Diabetes mellitus 2nd degree symptoms. Description of type 2 diabetes mellitus: signs and prevention. Lifestyle change

The most common cause of endocrine disruption is type 2 diabetes mellitus (DM), but you can understand what it is by calling the disease in simple terms, and in medicine it is referred to as an insulin-independent pathology, which has its own characteristic symptoms, diet and treatment. This disease became known 2 thousand years ago, but to this day it is still incurable.

People who suffer from this disease are most concerned about possible complications associated with the legs, vision, cardiovascular system and digestive organs, because without a properly selected diet, exercise and complex treatment they cannot be avoided. For this reason, in order to prevent these problems, you need to change your lifestyle when an endocrine failure is detected.

At the same time, to understand what type 2 diabetes means and what course of therapy even a child can have, I focus on information found on the Internet, for example, on Wikipedia, where you can find methods for treating legs, insulin administration techniques and a diet compiled by doctors for this disease .

Second-degree diabetes is non-insulin dependent and has its own causes. The development of the disease occurs against the background of constantly advanced level blood glucose (hyperglycemia) and at the same time the body ceases to perceive the insulin produced by the pancreas, which leads to various complications, including metabolic failures.

Doctors call the first stage an excessive amount of hormone produced, which ultimately leads to the depletion of pancreatic cells. Because of this, an additional injection of insulin is prescribed to compensate for its shortage. These actions provoke disruptions in carbohydrate metabolism and an increase in the amount of glucose that is produced by the liver.

When there is more sugar in the blood and the hormone that is responsible for its transportation does not perform its functions or does not do it completely, this process leads to a constant need to urinate. Due to the strong loss of water and salts, the body begins to dehydrate and there is a deficiency of anions and cations. In addition, excess sugar causes malfunctions in metabolism, which can disrupt the functioning of internal organs.

The reasons that can cause type 2 diabetes are still unclear, but there are risk groups and people in them are much more likely to suffer from this pathology and they are:

Hereditary predisposition, especially if the mother had the disease;
completeness;
Endocrine diseases, for example, problems with the thyroid gland;
Transferred viral diseases;
With pancreatitis and other inflammatory processes in the pancreas.

Features of Type 2 SD

Type 2 diabetes mellitus is divided into several types and they differ in their course, namely:

In a mild form, there are no special deviations and sharp jumps in sugar, and for treatment it is enough to follow a diet, measure glucose levels and take pills for better perception insulin produced by the body;
It is not so easy to treat the moderate form of severity, because it is characterized by complications in vascular system. In the course of therapy, in addition to these methods, you will need to add drugs that lower sugar levels or use short-acting insulin;
Severe form means an abundance of complications and comorbidities and for treatment it will be necessary to use insulin for a long and fast action and constantly measure the level of sugar.

In addition, type 2 diabetes should be divided according to the degree to which carbohydrate metabolism is located:

compensation phase. It is characteristic of her good performance sugars that have been achieved by treatment;
subcompensation phase. The glucose level will not exceed 13.9 mmol / l and it comes out with urine in an amount of not more than 50 g;
phase of decompensation. The disease is difficult to treat and the sugar level remains above 13.9 mmol/l. In addition, it is excreted daily in the urine in the amount of 50 grams or more. It should also be noted that acetone appears in urine and this degree of carbohydrate metabolism can lead to hyperglycemic coma.

You can also note the pathologies caused by diabetes, such as:

Angiopathy. Because of it, the walls of blood vessels become brittle, their patency worsens;
Polyneuropathy. It manifests itself in the form of unreasonable discomfort in the nerve trunks;
arthropathy. Signs of this disease are localized in the joints and manifest themselves in the form of pain;
Ophthalmopathy. She is characterized by impaired vision and eye pathologies;
Nephropathy. It appears over time as kidney failure;
encephalopathy. Because of this, mental disorders do not occur.

Symptoms of the disease

With type 2 diabetes, there are clear distinguishing symptoms by which it can be identified and subsequently prescribed treatment. Causes them started pathological process in the body, due to which fats are used as an energy source, the metabolism of proteins and minerals is confused and toxic substances begin to form.

Of the main signs of a disease such as type 2 diabetes, one can distinguish:

Feeling thirsty, dry mouth;
Regular urge to go to the toilet;
General weakness;
Fast fatiguability;
A feeling of hunger that cannot be completely appeased;
Poor tissue regeneration;
Constant desire to sleep;
Excess weight.

Unlike the insulin-dependent type, type 2 diabetes mellitus may not appear for years, and only after 50 will the first symptoms become noticeable.

In addition, pathology may not show obvious signs, and be expressed in the form of blurred vision, skin disease or resemble a cold.

