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LEARNING CENTRE : JOHOR LEARNING CENTRE

 i.

The situation of Sugu is currently in worst condition where she have to follow all the health
guideline in order to ensure the diabetes level did not reach to another stage level. Glucagon
overproduction and insulin deficiency all contribute to the development of diabetes mellitus
type 2 (DM2). Type 2 diabetes mellitus may also be referred to as adult-onset diabetes. In
T2DM, or type 2 diabetes, the body's capacity to control and utilise sugar (also known as
glucose) as a source of energy is hindered. The blood sugar level is too high as a consequence
of this chronic (ongoing) disorder. The overwhelming majority of diabetics have type 2
diabetes. Insulin resistance is another word for type 2 diabetes, which has a diminished
insulin response as a defining characteristic. Increased insulin synthesis is necessary to
maintain steady glucose levels in this condition. Type 2 diabetes occurs when the body's
ability to produce insulin decreases. When you have type 2 diabetes, you have to deal with
both issues at once. A decrease in the quantity of sugar that your cells can absorb is the
consequence of decreased insulin synthesis by your pancreas and impaired insulin
responsiveness by your cells. Insulin, a hormone generated by the pancreas, regulates blood
sugar levels by controlling the amount of sugar in the blood.

Type 2 diabetes may cause damage to the kidneys, eyes, blood vessels, and nerves. Diabetes
has been connected to a variety of additional major long-term health issues. Controlling your
diabetes and keeping a healthy blood sugar level may lower your chance of developing these
complications or other conditions (comorbidities). In the next sections, you'll learn about
common diabetic problems and comorbidities. Diabetes is connected to heart disease, stroke,
high blood pressure, and vascular constriction. Renal illness is also associated with an
increased risk of diabetes (atherosclerosis). Limb neuropathy, or damage to the nerves
Chronically high blood sugar levels may cause tingling, numbness, burning, and total loss of
feeling in the hands, feet and other parts of the body. Those who suffer from this condition
often begin with the smallest parts of their body and work their way up. A wide range of
factors may lead to nerve injury. Damage to the nerves in the heart may result in irregular
heartbeats. Nausea, vomiting, diarrhoea, and constipation may all be caused by damage to the
digestive system's nerves. Damage to the nerves in the male reproductive system may cause
erectile dysfunction. End-stage renal disease demands dialysis or kidney transplantation in
certain cases when chronic renal disease develops. Eye diseases including cataracts and
glaucoma are more common in people with diabetes. In certain cases, diabetes may damage
the retina's blood vessels, resulting in vision loss. You may be more vulnerable to skin
infections caused by bacteria and fungi if you have diabetes. Psoriasis and eczema are both
prevalent skin conditions. If left untreated, wounds and blisters may get infected, resulting in
a protracted healing period if they are not treated. A severe injury may need the amputation
of a toe, foot, or limb. A deficiency in hearing Those who have diabetes are more likely to
have hearing loss than the overall population. People with type 2 diabetes are more likely to
have obstructive sleep apnea (OSA), which is a kind of sleep apnea. The possibility exists
that both of these illnesses are caused mostly by fat. The treatment of sleep apnea may hinder
the ability of patients to effectively regulate their blood sugar. Dementia-causing conditions
such as Alzheimer's are connected to type 2 diabetes. Memory and other cognitive functions
decline more quickly when blood sugar levels are out of whack.

Type 2 diabetes is brought on by peripheral insulin resistance, impaired hepatic glucose

control, and decreased beta-cell function. Each one of these factors has an effect on how
quickly the sickness worsens. If beta cells are malfunctioning, insulin production decreases as
blood glucose levels rise. Type 2 diabetes-related glucose intolerance may be a prelude to this
complication. insulin secretagogues that do not include glucose impair glucose potentiation,
resulting in insulin release that is not timed with the body's needs and a reduction in the
amount of proinsulin converted to insulin in persons with type 2 diabetes. The fact that you
are overweight or obese raises a lot of red flags. Having a higher percentage of body fat in
your stomach than in your hips and thighs indicates that you are at greater risk of obesity-
related diseases. Males with a waist circumference more than 40 inches (101.6 cm) or
females with a waist circumference higher than 35 inches (89.1 cm) are more likely to
develop type 2 diabetes (88.9 cm). The risk increases in direct proportion to a person's level
of inactivity. Reducing your weight is simpler with regular physical activity that not only
burns glucose for energy but also increases insulin sensitivity in your cells. If one or more of
your parents or siblings has type 2 diabetes, you are at greater risk of developing the disease
yourself. There is an increased risk of developing type 2 diabetes among persons of African
American, Hispanic, Native American, Asian, and Pacific Islander ancestry. There is no
known explanation for this disparity. They have a lower risk of developing type 2 diabetes
than the general population. Coronary heart disease has been related to an increased risk of
triglyceride and HDL cholesterol levels. A higher amount of triglyceride lipids is also
associated with an elevated risk. After the age of 45, a person's chances of acquiring type 2
diabetes grow significantly. Those with prediabetes have higher blood sugar levels, but not to
the point where diabetes may be diagnosed. Diabetes is characterised by persistently
increased blood sugar levels. It is common for pre-diabetes to proceed to type 2 diabetes if it
isn't addressed. Type 2 diabetes is more likely to develop later in life if you were diagnosed
with gestational diabetes while pregnant or had a kid that weighed more than 9 pounds, two
risk factors associated with pregnancy (4 kilograms). Polycystic ovarian syndrome, a
common illness characterised by irregular menstrual cycles, excessive hair growth, and
obesity, increases the risk of diabetes in women. Diabetes may be caused by polycystic
ovarian syndrome. Those who are insulin resistant are more likely to have darker patches of
skin on their arms and neck.

