Type 2 diabetes (Diabetes mellitus) is a common chronic non-communicable disease. It affects both men and women, most commonly over the age of 40. The dangers of type 2 diabetes are underestimated by many, and some patients are, in fact, simply ignored. reported that they are susceptible to disease. And patients who are aware of their illness often don't know what it is - diabetes, what it threatens, and aren't aware of its dangers. As a result, type 2 diabetes can become severe and lead to life-threatening conditions. Meanwhile, adequate treatment and proper nutrition in type 2 diabetes can prevent the development of the disease.
Reason
When a person develops diabetes, the causes of this fact can be different. The latter usually leads to:
- wrong diet;
- lack of physical activity;
- excess weight;
- heredity;
- stress;
- self-medication, eg, glucocorticosteroids.
In fact, there is often not a single prerequisite, but a whole complex of reasons.
If we consider the occurrence of the disease from the point of view of pathogenesis, type 2 diabetes is caused by a relative deficiency of insulin in the blood. This is the name for the state when the insulin protein produced by the pancreas cannot reach the insulin receptors located on the cell membranes. As a result, the cells are deprived of their ability to absorb sugar (glucose), leading to a lack of glucose supply to the cells, and equally dangerous is the accumulation of glucose in the blood and deposition in towels. different paper. According to this criterion, non-insulin dependent diabetes mellitus differs from type 1 diabetes mellitus, in which the pancreas does not produce enough insulin.
Symptom
The symptoms of the disease largely depend on the stage of the disease. In the early stages, the patient may not feel seriously ill, except for increased fatigue, dry mouth, increased thirst and appetite. This condition is often attributed to the wrong diet, chronic fatigue syndrome, stress. In reality, however, the cause is an underlying medical condition. As the disease progresses, symptoms may include:
- Poor wound healing
- weakened immune system
- pain and swelling in the limbs,
- headache,
- oily dermatitis.
However, patients often do not correctly interpret even such a set of symptoms, and diabetes develops unhindered until it reaches an intractable stage or leads to life-threatening conditions. network.
Type 2 diabetes, how to treat
In fact, there is no method effective enough to increase the absorption of glucose by cells, so the main focus in treatment is to reduce blood sugar levels. In addition, efforts should be aimed at reducing the patient's excess weight, returning the patient to normal, since an abundance of adipose tissue plays an important role in the pathogenesis of diabetes.
The main factor affecting the likelihood of complications in type 2 diabetes is a violation of lipid metabolism. Excess cholesterol that is different from normal can lead to the development of vascular disease.
| Risk of developing vascular disease in diabetes | Short | Middle name | Tall |
|---|---|---|---|
| Total cholesterol, mmol/l | <4, 8 | 4, 8-6, 0 | >6. 0 |
| LDL, mmol/l | <3. 0 | 3. 0-4. 0 | >4. 0 |
| Triglyceride, mmol/l | <1, 7 | 1, 7-2, 2 | >2, 2 |
Treatments
Type 2 diabetes is a disease that requires long-term and persistent treatment. In fact, all the methods used are divided into three groups:
- use medicine,
- diet,
- lifestyle change.
Effective treatment of type 2 diabetes involves the fight not only with diabetes, but also with concomitant diseases, such as:
- fat,
- hypertension,
- vascular disease,
- neuropathy,
- Depression.
Type 2 diabetes is treated on an outpatient basis and at home. Only patients with hyperglycemic and hyperglycemic coma, ketoacidosis, severe forms of neurological and vascular disease, and stroke should be hospitalized.
Medicines against diabetes
In fact, all drugs are divided into two main groups - those that affect insulin production and those that don't affect insulin production.
The main drug of the second group is from the group of biguanides. This medication is commonly prescribed for type 2 diabetes. Without affecting the cells of the pancreas, it maintains blood sugar in the normal range. The drug does not threaten to cause a serious drop in blood glucose levels. In addition, the drug burns fat and reduces appetite, which leads to a reduction in the patient's excess weight. However, an overdose of the drug can be dangerous, as a serious medical condition with high mortality can occur - lactic acidosis.
