Demographics and Patient Professional Dynamics in

Introduction

The importance of having effective information regarding health and illness is that the individuals, as well as people in the society, would be able know regarding the way they are to manage their health to avoid illness. In the current state, it is seen that many individuals are not properly aware of the detailed information regarding various long-term and life-threatening illness such as asthma, arthritis diabetes and others. In this assignment, the overview along with changing demographic patterns of diabetes as seen among individuals in the UK is to be discussed. Later, the concept along with the consequence of diabetes is to be informed. Lastly, the relationship between patients and health professionals are to be evaluated to understand the way diabetes is influencing the patient’s condition.

Introduction to Diabetes

Diabetes is referred to the health disorder in which the body’s ability to maintain normal amount of glucose is lost that results in fluctuating blood sugar level of individuals (Care, 2019). As mentioned by Marso et al. (2016), blood sugar acts as the source that is used by the body to create energy. This means that fluctuating blood sugar level as seen in diabetes is going to adversely affect the body in producing energy to work effectively. There are mainly two types of diabetes that are Type1 diabetes and Type 2 diabetes. Type-2 diabetes is more common among individuals compared to Type 1 diabetes.

Mechanism and Causes of Diabetes

The presence of any type of Diabetes is referred as a long-term condition that is suffered by the patients and the illness cannot be cured but it can be controlled effectively with proper medical intervention and intake of dietary supplements. The Type-2 Diabetes is referred to as the metabolic disorder that causes higher level of blood sugar, lack of insulin and insulin resistance in the body (Kassan et al. 2015). The chronic fuel surfeit is regarded as the initial event which promotes individuals to develop type-2 diabetes. These people are affected by type-2 diabetes because of failure in providing adaptive responses for safe deposition of fuel surfeit. The defect in metabolism that are important for the development of type-2 diabetes include the β-cells inability for compensating the fuel surfeit, hypoadiponectinemia, impaired expansion of subcutaneous adipose tissue (SAT), increased level of glucagon secretion, presence of peripheral insulin resistance and increased production of indigenous glucose (Siddiqui et al. 2013).

In the study of Smith and Kahn (2016), it is mentioned that the key determinant related to metabolic health is the efficiency of the subcutaneous adipose tissue (SAT) for storing increased amount of fats rather than causing accumulation of the fats in the form of ectopic deposits. The ability for recruiting and differentiating precursor cells in the form of adipose cells in the SAT is controlled genetically and is seen to be improperly regulated in high-risk individuals who are susceptible to Type-2 diabetes. It is mentioned that the early recruitment of new form of adipose cells are dependent on the cross-talks of BMP4 and canonical WNT where BMP4 has the function to induce the commitment of the precursor cells to adipogenetic lineage and WNT function to enhance the proliferative and undifferentiated state. This dysfunction impairs adipogenesis as well as impairs ability in storing excess fat in SAT which in turn leads to dysfunctional, hypertrophic and insulin-resistant adipose cells with lower content of GLUT-4 that is the key transporter of insulin in the body (Gustafson et al. 2015; Liu et al. 2018).

In the study of Samuel and Shulman (2016), peripheral insulin resistance is mentioned to arise when the pathways to store nutrient which is evolved for maximisation of energy utilisation are exposed to chronic surplus of energy. This leads to ectopic accumulation of lipid in the skeletal muscles and liver triggering the pathway which impairs signalling of insulin leading to reduction in uptake of glucose and decreasing synthesis of hepatic glycogen raising the presence of sugar in the blood causing type-2 diabetes. In another study Drucker (2018), it is mentioned that the key function of the glucagon secretion is to prevent the lowering of blood sugar levels by stimulating the conversion of stored glucagon to glucose. The increased secretion of glucagon in the body leads to increased conversion of glycogen to glucose leads to raise the level of blood sugar in the body to higher amounts causing hyperglycaemia in type-2 diabetes (Suppli et al. 2016). The rise of type-1 diabetes is usually lower in nature compared to Type-2 diabetes and it mainly arises due to the combined influence of genetic as well as environmental factors (Peters et al. 2016). In Type-1 Diabetes, the β-cells in the pancreas who are responsible for the production of insulin which is the hormone that is responsible for maintaining the blood sugar level are damaged. This leads the body to have increased glucose in the blood but the cells are unable to use them and are starved of energy. It creates a threatening situation for the individuals as the cells being unable to use glucose to develop energy for their operation shows failure in performing their function. The study by Siddiqui et al. (2013) informed that environmental factors such as toxins, enteroviruses and others may trigger the formation of T-cell dependent autoimmunity among individuals those have genetic susceptibility to the disease.

