and Risk Factors:<\/strong><\/h1>\r\n<ul>\r\n \t<li><span style=\"font-size: 1em\"><strong>Cells become<\/strong> <b>less sensitive to insulin, meaning that:<\/b><\/span>\r\n<ul>\r\n \t<li><span style=\"font-size: 1em\"><b>Cells become insulin-resistant,<\/b> and<\/span><\/li>\r\n \t<li><span style=\"font-size: 1em\"><b>Insulin <\/b>can no longer stimulate cells to insert <b>GLUT4 glucose <\/b><strong>transporters<\/strong> into cell membranes, leading to <strong>low glucose uptake<\/strong> by cells<\/span><\/li>\r\n \t<li>Cells become starved for glucose.<\/li>\r\n \t<li>Glucose builds up in blood leading to <strong>hyperglycemia<\/strong><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li><span style=\"font-size: 1em\">Thought to be triggered by several possible factors:<\/span>\r\n<ul>\r\n \t<li><strong>Family history<\/strong>.<\/li>\r\n \t<li><strong>Obesity<\/strong>.<\/li>\r\n \t<li><strong>Sedentary lifestyle<\/strong>.<\/li>\r\n \t<li>Other <strong>environmental factors.<\/strong><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Typical Onset:<\/strong><\/h1>\r\n<ul>\r\n \t<li>Typically\u00a0<strong>older<\/strong>\u00a0in onset but increasingly affecting\u00a0<strong>children and teenagers<\/strong>\u00a0due to rising obesity.<\/li>\r\n \t<li>Onset is\u00a0<strong>insidious<\/strong>\u00a0(gradual) rather than sudden.<\/li>\r\n<\/ul>\r\n<h1><strong>Pathophysiology:<\/strong><\/h1>\r\n<ul>\r\n \t<li>Lack of\u00a0<strong>insulin<\/strong> prevents <strong>glucose entry<\/strong> into cells,\r\n<ul>\r\n \t<li>as cell's require insulin to insert GLUT4 glucose transporters into their cell membranes.<\/li>\r\n \t<li>leading to <strong>high blood<\/strong> <strong>glucose levels<\/strong>\u00a0(<strong>hyperglycemia<\/strong>).<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Cells<\/strong>\u00a0become\u00a0<strong>starved for glucose<\/strong>, impairing ATP production.<\/li>\r\n \t<li>Excess glucose\u00a0<strong>diffuses into urine<\/strong>, drawing water and causing\u00a0<strong>polyuria<\/strong>,\u00a0causing<\/li>\r\n \t<li><strong>Dehydration<\/strong>\u00a0triggers\u00a0<strong>thirst<\/strong>\u00a0(polydipsia).<\/li>\r\n \t<li>The body responds by\u00a0<strong>breaking down proteins and fats<\/strong>\u00a0for energy:\r\n<ul>\r\n \t<li><strong>Gluconeogenesis<\/strong>: Produces glucose from proteins and fats.<\/li>\r\n \t<li><strong>Lipolysis<\/strong>: Leads to high\u00a0<strong>lipid levels<\/strong>\u00a0(<strong>lipidemia<\/strong>).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Effects on the Body<\/strong>\r\n<ul>\r\n \t<li><strong>Muscle wasting<\/strong>\u00a0due to protein breakdown.<\/li>\r\n \t<li><strong>High blood lipids<\/strong>\u00a0increase risk of\u00a0<strong>atherosclerosis<\/strong>.<\/li>\r\n \t<li><strong>Ketone production<\/strong>\u00a0causes\u00a0<strong>ketosis<\/strong>\u00a0and potentially\u00a0<strong>ketoacidosis<\/strong>:\r\n<ul>\r\n \t<li>Blood becomes\u00a0<strong>acidic<\/strong>.<\/li>\r\n \t<li>Ketones and glucose are\u00a0<strong>excreted in urine<\/strong>\u00a0(ketonuria and glucosuria).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Signs and Symptoms:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Polydipsia:<\/strong>\u00a0 Increased <strong>thirst<\/strong> (due to dehydration)<\/li>\r\n \t<li><strong>Polyphagia:<\/strong>\u00a0 Increased <strong>hunger<\/strong><\/li>\r\n \t<li><strong>Polyuria:<\/strong>\u00a0 Increased <strong>urine volume<\/strong> (due to <strong>glucosuria<\/strong> and osmotic diuresis)\r\n<ul>\r\n \t<li><strong>Electrolyte loss<\/strong>\u00a0(sodium, potassium) follows water loss.