Task Solutions | Epidemiology of Type 2 Diabetes: UM4602

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Running head: DIABETES TYPE 2
Diabetes Type 2
Name of the Student
Name of the University
Author Note
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Biology and Epidemiology of Type 2 Diabetes Mellitus
Definition
The disease type 2 diabetes mellitus is acommon chronic disease around the world
that is characterized by the hyperglycaemia conditions caused due to the issue of insulin
resistance and irregular functionality of pancreatic Î’-cells that is responsible for producing
inadequate or non-functional levels of insulin (DeFronzo 2018 ).
Pathology/pathophysiology
Hyperinsulinemia, which is linked to the early phases of T2DM, is caused by
pancreatic B cells compensating for insulin resistance. Insulin resistance (IR) results in poor
glucose metabolism by target tissues, resulting in hyperglycemia (Thomas et al. 2019 ). IR
begins with an increase in BMI, which is a risk factor, but the exact process is uncertain.
Pancreatic B-cells get exhausted along with the disease progression, resulting in inadequate
levels of plasma insulin and an inability to maintain glucose homeostasis, leading in
hyperglycemia (Galicia-Garcia et al. 2020 ). According to the study of Orliaguet, Ejlalmanesh,
and Alzaid (2020), adipose tissue expansion is linked to aberrant inflammatory signalling
paths, such as adipokine dysregulation (irregular manner of cytokines production by adipose
tissue), which leads to insulin resistance.
Signs/ Symptoms and Diagnosis
Polydipsia, recurrent infections, polyurea, sweet-smelling breath (sign of
ketoacidosis), lethargy, impaired vision and acanthosis nigricans are all common clinical
symptoms of T2DM (indicating insulin resistance) (Dou et al. 2017 ). To diagnose T2DM in
adults, HbAc1 values, plasma glucose concentration levels, and clinical characteristics based
on patient history are commonly utilized (NICE 2022).
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Fig.1- Symptoms of Diabetes
Epidemiology of the Disease
While discussing about the epidemiology of the disease conditions in UK, it can be
reported that the approximately 7 per cent of UK population are living with the problem of
diabetes and along with this the most alarming thing is that almost 1 million people are
having the type 2diabetes however they are undiagnosed completely (Whicher, Oâ€Neill and
Holt 2020). It is reported that, in UK, approximately one out of 40 people are suffering from
the diabetes type 2in the country that revealed that approximately 3.8 million people have the
disease conditions in UK and among them 90 per cent of the cases are type 2 diabetes
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mellitus and it is estimated that by the end of 2030 the number of cases will reach to 5.5
million cases (Whicher, Oâ€Neill and Holt 2020). The scenario of the whole world is also
alarming and according to the study of Khan et al. (2020) it was reported that in the year of
2017, almost 462 million people worldwide was suffering from the Type 2diabetes mellitus
which was 6.28 per cent of world population. The age stratified data of the Type 2diabetes
mellitus revealed that the disease affected 4.4 per cent of the individuals under the age group
of 15 years to 49 years, 15 per cent of the individuals were under the age group of 50 years to
69 years and 22 per cent of the diagnosed cases were found among the people under the age
group of 70 years or above (Khan et al. 2020). The prevalence rate of the disease indicated
that the disease had the prevalence rate of 6059 cases per 100,000 population. In terms of the
death cases, it was reported that more than 1 million cases of deaths per year can be
contributed due to the diabetes conditions that makes the disease the ninth foremost cause of
death in the world. It is estimated that the global prevalence of the disease will reach 7079
individuals per 100,000 people by the end of 2030 (Khan et al. 2020).
Common risk factors (modifiable and non-modifiable)
Genetics, family history, age, and ethnicity are non-modifiable risk factors for T2DM,
and BMI, medical history of cardiovascular diseases, hypertension, PCOS, and sedentary
lifestyle are modifiable risk factors (DeFronzo 2018). T2DM and higher BMI are highly
connected and have been proved to be linked in research investigating its pathogenesis, with
90 percent of T2DM patients being overweight or obese. As aresult, the self-management
strategies examined in this research, specifically improved food and nutrition, will focus on
lowering BMI, achangeable risk factor, in diabetic patients (DeFronzo 2018 ).
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Aims and Objectives
The goal of this study is to find the best effective pharmaceutical, lifestyle, and social
measures for T2DM control. This will be accomplished through a comprehensive
examination of relevant peer-reviewed literature. This research will examine and analyse the
efficacy of various medicinal and dietary strategies in managing T2DM and decreasing the
condition’s key risk factor, BMI.