Demographic and epidemiological data regarding of Diabetes

The epidemiological and demographic data related to Diabetes in the UK informs that in 2017-18, in the UK, 3.8 million of individuals from the total population were found to be diagnosed with diabetes out of 4.7 million people who are already suffering from the disease. Moreover, it is informed at each two minutes someone in the UK is seen to be diagnosed with diabetes (www.diabetes.org.uk, 2018). The statistics indicate that diabetes prevalence is at a concerned rate within the UK as more individuals are affected by the disease each year and at a faster rate. Moreover, the data reveals that there are concerning number of individuals in the UK who are suffering from the disease but are unknowledgeable about the issue because they are not yet diagnosed with the disease. It indicates that there is lack of proper availability of healthcare opportunity for all the individuals in the country so that they can be diagnosed with the disease at the earliest to avail healthcare. The diagnosis of the disease at the earliest is required so that effective healthcare interventions can be taken to control the health issue avoiding further complication and deteriorated effect on the health of the individuals (www.diabetes.org.uk, 2019). The comparison of epidemiological and demographic data regarding diabetes in the UK indicates that within the last 20 years nearly double numbers of people are affected by diabetes in the UK. This is evident as in 1996 there were only 1.4 million people in the UK being diagnosed with diabetes but in 2019 nearly 3.8 million people are presently diagnosed with the disease (www.diabetes.org.uk, 2018). It is also informed that out of the total diagnosed people with diabetes in the UK, 90% of them are affected by type-2 diabetes 8% with Type-1 diabetes and only 2% with other rare types of diabetes (www.diabetes.org.uk, 2018). Thus, type-2 diabetes is seen to be the most prevalent nature of diabetes affecting increasing number of individuals in the UK. Moreover, these statistical data indicates that effective healthcare opportunity and proper awareness regarding the disease is not been successfully taken due to which more people are getting affected by the disease. This is

evident as the demographic data collected indicates that more than half of the type-2 diabetes is able to be delayed or prevented in case proper health intervention and health awareness regarding the diseases is been offered to the population in the UK (www.diabetes.org.uk, 2019). This informs that effective healthcare intervention and increased health promotion regarding the disease is required at the present is required to control diabetes in the UK. The detailed statistical data regarding the demographic distribution of diabetes indicates that in England a total of 3,222,559 people are affected by the disease. Moreover, in Northern Ireland nearly 96,114 individuals are affected, in Scotland nearly 295,753 individual are affected and in Wales nearly 195,693 people are found to be affected as well as diagnosed with diabetes (www.diabetes.org.uk, 2018). This informs that in the UK, diabetes is more prevalent in England followed by Scotland, Wales and Northern Ireland. The reports inform that no less than 500 people in the UK die prematurely each week due to diabetes. Moreover, 680 strokes, 169 amputations and 530 heart attacks along with 2000 cases related to heart failure are reported to occur in the UK for individuals who are suffering from diabetes (www.diabetes.org.uk, 2019). This indicates that the disease has created various other threatened chronic illnesses for the UK individuals that have lead to cause further deterioration in health situation in the country. At present, in the UK, 12.3 million people are at concerning risk of experiencing type-2 diabetes. It is also informed that compared to the white individuals, the Asian and the Black individuals in the UK are 2-4 times more prone to get affected by type-2 diabetes (www.diabetes.org.uk, 2019). This indicates that the ethnic minority groups present in the UK are at high risk of experiencing diabetes as illness compared to others in the UK. The future predictions indicate that by 2025 the suffering of UK individuals will be total of 5 million in number (www.diabetes.org.uk, 2019). This informs that with time the incidence and prevalence of the diabetes are going to deteriorate in the UK.

