Type 2 diabetes (DM) is a common non-communicable chronic disease. It affects both men and women, most commonly over the age of 40. Many people underestimate the dangers of type 2 diabetes, and in fact, some patients are not told they are susceptible to the disease at all. And those patients who understand their pathology often don't know what it is -- diabetes, what its threats are, and don't know its dangers. As a result, type 2 diabetes can become severe and lead to life-threatening conditions. At the same time, adequate treatment and proper nutrition for type 2 diabetes can stop the disease from progressing.
When a person develops diabetes, the reasons for this fact can vary. The second disease usually causes:
- wrong diet;
- lack of physical activity;
- excess weight;
- Self-medication with medication, such as glucocorticoids.
In fact, it is often not a prerequisite, but a complex set of reasons.
If the occurrence of the disease is considered from the perspective of pathogenesis, then type 2 diabetes is caused by a relative lack of insulin in the blood. This is the name for the state when insulin proteins produced by the pancreas become unable to access insulin receptors on the cell membrane. As a result, cells are deprived of their ability to absorb sugar (glucose), which results in a lack of glucose supply to cells and, equally dangerous, accumulation and deposition of glucose in the bloodstream. various organizations. According to this criterion, non-insulin-dependent diabetes differs from type 1 diabetes, in which the pancreas does not produce enough insulin.
Symptoms of the disease largely depend on the stage of the disease. In the early stages, patients may not experience serious illness, except for increased fatigue, dry mouth, thirst, and appetite. This condition is often attributed to wrong diet, chronic fatigue syndrome, stress. In reality, however, the cause is an underlying pathology. As the disease progresses, symptoms may include:
- poor wound healing
- weakened immune system
- pain and swelling in the extremities,
However, even a group of such symptoms is often not interpreted correctly by patients, and diabetes develops unhindered until it reaches an intractable stage or leads to a life-threatening condition.
type 2 diabetes, treatment
In fact, there are currently no sufficiently effective methods to increase glucose uptake by cells, so the main focus of treatment is to lower blood glucose concentrations. In addition, efforts should be made to reduce the patient's overweight and bring it back to normal, as adipose tissue plays an important role in the pathogenesis of diabetes.
A major factor influencing the likelihood of complications in type 2 diabetes is a violation of lipid metabolism. Excess cholesterol that differs from normal levels can lead to the development of vascular disease.
|Risk of vascular disease in people with diabetes||short||middle||High|
|Total cholesterol, mmol/L||<4. 8||4. 8-6. 0||>6. 0|
|LDL, mmol/L||<3. 0||3. 0-4. 0||>4. 0|
|Triglycerides, mmol/L||<1. 7||1. 7-2. 2||>twenty two|
Type 2 diabetes is a disease that requires long-term and ongoing treatment. In fact, all the methods used fall into three groups:
- take medicine,
- Lifestyle changes.
Effective treatment of type 2 diabetes involves fighting not only the diabetes itself, but also accompanying diseases, such as:
- vascular disease,
Type 2 diabetes is treated in outpatient settings and at home. Only patients with hyperglycemia and hyperosmolar coma, ketoacidosis, severe forms of neuropathy and vascular disease, and stroke require hospitalization.
In fact, all drugs fall into two broad categories - those that affect insulin production and those that don't.
The main drugs in the second group are from the biguanides. This medication is most commonly used to treat type 2 diabetes. It maintains blood sugar at normal levels without affecting the cells of the pancreas. The drug does not threaten very low drops in glucose levels. In addition, the drug burns fat and reduces appetite, thereby reducing excess weight in patients. However, drug overdose can be dangerous because a serious pathological condition with high mortality - lactic acidosis can occur.
Typical representatives of another group of drugs that affect insulin production are sulfonylurea derivatives. They directly stimulate pancreatic beta cells, causing them to produce more insulin. However, overdose of these drugs can cause a patient to experience a hypoglycemic crisis. Sulfonylurea derivatives are usually taken with biguanides.
There are other types of drugs. Incretin mimetics (GLP-1 agonists) and DPP-4 inhibitors belong to the class of drugs that enhance insulin production according to glucose concentration. These are new drugs, and they are quite expensive so far. They inhibit the synthesis of the glucose-raising hormone glucagon and enhance the action of incretin -- a gut hormone that increases insulin production.
There is also a drug that blocks the absorption of glucose in the gastrointestinal tract—alpha-glucosidase inhibitors. The tool does not affect insulin production. This drug is usually used for prophylactic purposes to prevent 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 to treat type 2 diabetes. Mostly, it is used with other drug treatments ineffective, decompensated forms of diabetes when the pancreas is depleted and cannot produce enough insulin.
Type 2 diabetes is also often accompanied by comorbidities:
- vascular disease,
- Disorders of lipid metabolism.
If such a disorder is detected, a prescription for treatment is prescribed.
|Sulfonylureas||stimulate insulin secretion|
|Glinide||stimulate insulin secretion|
|Biguanides||Decreased glucose production by the liver and tissue resistance to glucose|
|glitazones||Decreased glucose production by the liver and tissue resistance to glucose|
|Alpha-glucosidase inhibitor||Glucose is slowly absorbed in the gut|
|Glucagon-like peptide receptor agonists||Glucose-dependent stimulation of insulin secretion and decreased glucagon secretion|
|Gliptins (Dipeptidyl Peptidase 4 Inhibitors)||Glucose-dependent stimulation of insulin secretion and decreased glucagon secretion|
|insulin||increase glucose utilization|
The essence of DM's altered diet is to modulate nutrient entry into the gastrointestinal tract. An endocrinologist should determine the necessary nutrition for each patient individually based on the severity of diabetes, concomitant diseases, age, lifestyle, etc.
