How does diabetes mellitus type 2 work in the body? And how to manage it?

Diabetes Mellitus Type 2 is a complex chronic condition characterized primarily by insulin resistance and a relative insufficiency of insulin, leading to the hallmark feature of hyperglycemia. Its pathophysiology intertwines various biological and environmental factors, making its management challenging.
Central to diabetes type 2 is the hormone insulin, produced by the beta cells in the pancreas. Insulin’s crucial role is to regulate blood glucose levels, primarily by promoting glucose uptake into cells, especially muscle and fat cells, and suppressing glucose production in the liver. In a healthy state, this process ensures that blood glucose levels remain within a narrow, normal range, particularly after eating.
In the case of diabetes type 2, the body’s cells become resistant to the actions of insulin, a condition known as insulin resistance. This means that despite the presence of insulin, cells are less effective in absorbing glucose from the bloodstream, resulting in elevated blood glucose levels. The pancreas initially tries to overcome this resistance by producing more insulin, leading to a state of hyperinsulinemia. However, over time, this compensatory mechanism often fails as the beta cells become exhausted, leading to relative insulin deficiency.
Obesity, especially abdominal obesity, is a significant risk factor for the development of insulin resistance and diabetes type 2. Excess adipose tissue, particularly visceral fat, secretes various substances that can interfere with insulin signaling pathways, exacerbating insulin resistance. This link between obesity and diabetes type 2 underscores the importance of weight management in preventing and managing this disease.
Clinically, diabetes type 2 often presents with symptoms like increased thirst, frequent urination, excessive hunger, fatigue, and blurred vision. However, in the early stages, many individuals may have no symptoms or only mild, non-specific symptoms, leading to delayed diagnosis and management.
The prognosis of T2DM is closely tied to how well blood glucose levels are controlled. Unmanaged hyperglycemia can lead to various complications, including cardiovascular disease, neuropathy, retinopathy, and kidney damage. Effective management through lifestyle modifications (diet and exercise), medication, and regular monitoring can significantly improve outcomes and reduce the risk of complications. The goal is to maintain blood glucose levels within a target range, as evidenced by measures such as glycated hemoglobin, to prevent or delay the onset of diabetes-related complications.