Nursing: Diabetes Mellitus Type II


Diabetes Mellitus II comprises a group of metabolic diseases typified by high blood sugar levels in the blood that is accrued to the malfunction of the Insulin hormone; upsetting the way the blood cells utilize glucose (Wingard, 1999). For the body cells to function properly, they must have an ample supply of sugar which is consumed by the intestinal cells in form of glucose. These intestinal cells obtain the glucose from the surrounding blood with the help of a hormone called insulin which activates the metabolic process of glucose absorption. Insulin is a chemical blood messenger which helps the body cells in the process of absorbing glucose.

When the glucose level in the body is excessive, the pancreas secretes insulin hormone into the blood to enhance its absorption by the blood cells. On the other hand, when glucose levels are low, the insulin hormone is produced at a lower rate to ensure that the rate of glucose absorption is minimized.

When blood glucose levels plummet below 70 mg/dl, a condition known as hypoglycemia occurs and in this case, the blood constitutes low blood glucose (Kannel, 2000). When the level of glucose in blood hikes above 180 mg/dl, a medical condition known as hyperglycemia occurs, whereby the blood comprises more than necessary glucose (Kannel, 2000). To ensure that the blood sugar is kept at the optimum acceptable level, the Insulin hormone must be secreted in accordance with the levels of glucose in the blood. If the hormone insulin is not produced in sufficient supply as per the blood glucose level, excessive sugar is accumulated in the blood. When an individual has this medical condition, their urine normally shows traces of glucose and the medical disorder is termed as Diabetes Mellitus.

The Two Types Of Diabetes

Normally there are two types of diabetes categorized as Diabetes type one and Diabetes type two. In order for Diabetes Type one to occur, the pancreas, the insulin-producing organ in the body, goes through autoimmune attack by antibodies manufactured by the immune system; consequently, it incapacitates the ability of the pancreas to make or secrete insulin (Barnett, 2003).

The patients who are detected with Diabetes type one tend to have abnormal antibodies which are caustic in nature and which attack and hinder the normal production of the insulin hormone by the pancreas. Antibodies are constituent proteins found in the human immune system; some may be destructive while others are constructive to aid the normal function of the body organs. When the human immune system produces the destructive antibodies, they proceed to attack beta cells located in the pancreas and this hinders the normal production of insulin. Patients suffering from Diabetes type one must get artificial insulin injection through medication to help the body in the glucose absorption process.

The actual problem in Diabetes 1 is that the human immune system mistakably produces lethal antibodies and inflammatory cells that cause damage to the human body (Kannel, 2000). When the human beta cells in the pancreas are attacked their normal functions become impaired and they are unable to produce enough insulin to cater to the body’s requirements for the hormone. Contemporary research has established that hereditary disorders are the key reasons why the human immune system may sometimes produce abnormal antibodies (Stamler, 2005).

The other type of Diabetes is known as Diabetes Mellitus type two; the patients suffering from this disorder are termed as non-insulin dependent patients. The patients don’t have a deficiency in the production of the insulin hormone; rather, in this case, the pancreas demonstrates failure whereby it can produce excessive or insufficient insulin hormone into the blood. In some other cases, the body organs also tend to resist the insulin hormone. When the body cells resist insulin, the absorption process is impeded leading to massive accumulation of blood sugar levels resulting in Diabetes Mellitus II. The key cause of this disorder is not the lack of insulin in the bloodstream as in the case with diabetes, rather, in this case, the blood cells resist the insulin hormone leading to deterred glucose absorption.

In special cases, Diabetes Mellitus II victims may exhibit impaired secretion of insulin into the blood, the beta cells gradually become depleted leading to poor glucose control. Steadily, the liver of the victims suffering from this disorder begins to secrete glucose into the blood through the process of gluconeogenesis (whereby the glucose stored by the liver cells in form of glycogen compounds is broken back to simple glucose and is released to the blood cells (Wingard, 1999).

Gluconeogenesis in return leads to elevation of the blood sugar level further accelerating the excessive glucose crisis. Diabetes Mellitus II is associated with what is commonly known as sweet urine because the excessive glucose found in the blood spills into the urine and it is excreted like a body waste through the urine. Diabetes is an unremitting medical condition, which lasts for a lifetime and can only be controlled.

Diabetes Mellitus II Causal factors

Diabetes Mellitus two occurs in an individual when the pancreas is unable to produce the optimum level of insulin hormone into blood cells. In this case, the pancreas may produce little or excessive insulin that leads to body cells breakdown. When the blood cells in a human body are unable to use insulin properly in the glucose absorption process, the blood accumulates excessive sugar leading to diabetes II (Kannel, 2000). The body cells mostly affected by this pancreatic malfunction are the body muscles and fat tissues (Wingard, 2005). The disorder comes as a result of body cells resisting insulin and also as a result of beta cells destruction which inhibits the insulin production process.

Glucose is a simple form of sugar broken down through a metabolic process to help generate energy sufficient to sustain the human cells and ultimately the normal human body functions. When glucose is broken down, it is normally released into the bloodstream for the intestinal cells to absorb through the osmosis process. The cells then proceed to transport the glucose via the bloodstream to all the other body cells to be utilized for energy production. In other words, the human body obtains energy from glucose which is obtained from the blood through the cells and transported to the human organs and cells spawning energy for them to function normally.