Diagnostics

Diagnosing the fact that this is type 2 diabetes and starting to treat it should be a doctor such as an endocrinologist. First of all, a blood test is taken for the sugar content in it by the capillary method (from a finger). The material is taken only on an empty stomach and 8 hours before that you can not eat anything, and only boiled water is allowed to drink. After that, the doctor will conduct a test to find out how the body reacts to sugar, and this time the blood will be taken after the patient has consumed a glass of diluted glucose, and then after 1-2 hours.

In addition to blood, you will need to pass urine for analysis to find out whether sugar and ketone bodies (acetone) are excreted from the body during urination. After all, if this is so, then the person will be diagnosed with diabetes.

It is worth noting the need for a blood test for the amount of glucosylated hemoglobin in it. If this figure is increased, then doctors call it clear sign SD.

Most important feature diabetes the second type is elevated blood sugar and an excess is a number above 120 mg/dL. In addition, a healthy person should not have glucose in urine at all, not to mention acetone, because in the normal state, the kidneys filter the fluid that enters them. Failures in this process occur when the sugar level rises above 160 mg/dL and it gradually seeps into the urine.

A test designed to find out the reaction of the body to the glucose that has entered it is considered successfully passed if the indicators at the first blood sampling were less than 120 ml / dl, and after the second they did not increase above 140 ml / dl. Treatment will be required if the concentration was more than 126 ml / dl at 1 time, and more than 200 ml / dl at 2 times.

Diet for diabetes

The most important part of the course of therapy is a properly formulated diet. A properly formulated diet will help overweight people increase the effectiveness of insulin produced by their pancreas. As for the products that are acceptable for this disease, the daily diet can be made up of the following products:

Vegetables;
Tea, coffee without sugar;
Low-fat varieties of meat and fish;
dairy products;
Potatoes, corn;
leguminous crops;
Bread;
Cereals;
Eggs.

At the same time, experts advise limiting to a minimum such products:

Fatty or smoked meat and fish;
Sausages;
Oil;
canned meat;
Fatty cheeses;
sour cream;
Various confectionery products, including jam;
Walnuts;
Alcoholic drinks;
Mayonnaise.

You have to try to daily diet fresh vegetables were present without processing and additional components, such as mayonnaise or vinegar, etc. In addition, instead of frying, it is better to bake food in your own juice, and if it comes to poultry, then you need to remove the skin from it during cooking. Meals should be evenly distributed and carried out at least 3-4 times.

A course of treatment

Type 2 diabetes cannot be completely cured, but it is possible to keep the patient's body in a healthy state by creating the appearance of the pancreas. If the course of the disease is mild, then it is enough to follow a strict diet and exercise, but doctors recommend using medications to improve insulin sensitivity. The average form of the disease is no longer so easy to treat and it will be necessary to control sugar and give injections of a fast-acting hormone before or after meals if necessary. In advanced cases, there are many complications associated with the patient's vision, legs, and the cardiovascular system, and a course of rehabilitation therapy will be required to eliminate them. In addition, it is necessary to measure the sugar level 6-7 times daily and inject insulin.

The course of therapy includes drugs, for example, biguanides, which increase the sensitivity of tissues to insulin so that the body can cope with the transport of sugar on its own. In addition, the doctor will definitely prescribe medications like glycosidase inhibitors to normalize carbohydrate metabolism. Also, with diabetes, drugs to enhance insulin, such as sulfonylurea and gliquidone, will not interfere. In addition to the listed drugs, the course of therapy will also include nuclear receptor activators to improve liver function. All these groups of medicines can be perfectly combined with each other, but only a doctor can prescribe them, focusing on the course of the disease, so their self-administration is prohibited.

Diabetes is not a sentence, but only a difficult test and you need to pull yourself together and start taking care of your health. In addition, thanks to the Internet, anyone can look at the same wikipedia for exercises and diets that are recommended for this disease.

When you are diagnosed with diabetes, it is important to immediately understand the characteristics of the type of disease, as well as how to properly treat it. After all, compensation started on time is almost a 100% guarantee of the absence of diabetic complications. In this article, you will learn what type 2 diabetes is, how it occurs, and how to properly treat it.

What is type 2 diabetes

In type 2 diabetes, the interaction of insulin with the cells of the body is disrupted, which leads to permanent.

Also developing insulin resistance that is, tissues lose sensitivity to insulin.

On the initial stages disease, insulin continues to be produced in full, which creates its redundancy in the body. This depletes the β-cells of the pancreas, and over time, diabetics have to take insulin injections.

This type is the most common and is 80% from all cases of illness.

More people suffer after 40 who have severe obesity, who do not eat well and lead an inactive lifestyle. About the reasons in more detail.