ii.

Type 1 and type 2 diabetes are the two forms of the disease that are diagnosed most often.
Diabetes mellitus type 1 may be distinguished from diabetes mellitus reliant on insulin by the
absence of beta cells in the pancreas, which are responsible for the production of insulin. As a
result of this factor, the only kind of treatment that is shown to be successful for this
condition is insulin injections. Insulin resistance is a symptom that manifests in the cells of
the body in response to the presence of diabetes mellitus type 2, often known as T2DM.
Insulin resistance is a symptom that occurs when the cells in the body do not use insulin
appropriately. This leads to an increase in the amount of glucose in the blood. Because a
balanced diet and consistent exercise routine are often sufficient for managing this kind of
diabetes, it is possible that exogenous insulin will not always be required to be used.

An autoimmune disease is characterised by the body's immune system wrongly attacking and
destroying beta cells that are located in the pancreas. As a consequence of this fact, the only
treatment option accessible to persons who have diabetes is insulin injections. Patients who
have type 2 diabetes have cells in their bodies that do not react to insulin in the correct
manner. Diabetics with type 1 have the opposite difficulty. Alterations to one's lifestyle, such
as adopting a healthier diet and being more physically active on a regular basis, are often
sufficient in treating this kind of diabetes, which means that exogenous insulin is seldom
required. Diabetic type 1 is diagnosed in children and adolescents at rates that are much
higher than in adults. In recent years, there has been a rise in the number of adolescents and
young adults who have been diagnosed with type 2 diabetes. Type 1 diabetes is characterised
by more severe symptoms and an earlier beginning of the disease when compared to other
types of diabetes. One of the most prevalent signs of this condition is an increase in the
amount of urine that is produced. Symptoms of diabetes type 2 that are difficult to identify in
the early stages of the disease are very rare. Type 2 diabetes mellitus is a progressive
condition. One of the negative effects of taking this drug is an increase in the amount of thirst
that one experiences, in addition to the more significant side effects of sleepiness and a
reduction in one's ability to see. The most popular therapies for type 1 diabetes include
insulin injections, regular physical activity, and a diet that is well-balanced. According to the
findings of the research, managing type 2 diabetes may include maintaining a healthy diet,
engaging in regular physical activity, and taking insulin injections.

Even though the outlook for individuals who have type 1 diabetes is typically positive, it is
essential to be aware of the potential hazards associated with the illness as well as the steps
that may be taken to reduce those risks to the greatest extent feasible. Nephropathy, high
blood pressure, and even ketoacidosis is some of the potential adverse effects of this
condition. People who have diabetes mellitus type 2 should be aware of the challenges that
may present themselves as a result of their disease, despite the fact that they tend to have a
positive attitude on life. This condition may present with a wide variety of symptoms, some
of which include hypertension, nephropathy, and retinopathy.

Diabetes type 1, also known as diabetes in children and adolescents or insulin-dependent

diabetes, is an extremely uncommon form of the disease. This is in contrast to diabetes type
2, which affects a far greater percentage of the general population. According to figures
compiled by the Centers for Disease Control and Prevention (CDC), between five and ten
percent of people who have diabetes have Type 1 diabetes (CDC). Having a member of their
immediate family who is diabetic increases a person's risk of developing type 1 diabetes to a
greater extent than it would otherwise be. When you have type 1 diabetes, your pancreas
produces little or no insulin, which prevents sugar from entering your cells and being utilised
as a source of energy. As a direct consequence of this, low blood sugar will ensue. As a direct
consequence of this, the amount of glucose in the blood has increased to an unhealthy level.

