Diabetes 2 Treatment You Need to Know


Causes


Type 2 diabetes is the most common type of diabetes in the world. There are two causes of type 2 diabetes: one is impaired insulin secretion, which is influenced by various genetic factors, the other is insulin resistance (insulin resistance), which can be caused by both genetic factors and obesity. Thus, two factors are involved in the formation of type 2 diabetes: genetic, which we have no influence on, and environmental - obesity, especially abdominal, which is called a modifiable factor, i.e. it is largely due to a person's lifestyle and may change as a result of appropriate behavior.

 Development of type 2 diabetes


Diabetes is a progressive disease, its development is gradual. At the beginning, we are dealing with obesity and a genetically determined disorder of insulin production and/or secretion. This means that insulin is produced by the pancreas, but its secretion does not occur as in a healthy person - it is secreted with a delay and longer than it should. At this stage, blood glucose (glycemia) is still normal.

In turn, the second factor causing diabetes - obesity - is the cause of insulin resistance; the pancreas must produce more and more insulin to maintain blood glucose levels normal. After several to a dozen or so years of such a state, pancreatic ß cells become depleted and produce less and less insulin. This is the time when blood glucose levels rise, leading to the diagnosis of type 2 diabetes.

Epidemiology

Type 2 diabetes is a hereditary disease. Usually, it affects older people, in the past it was even called senile diabetes, but due to the epidemic of obesity, the age of developing type 2 diabetes has significantly decreased and type 2 diabetes is now more and more common in obese young people, sometimes even teenagers.

Prevention

Preventing the development of type 2 diabetes is taking care of maintaining healthy body weight through proper diet and regular physical activity. Regular exercise reduces insulin resistance. Studies show that proper diet and exercise are very effective in preventing the development of type 2 diabetes.

Symptoms

Symptoms of type 2 diabetes develop gradually. Initially, when the blood glucose is not very high yet, diabetes usually does not cause any symptoms. Therefore, people at increased risk of developing diabetes should be checked for fasting glucose or glucose tolerance periodically, especially if they have obesity, hypertension and heart disease, and family history of diabetes has been reported.

As insulin resistance deteriorates and the ability of the pancreatic β-cells to become insulin depleted, clinical symptoms of diabetes develop: excessive thirst, urination, general weakness, and urogenital infections. People with persistently high blood glucose levels may experience spontaneous weight loss due to a lack of insulin, which means glucose is not introduced into the body's cells and is not used as energy.

Treatment

Treatment of type 2 diabetes is comprehensive and requires several methods to be used simultaneously. These include non-pharmacological methods, i.e. education, dietary treatment, exercise, and pharmacological treatment. In addition, it is necessary to treat cardiovascular risk factors, and appropriate treatment is required for patients with diabetes complications.

In the treatment of type 2 diabetes, the patient's involvement in therapy is of great importance, as diet and regular physical activity are very effective. The primary line tranquilize is metformin, which lessens insulin opposition. If your blood glucose levels continue to rise despite your treatment, then your therapy will be intensified by adding more oral or subcutaneous medications. The ineffectiveness of such treatment means the total lack of insulin secretion by the pancreas and requires the transition to the next stage of treatment, i.e. the use of insulin.


Diabetes leads to the development of chronic complications - in the world every few seconds the foot is amputated due to diabetes, diabetes is the most common cause of blindness, most often dialysis is due to diabetic kidney failure.

Patient training is also a very important method of treating diabetes ("Who knows more about diabetes, lives longer" - Joslin). An important goal of education is to strive to implement in the patient behaviors promoting cooperation in treatment.

Physical activity is highly recommended, but it should be tailored to the person's abilities. Regular exercise is recommended. It has been proven that it leads to a reduction of insulin resistance. Fast walking is best, preferably 30 minutes daily or at least 3 times a week.

Diet

The diet used for type 2 diabetes is to reduce weight. The number of calories consumed by a person diagnosed with diabetes is usually very high - up to 3500 kcal / d. It is important to determine exactly how many calories you consume; you can do it together with a dietitian or yourself, using the calorie tables.


Realizing how much calories we really eat is extremely important - obese people usually say they don't eat anything or eat very little. Then gradually reduce the number of calories consumed by about 500 kcal every few months. By reducing the number of calories supplied with food, we lose weight. A typical reduction diet, i.e. one that leads to a decrease in body weight, is 1000-1200 kcal / d. A satisfactory rate of weight loss is about 2.5 kg per month. The person who says: "I follow the diabetic diet" and is still obese and does not reduce his body weight, unfortunately, he is wrong - he does not follow the diet because he does not lose weight, or his diet contains too many calories in the case of her metabolism. It is worth checking the number of calories consumed daily from time to time. Of course, every diet,


The diet of a person with type 2 diabetes treated with oral medications should include 5 meals: three main and two snacks (second breakfast and afternoon tea). Often patients say that this is too many meals, making it impossible to lose weight. This is not true - in the concept of dietetics, eating a meal is also considered to be eating an apple or yogurt. We are often not aware of the number of so-called empty calories that we consume, but not included in the calories of meals: sweet carbonated drinks, juices, fruits, sugar used to sweeten drinks, cereal coffee with milk. Also often eaten small cookies, pretzel, buns, and chips are not taken into account.

A person with type 2 diabetes treated with 4 injections of human insulin or 2 injections of human insulin mixtures should consume 5-6 meals. This sixth meal, the second dinner, is not mandatory if your blood glucose is> 130 mg/dl before going to bed and you do not have any hypoglycemia at night. If type 2 diabetes is treated with fast-acting insulin analogs, eat as many meals as the injections, usually 3, and sometimes 4 or 5. If you are being treated with 2 injections of analog mixtures, 3 meals will suffice. However, you should always adapt your meals to your blood glucose - if you have hypoglycemia, you may need to eat small snacks to prevent hypoglycemia.

Periodic examinations

Everyone with type 2 diabetes should remain under the care of a diabetologist and control their blood glucose with a meter. Recommended periodic tests include determining the percentage of glycated hemoglobin (HbA1c) - diabetes control indicator; it is recommended to perform such a determination once a year. The physician should also prescribe urine albumin excretion (see Diabetic Nephropathy ). The patient should remember about the annual eye fundus ophthalmological examination for diabetic retinopathy, as well as watch his feet every day and take care of their hygiene.


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