According to the latest epidemiological survey, the prevalence of type 2 diabetes among adults in our country has reached 11.9%, and understanding its pathogenesis and diagnosis and treatment methods is crucial for preventing and controlling the disease.
Pathogenesis:
Insulin “failure” or “insufficiency” is central
The beginning of type 2 diabetes is not a one-factor phenomenon but rather a confluence of genetic and environmental factors. In simple terms, it mostly originates from two main problems that are insulin resistance and insulin secretion.
Insulin is a hormone that is produced by the pancreas “hypoglycemic hormone” and behaves like a key that gives access to the cells, allowing glucose in the blood to enter the cells and be changed into energy. When the body gets insulin resistance, the sensitivity of the cells towards insulin goes down, the “key” is not able to open the “gate”, glucose is not going into the cells easily, and the blood sugar increases. Bad lifestyles such as long-term high-calorie diet, lack of exercise and obesity (especially abdominal obesity) are the main reasons for insulin resistance.
When the disease advances, the pancreas will be overworked and will secrete insulin to take blood sugar under control. The function of the pancreas will be gradually damaged after long-term “overwork”, which will lead to insufficient insulin secretion and difficulties in controlling blood sugar, thus type 2 diabetes will be the result. Moreover, it is immaterial to what extent genetics play a role but if a parent or immediate family member has type 2 diabetes, the risk of the child getting the disease is significantly increased.
Disease diagnosis:
Focus on blood glucose indicators and detect and intervene early
Finding out if somebody has diabetes is not a very complicated matter. Three tests, that is intravenous blood glucose test, oral glucose tolerance test and glycosylated hemoglobin test will give a doctor enough information to state the diagnosis. It must be emphasized that in the early stages of diabetes, symptoms are almost invisible, and quite a few patients. find out about their illness by accident during a health check. Thus, it is recommended that people over the age of 40, those with a family history of diabetes, obese people, and other high-risk groups should set a blood glucose test for themselves at least once a year to detect the disease at an early stage and intervene early.
Standardize diagnosis and treatment:
Integrated management, multi-pronged approach
The treatment of type 2 diabetes is based on the principle of “comprehensive management”, aiming at both controlling blood sugar and delaying complications, mainly through lifestyle changes and drug therapy.
Lifestyle interventions:
Basic and critical
Lifestyle interventions are the first line “compulsory” for all diabetics and form the basis of pharmacotherapy. First of all, it is necessary to regulate the diet, reduce the consumption of high oil, sugar, and salt foods, and increase the proportion of whole grains, vegetables, and high-quality protein; second, it is necessary to continue the exercise and carry out 150 minutes of moderate-intensity aerobic exercise every week, for instance, brisk walking, swimming, etc.; at the same time, controlling weight will be very helpful especially obese abdominal patients, losing 5% to 10% of the weight can considerably improve blood sugar.
Pharmacotherapeutic:
Follow your doctor’s advice is a prerequisite
Medication is recommended by the doctor when lifestyle interventions are not effective in controlling blood sugar. Drugs that are commonly used are metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, insulin and so on. The doctor will personalize the treatment plan depending on the patient’s age, blood glucose level, liver and kidney function, comorbidities, etc. Particularly, it is unsafe to increase or decrease the dosage or stop it totally by yourself which may lead to diabetes acute complications and also cause long-term glycemic control to be poor which in turn will make complications such as diabetic retinopathy and nephropathy get worse. Besides that, it is wise to keep a watch on blood sugar and do the tests regularly so that the doctors can make their treatment plan changes on time.
Although type 2 diabetes will never be totally cured, through science-based pathogenesis comprehension, early diagnosis and standardization of diagnosis and treatment, proper control can be achieved to the extent that diabetes will not be a “stumbling block” in a person’s life.
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“Dr. Harnarayan Singh is a Neurosurgeon and Minimally Invasive spine surgeon. His areas of speciality are brain tumours(Glioblastomas, Gliomas, Astrocytomas etc), Spine tumours like Neurofibromas or Meningiomas, head injury, spine injury, Minimally invasive spine surgery for lumbar canal stenosis(MIS Lumbar decompression), Lumbar microdiscectomy, Cervical disc surgery, spondylolisthesis, and degenerative spinal disorders. He has special interest in keyhole or endoscopic brain and spine surgeries. He is available from Monday to Saturday, during working hours at Narayana Super Speciality hospital, Gurugram.”