Classification of this type of diabetes

The disease is classified according to severity into the following forms:

mild form - diabetes can be compensated by dietary nutrition (read about), with a rare intake of one tablet of a sugar-lowering drug. The likelihood of developing complications is minimal.
the form moderate- the diet itself does not help, and you need to take 2-3 hypoglycemic drugs. Vascular complications are possible.
severe form - with this form, the diabetic is already forced to resort to insulin therapy. Severe complications are frequent.

Type 2 diabetes symptoms

There are quite a few symptoms of diabetes and they are described in detail in the article. Now let's look at the most common with this type.

Weakness

infections

Intense thirst accompanied by an unhealthy dry mouth
Development of osmotic diuresis (excessive loss of water through the kidneys)
General weakness and malaise
Itching of the skin and mucous membranes
Obesity, especially in the face
Frequent infections

Diagnosis of type 2 diabetes

The diagnosis is made in the presence of hyperglycemia, as well as after laboratory research.

When analyzing for sugar in the patient's blood, there is ≥ 7.0 mmol/l on an empty stomach and/or ≥ 11,1 mmol/l 2 hours after the glucose tolerance test.

Compensation criteria for type 2 diabetes (click on the picture to enlarge)

Diet and treatment for type 2 diabetes

To compensate, you should adhere to a diabetic diet, and perform moderate exercise. With a mild form, this is quite enough. There are many on our site that will help you stick to healthy eating and effectively control sugar levels. Also in the section you will find helpful tips, which will help you compose your menu and better understand the usefulness of certain products.

If speak about medicines , then they are classified into:

increase the sensitivity of body tissues to insulin (metformin, rosiglitazone, pioglitazone)
insulin secretagogues (glibenclamide, gliclazide, glimepiride, gliquidone, glipizide, repaglinide, nateglinide)
α glycosidase (acarbose) inhibitors
nuclear alpha receptor activator (fenofibrate Traykor 145 mg)

Only your attending physician can prescribe medications, taking into account all examinations and individual characteristics the course of the disease.

What are the complications of type 2 diabetes?

This type is often considered mild form, and many are not serious about his compensation. It is important to remember that a careless attitude towards your body entails serious troubles.

We have a whole section about complications.

If we talk about the second type, then the most common complications are:

vascular system
nervous system
on the eyes

Conclusion

It can be concluded that this type of diabetes is more of a dietary disease. If you don't have running form, with the help of a normal healthy diet, you can compensate for the disease.

To avoid complications, always control your sugar levels.

Remember that small efforts at the beginning of the disease will help to avoid serious problems in the future.

- is chronic endocrine disease, which develops due to insulin resistance and dysfunction of pancreatic beta cells, is characterized by a state of hyperglycemia. Manifested by profuse urination (polyuria), increased thirst (polydipsia), itching of the skin and mucous membranes, increased appetite, hot flashes, muscle weakness. The diagnosis is established on the basis of the results of laboratory tests. A blood test is performed for the concentration of glucose, the level of glycosylated hemoglobin, and a glucose tolerance test. The treatment uses hypoglycemic drugs, a low-carbohydrate diet, increased physical activity.

ICD-10

E11 non-insulin dependent diabetes mellitus

General information

Pathogenesis

At the heart of type 2 diabetes is a violation of carbohydrate metabolism due to increased cell resistance to insulin (insulin resistance). The ability of tissues to receive and utilize glucose decreases, a state of hyperglycemia develops - an elevated level of plasma sugar, alternative ways obtaining energy from free fatty acids and amino acids. To compensate for hyperglycemia, the body intensively removes excess glucose through the kidneys. Its amount in the urine increases, glucosuria develops. A high concentration of sugar in body fluids causes growth osmotic pressure, which provokes polyuria - profuse frequent urination with loss of fluid and salts, leading to dehydration and water-electrolyte imbalance. These mechanisms explain most of the symptoms of diabetes - intense thirst, dry skin, weakness, arrhythmias.

Hyperglycemia alters the processes of peptide and lipid metabolism. Sugar residues attach to protein and fat molecules, disrupting their function, hyperproduction of glucagon occurs in the pancreas, the breakdown of fats as an energy source is activated, glucose reabsorption by the kidneys increases, transmitter transmission in the nervous system is disrupted, and intestinal tissues become inflamed. Thus, the pathogenetic mechanisms of DM provoke vascular pathologies (angiopathy), the nervous system (neuropathy), digestive system, glands of endocrine secretion. A later pathogenetic mechanism is insulin deficiency. It is formed gradually, over several years, due to depletion and natural programmed death of β-cells. Over time, a moderate deficiency of insulin is replaced by a pronounced one. Secondary insulin dependence develops, patients are prescribed insulin therapy.

