Type 2 diabetes is one of the most common diseases and has dangerous health consequences. At the same time, a significant part of the population does not know about their diagnosis or attend hospitals after several years of illness with complaints on its complications. The Australian community is also faced with the problem that doctors call a “silent epidemic” because the public does not often talk about the dangers and need for screening for type 2 diabetes (1). However, although this type of diabetes is most often diagnosed in older people, it also increasingly appears in young people and children. Therefore, this article explores the pathophysiology, epidemiology and impact of type 2 diabetes to highlight the importance of its timely diagnosis and treatment.
Type 2 Diabetes
The first task for studying type 2 diabetes is to identify and clarify the basic terms that are most often associated with this disease. First, it is necessary to find out the common features and definition of all types of diabetes. According to Harris, diabetes mellitus is a complex heterogeneous metabolic disease characterised by hyperglycaemia, or high blood glucose levels (2). The main difference between type 2 and type 1 diabetes is that type 2 is caused by insufficient insulin secretion or increased insulin resistance rather incapability of pancreas to secret the hormone at all (3). Insulin is a hormone essential for metabolic processes, more specifically the absorption of glucose from carbohydrates, energy production and glycogenesis (4). With a lack of insulin, glucose is not absorbed by the body from the blood and becomes the cause of hyperglycaemia, which harms blood vessels and organs.
Type 2 diabetes is most often a disease that emerges in adulthood and develops over time. For this reason, people 55 and older are most often diagnosed with type 2 diabetes, although younger people are also increasingly faced with the disease (1). In addition, the danger of type 2 diabetes is that it can remain diagnosed for years because mild symptoms are similar to those common in older people, such as fatigue, leg pain, or frequent urination. For this reason, many people learn about diabetes because of its complications that could have been avoided. Thus, these facts are enough to understand the main features of type 2 diabetes and delve into its study.
Pathophysiology and Epidemiology
The pathophysiology and epidemiology of Type 2 diabetes are diverse and often uncertain as many factors are not fully understood; however, scientists highlight common features of the development of the disease. First, the population group most commonly affected by type 2 diabetes is people 55 years of age and older and with age risk increases twice, although young people are also affected, in some cases (4,5). Scientists also note that people 45 years old who have problems with blood pressure or obesity are also more susceptible to diabetes, since excess weight interferes with insulin secretion. However, this diagnosis is also likely in young people of average weight, which so far has little explanation (6). In addition, in Australia, men are more frequently affected than women, and diabetes is more common in people who have Aboriginal or Torres Strait Islander background. (1,7) Therefore, although older age and lifestyle have a significant impact on the spread of type 2 diabetes, they are not always decisive.
The pathophysiology of Type 2 diabetes has different developmental options rarely associated on life stage. Differences in pathophysiology depend on a person’s lifestyle, weight, diet, and duration of the disease and are expressed in the period of its development. However, the known developmental mechanisms are similar and are associated with the degradation of the pancreatic beta cells, which produce insulin, and increased insulin resistance (3). A lack of insulin production leads to an increased level of glucose in the blood, which in turn negatively affects blood vessels and organ function. At the same time, with an early diagnosis of diabetes, a person is more likely to influence secretion through diet and exercise. However, over time, cells lose their function to secrete insulin, which can be stimulated with medications or, if the hormone is lacking, it can be replaced with insulin therapy (6). The difference in the development of the disease at a young age or childhood is only that over time diabetes leads to more complications, although with proper treatment, this process takes a long time.
Morbidity, Mortality, and Prognosis
Diabetes is one of the most common diseases in the world. At the same time, 90-95% of cases are type 2 diabetes, and it is currently considered as a global epidemic (2). However, there are trends in the spread of diabetes or morbidity rates. Although older age is a significant risk factor, an increasing number of young people among ethnic groups such as African Americans, American Indians, Asians, and Pacific Islanders are being diagnosed with type two diabetes (3). In addition, people with lower social status are also more likely to have type 2 diabetes, and more often than not receive quality health care.
The latter fact is also associated with mortality from type 2 diabetes that is at a high level. Most often, people with diabetes die from its complications due to lack of control, ignorance of the diagnosis, or lack of treatment, which is common in remote regions and low-income countries. Besides, people with diabetes are more susceptible to infectious diseases, which also cause death (2). However, even in advanced societies, diabetes mortality remains high. For example, 10.5% of Australians died of diabetes in 2018, with 56% of people having type 2 and another 39% of another or unrefined type (7). Consequently, diabetes mortality can be reduced with a conscious approach to screening and treatment that can help avoid or reduce the appearance of diabetes.
In recent years, society has been talking more often about diabetes and its dangerous to prevent its spread. According to prognosis, by 2045, the number of patients with type 2 diabetes will reach 531.6 million (8). Consequently, world organisations direct their efforts to prevent the disease by providing medicines to people and countries with low income. The individual prognosis for each person with type 2 diabetes varies with age and disease control; however, in general, health conditions are gradually deteriorating, and life expectancy is decreasing. However, the more responsibly a person approaches his or her diagnosis and undergoes routine screening, the higher the likelihood of deteriorating health. Therefore, while the prognosis is disappointing, the global and personal fight against type 2 diabetes can improve them.
Short-Term and Long-Term Effects of Diabetes on Health
Proper and responsible treatment and management of type 2 diabetes help to avoid deadly consequences; however, this disease has short and long term health effects. The short-term results can be distinguished as the symptoms that people usually describe when they are first diagnosed with diabetes. These effects include excessive fatigue, thirst, frequent urination, weight gain or loss, blurred vision, headaches, or poor wound healing (4). These symptoms are most often caused by fluctuations in blood glucose levels and ketoacidosis, which occur due to lack of diet and exercises. However, with proper treatment, these symptoms disappear after time.
Nevertheless, type 2 diabetes is a dangerous disease because of its complications or long-term effects on the body. Most of them are associated with the destruction of blood vessels due to the high content of glucose in the blood, which leads to disruption of the functioning of organs. The most common disorders are retinopathy, peripheral neuropathy, and nephropathy (3). In other words, the main complications of diabetes can be kidney disease, an increased risk of cardiovascular disease, blurred vision or blindness, pain in the limbs, ulcers and wounds, and even amputation. However, timely diagnosis and control of the disease help to avoid these consequences or minimise their harm.
Therefore, type 2 diabetes is one of the most common diseases that lead to serious health problems and death. A particularly disturbing sign is that although this type of diabetes is more common in older people, youth and children are increasingly exposed to this disease. However, timely diagnosis, a healthy lifestyle and control of the disease course allows people to live with diabetes for a long time. In addition, although all the features of diabetes have not yet been studied, there are measures to prevent it and reduce its complications. Consequently, the world community and every person should pay more attention to the problem of type 2 diabetes, get timely screening and preventing measures to reduce its spread.
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