What is diabetes mellitus?
Type 2 diabetes mellitus (DM) is a common non-infectious chronic disease. It affects both men and women, most often over the age of 40 years.
The danger of type 2 diabetes is underestimated by many, and some patients, in fact, are simply not informed that they are prone to illness. And those of the patients who are aware of their pathology, often do not know what it is – diabetes, what it threatens, and are not aware of its danger.
As a result, type 2 diabetes can take severe forms and lead to life-threatening conditions. Meanwhile, adequate treatment and proper nutrition in diabetes mellitus type 2 can stop the progression of the disease.
What causes diabetes?
When diabetes mellitus occurs in a person, the causes of this fact can be varied. The second type of disease often leads to:
- Improper Diet;
- Lack of physical activity;
- Excess weight;
- Self-medication with drugs such as glucocorticosteroids;
In fact, often there is not one prerequisite, but a whole complex of reasons.
If we consider the occurrence of the disease in terms of pathogenesis, then type 2 diabetes is caused by a relative lack of insulin in the blood. This is the state when the protein insulin produced by the pancreas becomes inaccessible for insulin receptors located on cell membranes.
As a result, cells lose the ability to assimilate sugar (glucose), which leads to a lack of glucose supply to the cells, and also, which is no less dangerous, to the accumulation of glucose in the blood and its deposition in various tissues.
According to this criterion, insulin-dependent diabetes mellitus is different 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. At the first stages, the patient may not feel serious discomfort, with the exception of increased fatigue, dry mouth, increased thirst, and appetite.
This condition is usually attributed to the wrong diet, chronic fatigue syndrome, stress. However, in fact, the cause is hidden pathology. As the disease progresses, symptoms may include:
- Poor wound healing,
- Weakening of immunity
- Pain and swelling in the limbs,
However, patients often do not interpret even a set of similar symptoms correctly, and diabetes develops unimpeded until it reaches incurable stages or results in life-threatening conditions.
Some Important Links:
Glucose Intolerance – StatPearls – NCBI Bookshelf
Metabolic syndrome – Symptoms and causes – Mayo Clinic
Alzheimer’s Disease Fact Sheet – National Institute on Aging – NIH
What Is Diabetes Mellitus, Causes, Symptoms & Diagnosis – Life-Fitness
In fact, there are no sufficiently effective methods that increase the digestibility 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 directed at reducing the patient’s excess weight, bringing him back to normal, since the abundance of adipose tissue plays an important role in the pathogenesis of diabetes.
The main factor influencing the likelihood of developing complications in type 2 diabetes is a violation of lipid metabolism. An excess of cholesterol that differs from the norm can lead to the development of angiopathies.
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Type 2 diabetes mellitus is a disease that requires long and persistent therapy. In fact, all the methods used are divided into three groups:
- Taking drugs
- Lifestyle change.
Effective treatment of type 2 diabetes involves not only diabetes mellitus itself but also co-morbidities such as:
Type 2 diabetes is treated on an outpatient basis and at home. Only patients with hyperglycemia and hyperosmolar comas, ketoacidosis, severe forms of neuropathy and angiopathy, stroke are subject to hospitalization.
Drugs for diabetes
In fact, all medications are divided into two main groups – those that affect insulin production, and those that do not.
The main drug of the second group is metformin from the biguanide class. This drug is most often prescribed for type 2 diabetes. Without affecting the cells of the pancreas, it maintains glucose in the blood at the normal level.
The drug does not face a critically low decline in glucose levels. Metformin also 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, as it can be a serious pathological condition with a high percentage of mortality – lactic acidosis.
Typical representatives of another group of drugs that affect insulin production are sulfonylurea derivatives. They directly stimulate the beta cells of the pancreas, with the result that they produce insulin in increased quantities.
However, an overdose of these drugs threatens the patient with a hypoglycemic crisis. Sulfonylurea derivatives are usually taken together with metformin.
There are other types of drugs. The class of drugs that increase insulin production depending on glucose concentration includes incretin mimetics (GLP-1 agonists) and DPP-4 inhibitors.
These are new drugs, and so far they are quite expensive. They inhibit the synthesis of sugar-enhancing hormone glucagon, increase the action of incretins – the gastrointestinal hormones, which increase insulin production.
There is also a drug that prevents the absorption of glucose in the gastrointestinal tract – acarbose. This remedy does not affect insulin production. Acarbose is often prescribed for prophylactic purposes in order to prevent diabetes.
There are also medical agents that increase the excretion of glucose in the urine, and agents 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 for the ineffectiveness of therapy with other drugs, for decompensated diabetes mellitus, when the pancreas is depleted and cannot produce enough insulin.
Type 2 diabetes is also often accompanied by concomitant diseases
- Lipid metabolism disorders.
If similar diseases are found, then drugs are prescribed for their treatment.
The essence of dietary changes in diabetes is the regulation of nutrients entering the gastrointestinal tract. The necessary nutrition must be determined by the endocrinologist individually for each patient, taking into account the severity of diabetes, concomitant diseases, age, lifestyle, etc.