Naturally, the blood cells need the chemical messengers known as the insulin hormone to aid in the glucose absorption process, thus when insulin is lacking the blood cells are starved and the normal body functions are hindered. The arising situation is that profuse unutilized glucose is extravagantly excreted into the urine while the blood cells starve for glucose energy (Kannel, 2000). When the blood cells resist the insulin hormone, their ability to absorb glucose is obstructed, thus the human body lacks enough supply of energy leading to weakness and fatigue. As outlined, in diabetic patients the insulin hormone may either be absent, insufficient to cater for body needs or extravagantly secreted into the blood stream and all these factors elevate blood glucose levels giving rise to diabetes Mellitus II.

Symptoms Associated With Diabetes Mellitus Two

Diabetes Mellitus type two develops slowly and may take a while before an individual detects it. Many victims of the disease may stay for as long as eight years without realizing that they have the disease because its symptoms are often subtle and develop over a long time (Wingard, 1999). Gradually, when symptoms associated with this disease develop they may vary from one individual to another. The signs that are prominently seen in the first phases of discovery are increased thirst and frequent urination. (Barnett, 2003). The number one sign which should trigger alarm on an individual is the increasing desire to drink water followed by frequent urination.

These conditions arise owing to the excessive glucose circulating in the body that draws water from body tissues leading to dehydration. The sugar in blood creates an osmotic gradient so that the fluid found in the body cells and tissues is drawn out and this leads to dehydration. Dehydration, triggers thirst, causing the diabetic patient to crave water recurrently and automatically, this causes the patient to frequent the urinal.

Another commonly detected signs of Diabetes Mellitus include manifestation of flu-like signs such as body weakness and loss of appetite. This sign is commonly found in patients suffering from Diabetes Mellitus II because the blood cells are starved. When blood cells resist insulin they fail to absorb glucose into the blood system thus energy is not transmitted from the blood to the other body organs and tissues. All these factors lead to lack of sugar or energy in the body and in the end the individual may feel weak. Blood sugar is the main source of energy for the body, when it is not transmitted by the blood cells, the body lacks fuel to activate its functions and that is why Diabetic patients tend to fatigue, and experience general body weakness.

In its advanced state, diabetes Mellitus II is associated with body weight loss or gain, this symptom is manifested on the patient as the human body fight to reimburse for the lost fluids and sugar through urine excretion(Barnett, 2003). The patient may react to this insufficiency by eating more food leading to excessive weight gain. Whilst the patient may be consuming a lot of food, in some cases he may lose weight when the body muscle tissues are not supplied with ample amount of glucose necessary for growth and body energy.

Due to the excessively accumulated glucose in the blood, the sugar in the blood pulls out fluid from the body tissues including the eye lenses and this may lead to blurred vision (Stamler, 2005). When this occurs the patient is unable to focus, this problem can be highly minimized by regulating the amount of glucose in the blood, some patients may manifest mild vision problem while in the severe diabetic cases people may lose there sight totally.

Neuropathy, also known as nerve damage may also arise in diabetic patients. This condition occurs when the excessive sugar in the blood damages the small blood vessels to the bodily nerves and this garners many other symptoms such as lack of sensation on feet and hands and burning pain in legs and feet (Barnett, 2003). Research has established that more men of 50 and above ages with diabetes may experience sexual dysfunction due to the damage of the nerves necessary for producing erection(Kannel, 2000).

Another prominently symptom of Diabetes type two is red, swollen, tender gums. Owing to the Diabetes disease, patients have an increased risk of gum infection and in the bone that hold teeth (Kannel, 2000). When this happens, the patient’s gum tends to pull away from the teeth causing the teeth to become loose. Later the patient end to develop sores or pus pockets in the gum.

The Impact Of Diabetes Mellitus Two (II)

As the malady of diabetic problem escalates, the patient may exhibit nerve damage, kidney failure or blindness (Barnett, 2003). These adverse bodily damages are associated with the damage of small vessels, leading to micro-vascular disease (Stamler, 2005). Diabetes plays a key role in accentuating the hardening and tapering or contracting of the blood arteries, which eventually garner other lethal medical conditions like stroke and heart diseases.

Research conducted by Kannel established that 8% of the US populace, which translates to seventeen million is affected by Diabetes Mellitus (Kannel, 2000) and through the economic scope, the annual cost associated with he illness in the year 2004 was estimated at ninety eight billion dollars in the United States (Stamler, 2005). Diabetes has rampantly claimed lives amongst the elderly in the US; it is rated as the third leading cause of death after the heart disease and cancer (Kannel, 2000).

Diabetes Mellitus II Risk Factors

Diabetes type two is commonly found in individuals aged thirty years and above, the incidence of its occurrence amplifies with the age. So that the older an individual is, the higher the chances of getting Diabetes type two. In the ancient days diabetes two was only found amongst the oldest society members. In the recent past however, a very perturbing trend of Diabetes Mellitus II in young people has arisen, the disease is now common amongst the teens and in childhood, this changing pattern in prevalence could be accrued to body weight gain, poor eating habits and minimal or lack of body exercises.

