Type 2 diabetes (DM) is a common chronic non-communicable disease. It affects both men and women, most often from the age of 40. The danger of type 2 diabetes is underestimated by many, and some patients, in fact, are simply not informed that they are susceptible to the disease. And those of the patients who know their pathology often do not know what it is - diabetes mellitus, what it threatens, and ignore its danger. As a result, type 2 diabetes can become serious and lead to life-threatening conditions. Meanwhile, proper treatment and adequate nutrition in type 2 diabetes can stop the development of the disease.
causes
When a person develops diabetes, the causes of this fact can be varied. The second type of disease often results in:
- bad nutrition;
- lack of physical activity;
- overweight;
- heredity;
- stress;
- self-medication with drugs, for example, glucocorticosteroids.
In fact, there is often not just one prerequisite, but a whole set of reasons.
Considering the onset of the disease from the point of view of pathogenesis, type 2 diabetes mellitus is caused by a relative lack of insulin in the blood. This is the name for the condition where the protein insulin produced by the pancreas becomes inaccessible to insulin receptors located on cell membranes. As a result, cells are deprived of the ability to absorb sugar (glucose), which leads to a lack of supply of glucose to cells, and also, no less dangerously, to the accumulation ofblood glucose and its deposition in various tissues. By this criterion, non-insulin-dependent diabetes mellitus differs from type 1 diabetes, in which the pancreas produces insufficient insulin.
Symptoms
Symptoms of the disease largely depend on the stage of the disease. In the early stages, the patient may not experience serious illness except for increased fatigue, dry mouth, increased thirst and appetite. This condition is usually attributed to poor diet, chronic fatigue syndrome, stress. However, in fact, the cause is a latent pathology. As the disease progresses, symptoms may include:
- poor healing
- weakened immune system
- limb pain and swelling,
- headache,
- dermatitis.
However, often patients misinterpret even one set of these symptoms, and diabetes grows unchecked until it reaches intractable stages or leads to life-threatening conditions.
Type 2 diabetes mellitus, treatment
In fact, there are no sufficiently effective methods to increase the uptake of glucose by cells, so the main focus of treatment is on reducing the concentration of sugar in the blood. In addition, efforts should be aimed at reducing the excess weight of the patient, bringing it back to normal, since the abundance of fatty tissue plays an important role in the pathogenesis of diabetes.
The main factor influencing the likelihood of complications of type 2 diabetes is a violation of lipid metabolism. An excessive amount of cholesterol that differs from the norm can lead to the development of angiopathy.
| The risk of developing angiopathy in diabetics | Short | Environment | 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 | >2. 2 |
Treatment methods
Type 2 diabetes mellitus is a disease that requires long-term and persistent treatment. In fact, all the methods used are divided into three groups:
- to take drugs,
- diet,
- lifestyle change.
Effective treatment for type 2 diabetes involves fighting not only the diabetes itself, but also co-occurring diseases, such as:
- obesity,
- hypertension,
- angiopathy,
- neuropathy,
- depression.
Type 2 diabetes is treated on an outpatient basis and at home. Only patients with hyperglycemic and hyperosmolar coma, ketoacidosis, severe forms of neuropathies and angiopathy, and strokes are subject to hospitalization.
Diabetes medications
In fact, all drugs are divided into two main groups - those that affect insulin production and those that do not.
The main drug of the second group belongs to the class of biguanides. This drug is most often prescribed for type 2 diabetes. Without affecting pancreatic cells, it keeps blood sugar at normal levels. The drug does not threaten a critical decrease in glucose levels. Also, the drug burns fat and reduces appetite, which leads to a decrease in the patient's excess weight. However, an overdose of the drug can be dangerous, since a serious pathological condition with a high percentage of mortality can occur - lactic acidosis.
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, an overdose of these drugs threatens the patient with 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 increase insulin production as a function of glucose concentration. These are new drugs, and so far they are quite expensive. They inhibit the synthesis of the sugar-elevating hormone glucagon, enhance the action of incretins - gastrointestinal hormones that increase insulin production.
There is also a drug that prevents the absorption of glucose from the gastrointestinal tract - an alpha-glucosidase inhibitor. This tool does not affect the production of insulin. The drug is often prescribed for prophylactic purposes, to prevent diabetes.
There are also drugs that improve 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. Most often it is used with the ineffectiveness of therapy with other drugs, with a decompensated form of diabetes mellitus, when the pancreas is exhausted andcannot produce enough insulin.