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Fatigue<\/strong> (due to cell's reduced ability to uptake glucose)<\/li>\r\n \t<li><strong>Blurred vision<\/strong> (due to retinopathies and diabetic cataracts)<\/li>\r\n \t<li><strong>Slowed healing of wounds<\/strong> (due to cell's reduced ability to uptake glucose)<\/li>\r\n \t<li><strong>Irritability, slowed reaction<\/strong>, and <strong>cognitive impairment<\/strong> (due to neuronal energy deficiency)<\/li>\r\n<\/ul>\r\n<h2><strong>Diagnostic Blood Tests:<\/strong><\/h2>\r\n<ol>\r\n \t<li><strong>Glycated hemoglobin (A1c) test<\/strong>\r\n<ul>\r\n \t<li>Measures the percentage of hemoglobin with blood sugar attached.<\/li>\r\n \t<li>Reflects\u00a0<strong>blood glucose control over 2-3 months<\/strong>.<\/li>\r\n \t<li>Levels\u00a0<strong>above 6.5%<\/strong>\u00a0suggest diabetes.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Random blood sugar test<\/strong>\r\n<ul>\r\n \t<li>Blood sample taken randomly, regardless of fasting.<\/li>\r\n \t<li>Blood glucose\u00a0<strong>above 110 mg\/dL<\/strong>\u00a0indicates abnormality.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Fasting blood sugar test<\/strong>\r\n<ul>\r\n \t<li>Fasting for 12 hours before testing.<\/li>\r\n \t<li>Normal:\u00a0<strong>&lt;110 mg\/dL<\/strong>.<\/li>\r\n \t<li>Diabetic:\u00a0<strong>&gt;125 mg\/dL<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Glucose tolerance test:<\/strong>\r\n<ul>\r\n \t<li>Drink 75g glucose, measure levels at 1 and 2 hours.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<h1>Urinalysis:<\/h1>\r\n<ul>\r\n \t<li><strong>Urine tests:<\/strong>\r\n<ul>\r\n \t<li><strong>Glucosuria:<\/strong>\u00a0Glucose in urine.<\/li>\r\n \t<li><strong>Ketonuria:<\/strong>\u00a0Ketones in urine.<\/li>\r\n \t<li>Useful for detecting\u00a0<strong>diabetic ketoacidosis<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Treatments:<\/strong><\/h1>\r\n<ol>\r\n \t<li><strong>Lifestyle modifications:\u00a0<\/strong> Can reverse some issues by improving insulin sensitivity.\r\n<ul>\r\n \t<li>Healthy\u00a0<strong>diet<\/strong>.\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Avoid high-glycemic foods (candies, sugary drinks).<\/li>\r\n \t<li>Favor\u00a0<strong>complex carbohydrates<\/strong>\u00a0(fibers, polysaccharides).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Regular\u00a0<strong>exercise<\/strong>.\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Helps\u00a0<strong>reduce blood glucose<\/strong>\u00a0by increasing skeletal muscle uptake.<\/li>\r\n \t<li>Monitor blood sugars during activity.<\/li>\r\n \t<li>Have carbohydrate snacks available to prevent\u00a0<strong>hypoglycemia<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Stress reduction:<\/strong>\r\n<ul>\r\n \t<li>Stress increases\u00a0<strong>cortisol and glucocorticoids<\/strong>, which raise blood glucose levels.<\/li>\r\n \t<li>Managing stress helps control glucose.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Weight control:<\/strong>\r\n<ul>\r\n \t<li>Reducing body mass index (BMI) decreases\u00a0<strong>insulin resistance<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Oral hypoglycemic agents:<\/strong>\u00a0Lower high blood glucose by increasing cellular responsiveness or insulin secretion.\r\n<ul>\r\n \t<li><strong>Oral hypoglycemic agents<\/strong>\u00a0for type 2\r\n<ol>\r\n \t<li><strong>Metformin:<\/strong>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Reduces\u00a0<strong>hepatic gluconeogenesis<\/strong>.<\/li>\r\n \t<li>Decreases the liver's production of excess glucose.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Medications to enhance insulin sensitivity:<\/strong>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>Improve tissue response to insulin.