Type 2 Diabetes
MEDICAL ANIMATION TRANSCRIPT: Type 2 diabetes is a condition in which your blood sugar level is too high. After you eat foods that contain carbohydrates, chemicals in your small intestine break them down into single sugar molecules called glucose. Next, the cells lining your small intestine absorb the glucose, which passes into the bloodstream. When the blood reaches your pancreas, beta cells inside the pancreas detect the rising glucose levels. To reduce the glucose level, your beta cells release insulin into your bloodstream. As the blood circulates through your body, the insulin and glucose exit the bloodstream into your tissues to reach your body's cells. Most cells of the body have certain receptors on their surface that bind to the circulating insulin. Insulin acts like a key in a lock to open up the cell so that the circulating glucose can get inside the cell. Now, your cell can use the glucose to produce the energy it needs to function properly. If you have type 2 diabetes, either your pancreas does not produce enough insulin or your body's cells resist it's effects or both. If you have insulin resistance, your insulin cannot unlock the cells to let glucose in because the locks, called receptors, are abnormal or missing. As a result, glucose is locked out of your cells. Consequently, the amount of glucose builds up in your bloodstream in a condition called hyperglycemia. To compensate for hyperglycemia, your pancreas produces more and more insulin. Your overworked beta cells try to keep up with the demand, but gradually lose their ability to produce enough insulin. Due to hyperglycemia and the lack of insulin, you may experience the following classic symptoms of diabetes-- excessive hunger, excessive thirst, increased urine volume, and unexplained weight loss. Symptoms of type 2 diabetes that may appear over time include fatigue, recurrent infections, changes in vision, itching, and tingling or prickling sensations in your skin. Life threatening complications of type 2 diabetes include diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic syndrome, and hypoglycemia. If you don't receive treatment for hyperglycemia, diabetic ketoacidosis can result. Because you no longer have enough insulin circulating in your blood, your cells can't get the glucose they need to produce energy. As a result, your body turns to fats and proteins as an alternative source of energy. During the fat breakdown process, certain byproducts, known as ketone bodies, accumulate in your blood, resulting in a condition called ketosis. If ketones build up to dangerously high levels in your bloodstream, you may develop diabetic ketoacidosis, or DKA, which can lead to coma and death. Another complication resulting from failure to treat hyperglycemia is called hyperosmolar hyperglycemic nonketotic syndrome, or HHNS. As the insulin deficiency continues, your blood glucose level increases. In response, your kidneys filter excess glucose out of the blood into urine, along with large amounts of water. Unless you consume large amounts of water, your kidneys cannot keep up with the demand of removing the glucose from your bloodstream and diluting it sufficiently in urine. As a result, your blood becomes much more concentrated than normal, a condition called hyperosmolarity. Hyperosmolarity pulls water out of your body tissues into your bloodstream, causing severe dehydration, which may lead to hyperosmolar hyperglycemic nonketotic syndrome. Neurological symptoms, such as seizures and coma, can occur. If you take an excessive dose of diabetic medication, you may experience an acute complication called hypoglycemia or insulin shock. Excessive insulin or oral hypoglycemic medication causes too much glucose to go into cells, leaving an insufficient amount in your bloodstream. Certain organs, such as the brain, need a constant energy supply to function properly. Because the brain's primary source of energy is glucose, it is the first organ affected by lower glucose levels. When your brain cells, called neurons, are starved for glucose, they start to malfunction, causing symptoms such as nervousness, shakiness, and confusion. If your glucose level continues to drop, the electrical activity of your neurons diminishes significantly, resulting in seizures or diabetic coma. Over time, chronic poorly controlled type 2 diabetes can cause degenerative tissue damage, resulting in long term complications such as atherosclerosis, blindness, neuropathy, and renal failure. To avoid the complications of type 2 diabetes, you can take steps to keep your glucose level within a normal range using a combination of blood glucose monitoring, a healthy diet, regular exercise, and medications as necessary. You will need to check the level of glucose in your blood frequently with a glucometer. To do this, you will prick your finger with a small needle called a lancet and place a drop of blood on the strip attached to the glucometer. Based on your blood glucose level, you may need to adjust your meals, physical activity, or medication dose. Eating a healthy diet will help to lower your glucose level when you eat a diet rich in fruits, vegetables, and whole grains, have meals and snacks about the same time every day, consume the right balance of carbohydrates, proteins, and fat, and minimize your intake of high sugar foods. Getting regular exercise-- even just 30 minutes a day-- will lower your blood glucose level, decrease insulin resistance, and may lead to weight loss. You may need to take one or more diabetic medications to help lower blood glucose. Some of these medications increase insulin production in your pancreas. Others decrease insulin resistance in your skeletal muscles. Some treatments increase insulin sensitivity in certain tissues. Others promote a slight decrease in absorption of glucose in your digestive system. If your type 2 diabetes cannot be controlled with diet, exercise, and oral medications, your doctor may prescribe insulin and train you to inject it just under your skin. By treating and controlling your blood glucose level, you may prevent the occurrence of complications from type 2 diabetes.