Classification

Depending on the severity of carbohydrate metabolism disorders in diabetes mellitus, a compensation phase is distinguished (a state of normoglycemia is reached), a subcompensation phase (with a periodic increase in blood glucose levels) and a decompensation phase (hyperglycemia is stable, difficult to correct). Depending on the severity, there are three forms of the disease:

Light. Compensation is achieved by adjusting nutrition or diet in combination with a minimum dosage of a hypoglycemic drug. The risk of complications is low.
Average. To compensate for metabolic disorders, regular intake of hypoglycemic agents is necessary. The probability of the initial stages of vascular complications is high.
Heavy. Patients need constant use of tableted hypoglycemic drugs and insulin, sometimes only insulin therapy. Serious diabetic complications are formed - angiopathy of small and large vessels, neuropathy, encephalopathy.

Symptoms of type 2 diabetes

The disease develops slowly, at the initial stage, the manifestations are barely noticeable, which greatly complicates the diagnosis. The first symptom is an increased feeling of thirst. Patients feel dry mouth, drink up to 3-5 liters per day. Accordingly, the amount of urine and the frequency of the urge to empty Bladder. Children may develop enuresis, especially at night. because of frequent urination and high sugar content in urine irritates the skin inguinal region, itching occurs, redness appears. Gradually, itching covers the abdomen, armpits, elbow and knee bends. Insufficient supply of glucose to the tissues contributes to an increase in appetite, patients experience hunger already 1-2 hours after eating. Despite the increase in the caloric content of the diet, the weight remains the same or decreases, since glucose is not absorbed, but is lost with urine.

Additional symptoms are fatigue, constant feeling fatigue, daytime sleepiness, weakness. The skin becomes dry, thinner, prone to rashes, fungal infections. The body bruises easily. Wounds and abrasions heal for a long time, often become infected. Girls and women develop genital candidiasis, boys and men develop infections urinary tract. Most patients report a tingling sensation in the fingers, numbness in the feet. After eating, you may experience nausea and even vomiting. Arterial pressure increased, frequent headaches and dizziness.

Complications

The decompensated course of type 2 diabetes is accompanied by the development of acute and chronic complications. Acute conditions are those that occur quickly, suddenly and are accompanied by a risk lethal outcome- hyperglycemic coma, lactic acid coma and hypoglycemic coma. Chronic complications are formed gradually, include diabetic micro- and macroangiopathies, manifested by retinopathy, nephropathy, thrombosis, and vascular atherosclerosis. Diabetic polyneuropathies are detected, namely, polyneuritis of peripheral nerves, paresis, paralysis, autonomic disorders in the work of internal organs. There are diabetic arthropathy - joint pain, limited mobility, a decrease in the volume of synovial fluid, as well as diabetic encephalopathy - mental disorders, manifested by depression, emotional instability.

Diagnostics

The difficulty of identifying non-insulin-dependent diabetes mellitus is due to the absence of severe symptoms in the initial stages of the disease. In this regard, people at risk and all persons over 40 years of age are recommended screening plasma tests for sugar levels. Laboratory diagnostics is the most informative, it allows you to detect not only the early stage of diabetes, but also the state of pre-diabetes - a decrease in glucose tolerance, manifested by prolonged hyperglycemia after a carbohydrate load. With signs of diabetes, an examination is carried out by an endocrinologist. Diagnosis begins with clarification of complaints and anamnesis, the specialist clarifies the presence of risk factors (obesity, physical inactivity, hereditary burden), reveals the basic symptoms - polyuria, polydipsia, increased appetite. The diagnosis is confirmed after receiving the results laboratory diagnostics. Specific tests include:

Fasting glucose. The criterion for the disease is a glucose level above 7 mmol / l (for venous blood). The material is taken after 8-12 hours of fasting.
Glucose tolerance test. For the diagnosis of DM early stage the concentration of glucose is examined a couple of hours after eating carbohydrate foods. An indicator above 11.1 mmol / l reveals diabetes, in the range of 7.8-11.0 mmol / l prediabetes is determined.
Glycated hemoglobin. The analysis allows you to evaluate the average value of glucose concentration over the past three months. Diabetes is indicated by a value of 6.5% or more ( deoxygenated blood). With a result of 6.0-6.4%, prediabetes is diagnosed.

Differential diagnosis includes distinguishing between non-insulin-dependent diabetes mellitus and other forms of the disease, in particular, type 1 diabetes mellitus. Clinical differences are slow onset of symptoms, more late deadline onset of illness (although last years the disease is also diagnosed in young people 20-25 years old). Laboratory differential signs- elevated or normal level insulin and C-peptide, the absence of antibodies to pancreatic beta cells.