Signs and Symptoms of Diabetes

The symptoms and signs of Type-2 diabetes include frequent urination, slowing the healing of wounds, itching and yeast infection, increased thirst, fatigue, blurred vision, numbness in fingers and legs and others (Reusch and Manson, 2017). As mentioned by de Carvalho et al. (2016), the individuals with Type-2 diabetes often feel the urge to frequently urinate as the kidneys wish to remove the high level of sugar present in the blood. This is evident as in this nature of diabetes the blood sugar levels are high indicating increased level of presence of glucose in the bloodstream. As criticised by Santilli et al. (2016), people affected by Type-2 diabetes due to frequent urination lose excess water from the body. This leads them to feel dehydrated making the person feel thirsty. The inability of the body cells to effectively use glucose derived from the blood in production of energy in Type-2 diabetes makes the individuals feel fatigued. This is because sufficient glucose required by the body does not move from the bloodstream making the individual experience lack energy to perform their activities (Storgaard et al. 2016). As stated by Ahsan (2015), the presence of excess sugar in the blood leads to damage the tiny blood vessels in the eyes. This results the individuals suffering from the disease to face blurred vision.

The study by Abraham et al. (2018) indicates that presence of increased amount of sugar in the blood causes damage of the blood vessels and nerves of the individuals creating impaired blood circulation. This result the individuals suffering from the disease to experience issues with wound healing as proper blood circulation to the parts are unable to be made by the body. The presence of increased level of blood sugar than normal among the individuals suffering from Type-2 diabetes leads them to face numbness or tingling in the hands and feet as the nerve cells are also damaged due to the condition. The presence of excess sugar in the blood leads to create favourable environment for the growth of yeast and infection resulting individuals suffering from the disease face itching and yeast infections (Monea et al. 2017).

The signs and symptoms in Type-1 Diabetes are similar to Type-2 Diabetes such as increased thirst, blurred vision, frequent urination, and others. However, in this nature of infection few signs and symptoms are more extremely experienced compared to Type-2 diabetes. This is evident as people suffering from Type-1 Diabetes are seen to experience signs of extreme hunger. This is because the body in this nature of diabetes is entirely unable to develop energy by breakdown of glucose from the food as the cells in the body become insulin resistant avoiding the use of glucose. Thus, the body being unable to produce energy feels lack of it, in turn, instigating increased hunger for food (Bolinder et al. 2016). The people suffering from Type-1 diabetes are seen to show symptoms of unintended weight loss. This is because the body is unable to produce energy through glucose making the body to burn stored fat to use them as source for energy leading to reduction in the overall body weight (Rewers et al. 2015).

Description of the way diabetes is influencing the everyday life of individuals in the surrounding society

The physical health aspects of the individuals suffering from diabetes are seen to be affected adversely as it is seen to cause damage in the blood vessels, nerves, body organs and others. As mentioned by Fitchett et al. (2016), the presence of high level of glucose in the blood in type-2 diabetes patients leads them to create storage of cholesterol in the blood vessels. The presence of cholesterol in the blood vessels leads to thickening of the inside of the arteries creating blockage in the proper flow of blood that supplies nutrient and oxygen to the heart. This leads to inappropriate supply of the vital elements to the heart for its proper function creating cardiovascular diseases among the diabetes patients making them experience heart attack or stroke. The people suffering from diabetes often develop diabetic retinopathy. In diabetic retinopathy, the increased presence of glucose in the blood damages the blood vessels that offer blood flow to the tissues in the retina. This leads the individuals suffering from diabetes to experience blindness or vision impairment as retina that detects the lights and convert them to images in the brain to visualise is damaged (Agrawal et al. 2016). The people suffering from diabetes are also prone to develop glaucoma in the eye. This occurs because the increased glucose in the blood damages the optic nerve present in the eye which creates connection between the eye and the brain (Zhao et al. 2015). The people with diabetes experiences leg ulcer and numbness in feet as physical health issues as they create mobility issues for the individuals. The diabetic people develop leg ulcer and numbness as result of peripheral diabetic neuropathy because the condition leads the nerve vessels that carry the pain sensation message from the brain to the feet function improperly due to damage. This leads people with diabetes to lose sensation and become unaware of any cuts or damages in the legs. Further, the diabetes causes narrowed arteries due to deposition of cholesterol that makes wounds become unable to heal within proper amount of time that often later leads to development of leg ulcer (Teobaldi et al. 2018). The people suffering from diabetes develop diabetic neuropathy in which their kidneys are damaged as blood vessels in the organs are damaged with the increased presence of sugar in the blood thus making them unable to filter out wastes from the body (Hewston and Deshpande, 2016). The psychological aspects of people suffering from diabetes are seen to be negatively affected. This is because diabetes is a chronic disorder that leads individuals from its long-term suffering to develop mental health issues such as depression, stress and others

