Type 2 diabetes mellitus refers to metabolic disorder whereby the human body has high levels of blood glucose due to insulin resistance and insulin deficiency in the body. There are a number of complications associated with type 2 diabetes mellitus if there are no appropriate medication and management procedures put in place in time. Global statistics reveal that type 2 diabetes mellitus is a major problem and the World Health Organization considers it as an endemic. In addition, the most underlying cause of type 2 diabetes mellitus in most parts of the world is lifestyle factors (Manfred, 2005). The WHO reports indicating a worrying trend that Type 2 diabetes is also affecting children due to childhood dietary habits and increasing the occurrences of obesity among the global population, amidst the complications associated with the type 2 diabetes mellitus. This paper outlines the mechanism of action and medication treatment for type 2 diabetes mellitus.

Diagnosis of type 2 diabetes mellitus

According to the World Health Organization, diagnosis for type 2 diabetes mellitus bases on raised glucose levels and a combination of symptoms. Levels of fasting plasma glucose equal to greater than 126 milligrams per deciliter amounts to type 2 diabetes mellitus. In cases whereby a glucose tolerance test is carried immediately two hours after the issuance of oral plasma glucose dose, levels of glucose that are equal to or greater than 200mg per deciliter of blood amounts to diabetes. The latter diagnosis is a reference standard during the diagnosis of type 2 diabetes mellitus. The WHO Diabetes criterion of 2006 identifies four conditions diabetes basing on the levels of two-hour glucose and fasting glucose. The conditions are Normal, impaired fasting glycaemia, impaired glucose tolerance and Diabetes mellitus (Manfred, 2005).

Causes of type 2 diabetes mellitus

Lower levels of insulin required to meet the body's needs, the production of insulin that is defective, and the failure by the cells to use the insulin produced to break down the blood sugar results to high levels of glucose in the blood. This in turn results to type 2 diabetes mellitus and a condition called hyperglycemia, which normally affects the fats tissues through a phenomenon called insulin resistance. Insulin resistance is a principal major problem associated with type 2 diabetes mellitus. The complete lack of insulin in the body is a secondary problem associated with Type 2 diabetes mellitus. If a person is more resistant to insulin, one is most likely to develop hyperglycemia, which is a developmental stage towards type 2 diabetes mellitus. The underlying causation factor of type 2 diabetes is the failure of the body to produce enough insulin to break down blood sugar (Manfred, 2005).

The underlying cause of type 2 diabetes mellitus depends on the type of lifestyle and genetic factors. Recent advancements on the causes of Type 2 diabetes mellitus identified pre-natal under nutrition as another possible causation factor.

Lifestyle factors are one of the primary causes of type 2 diabetes mellitus. Research studies concerning the onset of type 2 diabetes mellitus reveal that individuals who were more involved in physical activities and had a healthy diet had minimal chances of developing type 2 diabetes mellitus compared to individuals who lived a sedentary lifestyle and got involved in minimal physical activities.  Obesity is one of the contribution factors associated with the development of type 2 diabetes mellitus. Sedentary lifestyle is also one of the significant causation factors for Metabolic Syndrome. Lack of physical activity is always associated with increased cases of fat deposits and a decrease in the levels of HDL cholesterol, which in turn causes high blood pressure and high levels of blood sugar. Studies have depicted that individuals who sit idle for most of the time during the day are more likely to develop type 2 diabetes mellitus compared to active individuals (Manfred, 2005).

There are also medical conditions that are responsible for causing type 2 diabetes mellitus. One of the most common medical conditions that can accelerate the onset of type 2 diabetes is obesity. A person suffering from obesity is more likely to develop type 2 diabetes mellitus. Hypertension and high levels of cholesterol in the body can make a person to succumb to diabetes mellitus of type 2.  Other conditions such as metabolic syndrome, chronic pancreatic and high fat diets increase the risk of developing of diabetes mellitus of type 2. A less active lifestyle accompanied with the above medical conditions can also develop type 2 diabetes mellitus (Manfred, 2005).

There are genetic factors that can lead to the development of diabetes mellitus of type 2.  Reports indicate that approximately 55 per cent of individuals diagnosed with diabetes mellitus type 2 are obese; this is because there is a relationship between chronic obesity and insulin resistance. The onset of type 2 diabetes mellitus shows some inheritance patterns; this means that first-degree relatives of individuals with diabetes mellitus of type 2 have high chances of developing the condition compared to individuals whose lineage has no signs of diabetes mellitus of type 2 (Manfred, 2005).

Prevention of type 2 diabetes

Type 2 diabetes mellitus is preventable through engaging in regular exercise and the intake of healthy diets. In order to delay the onset of diabetes type 2, individuals should focus on intensive lifestyle, since this reduces the risk of developing the condition by 50 per cent. Generally, lifestyle interventions have proved more effective in preventing diabetes type 2 compared to medical intervention. Medical intervention is only recommended after lifestyle intervention cannot prevent diabetes type 2. The WHO report of 2005 concluded that a combination of healthy diet and exercise is an effective approach to preventing the onset of diabetes (Gwen, 2007).

