Diabetes Type 2: The Modern Epidemic and How We Manage It?

Authors: Salman Siddiqi (1), Erkam Bahceci (2), Ariana Hung (3), and Asude Arslan (4)

Editor: Monsurat Lawal, Ph.D.

Author Affiliations: (1) Willowbrook High School, (2) Pinnacle Academy, (3) Diamond Bar High School, (4) Chantilly High School

Introduction

Despite sufficient intake of sugar or glucose, life can still be at risk. Glucose is one of the most essential energy sources for the human body; without it, vital functions of our cells, especially those in the brain and red blood cells, fail.[1] Consequently, critical bodily processes come to a halt. In this article, we will delve Type 2 diabetes, a disorder characterized by disruptions in blood sugar regulation.

Keywords

Type 2 diabetes, Metabolic disorder, Glucose transporter, Insulin, Signaling pathway

Blood Sugar Spikes and Health Risks

For some people, the journey of glucose from digestion to cellular usage isn't always smooth, often lingering in the bloodstream if not adequately managed. This poor metabolism can lead to various complications and if left unchecked and can become life-threatening [1]. Figure 1 depicts a test kit to measure blood sugar levels. Diabetes is a major global issue with approximately 422 million patients worldwide and over 1.5 million deaths each year [2]. The most widespread types of diabetes mellitus are Type 1 diabetes, Type 2 diabetes and gestational diabetes.

Understanding Insulin Resistance in Type 2 Diabetes

Type 2 diabetes is a chronic metabolic disorder characterized by elevated blood sugar levels resulting from insulin resistance. Around 1 in 10 Americans have it, and contraction in young adults is increasing [3]. Insulin, a hormone produced by the pancreas, is crucial in regulating blood sugar [4]. After food ingestion, incretins, such as glucagon-like peptide 1 (GLP-1), are released from the intestines. GLP-1 signals the pancreas to increase insulin secretion and decrease glucagon release, which helps to lower blood sugar levels by facilitating glucose uptake into cells [4]. Insulin binds to receptors on target cells, allowing glucose to enter cells for energy purposes. However, when cells become resistant to insulin, as in Type 2 diabetes, this process is disrupted. Cells do not respond effectively to insulin signals, leading to inadequate glucose uptake and persistently high blood sugar levels. This resistance is typically developed over time and characterized by adult-onset [1, 3]. Understanding the impact of insulin resistance and its development in Type 2 diabetes sets the stage for exploring its risk factors, diagnosis, and management strategies.

Unveiling the Risk Factors for Type 2 Diabetes

Type 2 diabetes often develops gradually, influenced by a combination of genetic predisposition and lifestyle factors. Genetics can play a significant role, with a family history of diabetes increasing the likelihood of developing the disorder. Additionally, lifestyle choices such as obesity, which results from excessive body fat accumulation, and physical inactivity contribute significantly to the risk. An inactive lifestyle and an unhealthy diet high in artificial sugars and fats can further add to the risk of developing insulin resistance and Type 2 diabetes. Ethnicity also plays a role, as certain racial and ethnic groups, including African Americans, Hispanic/Latino Americans, Native Americans, and Asian Americans, have a higher risk of developing Type 2 diabetes compared to Caucasians [3]. As it progresses, pre-diabetics may experience symptoms such as increased thirst, frequent urination, weight loss, fatigue, blurred vision, and slow wound healing. These symptoms often develop gradually and may not be immediately noticeable, so regular health checkups and screening for diabetes risk factors are essential [1, 3, 5]. Understanding these risk factors and recognizing early symptoms (Figure 2) can help choose individuals to seek medical advice and undergo appropriate testing for diagnosing and managing Type 2 diabetes.

Monitoring, Medications, and the Art of Type 2

Managing Type 2 diabetes effectively revolves around controlling blood sugar levels to enhance quality of life. Initially, lifestyle modifications play an imperative role and are often highly effective in treatment. This approach includes adopting a balanced diet low in artificial sugars and saturated fats, engaging in regular physical activity to improve insulin sensitivity, and maintaining a healthy weight to alleviate strain on the pancreas [1, 3]. Regular monitoring of blood sugar levels serves as a daily checkup of health status, guiding individuals to manage the condition [1]. Additionally, managing Type 2 diabetes effectively often requires the use of medications and inhibitors that target various aspects of glucose metabolism. These medications work through different mechanisms to improve blood sugar control. For instance, some medicines stimulate insulin production in the pancreas, facilitating glucose uptake into cells for energy [1, 3]. Others reduce glucose production in the liver, which helps prevent excessive glucose buildup in the bloodstream.

Additionally, medications that enhance insulin sensitivity in cells improve the body's ability to respond to insulin signals, promoting more efficient glucose uptake. Combining medications with lifestyle modifications like diet and exercise (Figure 3) plays a crucial role in managing Type 2 diabetes and reducing the risk of complications associated with high blood sugar levels [1, 2].

Cutting-Edge Therapies Transforming Type 2 Diabetes Care

Recent advancements in treating Type 2 diabetes have revolutionized diabetes care, offering innovative medications and advanced technologies that enhance blood sugar control and patient outcomes. Modern advances in managing Type 2 diabetes have focused on improving treatment efficacy, enhancing patient convenience, and reducing the risk of complications. One significant advancement involves the development of new classes of medications that offer notable mechanisms of action. For example, GLP-1 receptor mimickers have gained traction for their ability to copy the action of GLP-1, promoting insulin secretion and suppressing glucagon [4]. Another notable advancement is the introduction of Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which block glucose reabsorption in the kidneys, thereby increasing glucose excretion in urine. This mechanism helps lower blood sugar levels without using insulin, with the prospect of reducing the risk of cardiovascular events in patients with Type 2 diabetes [4]. These innovations represent significant changes in diabetes care, offering patients more personalized and effective treatment options to manage their condition better and improve long-term health outcomes [4].

Conclusion

Type 2 diabetes is a complex disease requiring a comprehensive approach for effective management. While lifestyle changes and medications form the cornerstone of treatment, ongoing research, and technological advancements hold promise for more personalized and effective interventions in the future. By understanding the complexity of Type 2 diabetes, individuals can better manage their health and work towards preventing complications associated with this chronic condition.

Glossary

Insulin: A hormone produced by the pancreas that regulates blood sugar levels by allowing cells to absorb glucose from the bloodstream.
Blood Sugar: The amount of glucose (sugar) circulating in the blood.
Chronic: Persisting for a long time or constantly recurring.
Complications: Health problems arising from a primary disease or condition, such as diabetes.
Cardiovascular Disease (CVD): A general term for conditions affecting the heart and blood vessels, including heart attack, stroke, and peripheral artery disease.
Obesity: A chronic condition characterized by excessive body fat accumulation that poses a health risk.
Hyperglycemia: An abnormally high glucose (sugar) level in the bloodstream.
Metabolism: Complex biochemical processes within the body to keep for live and optimal functioning.