Type 2 Diabetes Management and Complications

Type Ⅱ DM Pathophysiology and Clinical Manifestations

• Type Ⅱ DM is a metabolic disorder characterized by insulin resistance, impaired insulin secretion, and increased glucose production in the liver.
• Insulin resistance is the primary defect, leading to decreased glucose uptake in peripheral tissues, particularly in skeletal muscles.
• The body's inability to respond to insulin leads to hyperglycemia (high blood sugar levels).
• Clinical manifestations of type Ⅱ DM include:
  • Polyuria (frequent urination)
  • Polydipsia (increased thirst)
  • Polyphagia (increased hunger)
  • Fatigue
  • Blurred vision
  • Slow healing of cuts and wounds
  • Recurring skin, gum, or bladder infections

Differentiation from Type Ⅰ DM

• Type Ⅱ DM is distinct from type Ⅰ DM, which is characterized by beta-cell destruction and absolute insulin deficiency.
• Type Ⅱ DM is often associated with insulin resistance, whereas type Ⅰ DM is associated with insulin deficiency.
• Type Ⅱ DM is more common than type Ⅰ DM, accounting for approximately 90% of all diabetes cases.

Nutrition and Exercise as Management Strategies

• Nutrition plays a crucial role in managing type Ⅱ DM, with a focus on:
  • Reducing carbohydrate intake to regulate blood sugar levels
  • Increasing fiber intake to improve insulin sensitivity
  • Incorporating healthy fats, such as omega-3 fatty acids, to reduce inflammation
• Exercise is essential for improving insulin sensitivity, reducing cardiovascular risk, and enhancing overall health.
• Regular physical activity, such as aerobic exercise and strength training, can help improve glucose uptake in peripheral tissues.

Nursing and Interdisciplinary Management

• Nursing management involves:
  • Educating patients on self-care practices, including glucose monitoring, insulin administration, and foot care
  • Providing emotional support and promoting healthy lifestyle habits
  • Collaborating with healthcare professionals to develop individualized care plans
• Interdisciplinary management involves:
  • Coordinating with healthcare providers, including primary care physicians, endocrinologists, and registered dietitians
  • Encouraging patient participation in care planning and decision-making
  • Fostering effective communication among healthcare team members

Pathophysiology and Complications

• The pathophysiology of type Ⅱ DM can lead to acute complications, such as:
  • Hypoglycemia (low blood sugar levels)
  • Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)
  • Diabetic ketoacidosis (DKA)
• Chronic complications of type Ⅱ DM can include:
  • Microvascular complications, such as nephropathy, neuropathy, and retinopathy
  • Macrovascular complications, such as cardiovascular disease, peripheral artery disease, and stroke.