There are several types of diets that can be used to treat non-insulin-dependent diabetes (Table 9, low-carb diets, etc. ). They both prove themselves very well, they just differ in a few details. But they agreed on the basic principle - carbohydrate intake when sick should be strictly limited. First, this applies to products that contain "fast" carbohydrates, that is, carbohydrates that are absorbed very rapidly from the gastrointestinal tract. Fast carbs are found in refined sugars, jams, candies, chocolate, ice cream, desserts, baked goods. In addition to reducing the amount of carbohydrates, weight loss efforts must also be made, as weight gain is a factor that exacerbates the disease process.
It is recommended that you increase your water intake to replace the fluid loss caused by frequent urination that often accompanies diabetes. At the same time, it is necessary to completely ditch sugary beverages - cola, lemonade, kvass, fruit juices and sweetened teas. In fact, you can only drink unsweetened beverages—mineral and plain water, unsweetened tea and coffee. It must be remembered that drinking alcohol can also be harmful - because alcohol disrupts glucose metabolism.
Meals should be regular—at least 3 times a day, and most importantly—5-6 times a day. Don't sit at the dining table immediately after exercising.
How to monitor blood sugar levels
The essence of diabetes treatment is patient self-control. In type 2 diabetes, blood sugar levels should be in the normal range, or close to the normal range. Therefore, patients need to control their blood sugar levels on their own to avoid severe spikes. For this, it is recommended to keep a diary, in which the value of the glucose concentration in the blood will be recorded. You can measure your blood sugar with a special portable blood glucose meter equipped with test strips. It is recommended to perform the measurement procedure daily. The best time to measure is in the early morning. Do not eat any food before surgery. If possible, this process can be repeated several times a day to measure blood sugar levels not only on an empty stomach in the morning, but also after meals, before bed, etc. Knowing the blood sugar chart allows patients to quickly adjust their diet and lifestyle to keep their blood sugar levels in a normal state.
However, the presence of a blood glucose meter does not alleviate the need for patients to regularly check their blood glucose levels in an outpatient setting, as the values obtained in the laboratory are more accurate.
It's not difficult to control your blood sugar levels when you eat foods, as most groceries are labeled with their energy value and the amount of carbohydrates they contain. There are diabetic analogs of traditional foods in which carbohydrates are replaced by low-calorie sweeteners (sorbitol, xylitol, aspartame).
|stage||Glucose level, mmol/L|
|canonical status||3. 3-5. 5|
|impaired glucose tolerance||5. 6-6. 0|
|diabetes, early||6. 1-8. 0|
|diabetes, intermediate||8. 1-14. 0|
|diabetes, severe stage||>14. 1|
fruits and vegetables
Can type 2 diabetes eat fruits and berries? Preference should be given to vegetables that contain a lot of indigestible but good for digestion and less fiber and sugar. However, many vegetables, such as potatoes, beets, and carrots, are high in starch and should be limited. Fruits can be eaten in moderation, and only those that are not high in carbohydrates should be eaten. Among fruits, bananas have the highest carbohydrate content, followed by grapes and melons. They are not recommended because they can increase blood sugar levels.
Folk remedies include taking herbal decoctions. Not only does this therapy lower blood sugar levels, it also reduces appetite and reduces excess weight. However, folk remedies can only be taken with medication and consultation with a doctor.
An adjunct therapy is physical exercise. During moderate-intensity exercise, the body burns a lot of glucose. Metabolism returns to normal and the cardiovascular system is strengthened. Physical exercise is essential every day. However, the practice should not be exhausting, as this can only have the opposite effect. With severe fatigue, appetite increases, and a hearty meal can counteract all the positive effects of physical activity. Fatigue causes stress and the release of adrenal hormones that increase blood sugar levels. Therefore, it is recommended to choose the type of physical activity that suits the patient's form of exercise - simple exercises, dumbbell exercises or walking, jogging, swimming, cycling.
|type of activity||Cost, kcal/hour||foods with similar energy|
|lie down and rest||80||apples, 20 g nuts|
|rest||one hundred||apples, 20 g nuts|
|stand and rest||140||glass of milk|
|housework||180||glass of milk|
|Slow walk, easy infield work||220||120 g ice cream|
|Cycling||250||100 g white bread|
|brisk walking, slow swimming, slow dancing, rowing||300||150 g brown bread|
|Volleyball, badminton, table tennis||350||90 g crackers or cheese|
In severe cases, when type 2 diabetes reaches a stage of decompensation, it is often already impossible to reverse the disease and return blood sugar levels to normal - due to the depletion of the pancreas and the body's resources throughout. Therefore, type 2 diabetes in this case is an incurable disease. However, the correct treatment of type 2 diabetes can add many years to a patient's life. In the initial stages of type 2 diabetes, only through dietary and lifestyle changes, and increased physical activity, can blood glucose levels be controlled and maintained within an acceptable range. As a result, patients can live for decades without facing any diabetic complications.