related to the disease (Hackett and Steptoe, 2017). This is evident as in 2017 it was reported that 33% of the people who are affected by diabetes in the UK have consulted the NHS helpline to have emotional and mental support (www.diabetes.org.uk, 2019). The diets of the individuals suffering from diabetes are seen to include more amounts of fluids along with carbohydrates to help them improve their condition. The presence of diabetes in the UK has led individuals in society to experience the burden of care of the people affected by the disease. This is because the diabetic patients are not always able to take their own care due to physical weakness such as blurred vision, inability to walk on own due to leg ulcer, fatigue and tiredness and others along with the presence of mental health issues (van Dooren et al. 2016). Moreover, the family of individuals who is suffering from diabetes may face financial issues. This is because diabetes in the chronic condition that cannot be cured and thus continuous finances has to be spent for buying medication and monitoring the blood sugar level to keep a check on the disease (Ely et al. 2017).

Key insight into illness

The people suffering from diabetes are offered various treatments and health intervention to help them effectively live with the disease. As mentioned by Hemmingsen et al. (2017), the individuals affected by type-2 diabetes are asked to execute regular physical activity as a part of the treatment process. This is because physical activity leads individuals suffering from diabetes to lower their level of blood sugar by making the body developed to use glucose from the blood to create energy. The people suffering from type-1 diabetes as well as individuals suffering from type-2 diabetes who are unable to produce glucose in the body use insulin therapy in controlling their blood sugar level to normal. This is because in this therapy the insulin is administered to the fat layer in the body to assist the body in production and processing of the increased amount of glucose to create required energy needed for maintaining normal function of the body (Khunti et al. 2015). The people affected by type-2 diabetes executes regular monitoring of the blood sugar levels to keep check on the glucose level in the body to live properly. This is because regular monitoring helps the individuals to understand whether or not their daily activities and diet along with medication are effective in controlling the health disorder properly (Chatterjee et al. 2017). The people suffering from type-2 diabetes are offered medications such as Metformin, Sulfonylureas, Meglitinides and others. The Metformin is the primary medication offered to the people suffering from type-2 diabetes as it is seen to be effective in lowering the production of glucose in the liver that results the body to be able to improve their sensitivity to use insulin in controlling proper level of blood sugar (Forslund et al. 2015). The Sulfonylureas are used for the purpose to create more insulin in the body to lead increased use of glucose by the body cells that are present in the bloodstream leading to normalise the blood sugar level (Yu et al. 2018).

Cultural meaning of Diabetes

The presence of diabetes among individuals in all the cultures is regarded as common illness. In different cultures around the world, it is seen that many perceive the cause of diabetes to be intake of increased amount of sweets. This is because they believe that sweets create imbalance in the blood sugar level leading the individuals to face high blood sugar as seen in type-2 diabetes (Grzywacz et al. 2014). In African American, White individuals as well as Asian, it is seen that there are many individuals who have the cultural belief that diabetes is hereditary in nature (Grzywacz et al. 2012). This is because in many cases they have seen that diabetes is developed by those individuals who have their parents suffering from the illness previously. The African American, Asian and White individuals in their culture believe that diabetes is illness for the adults and the children are not affected by it. They also have the cultural belief that people of different weight can develop diabetes because thin individuals are also found to be diabetic in nature. The African Americans have the cultural belief that diabetes occurs among individuals due to intake of increased amount of processed food that adversely affect the functioning of the body creating fluctuations in the blood sugar level (Grzywacz et al. 2012).

Experimental dimension of Diabetes

The individuals suffering from diabetes explains that it leads them to develop various compromises in eating foods. This is because many of the foods such as potato, sweet beverages, white bread and others are avoided to be eaten as it creates hindrance in maintaining the blood sugar level (Steven et al. 2016). The individuals who are suffering long time from type-2 diabetes without proper intake of medication informs that they experience issues with making mobility as their eye sights are reduced and they experienced blurred vision (Khan et al. 2017). This mainly occurs due to the development of diabetic retinopathy. Many individuals who are suffering from the illness report that they experience issues with controlling elimination as their frequent urgency to urinate makes them sometimes inappropriately eliminate urine leading them to face an apologetic situation in the society (Nitzan et al. 2015). The individuals with diabetes report that the issues of the experience with the healing of wounds as it often takes longer time. This leads them to face hindrance in making proper movement and develop fear of contamination of wounds. The people with diabetes mention of facing fear of falls and inability to properly hold things due to rise of numbness ion the hands and feet (Alhabshan et al. 2017).