Whilst, this kind of diabetes may be hereditary, other risk factors associated with it are obesity and inactivity. There is a very high co-relation between obesity and the risk of developing diabetes two and this case is applicable in both the adults and the young ones. A great percentage of the people who are diabetic tend to become diabetic as they grow old as the excessive weight predisposes them to the danger of pancreatic malfunction leading to diabetes.

Data collected by Stamler demonstrates that for each elapsing decade, after forty years, irrespective of the weight factor, there is an increased occurrence of diabetes incidences (Stamler, 2005). The diabetes two prevalence, heightens by twenty percent amongst the people aged between sixty five and seventy four. Diabetes two prevalence differs in respect to the numerous ethnic groups; amongst the Caucasians the prevalence is rated at six percent while amongst the African Americans in the US, the prevalence rates have been placed at ten percent. In the Hispanic community, the rate is established at a bit higher level of fifteen percent; while the Native American community is rated at twenty to fifty percent (Barnett, 2003).

Diabetes Mellitus II Diagnosis

The most commonly used method to detect and diagnose Diabetes Mellitus II disease is the method referred as fasting blood glucose or the sugar test (Barnett, 2003). Performing this test is simple and convenient. In order for the test to be conducted, the patient has to forge his meal for one night; at least his stomach should be empty for eight hours after which a sample of his blood is obtained by the medical practitioner and send to the medical laboratory for testing. In a normal case, the patient should have a fasting plasma glucose level of less than hundred milligrams per deciliter (mg/dl) (Wingard, 1999).

If the Fasting plasma glucose levels exceed 126 mg/dl after the doctor conducts on two or more tests on two different days, the person is termed as diabetic(Stamler, 2005). Another simplified way of testing diabetes mellitus two is by drawing the blood sample randomly and when the level of the random sample exceed 200 mg/dl or higher it will be an indicator that the patient is diabetic.

Coping With Diabetes Mellitus II

It is important for all the patients of Diabetes Mellitus II to develop mechanisms of coping and managing the disease to ensure health fitness and ultimately prolonged livelihood. The diabetic patients should pursue physical treatments such as taking pills to make sure that the adverse effects of diabetes are minimized. Generally, diabetes is a very rough diseases on the body organs especially the kidneys and the eyes (Stamler, 2005). The Diabetes patients should embrace all the necessary methodologies in order to assuage the coarseness of the malady.

Diabetic patients should follow a specific diet course of therapy and do the right exercises as instructed by the medical practitioners to substitute for the body weaknesses. The patients should avoid taking meals rich in starch and sugar as they inject a lot of glucose into the blood and cause the body to malfunction. Diets rich in fiber and roughage should be encouraged as they bolster the immune system and give the body resilience to cope with the weaknesses associated with the disease.

Patients should have a will power to cope with the diabetes; in many cases the patients might have to cut down on some diets and embrace a living regimen in their life which helps to bolster physical fitness, mental agility and body immunity steadiness. Although at first, adjusting to the Diabetes disease is an uphill task, it is important that the patients become brave in order to take care of themselves and attain normalcy in life. Good planning and working in consensus with medical practitioners helps the patients to go a mileage in combating the ill side effects associated with Diabetes. Strength and fortitude is very necessary when dealing with tough medical predicaments, therefore, individuals have to summon on regular basis the determination to keep fighting in order to achieve potency and medical stability.

Conclusion And Recommendations

Diabetes mellitus II is a terminal disease which must be managed acutely in order to minimize ill effects. The victims of diabetes two must be handled with a lot of patience and care as they often feel stressed and overburdened by the management practices carried out to manage the disease. The medical practitioners tending to diabetes II patients should train them how to carry out routine practices such as testing the level of blood sugar, diet observation and regular physical exercise (Barnett, 2003). Other medical management practices include taking insulin substitutes and having ample time for rest and rebounding.

The medical practitioners should show apathy when dealing with newly detected diabetic mellitus two patients. This is because most of the people once detected with the disease tend to be depressed. The order of going for medical check ups, changing diets and lifestyles in an instant is very strenuous. So the doctors should be supportive and have an open and honest discussion with their patients in order to usher them into the new lifestyle without complications. Family members of the patient should be involved in the treatment therapy whereby they should play an active role in helping the patients to manage the disease. Family members should remind the patients on when to take their drugs, help them in testing blood glucose level, help them to healthy diet and stick with and assist them to stick to the formulated physical exercise plan.


Barnett, H. D. (2003). Hypertension and Diabetes. Science Press: London.

Kannel, W.B. (2000). Hyperglycemia, Diabetes and Vascular Disease. Ruderman Publishers: Oxford.

Stamler, J, N. (2005). Diabetes And The Associated Risk Factors. Factor Intervention Trial. Diabetes Care journal Volume 18(3): pg 411-424.

Wingard, J. (1999). Managing And Combating The Symptoms Of Diabetes. Washington DC: US Government Printing Office.