There are several varieties of diets used for non-insulin dependent diabetes (table number 9, low-carb diet, etc.). All of them are well established and differ from each other only in some details. But they agree on the main principle – the norms of carbohydrate consumption in case of illness should be strictly limited.
First of all, this concerns products containing “fast” carbohydrates, that is, carbohydrates that are very quickly absorbed from the gastrointestinal tract. Fast carbohydrates are contained in refined sugar, jams, confectionery, chocolate, ice cream, desserts, baked rich products.
In addition to reducing the number of carbohydrates, it is necessary to strive to reduce body weight, since increased weight is a factor aggravating the course of the disease.
It is recommended to increase water intake in order to compensate for fluid loss during frequent urination, often associated with diabetes mellitus. At the same time, it is necessary to completely abandon the sweet drinks – cola, lemonade, kvass, juice, and tea with sugar.
In fact, you can only drink drinks that do not contain sugars – mineral and plain water, unsweetened tea and coffee. It must be remembered that alcohol consumption can also be harmful because alcohol disturbs glucose metabolism.
Meals should be regular – at least 3 times a day, and best of all – 5-6 times a day. Do not sit at the dinner table immediately after exercise.
How to monitor blood glucose concentration
The essence of diabetes therapy is self-control on the part of the patient. In the case of type 2 diabetes, the sugar level should be within the normal range, or close to it. Therefore, the patient needs to control his sugar level independently in order to avoid his critical increases.
For this, it is advisable to have a diary in which the values of glucose concentration in the blood will be recorded. Glucose measurements can be done with special portable blood glucose meters equipped with test strips. The measurement procedure is desirable to perform every day.
The best time to measure is early morning. Before the procedure is prohibited to take any food. If possible, the procedure can be repeated several times a day and determine the level of sugar not only in the morning on an empty stomach but also after eating, before bedtime, etc. Knowing the graph of changes in blood glucose,
However, the presence of a glucometer does not relieve the patient of the need to regularly check blood for the level of sugar in the outpatient clinic, since the values obtained in the laboratory have higher accuracy.
It is not so difficult to control the level of sugar in the consumption of food – after all, most of the products bought in the store indicate their energy value and the number of carbohydrates they contain. There are diabetic analogs of common foods in which carbohydrates are replaced by low-calorie sweeteners (sorbitol, xylitol, aspartame).
The level of sugar in the analysis of blood on an empty stomach:
|| Glucose Level, mmol/l
|Impaired Glucose Tolerance
Fruits and vegetables
Is it possible to use fruits and berries in the second type of diabetes? Preference should be given to vegetables that contain a large amount of indigestible, but useful for digestion, fiber, and fewer sugars. However, many vegetables, for example, potatoes, beets, and carrots contain a large amount of starch, so their consumption should be limited.
Fruits can be consumed in moderation and only those that do not contain a very large amount of carbohydrates. Among fruits, bananas are champions in carbohydrate content, followed by grapes and melons. Their use is not recommended, as they can increase the level of sugar.
Folk remedies involve taking decoctions of medicinal herbs. Such therapy can not only reduce the level of glucose in the blood but also reduce appetite, reduce weight. However, folk remedies can be taken only in addition to taking medication and in consultation with your doctor.
Auxiliary method of therapy – exercise. When performing an exercise of moderate intensity, the body burns large amounts of glucose. Metabolism returns to normal, the cardiovascular system is strengthened. Exercise is necessary every day.
However, the exercises should not be exhausting, because only the opposite effect can be achieved. With extreme tiredness, the appetite increases, and a rich meal can negate all the positive effects of physical exertion. Fatigue triggers stress and the release of adrenal hormones, which increases blood glucose levels.
Therefore, it is recommended to choose the type of physical activity that would fit the patient’s fitness – simple exercises, exercises with dumbbells or walking, jogging, swimming, cycling.
Energy costs in various activities:
||Products Containing the Same Amount Of Energy
|Apple, 20g Nuts
|Apple, 20g Nuts
|One Glass Of Milk
|One Glass Of Milk
|Slow Walking, Easy work on the plot
|120g Ice Cream
|100g White Bread
|Fast Walking, Slow Swimming, Dancing, Rowing
|150 Black Bread
|Volleyball, Badminton, Table tennis
90g Pastry or Cheese
In severe cases, when diabetes mellitus type 2 reaches the stage of decompensation, then, as a rule, it is impossible to return the disease back and return the glucose indicators to the normal state – due to depletion of the pancreas and the body as a whole.
Therefore, diabetes mellitus type 2 in such a situation is an incurable disease. However, proper treatment of type 2 diabetes can prolong a patient’s life for many years. At the initial stage of diabetes mellitus type 2, it is possible to control the concentration of glucose in the blood and maintain it within acceptable limits only by changing the diet and lifestyle, increasing physical activity.
As a result, the patient can live for many decades and not face any complications of diabetes.
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