Biomedical dimension of Diabetes

The biomedical dimension regarding diabetes explains it to be disorder which affects the blood sugar level of the individuals due to lack of proper production of insulin in the blood or as a result of inability of the cells of the body to breakdown glucose into energy. The dimension informs that diabetes is a hereditary disease and type-1 diabetes mainly occurs due to genetic mutation. The medical professionals in this dimension inform that the prevalence of diabetes is more among the adults but the children are equally at risk of getting affected by the illness. They inform that people suffering from type-2 diabetes are more in number compared to type-1 diabetes. Moreover, the health professionals informs that with proper intervention and empowerment of individuals to control their daily lifestyle and activities is able to prevent as well as efficiently control incidence of diabetes (Jørgensen et al. 2016; Mohammadi et al. 2015). The biomedical dimension informs that diabetes cannot be cured but with effective awareness can be controlled at a higher level. The medical knowledge informs that obesity is one of the prime risk factors for diabetes. Further, it is informed that diabetes can leads to various complications in health such as heart diseases, damage in the eye and like as if not treated at the right time. The medical knowledge informs that frequent urination, extreme thirst and fatigue are the key symptoms related to diabetes (Oz et al. 2017).

Conclusion

The above discussion informs that diabetes is of two kinds that are Type-1 and Type-2 out of which the latter is the most common in nature. In the UK, increased incidence of diabetes is being reported with statistics showing increased prevalence of the disease in the future. The signs and symptoms of diabetes include extreme thirst, frequent urination, tiredness, numbness in the hands and legs and others. The key cause of the rise of type-2 diabetes is the inability of the body cells to use glucose in the blood to convert it and use it as energy. The cause of type-2 diabetes is due to genetic mutation where the body cells develop insulin resistance. The medical dimension informs that effective diagnosis and treatment at the right time can prevent as well as reduce the incidence of the disease.