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Insulin injections:<\/strong>\u00a0Necessary for\u00a0<strong>Type I<\/strong>\u00a0and often\u00a0<strong>Type II<\/strong>\u00a0or\u00a0<strong>gestational<\/strong> when beta cells are dysfunctional or destroyed.\r\n<ul>\r\n \t<li>Administered via\u00a0<strong>injections<\/strong>\u00a0or continuous\u00a0<strong>insulin pumps<\/strong>.\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li>New technology allows for precise, continual insulin delivery to stabilize blood glucose levels.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Note:<\/strong>\u00a0Insulin cannot be taken orally because stomach acids degrade it.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>\r\n<h1><strong>Complications of Uncontrolled Diabetes and Risk of Long-Term Damage:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Blood vessel damage<\/strong>\u00a0leads to:\r\n<ul>\r\n \t<li><strong>Atheromas<\/strong>\u00a0formation.<\/li>\r\n \t<li><strong>Vascular damage<\/strong> affecting organs. and putting person at risk for:\r\n<ul>\r\n \t<li><strong>Cardiovascular disease:<\/strong>\u00a0Stroke, heart attack, peripheral vascular disease.<\/li>\r\n \t<li><strong>Kidney failure<\/strong>\u00a0(due to nephropathy).<\/li>\r\n \t<li><strong>Nerve damage:<\/strong> Neuropathy<\/li>\r\n \t<li><strong>Pregnancy complications:<\/strong>\u00a0Stillbirths and miscarriages.<\/li>\r\n \t<li><strong>Increased risk of amputations<\/strong>\u00a0due to ischemia and gangrene.<\/li>\r\n \t<li><strong>Eye damage:<\/strong> Leading to blindness due to retinal damage (diabetic retinopathy).\r\n<ul>\r\n \t<li>Damage to tiny retinal blood vessels produces:\r\n<ul>\r\n \t<li><strong>Microaneurysms<\/strong>: Weakening and bulging of vessel walls.<\/li>\r\n \t<li><strong>Hemorrhages<\/strong>: Bleeding into the retina.<\/li>\r\n \t<li><strong style=\"font-size: 1em\">Neovascularization<\/strong><span style=\"font-size: 1em\">: Formation of new, fragile blood vessels that can rupture and cause scarring and distortion of retina.<\/span>\r\n<ul>\r\n \t<li>Blood and debris can\u00a0<strong>float in the vitreous humor<\/strong>, impairing vision.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Macular edema<\/strong> causes swelling in the central retina, resulting in distorted vision.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li><strong>Blurred Vision or Vision Loss:\u00a0<\/strong>\r\n<ul>\r\n \t<li>also due to development of <strong>diabetic<\/strong> (sugar) <strong>cataracts<\/strong> results from<strong> hyperglycemia<\/strong><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li>Monitoring and controlling blood glucose\u00a0<strong>minimizes complications<\/strong>.<\/li>\r\n \t<li>Lifestyle modifications and medication optimize management.<\/li>\r\n \t<li>Avoid extremes of\u00a0<strong>hypoglycemia and hyperglycemia<\/strong>\u00a0during daily activities and exercise.<\/li>\r\n \t<li>Proper diet and regular activity help\u00a0<strong>prevent vascular damage<\/strong>\u00a0and improve\u00a0<strong>quality of life<\/strong>.<\/li>\r\n<\/ul>","rendered":"<h1><strong>Overview<\/strong><\/h1>\n<ul>\n<li>Typically\u00a0<strong>older<\/strong>\u00a0in onset but increasingly affecting\u00a0<strong>children and teenagers<\/strong>\u00a0due to rising obesity.<\/li>\n<li>Onset is\u00a0<strong>insidious<\/strong>\u00a0(gradual) rather than sudden.<\/li>\n<li><span style=\"font-size: 1em\">More common than Type I, accounting for about <\/span><strong style=\"font-size: 1em\">90%<\/strong><span style=\"font-size: 1em\">\u00a0of diabetes cases.