According to the American Diabetes Association, symptoms of type 1 diabetes may include
extreme fatigue, an unusual appetite, hazy vision, a loss in weight, excessive thirst, frequent
urination, and the urge to urinate often. If you or your kid exhibit any symptoms that are
consistent with diabetes, you need to make an appointment with a medical professional as
soon as you possibly can. A test for blood sugar and a second test to identify autoantibodies
are both necessary to diagnose type 1 diabetes. Type 1 diabetics often have high levels of
autoantibodies, which may be discovered with the blood sugar test.

In the case that you have been given a diagnosis of type 2 diabetes, you will be required to do
routine checks on your levels of blood sugar and ketones, and you will start taking insulin as
part of your treatment. If your body does not produce enough insulin, you run the risk of
developing diabetic ketoacidosis, which is a potentially life-threatening disease. Because you
have this condition, sugar cannot enter your cells or circulate anywhere else in your body.
This prevents sugar from providing energy to your cells. In addition to this, you need to be on
the lookout for symptoms of hypoglycemia, commonly known as low blood sugar. When
compared to other types of diabetes, diabetes type 1 carries a greater potential for serious
complications in the road. Nephropathy, diabetic neuropathy, and diabetic retinopathy are a
few examples of these conditions. If you monitor your blood sugar levels regularly, you may
reduce the likelihood that you will acquire diabetes in the future.

Type 2 diabetes is by far the most prevalent form of the disease, and it accounts for the vast
majority of diagnosed cases of diabetes. It is estimated that between 90 and 95 percent of the
34 million people living in the United States who have been diagnosed with diabetes have
type 2 diabetes. When you have type 2 diabetes, the pancreas does not cease producing
insulin; as a result of this, your body still has a difficult time getting sugar into your cells.
Even though insulin is being produced in your body, if your cells aren't reacting to it, then
your pancreas isn't making as much use of the hormone as it possibly may be.

People who are overweight, inactive, older than 45, have smoked in the past, or have a family
history of the illness are more prone to develop type 2 diabetes. If type 2 diabetes runs in
your family, you should be more vigilant about the condition. In addition, those who have
polycystic ovarian syndrome, high cholesterol, or high blood pressure are more likely to be at
risk. Members of certain ethnic and cultural groups are also more likely to be at risk. [This
phrase needs a reference] A blood test called an A1C test or a glycated haemoglobin test may
be used to identify type 2 diabetes. This test is also referred to as a glycated haemoglobin
blood test in certain circles. They will give you a percentage of your blood sugar levels based
on the average of your readings over the past three months. Only 5.7 percent is considered to
be an acceptable proportion for a number. If the proportion is more than or equivalent to 6.5
percent, then the condition being evaluated is type 2 diabetes.

In terms of the degree to which they manifest, the symptoms are remarkably comparable to
those of type 1 diabetes. "The development of type 2 diabetes is typically delayed, and
symptoms are not as obvious as they are in type 1 diabetes," explains Aleida Saenz, APRN,
FNP-BC, CDCES, who is the chief of patient education at the Diabetes Research Institute.
Saenz has the credentials of a licenced nurse, a trained diabetes educator, and a certified
diabetes educator expert (DRI). Because of this, the majority of individuals choose to ignore
early warning indications of a problem. An increase in the worker's age, an increase in the
worker's overall stress level, as well as working in conditions that are excessively hot, are all
typical contributing factors that might explain the appearance of these symptoms. The
problems that are associated with diabetes type 2 may, throughout the course of a person's
lifetime, be the same as those that are associated with diabetes type 1.

Patients diagnosed with diabetes who have not yet started taking their prescribed medication
or insulin may have their doctor recommend that they do so. Metformin is a common
medication used to patients suffering from type 2 diabetes. According to the Mayo Clinic,
using this medication leads to a reduction in the amount of glucose produced by the liver and
an increase in insulin sensitivity. There is not only a vast variety of oral diabetic treatments
available, such as sulfonylurea and meglitinide, but also a wide variety of additional
medications that belong to different pharmacological categories. You have a lot of options to
choose from. You are free to take any one of these medications, even if you have diabetes.
Many individuals who have type 2 diabetes may be able to bring their blood sugar levels
under control by making modifications to their lifestyles, such as bringing their body mass
index (BMI) down and altering their eating patterns.

Given that pregnant women are the most likely to have this condition, the condition has been
given the name "gestational diabetes." If a woman's blood sugar levels remain consistently
high during her pregnancy, she may develop gestational diabetes, which may have serious
repercussions not just for the mother but also for the unborn child. According to the Centers
for Disease Control and Prevention (CDC), gestational diabetes affects more than one in
every five pregnancies (Centers for Disease Control and Prevention). According to the most
recent recommendations, testing should be performed on pregnant women between the 24th
and 28th week of their pregnancies. In order to determine the glucose levels in a woman's
blood, an oral glucose tolerance test is performed. It is possible that the majority of pregnant
women who have been diagnosed with gestational diabetes will need to continue to take
insulin injections throughout the duration of their pregnancy. After delivery, a large majority
of women will see a return of their blood sugar levels to the levels they had before becoming
pregnant. It is not unheard of for new mothers to desire some more attention after giving
birth; yet, it is possible for them to feel this way. If these women are found to have
gestational diabetes, which happens in around fifty percent of all instances, it is also possible
that they may be need to undergo continuous long-term monitoring.

iii.

