Type 2 Diabetes
(Diabetes mellitus type 2, insulin resistant diabetes, diabetes, type 2)
Glucose is generated from the decomposition of food.It is the body's energy source.The cells can be absorbed from the blood with the help of a hormone called insulin.Without insulin, glucose accumulates in the blood and causes hyperglycemia.At the same time, body cells need glucose (energy).
The lack of insulin, or the resistance she, causes diabetes.In type 2 diabetes, the body is resistant to high insulin levels.The body contains a large amount of insulin but the cells cannot use it.
High blood sugar levels for a prolonged period can damage vital organs, such as kidneys, eyes and nerves.
Causes
Two conditions contribute hyperglycemia in type 2 diabetes:
Insulin resistance related to excess body fat.
The inability of the body to produce an adequate amount of insulin.
Risk factors
The factors that increase the chances of developing type 2 diabetes include:
Have a family history of type 2 diabetes.
Suffer obesity or overweight.
Have cholesterol problems.
Have high blood pressure.
Have a history of cardiovascular disease.
Have a history of gestational diabetes or have a baby that weighs more than 4 kg (9 pounds)
Have an endocrine disorder (Cushing Syndrome, Hyperthyroidism, Acromegaly, Ovarian Polycion, Pheochromocytoma, Glucagonoma).
Have a condition related to insulin resistance (eg, pigmentary acanthosis).
Symptoms
You may not manifest symptoms for years.Symptoms due to the high content of blood sugar or complications for diabetes may include:
Urine increase
Excessive thirst
Hunger
Fatigue
Blurred vision
Irritability
Recurring or frequent infections
Bad healing wounds
Angina
Painful legs on the legs when walking
Numbness or tingling in the hands or feet
In women: frequent vaginal infections and urinary tract infections
Gum problems
Itch
Impotence
Diagnosis
The diagnosis is based on the results of blood tests.The American Diabetes Association (ADA) established the following guidelines:
Diabetes symptoms and random blood analysis that reveals a level of blood glucose greater than or equal to 200 mg/dl [11.1 mmol/l]
Glycemia analysis after at least eight hours of fasting (fasting glycemia) that reveal levels of blood glucose higher than or equal to 126 mg/dl (7.0 mmol/l) in two different days
Glucose tolerance test that measures blood sugar two hours after consuming glucose with a higher measurement · or equal to 200 mg/dl (11.1 mmol/l)
HBA1C level of 6.5% or higher, which indicates poor blood glucose control during the last 2 to 4 months
mg/l = milligrams per deciliter of blood, mmol/l = millimol per liter of blood
Treatment
The treatment has the objective of:
Keep blood sugar at levels as normal as possible
Prevent or delay complications (habitual medical care is important)
Control other conditions, such as high blood pressure and high cholesterol
Diet
Follow a balanced meal plan.Eat regular amounts · and moderate food at usual schedules.
Wife fruits and peanut butter are a good choice for snacks.These snacks can help reduce the risk of cardiovascular disease for women with diabetes.
Do not skip meals.
Eat a large amount of vegetables and fiber.
Limit fat consumption.
Consume moderate amounts of protein and dairy products with low contentof fat.
Carefully limit foods that contain high levels of concentrated sugar.
Keep a registration of the food you eat.This will help a nutritionist or a doctor to advise him.
Weight loss
If you are overweight, consult the doctor about a reasonable weight target.Develop with the doctor a safe diet program.If you lose weight, the body will respond better to insulin.
Group education can help people recently diagnosed to lower weight to the desired objective.
Physical activity:
It can cause the body to become more sensitive to insulin.
It helps to reach and maintain a healthy weight.
It can reduce blood fat levels.
To improve blood glucose control: aerobic exercises, a good physical condition and resistance training can help improve HBA1C levels.Researchers have also discovered that long -term strength and resistance training can improve HBAIC, even if it is not weight.
Diabetes is a risk factor for heart disease.Exercise can help reduce this risk.
oral medications
Oral medications can be used to reduce blood sugar:
Metformin: A class of medication that reduces body glucose production.It also makes the body more sensitive to insulin.This combination helps maintain blood glucose levels within normal limits.
Medications that stimulate pancreas cells to produce more insulin (eg, sulfonylureas [gliburid, tolezamide], dipeptidyl peptidase IV inhibitors IV [saxagliptin, sitagliptian], rephakard [prandin])
The Directorate of Drugs and Food (FDA) has warned that sigliptin can increase the risk of acute pancreatitis.
Insulin sensitizers: a class of medications that helps the body better use insulin (eg, pioglitazone)
Starch blockers: A class of medications (eg, carebose, miglitol) that reduce the absorption of glucose in the bloodstream
Injectable medications, for example:
Incredine mimetics (eg, exenatida) that stimulate insulin production in the pancreas and reduce appetite, which often derives in a weight loss (injections twice a day)
Amiline analogues (e.g., Pramlintida) that replaces a protein normally produced by the pancreas, scarce in people with type 2 diabetes (an injection before each meal)
See with the doctor about your medication program.
insulin
In some cases, the body does not produce enough insulin.Therefore, it may be necessary to use insulin injections.
They are necessary when blood sugar levels cannot be kept low after trying changes in lifestyle and medications..
Blood sugar measurement
Controlling glycemia levels during the day can help you stay in line.It also helps the doctor to determine if the treatment is working.This measurement is easy to perform with a detector.Keeping a record of blood glucose levels is especially important if it takes insulin.The measurement frequency depends on the result of blood glucose control.
HBA1C can also be controlled in the doctor's office.Doctors advise that HBA1C levels do not exceed 7% (ADA recommendation).This level has been shown to lead to less diabetic complications.
It may not be necessary for people with a condition that remains reasonably under control, even without insulin administration.See with the doctor before interrupting blood sugar control.