<\/span><\/li>\n<li>Often leads to <strong>chronic complications,<\/strong> and sometimes <strong>acute complications,<\/strong>\u00a0if blood glucose is not well-controlled.<\/li>\n<\/ul>\n<h1><strong>Causes and Risk Factors:<\/strong><\/h1>\n<ul>\n<li><span style=\"font-size: 1em\"><strong>Cells become<\/strong> <b>less sensitive to insulin, meaning that:<\/b><\/span>\n<ul>\n<li><span style=\"font-size: 1em\"><b>Cells become insulin-resistant,<\/b> and<\/span><\/li>\n<li><span style=\"font-size: 1em\"><b>Insulin <\/b>can no longer stimulate cells to insert <b>GLUT4 glucose <\/b><strong>transporters<\/strong> into cell membranes, leading to <strong>low glucose uptake<\/strong> by cells<\/span><\/li>\n<li>Cells become starved for glucose.<\/li>\n<li>Glucose builds up in blood leading to <strong>hyperglycemia<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"font-size: 1em\">Thought to be triggered by several possible factors:<\/span>\n<ul>\n<li><strong>Family history<\/strong>.<\/li>\n<li><strong>Obesity<\/strong>.<\/li>\n<li><strong>Sedentary lifestyle<\/strong>.<\/li>\n<li>Other <strong>environmental factors.<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Typical Onset:<\/strong><\/h1>\n<ul>\n<li>Typically\u00a0<strong>older<\/strong>\u00a0in onset but increasingly affecting\u00a0<strong>children and teenagers<\/strong>\u00a0due to rising obesity.<\/li>\n<li>Onset is\u00a0<strong>insidious<\/strong>\u00a0(gradual) rather than sudden.<\/li>\n<\/ul>\n<h1><strong>Pathophysiology:<\/strong><\/h1>\n<ul>\n<li>Lack of\u00a0<strong>insulin<\/strong> prevents <strong>glucose entry<\/strong> into cells,\n<ul>\n<li>as cell&#8217;s require insulin to insert GLUT4 glucose transporters into their cell membranes.<\/li>\n<li>leading to <strong>high blood<\/strong> <strong>glucose levels<\/strong>\u00a0(<strong>hyperglycemia<\/strong>).<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cells<\/strong>\u00a0become\u00a0<strong>starved for glucose<\/strong>, impairing ATP production.<\/li>\n<li>Excess glucose\u00a0<strong>diffuses into urine<\/strong>, drawing water and causing\u00a0<strong>polyuria<\/strong>,\u00a0causing<\/li>\n<li><strong>Dehydration<\/strong>\u00a0triggers\u00a0<strong>thirst<\/strong>\u00a0(polydipsia).<\/li>\n<li>The body responds by\u00a0<strong>breaking down proteins and fats<\/strong>\u00a0for energy:\n<ul>\n<li><strong>Gluconeogenesis<\/strong>: Produces glucose from proteins and fats.<\/li>\n<li><strong>Lipolysis<\/strong>: Leads to high\u00a0<strong>lipid levels<\/strong>\u00a0(<strong>lipidemia<\/strong>).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Effects on the Body<\/strong><\/p>\n<ul>\n<li><strong>Muscle wasting<\/strong>\u00a0due to protein breakdown.<\/li>\n<li><strong>High blood lipids<\/strong>\u00a0increase risk of\u00a0<strong>atherosclerosis<\/strong>.<\/li>\n<li><strong>Ketone production<\/strong>\u00a0causes\u00a0<strong>ketosis<\/strong>\u00a0and potentially\u00a0<strong>ketoacidosis<\/strong>:\n<ul>\n<li>Blood becomes\u00a0<strong>acidic<\/strong>.<\/li>\n<li>Ketones and glucose are\u00a0<strong>excreted in urine<\/strong>\u00a0(ketonuria and glucosuria).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Signs and Symptoms:<\/strong><\/h1>\n<ul>\n<li><strong>Polydipsia:<\/strong>\u00a0 Increased <strong>thirst<\/strong> (due to dehydration)<\/li>\n<li><strong>Polyphagia:<\/strong>\u00a0 Increased <strong>hunger<\/strong><\/li>\n<li><strong>Polyuria:<\/strong>\u00a0 Increased <strong>urine volume<\/strong> (due to <strong>glucosuria<\/strong> and osmotic diuresis)\n<ul>\n<li><strong>Electrolyte loss<\/strong>\u00a0(sodium, potassium) follows water loss.