1. Type 2 diabetes

2. Incidence of diabetes
In Finland about 40 000 patients with type 1 diabetes
160 000 type 2 patients (according to National Public Health Institute)

3. Progression of disease
The type 2 diabetes
-result of decreased secretion of insulin in beta-cells in pancreas
-insulin resistance
When there is not enough insulin in the blood, blood glucose levels rise
→ insufficient insulin for glucose uptake by others cells such as muscle, fat etc.

4. Progression of disease
Insulin resistance
-insulin has lost its ability to absorb
glucose
The disease is for a long time symptomless
Symptoms
-feeling of thirst, fatigue, increased
urination, blurred vision

5. Long term complications of diabetes
Neuropathy (damage to neurons, weakened vision, numbness, tingling, impotence)
Nephropathy (renal failure, protein in urine)
Foot problems
-foot infections and amputations

6. Oral Medicines 1. Metformin -reduce hepatic glucose production
-strengthen insulin’s activity
2. Rosiglitazone and pioglitazone
-treat insulin resistance

7. Oral Medicines
3. Sulphonyurea drugs act by stimulating the pancreas to release more insulin
-Chlorpropamide
-Glipizide
-Glyburide

8. Oral Medicines 4. Alpha-glucosidase inhibitors
-delay the absorption of carbohydrates in the gut by inhibiting alpha-glucoside enzymes
-Acarbose
-Miglitol
5. Guar gum
-a water-soluble fibre
-delays the absorption of food
-lower cholesterol levels

9. Insulin

10. Insulin 6. Insulin -injecting under the skin (subcutaneous fat)
Different kinds of insulin preparations
-short-acting
-long- and very-long acting
Insulin medication will be started if dietary changes and oral medicines don’ t work enough to normalize patient blood glucose levels

11. Lifestyle factors 7. Diet -Most type 2 diabetes patients are
overweight
-Low fat, low sugar, low salt and plenty of
fibre
-Losing weight improves insulin activity
8. Exercise
-exercise decreases insulin resistance

12. Lifestyle factors 9. Smoking -nicotine increases insulin resistance
10. Alcohol
-induces hypoglycemia by preventing
gluconeogenesis (liver produces glucose
from non-sugar components)
-stimulates excretion of insulin

13. Unbalanced treatment Hypoglycemia
-blood glucose levels have decreased below 3 mmol/l
-Insulin, alcohol and oral medicines that intensify body’s sensitivity to insulin can cause this condition
-Symptoms
-shakiness, dizziness, sweating, irritability, headache,
numbness around the mouth, weakness, pale skin
and clumsy or jerky movements
-in worst case patient can pass out and enter shock
-Treatment
-drink orange juice or eat sugar immediately if
patient is conscious

14. Unbalanced treatment Diabetic ketoacidosis -a lack of insulin
-blood glucose levels have risen and body has started to produce keto acid from fatty acids and amino acids.
Symptoms
-dry mouth, upset stomach and vomiting, shortness of breath, breath that smells fruity and decreased consciousness
-body’s pH has decreased to under 7.3 and
-can be treated by giving insulin

15. Conclusion Treatment for type 2 diabetes -healthy diet -exercise
-non-smoking
-medicines