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References

• Abraham, M.M., Tyng, T.S., Rekha, K., Shanmugananth, E. and Kiruthika, S., 2018. Comparison of Four Screening Methods for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Research Journal of Pharmacy and Technology, 11(12), pp.5551-5558.
• Agrawal, R., Smart, T., Nobre-Cardoso, J., Richards, C., Bhatnagar, R., Tufail, A., Shima, D., Jones, P.H. and Pavesio, C., 2016. Assessment of red blood cell deformability in type 2 diabetes mellitus and diabetic retinopathy by dual optical tweezers stretching technique. Scientific reports, 6, p.15873.
• Ahsan, H., 2015. Diabetic retinopathy–biomolecules and multiple pathophysiology. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 9(1), pp.51-54.
• Alhabshan, R.F., Huwaymil, M.S.B., Alsaqabi, O.A., Alzaid, A.N. and Almasoud, A.I., 2017. Assessment of Knowledge toward Complications of Diabetic Septic Foot among Diabetics Patients in Saudi Arabia. The Egyptian Journal of Hospital Medicine, 69(6), pp.2557-2562.
• Bolinder, J., Antuna, R., Geelhoed-Duijvestijn, P., Kröger, J. and Weitgasser, R., 2016. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. The Lancet, 388(10057), pp.2254-2263.
• Care, D., 2019. Standards of Medical Care in Diabetes 2019. Diabetes Care, 42, p.S81.
• Chatterjee, S., Khunti, K. and Davies, M.J., 2017. Type 2 diabetes. The Lancet, 389(10085), pp.2239-2251.
• de Carvalho, J.A.M., Tatsch, E., Hausen, B.S., Bollick, Y.S., Moretto, M.B., Duarte, T., Duarte, M.M., Londero, S.W., Premaor, M.O., Comim, F.V. and Delanghe, J.R., 2016. Urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin as indicators of tubular damage in normoalbuminuric patients with type 2 diabetes. Clinical biochemistry, 49(3), pp.232-236.
• Drucker, D.J., 2018. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell metabolism, 27(4), pp.740-756.
• Ely, E.K., Gruss, S.M., Luman, E.T., Gregg, E.W., Ali, M.K., Nhim, K., Rolka, D.B. and Albright, A.L., 2017. A national effort to prevent type 2 diabetes: participant-level evaluation of CDC’s National Diabetes Prevention Program. Diabetes Care, 40(10), pp.1331-1341.
• Fitchett, D., Zinman, B., Wanner, C., Lachin, J.M., Hantel, S., Salsali, A., Johansen, O.E., Woerle, H.J., Broedl, U.C. and Inzucchi, S.E., 2016. Heart failure outcomes with empagliflozin in patients with type 2 diabetes at high cardiovascular risk: results of the EMPA-REG OUTCOME® trial. European heart journal, 37(19), pp.1526-1534.
• Forslund, K., Hildebrand, F., Nielsen, T., Falony, G., Le Chatelier, E., Sunagawa, S., Prifti, E., Vieira-Silva, S., Gudmundsdottir, V., Pedersen, H.K. and Arumugam, M., 2015. Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature, 528(7581), p.262.
• Grzywacz, J.G., Arcury, T.A., Ip, E.H., Nguyen, H.T., Saldana, S., Reynolds, T., Bell, R.A., Kirk, J.K. and Quandt, S.A., 2012. “Culture” in Diabetes-Related Beliefs among Low-and High-Education African American, American Indian, and White Older Adults. Ethnicity & disease, 22(4), p.466.
• Grzywacz, J.G., Arcury, T.A., Nguyen, H.T., Saldana, S., Ip, E.H., Kirk, J.K., Bell, R.A. and Quandt, S.A., 2014. Patterns and stability over time of older adults' diabetes-related beliefs. Health behavior and policy review, 1(2), pp.111-121.
• Gustafson, B., Hammarstedt, A., Hedjazifar, S., Hoffmann, J.M., Svensson, P.A., Grimsby, J., Rondinone, C. and Smith, U., 2015. BMP4 and BMP antagonists regulate human white and beige adipogenesis. Diabetes, 64(5), pp.1670-1681.
• Hackett, R.A. and Steptoe, A., 2017. Type 2 diabetes mellitus and psychological stress—a modifiable risk factor. Nature Reviews Endocrinology, 13(9), p.547.
• Hemmingsen, B., Gimenez‐Perez, G., Mauricio, D., i Figuls, M.R., Metzendorf, M.I. and Richter, B., 2017. Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, (12).pp.34-56.
• Hewston, P. and Deshpande, N., 2016. Falls and balance impairments in older adults with type 2 diabetes: thinking beyond diabetic peripheral neuropathy. Canadian journal of diabetes, 40(1), pp.6-9.
• Jørgensen, P.G., Jensen, M.T., Mogelvang, R., von Scholten, B.J., Bech, J., Fritz-Hansen, T., Galatius, S., Biering-Sørensen, T., Andersen, H.U., Vilsbøll, T. and Rossing, P., 2016. Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics. Diabetes and Vascular Disease Research, 13(5), pp.321-330.
• Kassan, M., Ait-Aissa, K., Ali, M., Trebak, M. and Matrougui, K., 2015. Augmented EGF receptor tyrosine kinase activity impairs vascular function by NADPH oxidase-dependent mechanism in type 2 diabetic mouse. Biochimica et Biophysica Acta (BBA)-Molecular Cell Research, 1853(10), pp.2404-2410.
• Khan, A., Petropoulos, I.N., Ponirakis, G. and Malik, R.A., 2017. Visual complications in diabetes mellitus: beyond retinopathy. Diabetic Medicine, 34(4), pp.478-484.