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Fatigue<\/strong> (due to cell&#8217;s reduced ability to uptake glucose)<\/li>\n<li><strong>Blurred vision<\/strong> (due to retinopathies and diabetic cataracts)<\/li>\n<li><strong>Slowed healing of wounds<\/strong> (due to cell&#8217;s reduced ability to uptake glucose)<\/li>\n<li><strong>Irritability, slowed reaction<\/strong>, and <strong>cognitive impairment<\/strong> (due to neuronal energy deficiency)<\/li>\n<\/ul>\n<h2><strong>Diagnostic Blood Tests:<\/strong><\/h2>\n<ol>\n<li><strong>Glycated hemoglobin (A1c) test<\/strong>\n<ul>\n<li>Measures the percentage of hemoglobin with blood sugar attached.<\/li>\n<li>Reflects\u00a0<strong>blood glucose control over 2-3 months<\/strong>.<\/li>\n<li>Levels\u00a0<strong>above 6.5%<\/strong>\u00a0suggest diabetes.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Random blood sugar test<\/strong>\n<ul>\n<li>Blood sample taken randomly, regardless of fasting.<\/li>\n<li>Blood glucose\u00a0<strong>above 110 mg\/dL<\/strong>\u00a0indicates abnormality.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Fasting blood sugar test<\/strong>\n<ul>\n<li>Fasting for 12 hours before testing.<\/li>\n<li>Normal:\u00a0<strong>&lt;110 mg\/dL<\/strong>.<\/li>\n<li>Diabetic:\u00a0<strong>&gt;125 mg\/dL<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Glucose tolerance test:<\/strong>\n<ul>\n<li>Drink 75g glucose, measure levels at 1 and 2 hours.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<h1>Urinalysis:<\/h1>\n<ul>\n<li><strong>Urine tests:<\/strong>\n<ul>\n<li><strong>Glucosuria:<\/strong>\u00a0Glucose in urine.<\/li>\n<li><strong>Ketonuria:<\/strong>\u00a0Ketones in urine.<\/li>\n<li>Useful for detecting\u00a0<strong>diabetic ketoacidosis<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Treatments:<\/strong><\/h1>\n<ol>\n<li><strong>Lifestyle modifications:\u00a0<\/strong> Can reverse some issues by improving insulin sensitivity.\n<ul>\n<li>Healthy\u00a0<strong>diet<\/strong>.\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Avoid high-glycemic foods (candies, sugary drinks).<\/li>\n<li>Favor\u00a0<strong>complex carbohydrates<\/strong>\u00a0(fibers, polysaccharides).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Regular\u00a0<strong>exercise<\/strong>.\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Helps\u00a0<strong>reduce blood glucose<\/strong>\u00a0by increasing skeletal muscle uptake.<\/li>\n<li>Monitor blood sugars during activity.<\/li>\n<li>Have carbohydrate snacks available to prevent\u00a0<strong>hypoglycemia<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Stress reduction:<\/strong>\n<ul>\n<li>Stress increases\u00a0<strong>cortisol and glucocorticoids<\/strong>, which raise blood glucose levels.<\/li>\n<li>Managing stress helps control glucose.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Weight control:<\/strong>\n<ul>\n<li>Reducing body mass index (BMI) decreases\u00a0<strong>insulin resistance<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Oral hypoglycemic agents:<\/strong>\u00a0Lower high blood glucose by increasing cellular responsiveness or insulin secretion.\n<ul>\n<li><strong>Oral hypoglycemic agents<\/strong>\u00a0for type 2\n<ol>\n<li><strong>Metformin:<\/strong>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Reduces\u00a0<strong>hepatic gluconeogenesis<\/strong>.<\/li>\n<li>Decreases the liver&#8217;s production of excess glucose.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Medications to enhance insulin sensitivity:<\/strong>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Improve tissue response to insulin.