Treatment of type 2 diabetes

In practical endocrinology, a systematic approach to therapy is common. In the early stages of the disease, the focus is on changing the lifestyle of patients and consultations, in which the specialist talks about diabetes, ways to control sugar. With persistent hyperglycemia, the question of the use of drug correction is decided. Full complex medical measures includes:

Diet. The main principle of nutrition is to reduce the amount of food high in fat and carbohydrates. Especially "dangerous" are products with refined sugar - confectionery, sweets, chocolate, sweet carbonated drinks. The diet of patients consists of vegetables, dairy products, meat, eggs, a moderate amount of cereals. We need a fractional diet, small portions, the rejection of alcohol and spices.
Regular physical exercise. Patients without severe diabetic complications are indicated sports activities that enhance oxidation processes (aerobic exercise). Their frequency, duration and intensity are determined individually. Most patients are allowed walking, swimming and walking. The average time of one lesson is 30-60 minutes, the frequency is 3-6 times a week.
Medical therapy. Are used medicines several groups. The use of biguanides and thiazolidinediones, drugs that reduce insulin resistance of cells, absorption of glucose in the gastrointestinal tract and its production in the liver, is common. With their insufficient effectiveness, drugs are prescribed that enhance the activity of insulin: DPP-4 inhibitors, sulfonylurea derivatives, meglitinides.

Forecast and prevention

Timely diagnosis and responsible attitude of patients to the treatment of DM make it possible to achieve a state of stable compensation, in which for a long time normoglycemia persists, and the quality of life of patients remains high. To prevent the disease, it is necessary to adhere to a balanced diet high in fiber, limiting sweet and fatty foods, fractional regimen of meals. It is important to avoid hypodynamia, to provide the body with daily physical activity in the form of walking, to play sports 2-3 times a week. Regular glucose monitoring is necessary for people at risk ( excess weight, mature and elderly age cases of DM among relatives).

Type 2 diabetes mellitus is a chronic pathology that mainly develops in people with abdominal obesity. This is an insidious disease early stages which does not manifest itself in any way, later without treatment can lead to catastrophic complications that can lead to the onset of a person’s disability and even lead to death. It is impossible to cure this pathology completely, but the treatment of type 2 diabetes mellitus is extremely necessary in order to learn how to manage the disease.

Treatment methods:

Lifestyle correction (diet therapy, physical activity, influence on stress factors).
Drug therapy (hyperglycemic pills, insulin injections).

Despite the fact that there are a sufficient number of antidiabetic drugs in various forms, it is impossible to reduce the impact of lifestyle changes as one of the treatment options for type 2 diabetes. Let us consider in more detail how exactly it is necessary to correct the factors predisposing to diabetes.

swimming;
walking at a moderate pace;
a ride on the bicycle;
light morning exercises, etc.

It is important to understand that the main thing is not the intensity of the load, but its regularity. Exhausting workouts are not needed at all to correct diabetes, but a sedentary lifestyle will not help the disease either, so together with an endocrinologist you need to choose your pace, the duration of the load, taking into account all additional factors: age, individual load tolerance and the presence of concomitant pathology.

Positive effects of physical activity:

lead to faster utilization of glucose in the tissue;
improve the metabolism of lipoproteins (increasing the amount of "good" cholesterol and reducing the amount of triglycerides);
reduce blood viscosity;
stabilize the work of the myocardium;
help to overcome stress;
reduce .

However, there are contraindications to even simple exercises.

Glucose less than 5 mmol/l;
Glucose more than 14 mmol/l;
High degree of hypertension or hypertensive crisis;
Decompensation for other concomitant diseases.

Diet therapy for type 2 diabetes

for obese persons, the daily calorie content should not exceed 1800 kcal;
you need to eat food often (4-6 times a day) and fractionally (in small portions), a diet should be developed to maintain a relatively even level of glycemia;
limit the amount of salt consumed to 3 g in total, i.e. taking into account the salt contained in finished products (for example, cheese, bread);
limit easily digestible carbohydrates in the diet (flour products, sugar in pure form, nectars and juices);
reduce alcohol consumption to 30 grams or less per day;
increase the amount of food you eat rich in fiber(20-40 g per day);
the daily required amount of protein is 0.8-1 g / day ( exception: kidney disease);
nutrition balanced in terms of vitamins and minerals.

Medical therapy

Despite the fact that lifestyle changes can significantly affect the course of type 2 diabetes, few patients follow the recommendations for a long time. That's why drug treatment Type 2 diabetes has become an integral part of medical practice.