Typical representatives of another class of drugs that affect the production of insulin are sulfonylurea derivatives. They directly stimulate the beta cells of the pancreas, causing them to produce more insulin. However, overdose of these drugs carries the risk of hypoglycemia. Sulfonylurea derivatives are often used in conjunction with biguanides.
There are other drugs. Tinnitus enhancers (GLP-1 agonists) and DPP-4 inhibitors belong to the class of drugs that increase insulin production depending on glucose levels. These are new drugs, and so far they are quite expensive. They inhibit the synthesis of the hormone glucagon, enhance the action of incretin - the gastrointestinal hormone that helps increase insulin production.
There is also a drug that blocks the absorption of glucose in the digestive tract - an alpha-glucosidase inhibitor. This tool does not affect the production of insulin. Medicines are often prescribed with the aim of preventing and preventing diabetes.
There are also drugs that enhance the excretion of glucose in the urine, and drugs that increase the sensitivity of cells to glucose.
Medical insulin is rarely used in the treatment of type 2 diabetes. Usually, it is used when treatment has not been effective with other medications, with a decompensated form of diabetes, when the pancreasimpaired and unable to produce enough insulin.
Type 2 diabetes is also often accompanied by comorbidities:
- vascular disease,
- Depression
- neuropathy,
- hypertension
- metabolic lipid disorders.
If such diseases are detected, then drugs will be prescribed for their treatment.
| Type | Mechanism of action |
|---|---|
| Sulfonylureas | stimulates insulin secretion |
| Glinides | stimulates insulin secretion |
| biguanides | decreased glucose production by the liver and tissues resistant to glucose |
| Glitazones | decreased glucose production by the liver and tissues resistant to glucose |
| Alpha-glucosidase inhibitors | slow absorption of glucose in the intestine |
| Glucanogon-like peptide receptor agonist | stimulates glucose-dependent insulin secretion and reduces glucagon secretion |
| Gliptins (dipeptidyl peptidase-4 inhibitor) | stimulates glucose-dependent insulin secretion and reduces glucagon secretion |
| insulins | increased use of glucose |
Diet
The essence of dietary changes in DM is to regulate the nutrients entering the digestive tract. The required nutritional regimen should be determined individually by the endocrinologist for each patient, taking into account the severity of diabetes, comorbidities, age, lifestyle, etc. v.
There are several types of diets used for non-insulin-dependent diabetes (table 9, low-carbohydrate diets, etc. ). They are all well proven and differ only in some details. But they agree on a basic principle - the norm of carbohydrate consumption should be strictly limited in case of illness. First of all, this applies to products containing "fast" carbohydrates, that is, carbohydrates that are absorbed very quickly from the gastrointestinal tract. Fast carbohydrates are found in refined sugars, jams, confectionery, chocolate, ice cream, desserts, and baked goods. In addition to reducing carbohydrate intake, an effort should be made to reduce body weight, as weight gain is a factor that aggravates the course of the disease.
Other instructions
You should increase your water intake to compensate for the loss of water due to frequent urination that often accompanies diabetes. With that, it is necessary to completely abandon sugary drinks - colas, lemonade, kvass, juices and sugary teas. In fact, you can only drink sugar-free beverages - mineral and filtered water, unsweetened tea and coffee. It must be remembered that drinking alcohol can also be harmful - due to the fact that alcohol disrupts glucose metabolism.
Meals should be frequent - at least 3 times a day, and preferably - 5-6 times a day. You shouldn't sit at the dinner table right after exercising.