Medical Intervention
Current Approaches
As apart of the current treatment method for the managing the T2DM is the use of the
metformin monotherapy and it is considered as the first line treatment although it is
contradicted in case of the patients having the problem of renal disease. The use of the
metformin drug is most common for the management of the disease and the drug exerts its
function by preventing the production of hepatic glucose. On the other hand, as apart of the
second line therapy the use dual therapy that is the combination therapy (metformin+ other
drugs including either a pioglitazone, sulfonylurea, a sodium glucose co-transporter 2
inhibitor or DDP-4 inhibitor (SGLT-2 )). The current study compared and assesses the
effectiveness of the first line treatment and the second line treatment that is the use of the
pioglitazone along with metformin.
In the study of Kanto et al. (2018) the researchers reported the efficacy of the
metformin drug in managing the T2DM among the patients. The researchers included 71
Japanese patients having the T2DM. The foremost goal of the contemporary study was to
identify the effect of dose of drug and its efficacy along with the protection of high dose of
the metformin drug among the Japanese adults. 71 participants with the disease condition
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were prospectively followed for identifying the impacts of dosage and incidence of dosing on
the effectiveness and protection of metformin during hospital days. The study results reported
that the significant improvement of the daily glucose level of the body was observed followed
by the metformin amounts up to 1,500 mg/day, along with a trend towards additional
development noted at 2,250 mg/day. The study results also reported that the effectiveness of
the metformin at the dose of 1500mg/ day were similar in case the drug was given either
twice or thrice per day. The effectiveness of the conventional first line therapy was also
reported in the study of Ji et al. (2018) where the researchers performed an open-label, phase
IV interventional, randomized, multicentred study enrolling the Chinese T2DM patients to
obtain either metformin IR or metformin XR along awith a2-week observation period, a16-
week medical treatment period and a2-week follow-up period lacking treatment. The study
results reported that the use of the XR form of drug was not superior compared to the IR form
of the drug in terms of the least squares mean or LSM change in HbA1c from baseline to
week 16.
The comparative analysis between the first line and the second line treatment of the
T2DM, it can be reported that the use of the Pioglitazone effectively managed the level of
blood glucose in abetter manner among the patients whose T2DM cannot be managed by
using the metformin. The study of Jameshorani et al. (2017) reported to conduct a
randomized controlled trial study to assess the effectiveness of Pioglitazone. In this
comparative analysis study, the researchers performed a 12-week, randomised, open-label
and single centre study including 160 patients. The mean alteration in the HbA1c level was
reported as ± 1.20 with pioglitazone and in case of the fasting blood sugar (FBS) the change
was reported as -20.53 ± 53.97 mg/dl with pioglitazone. The study results concluded that the
drug was effective in managing the diabetes conditions among the patients with ineffective
metformin treatment. In another randomized controlled trial performed by Kim et al. (2017)
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the researchers also performed the comparative analysis between the metformin and
pioglitazone in management of the diabetes type 2 conditions among the patients. The 16-
week randomized controlled trial the researchers included 31 participants. The study results
contradicted the previous study findings and revealed that the pioglitazone was not able to
control the glycaemic inconsistency among the participants having the issue of type 2
diabetes who was incompetently controlled after using the metformin monotherapy.
Self-Management for the Chronic Conditions
The current report addresses the modifiable risk factor for the T2DM is the higher
BMI that is closely associated with the onset and progression of the T2DM among the
patients. In this regard, it can be reported that the use of the Mediterranean diet (MedDiet)
and the low-fat diet can be useful for lowering the BMI of the patients of T2DM. MedDiet
has numerous forms and is usually used in South France, Crete, Greece and parts of Italy.
The diet classically contains 2223 kilocalories (37% is fat) and generally comprises of low
red meats and dairy. Waist circumference was pointedly reduced in men after consuming a
Med Diet. The effectiveness of the MedDiet in managing the obesity condition as apart of
the BMI that is arisk factor for T2DM was reported in the study of Park et al. (2017). In this
cross-sectional study, the researchers obtained the data from 4700 adult individuals under the
age group of 20 –90 year without having any prior history of cardiovascular disease, cancer,
hypertension and diabetes based on the NHANES III, 1988 –1994. The study results reported
that the adherence to the MedDiet was allied with the lower BMI along with asignificant p
value of less than 0.005 (in kg/m 2;P = 0.004) and the waist circumference of the participants
were also reported to be reduced by 2.7 cm along with asignificant pvalue of less than 0.001
(P