• Khunti, K., Davies, M., Majeed, A., Thorsted, B.L., Wolden, M.L. and Paul, S.K., 2015. Hypoglycemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study. Diabetes care, 38(2), pp.316-322.
• Liu, L.B., Chen, X.D., Zhou, X.Y. and Zhu, Q., 2018. The Wnt antagonist and secreted frizzled-related protein 5: implications on lipid metabolism, inflammation, and type 2 diabetes mellitus. Bioscience reports, 38(4), p.BSR20180011.
• Marso, S.P., Daniels, G.H., Brown-Frandsen, K., Kristensen, P., Mann, J.F., Nauck, M.A., Nissen, S.E., Pocock, S., Poulter, N.R., Ravn, L.S. and Steinberg, W.M., 2016. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine, 375(4), pp.311-322.
• Mohammadi, S., Karim, N.A., Talib, R.A. and Amani, R., 2015. Knowledge, attitude and practices on diabetes among type 2 diabetic patients in Iran: a cross-sectional study. Science, 3(4), pp.520-4.
• Monea, A., Santacroce, L., Marrelli, M. and Man, A., 2017. Oral candidiasis and inflammatory response: a potential synergic contribution to the onset of Type-2 diabetes mellitus. AMJ, 10(6), pp.550-556.
• Nitzan, O., Elias, M., Chazan, B. and Saliba, W., 2015. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes, metabolic syndrome and obesity: targets and therapy, 8, p.129.
• Peters, A.L., Henry, R.R., Thakkar, P., Tong, C. and Alba, M., 2016. Diabetic ketoacidosis with canagliflozin, a sodium–glucose cotransporter 2 inhibitor, in patients with type 1 diabetes. Diabetes Care, 39(4), pp.532-538.
• Reusch, J.E. and Manson, J.E., 2017. Management of type 2 diabetes in 2017: getting to goal. Jama, 317(10), pp.1015-1016.
• Rewers, A., Dong, F., Slover, R.H., Klingensmith, G.J. and Rewers, M., 2015. Incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado youth, 1998-2012. Jama, 313(15), pp.1570-1572.
• Samuel, V.T. and Shulman, G.I., 2016. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. The Journal of clinical investigation, 126(1), pp.12-22.
• Santilli, F., Liani, R., Di Fulvio, P., Formoso, G., Simeone, P., Tripaldi, R., Ueland, T., Aukrust, P. and Davì, G., 2016. Increased circulating resistin is associated with insulin resistance, oxidative stress and platelet activation in type 2 diabetes mellitus. Thrombosis and haemostasis, 116(12), pp.1089-1099.
• Siddiqui, A.A., Siddiqui, S.A., Ahmad, S., Siddiqui, S., Ahsan, I. and Sahu, K., 2013. Diabetes: Mechanism, pathophysiology and management-A review. Int J Drug Dev Res, 5(2), pp.1-23.
• Smith, U. and Kahn, B.B., 2016. Adipose tissue regulates insulin sensitivity: role of adipogenesis, de novo lipogenesis and novel lipids. Journal of internal medicine, 280(5), pp.465-475.
• Steven, S., Hollingsworth, K.G., Al-Mrabeh, A., Avery, L., Aribisala, B., Caslake, M. and Taylor, R., 2016. Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders. Diabetes care, 39(5), pp.808-815.
• Storgaard, H., Bagger, J.I., Knop, F.K., Vilsbøll, T. and Rungby, J., 2016. Diabetic ketoacidosis in a patient with type 2 diabetes after initiation of sodium–glucose cotransporter 2 inhibitor treatment. Basic & clinical pharmacology & toxicology, 118(2), pp.168-170.
• Suppli, M.P., Lund, A., Bagger, J.I., Vilsbøll, T. and Knop, F.K., 2016. Involvement of steatosis-induced glucagon resistance in hyperglucagonaemia. Medical hypotheses, 86, pp.100-103.
• Teobaldi, I., Stoico, V., Perrone, F., Bruti, M., Bonora, E. and Mantovani, A., 2018. Honey dressing on a leg ulcer with tendon exposure in a patient with type 2 diabetes. Endocrinology, diabetes & metabolism case reports, 2018(1).pp.19-27.
• van Dooren, F.E., Denollet, J., Verhey, F.R., Stehouwer, C.D., Sep, S.J., Henry, R.M., Kremers, S.P., Dagnelie, P.C., Schaper, N.C., van der Kallen, C.J. and Koster, A., 2016. Psychological and personality factors in type 2 diabetes mellitus, presenting the rationale and exploratory results from The Maastricht Study, a population-based cohort study. BMC psychiatry, 16(1), p.17.
• www.diabetes.org.uk 2018, Diabetes Prevalence 2018, Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/statistics/diabetes-prevalence-2018 [Accessed on: 29 April 2019]
• www.diabetes.org.uk 2018, Facts & Figures: Diabetes, Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/statistics [Accessed on: 29 April 2019]
• www.diabetes.org.uk 2019, Tackling the crisis: Transforming diabetes care for a better future England, Available at: https://www.diabetes.org.uk/resources-s3/2019-04/Diabetes%20UK%20Tackling%20the%20Crisis.pdf? [Accessed on: 29 April 2019]
• Yu, O., Azoulay, L., Yin, H., Filion, K.B. and Suissa, S., 2018. Sulfonylureas as initial treatment for type 2 diabetes and the risk of severe hypoglycemia. The American journal of medicine, 131(3), pp.317-e11.
• Zhao, D., Cho, J., Kim, M.H., Friedman, D.S. and Guallar, E., 2015. Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology, 122(1), pp.72-78.