According to the mechanism of action, drugs are divided into the following groups:

insulin secretion stimulants (sulfonylurea drugs, glinides);
those that eliminate insulin resistance (biguanides, thiazolidinediones);
combined (mixed) action (incretinomimetics).

The following groups of drugs are used for treatment:

biguanides;
sulfonylurea derivatives;
thiazolidinediones;
prandial regulators;
alpha-glycosidase inhibitors;
incretinomimetics;
insulin preparations.

biguanides

The only representative is metformin. On sale is Siofor or Glucofage.

Mechanism of action

The medicine of this group is aimed at reducing the body's resistance to insulin. This is achieved in the following ways:

the formation of glucose from fats, proteins decreases, as well as in the process of splitting liver glycogen;
increases the "storage" of glucose by the liver in the form of glycogen;
the sensitivity of tissue receptors to insulin increases;
the absorption of sugar into the blood decreases;
increases glucose uptake by organs and tissues.

Side effects are quite frequent in this group, and they are all associated with a disorder in digestive tract. However, they pass within 2 weeks, so you need to be patient. If a side effects last too long, you should consult a doctor for correction of treatment. So, to the main adverse reactions from metformin include:

flatulence;
nausea;
diarrhea;
vomit;
metallic aftertaste in the mouth.

Sulfonylureas

These include such drugs: glibenclamide, glurenorm, gliquidone.

Mechanism of action

They bind to pancreatic beta cell receptors, stimulating insulin release.
The drugs are prescribed from the smallest dosages, and within one week the dose is increased to the desired level.

The main side effects are: risk of hypoglycemia, itching, skin rash, gastrointestinal disorders, liver toxicity.

Glinides

This group is represented by nateglinide and repaglinide.

Mechanism of action

Increases the amount of insulin released from the blood by increasing the flow of calcium ions into the cells of the pancreas, which allows for the control of post-strandial glycemia, i.e. the level of glucose after a meal.

Thiazolidinediones (glitazones)

Includes rosiglitazone and pioglitazone.

Mechanism of action

Drugs in this group activate receptors in muscle and fat cells, increasing their sensitivity to insulin, thereby contributing to the rapid utilization of glucose in muscle, adipose tissue and liver.

It should be noted that despite their proven high efficiency, there are a number of contraindications for their use:

chronic heart failure (CHF) 3-4 degrees according to NYHA;
an increase in hepatic transaminases in the blood by more than 3 times;
pregnancy;
lactation.

Incretinomimetics

The drug in this group is exenatide.

Mechanism of action

There is an increase in insulin secretion under the influence of increased glucose intake into the blood, while the secretion of glucagon and free fatty acids is suppressed. In addition, the evacuation of food from the stomach slows down, and a person experiences a feeling of fullness longer, so this group belongs to the mixed type according to the mechanism of action.
The main side effect is nausea, which lasts 1-2 weeks from the start of administration.

α-glucosidase inhibitors

Presented by the only drug acarbose. It is not the main one in the treatment of diabetes, but it is quite effective and devoid of such side effects, as hypoglycemia due to the fact that it itself is not absorbed into the blood and does not affect the synthesis of insulin.

Mechanism of action

The drug of this group competes with carbohydrates from food for binding to the enzymes of the digestive system responsible for their breakdown. Thanks to this mechanism, the rate of absorption of carbohydrates decreases, so there is no risk of sudden spikes in sugar after eating.

insulin therapy

Insulin therapy has not lost its relevance in the treatment of type 2 diabetes, despite the wide choice of tableted hypoglycemic drugs.

Insulin therapy can be divided by duration:

temporary;
constant;

at the start of treatment:

since the beginning of the diagnosis;
as a result of the progression of the disease (usually after 5-10 years);

Unlike the first type of the disease, type 2 diabetes is detected in every fourth patient, and often a person does not even know about the presence of pathological disorders in the body. All sorts of serious complications arise from such ignorance.

But if therapy is started in time in men and women, when the first signs appear and diabetes mellitus develops, severe consequences can be prevented. In type 2 diabetes, persistent hyperglycemia is observed due to the fact that the cells lack sensitivity to the produced insulin.

Thus, this type of disease is not associated with the synthesis of insulin. Due to decreased sensitivity, blood glucose levels usually increase, as a result of which, due to developing disease cells of blood vessels and internal organs are destroyed. To choose proper treatment, you need to know - what is type 2 diabetes and how to deal with it.

Causes of type 2 diabetes

In 90 percent of cases with the disease, patients are diagnosed with type 2 diabetes, the causes of which can be very different. AT this case the pancreas continues to produce insulin, but the body cannot properly dispose of the available hormone, which is why sugar accumulates in the blood and causes a number of complications.

