There is a rising number of type 2 diabetes mellitus (DM) not only in the Philippines but in the world nowadays, therefore, diabetes mellitus is a growing public health concern both to developing and developed countries.

It is believed that the current number of people with diabetes is estimated to be 30 million, is it being forecasted that by the year 2025, it will be at least 55 million.  Prevalence of Type 2 Diabetes mellitus exceeds 8% of the adult population in 13 countries and areas of the regions with some groups having the highest levels in the world. Large numbers of people have diabetes without knowing it.

Type 2 DM is a condition of high blood glucose in the presence of insulin in the body; there is a sufficient insulin production to prevent ketosis but  there is insufficient insulin production to lower blood glucose levels through the uptake of glucose by muscle and gat cells.  This condition is most commonly seen in middle aged and older people.

There are several theories involved in type 2 DM manifestations which include limited beta-cells response to hyperglycemia, peripheral insulin resistance and insulin-receptor or post-receptor abnormalities.  In view of these theories, the major factor of type 2 DM onset is the cellular resistance to the effect of insulin which is triggered by obesity, inactivity, illnesses, medications, increasing age, hypertension and family history.

The persons with type 2 DM experiences polyuria (increased urine output) and polydysia (increased amount of fluid intake). However, there is a slow onset of manifestation and patients are often unaware until  they seek health care for other problems as a result of hyperglycemia which includes blurred vision, fatigue, paresthesia, and skin infection.

Diabetic ketoacidosis is not experienced by persons with type 2 DM but they experience Hyperosmolar hyperglycemic state (HHS), which is a serious, life threatening medical emergency condition at the extent. It is characterized by a plasma osmolality of 340 mOsm/L or greater (normal values= 280-300 mOsm/L), highly elevated blood glucose level (more than 600mg/dL and often 1000 to 2000 mg/dL), and altered levels of conciosness.

COMPLICATIONS OF DIABETES MELLITUS

The person with type 2 DM has an increased risk for complications involving many different body systems.  These complications are manifested by:

1.        Alterations blood glucose levels

a.       Hyperclycemia

b.      Hypoglycemia

2.       Alterations cardiovascular system

a.       Orthostatic hypertension

b.      Accelerated atherosclerosis

c.       Cerebrovascular disease (stroke)

d.      Coronary artery disease (myocardial infarction)

e.      Peripheral vascular disease

f.        Blood viscosity and platelet disorders

3.       Neuropathies

a.       Somatic neuropathies

                                                               i.      Paresthesias

                                                             ii.      Pain

                                                            iii.      Loss of cutaneous sensation

                                                           iv.      Loss of fine motor control

b.      Visceral neuropathies

                                                               i.      Sweating dysfunction

                                                             ii.      Pupillary constriction

                                                            iii.      Fixed heart rate

                                                           iv.      Constipation

                                                             v.      Diarrhea

                                                           vi.      Incomplete bladder emptying

                                                          vii.      Sexual dysfunction

4.       Alterations in sensory

a.       Diabetic retinopathy

b.      Cataracts

c.       Glaucoma

5.       Alterations in Renal System

a.       Hypertension

b.      Albuminuria

c.       Edema

d.      Chronic  Renal Failure

6.       Alterations in musculosketetal system

a.       Joint contractures

7.       Alterations in Integumentary System

a.       Foot ulcers

b.      Gangrene of the feet

c.       Atrophic changes

8.       Alterations in Immune System

a.       Impaired Healing

b.      Chronic Skin Infections

c.       Periodontal Disease

d.      Urinary Tract Infection

e.      Vaginitis