How to monitor blood sugar level
The essence of diabetes therapy is patient self-control. In type 2 diabetes, the sugar level should be within the normal range or close to it. Therefore, patients need to control their own sugar to avoid an increase in danger. To do this, you should keep a diary in which the values \u200b \u200bof the concentration of glucose in the blood are recorded. You can measure your blood sugar with a special hand-held blood glucose meter equipped with test strips. It is recommended that the measurement procedure be performed every day. The best time to measure is early morning. Before the procedure, it is not allowed to take any food. If possible, this procedure can be repeated several times a day and sugar levels can be determined not only in the morning on an empty stomach but also after meals, at bedtime, etc. v. When the patient knows the blood sugar change chart, the patient will quickly adjust the diet and activities so that the blood sugar index is in a normal state.
However, the presence of a glucometer does not prevent the patient from having to regularly check blood sugar in the outpatient clinic, as the values obtained in the laboratory are more accurate.
It shouldn't be too difficult to control your sugar when consuming foods, as most grocery items are labeled with their caloric value and the amount of carbohydrates they contain. There are diabetic analogues of regular foods, in which carbohydrates are replaced with low-calorie sweeteners (sorbitol, xylitol, aspartame).
| Stage | Glucose level, mmol/l |
|---|---|
| Status of the standard | 3, 3-5, 5 |
| Impaired glucose tolerance | 5, 6-6, 0 |
| Diabetes, early stage | 6, 1-8, 0 |
| Diabetes, middle stage | 8. 1-14. 0 |
| Diabetes, severe stage | >14. 1 |
Fruits and vegetables
Can people with type 2 diabetes eat fruits and berries? Priority should be given to vegetables containing many indigestible substances but beneficial for digestion, fiber and low in sugar. However, many vegetables such as potatoes, radishes, and carrots contain a lot of starch, so they should be limited. Fruits can be consumed in moderation, and only those that do not contain excessive amounts of carbohydrates. Among fruits, bananas hold the record for carbohydrate content, followed by grapes and melons. They are not recommended, as they can raise blood sugar levels.
Folk methods of treatment
Folk treatments involve taking a decoction of medicinal herbs. Such therapy can not only reduce blood sugar, but also reduce appetite, reduce excess weight. However, only folk remedies can be applied in addition to taking drugs and consulting a doctor.
Do exercise
An adjuvant therapy is physical exercises. During moderate-intensity exercise, the body burns large amounts of glucose. Metabolism returns to normal, the cardiovascular system is strengthened. Daily exercise is essential. However, the exercises should not cause fatigue, as this can only achieve the opposite effect. When fatigue is severe, appetite increases, and a large meal can negate all the positive effects of physical activity. Fatigue causes stress and the release of adrenal hormones, which increase blood glucose levels. Therefore, the type of physical activity should be chosen according to the patient's physical fitness - simple exercises, weight training or walking, jogging, swimming, cycling.
| Type of operation | Cost, kcal/h | Food contains a similar amount of energy |
|---|---|---|
| Rest lie down | 80 | apple, 20 g nuts |
| Rest sitting | hundred | apple, 20 g nuts |
| Stand still | 140 | a glass of milk |
| Housework | 180 | a glass of milk |
| Walk slowly, work on the spot gently | 220 | 120 g cream |
| Ride bicycle | 250 | 100g white bread |
| Walk fast, swim slowly, jump slowly, rowing | 300 | 150g black bread |
| Volleyball, badminton, table tennis | 350 | 90 g biscuits or cheese |
Forecast
In severe cases, when type 2 diabetes reaches the stage of decompensation, it is usually impossible to reverse the disease and return glucose levels to normal - due to the depletion of pancreatic resources andbody as a whole. So, type 2 diabetes in such a condition is an incurable disease. However, the right treatment of type 2 diabetes can prolong a patient's life for many years. In the early stages of type 2 diabetes, simply changing the diet and lifestyle, increasing physical activity can control blood glucose levels and keep it within acceptable limits. As a result, patients can live for many more decades and do not experience any complications of diabetes.