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Our group selected type 2 diabetes as our focus problem. Seeing as type 2 diabetes is the most common form of diabetes, we thought that it would be important to understand who is affected and how.

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While type 2 Diabetes normally affects other populations, it is becoming increasingly more common in children, particularly those who consume a lot of sugar and lead a sedentary lifestyle.

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While other lifestyle choices do play a role in if an individual will develop type 2 diabetes, genetics is also another important factor. An individual with a parent that has type 2 diabetes greatly increases the risk that the individual will also have type 2.

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Insulin Resistance has a higher chance of leading someone to having prediabetes, which can eventually lead to type 2 diabetes. People that are 35 and older have a higher chance of developing insuling resistance, but this can happen to people at any age.

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Your liver stores any excess sugars you consume and slowly releases it back into your bloodstream when needed. When that sugar is not released, or too much is released over a long period, it turns into fat. Excess fat and sugar in your liver will cause it to fail. Also known as NAFLD and NASH.

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During type 2 Diabetes the pancreas cannot correctly produce and utilize insulin. The beta cells within the pancreas that are tasked with creating insulin may be damaged and cannot complete this task leading to an even further decrease in insulin production.

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Glucagon is a hormone produced by the pancreas that raises blood glucose levels by telling the liver to release stored glucose. This is especially problematic in type 2 Diabetes because it can further elevate blood glucose levels and with no insulin to combat this, the situation will worsen.

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The vagus nerve can be damaged either by having a high level of glucose for some time or a low amount of glucose entering the cells. This then can cause the muscles in the stomach to act abnormally, like the pyloric sphincter to tighten, and not allow food to pass to the intestine.

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The A1C tests what percent of the hemoglobin has been covered in sugar. This test is done twice, about 2-3 months apart from each other, and if the results are higher than 6.5% on two consistent results, then a person has diabetes.

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The OGTT is an alternative test to the A1C test, where a person fasts for 8 to 12 hours before the first test is done to get the person's fasting blood sugar level. Then they are to drink a liquid with a fixed amount of sugar, and then their blood is tested again usually 2 to 3 hours afterwards to see if their blood sugar levels have decreased. If the blood glucose levels are above 200mg/dl, then this suggests the person has diabetes. A modified version of this test is done for pregnant women to see if they have gestational diabetes, where they don't fast beforehand, and the second test is done an hour after the first test.

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A person can manage type 2 diabetes without the need for drugs if they are able to, such as change of diet, exercise, and weight loss. There isn't a specific diet for people with type 2 diabetes, but it is generally recommended to eat less calories, intake higher fiber foods like fruits and nonstarchy vegetables, using cooking oils like olive or canola oil. For exercising one can either do some cardio, strength training, or just moving around more than they usually do. Losing weight is only really needed if you're overweight, and the amount lost should be 5% of your body weight as this can help with blood sugar levels.

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Some of the medicines used to help manage diabetes are: Metformin, GLP-1 receptor agonists, and Glinides. Metformin is most of time the first medicine prescribed, and it lowers the amount of glucose the liver makes. GLP-1 receptor agonists are usually given by injection and they help with slowing down digestion and thus lowering blood sugar levels. Glinides such as repaglinide and nateglinide help by making your pancreas release more insulin into the blood stream, but this effect doesn't last very long.

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Because of the increased level of sugar in the blood, many people with Type 2 Diabetes experience dehydration which leads to increased thirst.

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Because of the high blood sugar in Diabetes patients, their blood vessels may become narrow, which causes poor circulation. Poor circulation delays the repair cells from reaching the wound site quickly, causing slowed healing.

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High blood sugar levels cause the lens in the eye to swell, which means the eye cannot focus properly. Additionally Glaucoma is another real fear for patients with Diabetes, as this disease can damage the optic nerve and cause blurred vision.

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Because of the bodies inability to correctly utilize glucose and provide insulin, the process of making energy for the body to use doesnt function correctly, which causes patients to feel tired.

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Because high blood sugar can lead to damage of the retina, Type 2 Diabetes can result in life long vision problems, including glaucoma, and even blindness.

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When blood sugar levels are consistently high, such as in patients with type 2 Diabetes, nerve damage is a common complication. This is what many patients describe as either a tingling sensation in their extremities or a complete numbness. Over time this can lead to losing feeling completely in the hands and feet. If left untreated many patients end up needing an amputation.

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Prolonged high blood sugar levels will lead to damage of the kidneys filters. Because the filters are damaged the kidneys are unable to do their job of filtering waste from the body. Because of this buildup of waste in the body the kidneys will potentially fail.

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Due to the increase in blood sugar during pregnancy, it is common for the mother to develop Gestational Diabetes around the second trimester. 50% of women who experienced gestational diabetes will develop type 2 diabetes postpartum.

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Insulin pens help people with type 2 diabetes regulate their blood sugar levels by adding insulin into their bodies which don't have enough insuling to regulate it. Insulin pens can cost anywhere from $0 to $100 with insurance and $700 to $1,400 without insurance. 28 states in the U.S. have caps on insulin copay amounts, Medicare part D and B cap insulin at $35 a month, and Medicaid can provide it for free or have it at a reduced cost. On a scale of 1-5 with 1 being not covered at all and 5 being fully covered, insulin is 2.5 as most insurance will at least cover the cost, but almost half the states in the U.S. don't have caps for insulin. If people don't take insulin, it could lead to their kidney's failing and eventually death, having a higher risk of heart disease and strokes, long term nerve damage to the arms, legs, the heart, and digestive system.