Despite the fact that the pancreas is not damaged, the body is not able to fully absorb the incoming insulin due to the presence of damaged insulin receptors on the cells, which causes type 2 diabetes.

First of all, this means that a person needs to follow a strict therapeutic diet and limit the use of foods rich in carbohydrates as much as possible.

Most often, the causes of type 2 diabetes are the natural aging of the body. In old age, a person may develop glucose tolerance, that is, the body gradually loses the ability to fully absorb sugar.
With age, such changes occur in almost everyone, but in healthy people sensitivity decreases slowly. But if the patient has genetic predisposition, this process occurs much faster, and as a result, a person can get type 2 diabetes.
Also, the causes of diabetes are often associated with obesity. Due to excess weight, there is a violation of the blood composition, an increase in cholesterol, which settles on the walls of blood vessels and leads to the development of atherosclerosis. In simple terms, with the appearance of cholesterol plaques nutrients and oxygen cannot enter the tissues and internal organs, as a result oxygen starvation reduced absorption of insulin and glucose.
The third main reason why type II diabetes occurs is the excessive consumption of foods rich in fast carbohydrates. Carbohydrates in an increased amount lead to depletion of the pancreas and damage to insulin receptors in the cells of tissues and internal organs.

As shown Scientific research, in the presence of type 2 diabetes in one of the parents, the risk of developing the disease in a child along the hereditary line is 35-40 percent. In the event that the disease is spread between two parents, the risk increases to 60-70 percent. Monozygotic twins can simultaneously have group 2 diabetes in 60-65 percent, and heterozygous twins in 12-30 percent of cases.

If type 2 diabetes is detected in men or women, it is most often associated with overweight, a similar metabolic disorder occurs in 60-80 percent of diabetics. The risk of morbidity is especially high in abdominal obesity when fat accumulates in the abdomen and waist.

With an excess of adipose tissue in the body, the level of free fatty acids increases. This is the main source of energy in humans, but with an increased content of these types of acids, hyperinsulinemia and insulin resistance develop.

Including this condition provokes a decrease in the secretory activity of the pancreas. For this reason, type 2 diabetes mellitus is diagnosed at an early stage by plasma analysis for free fatty acids. With an excess of these substances, glucose tolerance is detected, even if fasting hyperglycemia has not yet been detected.

Many tissues require a constant supply of glucose. But when fasting for more than 10 hours, there is a depletion of blood sugar reserves. In this case, the liver begins to synthesize glucose from substances that have a non-carbohydrate nature.
After eating, sugar levels rise, the liver stops its activity and stores glucose for the future. However, in the presence of cirrhosis, hemochromatosis and other serious illnesses the liver does not stop its work and continues to actively synthesize sugar, which ultimately provokes type 2 diabetes.
Due to the metabolic syndrome or the syndrome of resistance to the hormone insulin, the mass of visceral fat increases, carbohydrate, lipid and purine metabolism is disturbed, arterial hypertension develops.
Such causes of diabetes lie in the presence of menopause, polycystic ovary syndrome, hypertension, coronary heart disease, hormonal changes, and uric acid metabolism disorders.

Often, the causes of type 2 diabetes can be associated with organic and functional damage to pancreatic beta cells. Also, the disease can develop due to certain drugs - glucocorticoids, thiazides, beta-blockers, atypical antipsychotics, statins.

Thus, the second type of diabetes mellitus most often develops in the following cases:

In the presence of a hereditary predisposition;
In people with increased body weight and obesity;
In women who have previously given birth to a child weighing more than 4 kg, or with a pathological pregnancy;
With frequent use of glucocorticoid preparations - analogs of the hormone of the adrenal cortex;
When diagnosed with Itsenko-Cushing's disease or tumors of the adrenal gland, as well as acromegaly - tumors of the pituitary gland;
In men and women aged 40-50 years at an early stage of development of atherosclerosis, angina pectoris or hypertension;
In people at an early stage of cataract development;
When diagnosed with eczema, neurodermatitis and other allergic diseases;
After a stroke, heart attack, infectious disease as well as during pregnancy.

Symptoms and treatment of type 2 diabetes

Sugar level

If a person has type 2 diabetes, the symptoms are similar to those of type 1 diabetes. The patient has increased urination during the day and at night, thirst, dryness in oral cavity, increased appetite, unexplained weakness, bad feeling. Often there is itching skin, burning in the perineum, inflamed foreskin.

However, according to the second type of disease, the difference lies not in the absolute, but in the relative insufficiency of insulin. Not a large number of the hormone can still interact with receptors, metabolic disorders occur at a slow pace, due to which the patient may not be aware of the development of the disease.

