CHAPTER 1

I. Nature of Patient's Illness

A 43-year-old female diagnosed with Type 2 Diabetes Mellitus, manages her

condition through a carefully tailored diet and medication. Being diabetic, she strictly
avoids foods high in sugar, as they dangerously elevate her blood glucose levels. Her diet
primarily consists of sugar-free foods, lean proteins like chicken breasts, a variety of
fruits and vegetables, and sugar-free yogurt, ensuring a balanced intake while minimizing
blood sugar spikes. The medication Pregabalin, prescribed at a dosage of 75 mg, assists
in managing her diabetes-related symptoms. As a diabetic patient, Ma. Consuelo's
nutritional choices are crucial in maintaining her health and managing her illness
effectively, reflecting the importance of diet in the control of Type 2 Diabetes. The
underlying challenge in Type II Diabetes revolves around the diminished responsiveness
of the body to insulin, a pivotal hormone essential for the regulation of blood glucose
levels. In this pathological condition, the body's cellular response to insulin diminishes,
impeding the hormone's crucial role in facilitating the entry of glucose into cells for
energy production. Consequently, there is an elevation in blood glucose levels, resulting
in a state of hyperglycemia. As time progresses, the pancreas, responsible for insulin
production, encounters difficulties in maintaining normal blood sugar levels, contributing
to the advancement of the disease. Unlike Type 1 Diabetes, which involves autoimmune
destruction of insulin-producing cells, Type II Diabetes often develops gradually and is
strongly associated with lifestyle elements, such as sedentary behavior and poor dietary
habits, along with a genetic predisposition (American Diabetes Association, 2021).

II. Symptoms

A patient with a diverse linguistic background has been managing her Type II
Diabetes Mellitus primarily through dietary modifications. She focuses on consuming
sugar-free foods and snacks, such as biscuits, chicken breasts, fruits, vegetables, and
sugar-free yogurt, while strictly avoiding items high in sugar. Despite adhering to her
dietary restrictions, she may experience symptoms common in Type II diabetes, such as
increased thirst, frequent urination, fatigue, and blurred vision. Additionally, her
medication, Pregabalin 75 mg, suggests she might also be dealing with neuropathic pain,
a common complication in diabetic patients. Symptoms of type 2 diabetes often develop
slowly—over several years—and can be so mild that you might not even notice them.
Many people have no symptoms. Some people do not find out they have the disease until
they have diabetes-related health problems, such as blurred vision or heart disease.
(National Institute of Diabetes and Digestive and Kidney Diseases, 2023)

III. Causes

Several factors contribute to the development of type 2 diabetes, including:

 Genetic Factors: A family history of diabetes can increase the risk of developing
type 2 diabetes. Specific genetic factors may influence insulin resistance and beta-
cell function.

 Obesity: Excess body weight, particularly abdominal obesity, is a significant risk

factor for type 2 diabetes. Adipose tissue, especially around the abdomen, secretes
hormones and inflammatory substances that can contribute to insulin resistance.

 Insulin Resistance: Cells in the body become resistant to the effects of insulin,
leading to impaired glucose uptake. This is a key factor in the development of
type 2 diabetes.

 Physical Inactivity: Lack of regular physical activity is associated with an

increased risk of type 2 diabetes. Exercise helps improve insulin sensitivity and
regulate blood sugar levels.

 Unhealthy Diet: Consuming a diet high in refined carbohydrates, sugars, and

saturated fats can contribute to obesity and insulin resistance.

 Age: The risk of type 2 diabetes increases with age, especially after the age of 45.
Aging is often associated with a decline in physical activity and changes in
metabolism.
  Ethnicity: Certain ethnic groups, such as African Americans, Hispanic/Latino
Americans, Native Americans, and Asian Americans, have a higher predisposition
to developing type 2 diabetes.

 Gestational Diabetes: Women who had gestational diabetes during pregnancy are
at an increased risk of developing type 2 diabetes later in life.

One major cause of DM TYPE 2 is obesity, as it is often linked to a sedentary

lifestyle and high-calorie diets (American Diabetes Association, 2018). Ms. MCJ, with a
weight of 73 kg and a height of 5'4", falls into this risk category depending on her body
mass index (BMI). Another significant cause is her dietary habits, a high intake of foods
rich in sugar and fat increases the risk of Type 2 diabetes mellitus. Her diet, which
actively avoids high-sugar content foods and includes sugar-free foods and snacks,
suggests an awareness of this risk. Type 2 diabetes mellitus is a complex metabolic
disorder characterized by insulin resistance and impaired insulin secretion (Centers for
Disease Control and Prevention, 2022).

IV. Risk Factors

Type II Diabetes Mellitus is a complex condition with multiple risk factors that
are intricately interwoven with lifestyle choices and genetic predisposition. According to
the (National Institutes of Health, 2018), obesity is a significant risk factor for the
development of Type II Diabetes, as it increases the body's resistance to insulin. This is
particularly relevant in the case of Ms. MCJ, who at 73 kg and a height of 5'4", might be
at an increased risk considering her body mass index. Additionally, the NIH highlights
that a diet high in sugar and processed foods substantially raises the risk of diabetes
(National Institute of Diabetes and Digestive and Kidney Diseases, 2023), aligning with
Ms. MCJ's dietary restrictions that avoid high sugar content foods. Furthermore, genetic
factors play a role, and individuals with a family history of diabetes are more prone to
developing the condition (Leys, 2018).
The risk factors for developing type 2 diabetes can be categorized into modifiable and
non-modifiable factors.

Here are some key risk factors:

 Age: The risk of developing type 2 diabetes increases with age, especially after 45
years.

 Family History and Genetics: Individuals with a family history of diabetes are at a
higher risk. Certain genetic factors also contribute to the predisposition to type 2
diabetes.

 Unhealthy Diet: Diets high in refined carbohydrates, sugars, and saturated fats,
along with low fiber intake, contribute to the development of type 2 diabetes.

 Insulin Resistance: Insulin resistance occurs when cells do not respond effectively
to insulin, leading to elevated blood glucose levels. It is a key factor in the
development of type 2 diabetes.

 Ethnicity: Certain ethnic groups, such as African Americans, Hispanic/Latino

Americans, Native Americans, and Asian Americans, are at a higher risk of
developing type 2 diabetes.

 Gestational Diabetes: Women who had gestational diabetes during pregnancy are
at an increased risk of developing type 2 diabetes later in life.

 Hypertension (High Blood Pressure): Hypertension is a common comorbidity of

type 2 diabetes and contributes to cardiovascular complications.

 Polycystic Ovary Syndrome (PCOS): Women with PCOS are at an increased risk
of developing insulin resistance and type 2 diabetes.
REFERENCES:

Genetics of type 2 diabetes. (2018, August 1). PubMed.

https://pubmed.ncbi.nlm.nih.gov/33651556/

Ley, S. H. (2018, August 1). Risk factors for type 2 diabetes. Diabetes in America
- NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK567966/

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

(2023, July 19). National Institute of Diabetes and Digestive and Kidney Diseases.
https://www.niddk.nih.gov/

Centers for Disease Control and Prevention. (2022). Type 2 Diabetes.

https://www.cdc.gov/diabetes/basics/type2.html

American Diabetes Association. (2021). Classification and Diagnosis of Diabetes:

Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement_1), S15–
S33. doi: 10.2337/dc21-S002