DUHOK POLYTECHNIC UNIVERSITY

SHEKHAN MEDICAL TECHNICAL UNIVERSITY

NURSING DEPARTMENT
2023 - 2024

Type II Diabetic Mellitus

Prepared by Supervised by
 Muhammad Mahdi Dr. Ardawan F. Ali
 Adib Abdulsalam
 Nihad Nazil
OUTLINE

 Introduction
 Diabetes
 Main Types of Diabetes
 Type 2 Diabetes
 Pancreases
 Causes of Type 2 Diabetes
 Risk Factors
 Symptoms of Type 2 Diabetes Mellitus
 Laboratory Diagnosis
 Diagnostic Criteria for Diabetes
 Hypoglycemia & Hyperglycemia conditions
 Complications of type 2 diabetes mellitus
 Prevention
 INTRODUCTION

Diabetes is a chronic, metabolic disease characterized by elevated levels of

blood glucose (or blood sugar), which leads over time to serious damage to
the heart, blood vessels, eyes, kidneys and nerves.

The most common is type 2 diabetes, usually in adults, which occurs when
the body becomes resistant to insulin or doesn't make enough insulin. In the
past 3 decades the prevalence of type 2 diabetes has risen dramatically in
countries of all income levels.

About 422 million people worldwide have diabetes, the majority living in
low-and middle-income countries, and 1.5 million deaths are directly
attributed to diabetes each year. Both the number of cases and the prevalence
of diabetes have been steadily increasing over the past few decades.
DIABETES

 Diabetes is a group of metabolic disorders characterized by the presence of hyperglycemia in the absence of
treatment.

 Diabetes occurs either when the pancreas does not produce enough insulin or when the body cannot effectively
use the insulin it produces

 The long-term specific complications of diabetes include retinopathy, nephropathy and neuropathy
 MAIN TYPES OF DIABETES

 Type 1 diabetes
 characterized by deficient insulin production
 requires daily administration of insulin for survival

 Type 2 diabetes
 The most common type of diabetes (>90%)
 Combination of resistance to insulin action and an inadequate insulin
secretory response due to β-cell dysfunction
 Insulin is not required for survival, but often needed it for controlling
blood glucose levels

 Gestational diabetes
 Gestational diabetes is hyperglycemia with blood glucose values above
normal but below those diagnostic of diabetes, occurring during
pregnancy
 TYPE 2 DIABETES

 Type 2 diabetes develops when the body does not use

insulin efficiently and gradually loses the ability to
make enough insulin.
 Insulin is a hormone that controls the amount of
glucose in the blood. Insulin helps glucose produced
by the digestion of carbohydrates move from the
blood into the body’s cells where it can be used for
energy.

 In type 2 diabetes, the body’s cells do not respond

effectively to insulin. This is known as insulin
resistance. it causes glucose to stay in the blood,
leading to a higher than normal level of glucose in
 PANCREAS

 Pancreas a glandular organ located in the abdomen. It makes pancreatic juices, which
contain enzymes that aid in digestion, and it produces several hormones, including insulin.
 CAUSES OF TYPE 2 DIABETES MELLITUS

The causes of Type 2 diabetes mellitus include:

1. Genetic predisposition: People with a family history of the condition are more likely to develop it than those who
do not have that history

2. Obesity or Overweight: Becoming overweight or obese is another cause of type 2 diabetes mellitus. This can
increase of risk developing the disorder by up to 80%

3. Lack of physical activity and high-calorie diet. Being inactive leads to changes in the body composition which
increases blood glucose levels and contributes to an increased risk of developing type 2 diabetes mellitus over time.

4. Depression, Stress, Smoking, Lack of Sleep, and High blood pressure

Eating too many processed foods may also increase the risk of developing this condition because eating too much sugar
can cause weight gain, which increases insulin resistance
Risk Factors
SYMPTOMS OF TYPE 2 DIABETES MELLITUS
LABORATORY DIAGNOSIS

 Random blood sugar (RBS): A blood sample will be taken at a random time to measure sugar levels.
 Fasting blood sugar (FBS): Measures the level of blood glucose after 8 hours of fasting.
 Post prandial blood sugar (PPBS): Measures the level of blood glucose after 2 hours of food intake.
 Glycated hemoglobin test: Also known as HbA1c test, measures an average of blood glucose over 2-3 months.
 Oral glucose tolerance test (OGTT): Measures the levels of blood glucose before and 2 hours after consuming a
glucose solution.
 Urine test: To detect the amount of excess glucose being excreted out of the body.
 TESTS & DIAGNOSTICS FOR TYPE 2 DIABETES MELLITUS

The most common tests used to diagnose type 2 diabetes mellitus are:
 Fasting plasma glucose test (FPGT) - This is a blood test, which measures the amount of glucose in your bloodstream. It can be done
after an overnight fast or on an empty stomach
 Oral glucose tolerance test (OGTT) - This is an oral test that determines how well one’s body uses carbohydrates for energy production
over time. Its process starts with giving you either a liquid sugar drink or solid sugary food that contains carbohydrates and then measures
how much energy it takes for your body to use the available carbohydrates during a period after consuming these foods
 Random blood sugar test - The random blood glucose test is done using a glucometer and test strips at any random time of the day to
check the amount of glucose present in the blood. Other confirmation tests must be taken to confirm type 2 diabetes if the blood sugar level
is greater than 200mg/dl and the condition must be diagnosed
 HbA1c test - This test is used to check average blood glucose levels for 2 to 3 months of time. It is usually done to check how well the
person has managed type 2 diabetes mellitus by taking medicines or insulin. If the HbA1c level is above 6.5 percent your doctor will
confirm if you have a diabetic condition
 Other Tests -
Blood pressure test
Eye and vision test
Foot and infection check
Lipid profile (Fat & Cholesterol check)
Kidney & Liver function test (KFT, LFT)
Vitamin B12 test
BIOCHEMICAL PATHWAYS THAT AFFECT PROCESS AND UTILIZE
GLUCOSE
 Glucose Metabolism:
• In type 2 diabetes, there is impaired glucose uptake by peripheral tissues such as muscle and fat cells
due to insulin resistance.
• Insulin resistance results in decreased glucose transport into cells, leading to elevated blood glucose
levels (hyperglycemia).
• The liver, despite insulin resistance, may continue to produce excess glucose through processes like
gluconeogenesis (the production of glucose from non-carbohydrate sources)
and glycogenolysis (the breakdown of glycogen into glucose),
contributing to hyperglycemia.
 Insulin Secretion and Dysfunction:
• In early stages of type 2 diabetes, the pancreas compensates for insulin resistance by producing more insulin.
• Over time, the pancreatic beta cells may become exhausted and unable to sustain increased insulin production,
leading to relative insulin deficiency.
• Eventually, insulin production may decline, exacerbating hyperglycemia and contributing to the progression of
type 2 diabetes.
 Lipid Metabolism:
• Type 2 diabetes is often associated with abnormalities in lipid metabolism, including elevated levels of circulating
free fatty acids (FFAs) and triglycerides.
• Increased FFAs can contribute to insulin resistance by interfering with insulin signaling pathways in peripheral
tissues.
• Dyslipidemia (abnormal lipid levels) in type 2 diabetes is characterized by increased levels of triglycerides,
decreased levels of high-density lipoprotein (HDL) cholesterol, and changes in the size and density of low-density
lipoprotein (LDL) particles, which may increase the risk of cardiovascular disease.
Diagnostic Criteria for Diabetes
HYPOGLYCEMIA & HYPERGLYCEMIA CONDITIONS
COMPLICATIONS OF TYPE 2 DIABETES MELLITUS
Prevention
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