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Type 2 Diabetes Case Study - page 5
Keywords: Daibetes, case study, Diabetes Melltitus, NIDDM patient history
By Einstein10 on 30/12/2009
Level: Foundation Degree
Page Number: 5 of 6 pages: 1 2 3 4 5 64
Another short-term complication for type 1 and type 2 diabetes is hypoglycaemia. This is caused by excessive use of insulin and glucose-lowering drugs, hence lowering the blood glucose to a dangerous or even fatal level. It also can be caused by missing meals or fasting and intense exercise.
For type 2 diabetes Non-Ketotic-Hyperosmolar-Hyperglycaemic-State is the major short-term complication. An insulin deficiency leads to unusually high serum glucose, higher than 33mol/l and therefore a serum osmolality of more than 350mosm. This leads to excessive polyuria which lower’s blood volume and hemoconcentration. The result of this is dehydration, increased risk of thrombosis and neurological/mental malfunctioning. If untreated, death occurs.
Long term complications of type 2 diabetes occur gradually over a period of years if lifestyle changes do not be implemented. These include, heart and blood vessel disease, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), foot damage (like observed in Chimera), skin and moth conditions, osteoporosis, Alzheimer's disease and hearing problems.
Nephropathy is a major complication in chronic diabetes and can start after 15 years of diagnosis of diabetes. If blood glucose levels are poorly controlled then angiopathy of capillaries in the kidney glomeruli can cause end-stage kidney disease or even kidney failure requiring transplantation or dialysis.11 This in turn leads to several other complications including hypertension, which the diabetes patient most likely already suffers from. Nephropathy can be delayed via the use of ACE inhibitors and lifestyles changes. Antihypertensive drugs also would slow the progress of nephropathy.
Neuropathy can be caused by increase glucose levels damaging the capillaries to nerves, especially in the lower portion of the body. Numbness, pain and burning can be felt in the toes which spread upwards to the ankles. 12 Eventually total loss of sensation can occur. Poor blood circulation initiates infections, ulcers and gangrene. Again, this complication can be delayed/prevented by good glucose control. Treatments’ include revascularization of the organ or amputation.
Diabetic retinopathy may be seen 5-10 years after diagnosis of both type 1 and type 2 diabetes. Hyperglycemia causes pericyte death which makes the retinal blood vessels more permeable. Fluctuating blood glucose levels allow water movement in and out of the lens causing it to swell and shrink, altering the focusing power and resulting in intermittent blurring. Gulcoma is also a risk factor due to retinal neuropathy. Laser photocoagulation, Intravitreal Triamcinolone Acetonide and Vitrectomy are some of the treatments that can
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