Advanced practice in primary care

Common Causes and Risk Factors

T2DM is typically a result of a combination of genetic and lifestyle factors.

Obesity and Overweight: This is the most significant risk factor, especially central (abdominal) obesity, which is strongly linked to insulin resistance.

Physical Inactivity: Lack of exercise contributes to weight gain and decreased insulin sensitivity.

Age: Risk increases significantly after age 45.

Family History and Genetics: Having a parent or sibling with T2DM increases the risk.

Ethnicity: Certain ethnic groups (e.g., African American, Hispanic/Latino, American Indian) have a higher prevalence.

Other Health Conditions: Hypertension (high blood pressure), dyslipidemia (abnormal cholesterol/fats), and a history of Gestational Diabetes Mellitus (GDM) are also major risk factors.

🩹 Management and Treatment

The goal of T2DM management is to normalize blood glucose and prevent long-term complications.

1. Lifestyle Modifications (First-line)

Dietary Changes: Adopting a healthy eating pattern, such as the Mediterranean diet, focusing on whole foods, fiber, and limiting refined carbohydrates and saturated/trans fats.

Regular Exercise: At least 150 minutes per week of moderate-intensity aerobic activity and resistance training on 2-3 days a week.

Weight Loss: Losing $5\%$ to $10\%$ of body weight can significantly improve insulin sensitivity.

2. Medications

If lifestyle changes alone are insufficient, oral medications or injectable therapies are used.

Metformin: The most common first-line drug. It works by decreasing glucose production in the liver and improving the body's sensitivity to insulin.

Sample Answer

Type 2 Diabetes Mellitus (T2DM)

What is Type 2 Diabetes?

Type 2 Diabetes Mellitus is a chronic metabolic disorder characterized by high blood glucose (sugar) levels (hyperglycemia) due to two primary, interconnected problems:

Insulin Resistance: The body's cells (muscle, fat, and liver) don't respond effectively to insulin, the hormone produced by the pancreas that allows glucose to enter cells for energy.

Relative Insulin Deficiency: Over time, the pancreas, initially overworking to overcome resistance, can't produce enough insulin to maintain normal blood glucose levels.