A diabetic feels a slight dryness in the oral cavity and thirst, in some cases itching appears on the skin and mucous membranes, develops inflammatory process, in women, cases of thrush are not uncommon.

Also, a person has severe gum disease, teeth fall out, vision is noticeably reduced. This is due to the release of accumulated glucose through the skin to the outside or into the blood vessels, on sugar, in turn, fungi and bacteria begin to actively multiply.

If the doctor diagnoses diabetes mellitus 2, treatment begins after complete examination and passing all necessary tests.

With advanced disease, sugar can be detected in the urine, which leads to the development of glucosuria.

Therapy for type 2 diabetes

When a disease is detected in men or women, the doctor tells what type 2 diabetes is and selects the appropriate treatment. First of all, a diabetic is assigned a special therapeutic diet, which limits the intake of carbohydrates and high-calorie foods. Such measures help to reduce weight and restore the sensitivity of cells to the hormone insulin.

If the diet does not help, and the disease is activated, the patient takes hypoglycemic tablets, this remedy allows you to restore insulin synthesis and normalizes the pancreas. Medication to lower glucose levels is taken every day at least two to three times a day for 30 minutes before meals.

The dosage is selected strictly according to the doctor's prescription, it is also allowed to change the dose only after agreement with the doctors. If a patient has cirrhosis of the liver or kidney failure, taking hypoglycemic drugs is contraindicated, therefore, insulin therapy is provided for this group of diabetics.

Treatment with insulin may be prescribed if a therapeutic diet has not been followed for a long time and the prescribed drugs have not been taken. In the absence of the necessary therapy, the pancreas is depleted, and only injections can help.
Often, various folk methods treatment with herbs that restore the sensitivity of cells to the hormone. Herbal decoctions are also useful in type 1 diabetes mellitus, as they contribute to a better interaction of insulin with the cells of the internal organs.
But it is important to understand that such a method can only be auxiliary and used in combination with the main treatment. During herbal medicine, the therapeutic diet should not stop, you need to continue taking pills or injecting insulin.

In addition, a diabetic should lead an active lifestyle and not forget about exercise, this allows us to normalize general state diabetics and lower blood sugar levels. If you regularly follow physical activity and eat right, pills may not be needed, and sugar levels will normalize in just two days.

Nutrition for type 2 diabetes

As mentioned above, the therapeutic diet acts as the main and effective method therapy, which means the maximum rejection of foods high in carbohydrates. Carbohydrates are "light", they have small molecules, due to which they can be instantly absorbed into the intestines. These substances include glucose and fructose.

As a result, in men and women, this causes a rapid increase in blood glucose levels. There are also so-called "heavy" carbohydrates that slightly increase sugar levels - these are fiber and starch.

With type 2 diabetes, you need to stop eating granulated sugar, honey, jam, chocolate, sweets, ice cream and other sweets. Should be excluded from the diet bakery products from white flour, pasta, cookies, cakes, bananas and grapes are also not recommended. These types of foods contribute to a sharp increase in blood sugar, and if left untreated, a diabetic may develop.

Fiber and starch can be consumed, but in limited quantities. The patient is allowed to eat potatoes, coarse rye bread, various cereals, green peas, and beans. In the case of an increase in glucose levels, these types of products should also be temporarily abandoned.
However, a therapeutic diet allows the use of many foods that can be beneficial for a diabetic. In particular, the patient can eat lean meats and fish, dairy products without sugar and dyes, cheese, cottage cheese.
From vegetables, you need to include in the menu beets, carrots, turnips, turnips, radishes, radishes, cabbage, cauliflower, tomatoes, cucumbers, pumpkin, green beans, eggplant, zucchini, celery. Also, do not forget about unsweetened apples, pears, plums, cherries, wild berries.

The largest amount of fiber is found in bran, raspberries, strawberries, black, red and white currants, fresh mushrooms, blueberries, cranberries, gooseberries, prunes.
A slightly smaller amount of fiber is found in carrots, white cabbage, green peas, eggplant, sweet pepper, pumpkin, quince, sorrel, oranges, lemons, lingonberries.
Moderate fiber content is found in rye bread, green onions, cucumbers, beets, tomatoes, radishes, cauliflower, melons, apricots, pears, peaches, apples. Bananas, tangerines.
The least fiber in rice, zucchini, lettuce, watermelon, cherries, plums, cherries.

According to the type and severity of the disease, a special therapeutic diet is selected.

Choice of therapeutic diet

The therapeutic diet "Table No. 8" is used if diabetes mellitus has appeared recently. Typically, such a diet is prescribed for the elderly and children in order to quickly normalize the patient's blood glucose levels. But they adhere to this scheme of therapy not constantly, but periodically.