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<\/li>\n<\/ul>\n<\/li>\n<li><strong>Insulin injections:<\/strong>\u00a0Necessary for\u00a0<strong>Type I<\/strong>\u00a0and often\u00a0<strong>Type II<\/strong>\u00a0or\u00a0<strong>gestational<\/strong> when beta cells are dysfunctional or destroyed.\n<ul>\n<li>Administered via\u00a0<strong>injections<\/strong>\u00a0or continuous\u00a0<strong>insulin pumps<\/strong>.\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>New technology allows for precise, continual insulin delivery to stabilize blood glucose levels.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Note:<\/strong>\u00a0Insulin cannot be taken orally because stomach acids degrade it.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<h1><strong>Complications of Uncontrolled Diabetes and Risk of Long-Term Damage:<\/strong><\/h1>\n<ul>\n<li><strong>Blood vessel damage<\/strong>\u00a0leads to:\n<ul>\n<li><strong>Atheromas<\/strong>\u00a0formation.<\/li>\n<li><strong>Vascular damage<\/strong> affecting organs. and putting person at risk for:\n<ul>\n<li><strong>Cardiovascular disease:<\/strong>\u00a0Stroke, heart attack, peripheral vascular disease.<\/li>\n<li><strong>Kidney failure<\/strong>\u00a0(due to nephropathy).<\/li>\n<li><strong>Nerve damage:<\/strong> Neuropathy<\/li>\n<li><strong>Pregnancy complications:<\/strong>\u00a0Stillbirths and miscarriages.<\/li>\n<li><strong>Increased risk of amputations<\/strong>\u00a0due to ischemia and gangrene.<\/li>\n<li><strong>Eye damage:<\/strong> Leading to blindness due to retinal damage (diabetic retinopathy).\n<ul>\n<li>Damage to tiny retinal blood vessels produces:\n<ul>\n<li><strong>Microaneurysms<\/strong>: Weakening and bulging of vessel walls.<\/li>\n<li><strong>Hemorrhages<\/strong>: Bleeding into the retina.<\/li>\n<li><strong style=\"font-size: 1em\">Neovascularization<\/strong><span style=\"font-size: 1em\">: Formation of new, fragile blood vessels that can rupture and cause scarring and distortion of retina.<\/span>\n<ul>\n<li>Blood and debris can\u00a0<strong>float in the vitreous humor<\/strong>, impairing vision.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Macular edema<\/strong> causes swelling in the central retina, resulting in distorted vision.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Blurred Vision or Vision Loss:\u00a0<\/strong>\n<ul>\n<li>also due to development of <strong>diabetic<\/strong> (sugar) <strong>cataracts<\/strong> results from<strong> hyperglycemia<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li>Monitoring and controlling blood glucose\u00a0<strong>minimizes complications<\/strong>.<\/li>\n<li>Lifestyle modifications and medication optimize management.<\/li>\n<li>Avoid extremes of\u00a0<strong>hypoglycemia and hyperglycemia<\/strong>\u00a0during daily activities and exercise.<\/li>\n<li>Proper diet and regular activity help\u00a0<strong>prevent vascular damage<\/strong>\u00a0and improve\u00a0<strong>quality of life<\/strong>.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":16,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5213","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":63,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":12,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5213\/revisions"}],"predecessor-version":[{"id":5246,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5213\/revisions\/5246"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/63"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5213\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5213"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5213"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5213"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}