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In terms of lifestyle concerns, reducing weight, dietary changes and increased involvement in physical activities can reduce the risk of developing type 2 diabetes mellitus. The American Diabetes Association suggest that involving oneself in two and  half hours of physical activity on a weekly basis, reducing fat intake, increase fiber intake and checking weight is an effective strategy to prevent the onset of diabetes type 2. It is important to avoid lifestyles practices that entail smoking and excessive drinking since they increase the risk of developing type 2 diabetes mellitus (Fauci, 2008).

The intake of hydrogenated fats increases the incidence of type 2 diabetes mellitus and other cardiovascular risks factors; this implies that dietary intake should not contain hydrogenated fats in order to reduce the risk f developing diabetes mellitus and its respective complications. Intake of milk and other diets that contain fatty acids plays an important role in preventing the development of diabetes mellitus of type 2 (Gwen, 2007).

There are also medical interventions used to prevent the incidence of type 2 diabetes mellitus. Some of the medications that are effective in preventing type 2 diabetes include valsartan, metformin and rosiglitazone. Various medications aim at reducing insulin resistance in the body. For example, dopamine receptor agonists that reduce insulin resistance and play an important role in reducing the body weight to health standards (Manfred, 2005).

Management of type 2 diabetes mellitus

Type 2 diabetes mellitus has no known cure; this implies that effective management strategies are required in order to reduce the risks of development of complications associated with the condition. Effective management of type 2 diabetes mellitus requires sufficient exercise, dietary measures, oral medication, ensuring proper circulation of blood in the body and intake of insulin. External factors such as psychological factors and other illness significantly impair effective management of the condition (Fauci, 2008).

The goal of treating type 2 diabetes mellitus should aim at ensuring that the patient can regulate the levels of blood glucose and blood pressure in order to avoid the development of complications associated with type 2 diabetes mellitus. There are standard clinical guidelines that specify the targets for treatment of type 2 diabetes mellitus. One of the targets is to regulate the levels of pre-prandial blood glucose to between 4 and 6 milligrams per deciliter of blood.  Another target is to lower the post-prandial blood glucose levels to between 5 and 8 milligrams per deciliter of blood. The Hemoglobin levels should range between 6 percent and 7 percent.  

Since a principal risk factor associated with type 2 diabetes is the development of cardiovascular disease, the management approach should not increase the development of secondary conditions, which may in turn lead to the development of diabetes itself. It is therefore important to check the levels of cholesterol in the body, LDL and HDL (Fauci, 2008).

Medical treatment for type 2 diabetes

Prior to the onset of diabetes treatment, it is important that a person must show the readiness and commitment of adopting lifestyle changes healthy diet. Losing and maintaining the ideal weight is one of the difficult tasks in obesity treatment at the personal initiative level. Depending on the current status of one's weight, one must set up a target of losing weight at a given rate in a specified period of time, which in most cases, ranges between 1-2 pounds on a weekly basis. Medical research studies reveal that losing 10 per cent of the overall body weight plays a great deal in improving ones health and therefore preventing type 2 diabetes. It is important for a diabetic individual to lose weight gradually rather than lose it rapidly and fail to retain the new acquired weight. An effective weight loss strategy is to intake low calories and increase involvement in physical activity. Recommended amounts are low calorie diet containing about 1200-1500 calories daily for women while 1500-1800 calories daily for men. In attempt to lose weight, it is important for a person to focus on improving health conditions

Physical activities and lifestyle change can sometimes fail to guarantee effective treatment to type 2 diabetes mellitus. After six months and there are no fruitful results, health physicians recommend that obese individuals should seek medical intervention and in some cases surgical operations. Weight loss medicines work on the principles of limiting fat absorption by the body and make a person to feel full after consumption of small amounts of food, resulting to loss of appetite. Some of the most common medicines used in the treatment of type 2 diabetes include Meridia, phentermine, and Xenical. Meridia serves as a long-term medication, while phentermine serves as short-term medication. Xenical serves to inhibit the absorption of fats by the body (Fauci, 2008).

The American Heart Association proposes that lifestyle therapies are the most effective approach to preventing and managing Metabolic Syndrome. The most important interventions that a person should put into consideration while managing this condition include prioritizing on weight loss with the aim of reaching a Body Mass Index, which is healthy. In most cases, the appropriate BMI for any person should be less than 25 kilograms per square meter of the body surface area. Physical activities should entails about 30 minutes on a daily basis and incorporating a healthy eating trend that is contains less fat and calories (Fauci, 2008).

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