When we speak about type 1 diabetes, we are referring to a disease in which the pancreas,
which is a vital organ in our bodies and is responsible for the synthesis of a variety of
hormones, does not generate enough insulin. This is the most common kind of diabetes.
Insulin is a hormone that facilitates the entry of sugar from the blood into the cells of the
body so that the sugar may be converted into energy. In the absence of this hormone, glucose
in the bloodstream is unable to reach the cells of the body; as a result, glucose levels rise in
the bloodstream. On the other hand, in those who have type 2 diabetes, the cells of the body
that are found in the liver, the fat, and the muscles do not respond to insulin in the correct
manner. This syndrome is known by its technical name, insulin resistance. Because of this,
there will be an abnormally high concentration of sugar transported through the circulation.
These disorders could, in the long run, result in problems with the cardiovascular system.

The component of the body that is in charge of safeguarding it against potentially harmful
external agents such as viruses and bacteria is called the immune system. It is largely agreed
upon that an autoimmune response is the primary driving force behind type 1 diabetes. When
a person develops type 1 diabetes, their immune system targets their own healthy cells,
mistaking them for potentially dangerous invaders from the outside. The pancreatic beta cells
that are responsible for manufacturing insulin are a target of the immune system, which thus
leads to their eventual destruction. After the loss of these beta cells, the body will no longer
be able to produce its own insulin. The immune system has been known to mistakenly attack
healthy cells on occasion, but researchers have not been able to establish why this occurs. It is
likely that this illness was caused by genetic and environmental factors, such as exposure to
viruses. It is also possible that both factors worked together to cause this condition.
Investigations on autoimmune diseases are always being carried out in the medical
community.

The onset of type 1 diabetes is not related to a person's eating habits or lifestyle choices in
any way. Insulin resistance is a feature that is present in individuals who suffer from type 2
diabetes. Insulin continues to be created by the body, despite the fact that the body is unable
to effectively use it. Researchers do not completely understand why some people acquire
insulin resistance while others do not; nevertheless, they think that a variety of lifestyle
factors, such as inactivity and being overweight, may play a role in the development of
insulin resistance in some people. There are likely a great deal more genetic and
environmental factors at play here than have been mentioned. If you have type 2 diabetes,
your pancreas will try to compensate for the loss of insulin production by creating more
insulin in an effort to meet your body's needs. Your body's inability to make effective use of
insulin is the direct cause of the build-up of glucose in your circulation. Diabetes is
characterised by this incapacity.

iv.

Due to the fact that she is not taking any medicine to control her diabetes at the time of her
hospital admission, she develops high blood glucose and is therefore brought to the hospital.
Because of this, her condition has been allowed to deteriorate without being addressed, and
this has gone on for the last six months. Her consumption of sugary beverages and poor-
quality food, combined with her body's inability to effectively utilise insulin, led to an
increase in her blood glucose levels, which, in turn, made her pre-existing condition of
constipation even worse. Her body was unable to properly utilise insulin because of her
diabetes. Because of her diabetes, Madam Suba is well aware of the need of maintaining a
healthy lifestyle that consists of eating a diet that is both varied and nutritious while also
engaging in frequent physical activity. It is possible that maintaining her blood glucose level,
also known as blood sugar, within our specified range will be one of the benefits of
maintaining a healthy diet and engaging in regular exercise. This is in addition to the myriad
of other advantages of such an approach. She has to strike a healthy balance between the
foods and liquids she consumes, the amount of physical exercise she gets, and any diabetic
medication she may be taking in order to maintain a healthy level of blood sugar in her body.
It is essential that she carefully considers the timing, quantity, and composition of the food
that she ingests in order to maintain blood glucose levels that are within the range
recommended by her medical team.

REFERENCES

Corinne O’Keefe Osborn. (2017, August 24). Type 1 and Type 2 Diabetes: What’s the
Difference? Healthline; Healthline Media.
https://www.healthline.com/health/difference-between-type-1-and-type-2-
diabetes#causes

Do you know the types of diabetes? (2021, November 1). The Checkup.
https://www.singlecare.com/blog/types-of-diabetes/

NIDDK. (2019). Diabetes Diet, Eating, & Physical Activity | NIDDK. National Institute of
Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-
information/diabetes/overview/diet-eating-physical-activity
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