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Metformin is an oral medication that helps lower the amount of glucose that is produced by the liver and makes the muscle tissue more sensitive to insulin so that glucose can be used for energy. The tablets can cost anywhere from $60 to 170$ for more generic versions of Metformin and for the liquid version can cost $300 to 500$. The Brand name liquid version can cost $500+, all these are prices without insurance. Medicare part D can cover the prescription entirely, but for Medicaid it depends on how each state handles pricing, with some only allowing the generic versions to be covered. Most private insurance plans do cover Metformin tablets. If this isn't taken, it could lead to the same issues as not taking insulin like kidney failure, heart disease and strokes, long term nerve damage and death.

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CBT is often offered to individuals upon a T2D diagnosis. A licensed mental health professional will often assist with healthier habit changes, consistent medication tracking, and emotional support/reaction. Behavioral health specialists can be a Psychologist, social worker or counselor trained in CBT.

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Type 2 diabetes can cause peripheral neuropathy and physical therapy can help with those that struggle to walk because of it or trouble using their hands. This is usually a short term care, as the effects of peripheral neuropathy can be treated. A physical therapist would treat this.

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Peer support and therapy groups offer emotional support and physical accountability. Both of these ensure an individual doesn't feel isolated and has positive support throughout their process .

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Sodium-glucose transporter 2 AKA SGLT2 inhibitors limit the amount of sugar the kidney is allowed to take and lets most of the sugar leave the body in the urine. The cost can be about $5 to $137 a month, with the higher cost being without insurance. Medicaid can cover most of the cost and Medicare can cover more than half of it. Private insurance can cover the same amount as Medicare, if not more, but none of them fully cover these medications. The same long term health effects can occur from not taking insulin or metformin, such as kidney failure, heart disease and strokes, nerve damage and death.

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Individuals with Diabetes are 2x more likely to have a stroke or other heart complications. After having a stroke, individuals often experience Dysarthria (slurred speech) or aphasia (inability to speak). Most regain some ability to speak after short-term treatment with a Speech Language Pathologist.

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Chronic hypoglycemia caused by Type 2 Diabetes can cause serious cognitive issues such as Vascular Dementia and Alzheimer's. Glucose and insulin are regulators of cognitive functions. Therefore, improper diabetic care furthers the risk of declining cognitive functions. Learning Proper Diabetic care can prevent and, in rare cases, reverse the effects of cognitive diseases.

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Because high weight is the cause for high blood pressure, loosing even a small amount of weight would be an effective treatment for type 2 diabetes.

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A change in diet can help either prevent type 2 diabetes or help manage it by consuming less sugar and less saturated fats. The difficulty is a 5 as it may be easy for some people to change, but some people may not have the income to change their diet as easily as cheap food is usually higher in saturated fats and sugars. A nutritionist can help with creating a diet plan.

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Exercise can help with managing blood sugar levels and weight loss with exercise can reduce the amount of cholesterol. The difficulty would be a 7 since older folk wouldn't really be able to move as well, disabled folk, and those who don't have time to exercise wouldn't be able to. A personal trainer can help make a exercise plan and find the right workouts to adapt to your lifestyle.

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older adults will naturally develop a resistance to insulin. This is called insulin resistance and is a common occurrence in older adults. This often leads to fat around the abdomen and a decrease in muscle. The body will have to produce more insulin to get the same effect of younger people, which they will not be able to do naturally. When getting care older patients may not be able to get to doctors offices alone and cannot afford home visits, they often are on a fixed income and cannot afford the expensive drugs needed to treat the condition.

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People of lower economic status have a harder time affording and having access to healthier foods, health care, and often times cannot afford to work out with a trainer or even a gym membership. When getting care for type 2 diabetes, patients of lower economic status may not be able to afford the medication let alone the care needed to treat this condition.

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Achieving and maintaining a healthy weight will significantly reduce the risk of someone developing type 2 diabetes. The challenges involved include actively participating in a lifestyle of self control. While its ok to indulge sometimes, over eating is the main cause of weight gain. Many patients find it difficult to maintain a strict diet and exercise routine constantly.

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Healthy meal plans in addition to the exercise will also allow your body to get the fuel it needs while being able to maintain a healthy weight. Fad diets are detrimental, the healthy mean plan requires a full lifestyle change and dedication which patients often find challenging.

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CGM or Continuous Glucose Monitors allow real time accurate reading of a patients blood glucose levels. This allows the patient to make in the moment decisions about their glucose levels, and act accordingly. They consist of a sensor inserted under the skin and a transmitter that sends information to a smartphone app or receiver, which is extremely convenient in todays world where children are mostly glued to their phones.

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Smart Insulin Pens are reusable injector pens that communicate electronically with a smartphone app. They primarily aid in the treatment of diabetes by calculating and tracking insulin doses, providing helpful reminders, alerts, and reports, thereby simplifying insulin management for individuals using multiple daily injections.

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The commercials starring Wiford Brimley had brought greater awareness of diabetes in general to the population. This targeted individuals that needed to get diabetes testing equipment delivered to their homes. These commercials did become popular later on which helped overcome the challenge of spreading awareness of diabetes.

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The CDC has started a prevention program to help people who are prediabetic to try and help people stop from getting type 2 diabetes. This targeted individuals and the program's goal was to get people to make lifestyle changes backed by evidence. The biggest challenge for this outreach is trying to get this message out to everyone in the US, but even if it did reach people, making lifestye changes is still a challenge for individuals.