Complications of Type 2 Diabetes & Factors Association

Between 2010 and 2030, there is an expected 70% increase in numbers of adults with diabetes in developing countries and a 20% increase in developed countries (13). Each year more than 231,000 people in the United states and more than 3,96 million people worldwide die from diabetes and its complications (2). This number is expected to increase by more than 50 percent over next decade (1). Estimated global healthcare expenditures to treat and prevent diabetes and its complications is at least 376 billion US Dollar (USD) in 2010. By 2030, this number is projected to exceed some 490 billion USD (14).

These costs are mainly due to treatment of concomitant CVD (15).

It has been shown in several studies that a clustering of features, such as high plasma glucose, obesity, dyslipidemia (high triglyceride and total cholesterol levels low high density lipoprotein (HDL) cholesterol levels and hypertension, referred to as insulin resistance or the metabolic syndrome, is a marker of increased risk for the development of type 2 diabetes as well as for CVD (16,17). Environmental and lifestyle factors are the main causes of the dramatic increase in type 2 diabetes prevalence (18-20).

Genetic factors probably identify those most vulnerable to these changes. Further more, studies have shown certain ethnic groups to be more susceptible to developing diabetes than others (21,22).

Sosale A, et al(2016)22 in their study across 14 centers representing north, west, south and east region of India, found that out of the total 4,600 (males 67%, females 33%) newly diagnosed patients with T2D, majority were from the age group 41-50 years (40%). 13.15% of newly detected India T2D had neuropathy, 6.1% had retinopathy and 1.

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06% had nephropathy. Risk factors of macro vascular complication such as hypertension, obesity, and dyslipidemia were observed in 23.3%, 26%, and 27% of patients respectively. Ischemic heart disease was noticed in 6%. Mohan V et al(2013)25 in their study in Chennai in India found that the prevalence of neuropathy was most common complication followed by cardiovascular(23.6%), renal (21.1%) and eye(16.6%) and the prevalence of foot ulcer was 5.1% Aetiology of type 2 diabetes Type 2 diabetes results from an imbalance between insulin sensitivity and insulin secretion.

Both longitudinal and cross-sectional studies have demonstrated that the earliest detectable abnormality in type 2 diabetes is an impairment of the body’s ability to respond to insulin. Impaired insulin action is observed in several tissues e.g., skeletal muscle, adipose tissue and the liver. It leads to increased insulin secretion from the pancreas to overcome impaired insulin action. Compensatory hyperinsulinemia maintains glucose level within normal range, but in individual at high risk of developing diabetes, beta cells function eventually declines and leads to the development of impaired glucose tolerance and eventually overt diabetes mellitus (23-25).