Type II diabetes mellitus (T2DM) is when the body does NOT produce enough insulin at the right time in response to a rising blood sugar, and when insulin action is impaired. This results in elevated blood sugar levels.
Most people know this as adult-onset diabetes mellitus, a condition more commonly seen among overweight middle-aged individuals with a family history of T2DM. It is a lifestyle disease, a consequence of years of unhealthy habits like sedentary living, constant exposure to stress and a diet of processed foods and refined carbohydrates.
Since the mid-1990s, the incidence of T2DM has been on the rise worldwide across ethnicities, paralleling the epidemic of pediatric obesity. T2DM now accounts for up to 45 percent of new cases of diabetes in the pediatric population according to Susana P. Campos, MD from the Section of Endocrinology, Department of Pediatrics of the Makati Medical Center (MakatiMed).
“Other risk factors include having a family member with T2DM, clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovary syndrome, acanthosis nigricans) and maternal gestational diabetes.”
Although there is a genetic susceptibility to the development of T2DM, the recent rapid increase in the prevalence of T2DM, cannot be due to increased gene frequency and altered gene pool, and Dr. Campos highlights the importance of environmental factors.
Type 1 diabetes mellitus, on the other hand, results from autoimmune destruction of the pancreatic beta cells and absolute insulin deficiency, necessitating the administration of insulin by subcutaneous injections at the time of diagnosis. Often enough, the distinction between T1DM and T2DM is difficult, especially in obese children and adolescents.
Dr. Campos further warns that Diabetes Mellitus is a difficult disease to live with as it requires modification of diet, monitoring of blood sugar levels, regular exercise, use of pharmacologic agents (insulin for T1DM and metformin, dipeptidyl peptidase inhibitors of glucagon like peptide 1 mimetics for T2DM) and constant reminders about long term complications of uncontrolled blood sugar. The chronic complications of diabetes mellitus include accelerated development of cardiovascular disease, end-stage renal disease, visual loss, nerve damage, slow wound healing and dementia.
Sylvia Estrada, MD, section head of the MakatiMed Section of Pediatric Endocrinology raises the psycho-emotional and financial impact of Diabetes Mellitus on the patient and the entire family.
“Some may feel they are a burden to their family or that it was their fault. Others may not like changes being made to their diet or being constantly asked about what they ate or if they took their medicines. And then there is the fear of needles and doctor visits. The expenses incurred can also be overwhelming to some families. For more information, contact MakatiMed On-Call at +632.88888 999, e-mail [email protected], or visit www.makatimed.net.ph.