Type 2 diabetes is also often accompanied by comorbidities:
- angiopathy,
- depression
- neuropathies,
- hypertension
- lipid metabolism disorders.
If such diseases are found, drugs are prescribed for their treatment.
Diet
The essence of diet modification in DM is the regulation of nutrients entering the gastrointestinal tract. The necessary nutrition should be determined by the endocrinologist individually for each patient, taking into account the severity of diabetes, concomitant diseases, age, lifestyle, etc.
There are several types of diets used for non-insulin-dependent diabetes (table number 9, low-carb diet, etc. ). All of them are proven and differ from each other only in a few details. But they agree on the basic principle - the norms of carbohydrate intake in the event of illness should be strictly limited. First of all, this applies to products containing "fast" carbohydrates, that is, carbohydrates that are very quickly absorbed from the gastrointestinal tract. Fast carbohydrates are found in refined sugar, jams, confectionery, chocolate, ice cream, desserts, baked goods. In addition to reducing the amount of carbohydrates, it is necessary to strive to reduce body weight, since increased weight is a factor that aggravates the course of the disease.
Other guidelines
It is recommended that you increase your water intake to replace the fluid loss from frequent urination that often accompanies diabetes. Along with this, it is necessary to completely abandon sweet drinks - cola, lemonade, kvass, juice and tea with sugar. In fact, you can drink only drinks that do not contain sugars - mineral and still water, unsweetened tea and coffee. It should be remembered that alcohol consumption can also be harmful - due to the fact that alcohol disrupts glucose metabolism.
Meals should be regular - at least 3 times a day, and even better - 5-6 times a day. You should not sit down at the table immediately after exercise.
How to monitor blood sugar
The essence of diabetes therapy is self-control on the part of the patient. In type 2 diabetes, the sugar level should be within or near the normal range. Therefore, the patient must control his sugar level on his own in order to avoid critical increases. To do this, it is advisable to keep a diary in which the values of the concentration of glucose in the blood will be recorded. You can take glucose readings with special portable glucometers equipped with test strips. It is advisable to carry out the measurement procedure every day. The best time to measure is early in the morning. Before the procedure, it is forbidden to take food. If possible, the procedure can be repeated several times a day, and the sugar level can be determined not only in the morning on an empty stomach, but also after meals, before going to bed, etc. Knowing the graph of changes in blood sugar, the patient will be able to quickly adjust his diet and lifestyle, so that the glucose indicator is in the normal state.
However, the presence of a glucometer does not exempt the patient from the need to regularly check blood sugar levels in the outpatient clinic, since the values obtained in the laboratory are more accurate.
It's not that difficult to control your sugar level when consuming food because most grocery products are labeled with their energy value and the amount of carbohydrates they contain. There are diabetic analogues of conventional foods, in which carbohydrates are replaced with low-calorie sweeteners (sorbitol, xylitol, aspartame).
Fruits and vegetables
Is it possible to eat fruits and berries with type 2 diabetes? We must favor vegetables that contain a large amount of indigestible, but useful for digestion, fiber and less 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 do not contain very high amounts of carbohydrates. Among fruits, bananas hold the record for carbohydrate content, followed by grapes and melon. Their use is not recommended, as they can increase blood sugar levels.
Folk remedies
Folk remedies consist in taking decoctions of medicinal herbs. Such therapy can not only lower blood sugar, but also reduce appetite, reduce excess weight. However, folk remedies can only be taken in addition to taking medication and in consultation with your doctor.
Physical exercise
An auxiliary method of therapy is physical exercises. During moderate-intensity exercise, the body burns large amounts of glucose. The metabolism returns to normal, the cardiovascular system is strengthened. Physical exercise is essential on a daily basis. However, the exercises should not be strenuous, as this can only produce the opposite effect. With severe fatigue, 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 raise blood sugar. Therefore, it is recommended to select the type of physical activity that would suit the athletic form of the patient - simple exercises, exercises with dumbbells or walking, jogging, swimming, cycling.
Forecast
In severe cases, when type 2 diabetes mellitus reaches the stage of decompensation, then, as a rule, it is already impossible to reverse the disease and bring blood sugar levels back to normal - due to resource depletionpancreas and body as a whole. Therefore, type 2 diabetes in such a situation is an incurable disease. However, the correct treatment of type 2 diabetes can prolong the patient's life for many years. At the initial stage of type 2 diabetes mellitus, it is possible to control the concentration of glucose in the blood and maintain it within acceptable limits only by changing diet and lifestyle and increasing physical activity. As a result, the patient can live for several decades and not face diabetes complications.