Click here to break free from Type 2 Diabetes
Diabetes mellitus, an unjustly stigmatized disease for decades, has recently undergone a revolution in the form of a wide range of oral hypoglycemic drugs, the availability of sophisticated glucometers and reliable self-monitoring aids, and an increasing number of educators, associations, workshops and lectures. guidelines, applicable innovations in the field of medicine and nutrition, the principles of self-control, the importance of regular exercise and help them overcome everyday psychosocial barriers) and "user-friendly" insulin therapy.
As with other chronic diseases, doctors in diabetes often encounter a revolted and disappointed, but at the same time confused and insecure patient, faced with a lot of new information, requirements, advice and prohibitions necessary to achieve the therapeutic goal, prevent chronic complications and improve quality of life. to the highest possible level. On the one hand, therefore, there is a patient with high glycemia, cardiovascular risk, often of high age and accompanying comorbidities, and on the other hand there is a doctor who must take all this into account when prescribing the optimal therapeutic strategy. The goal of the strategy is always the same - optimal glucoregulation, with a minimum of side effects, maximum compliance and high motivation of patients to further achieve / maintain ideal anthropometric and metabolic parameters.
Who gets type 2 diabetes?
Diabetes, especially type 2, is reaching epidemic proportions around the world as Western eating habits are increasingly adopted. It typically occurs after the age of 40 years. Aging alone can increase susceptibility to glucose intolerance and diabetes. Although still rare, the significant increase in diabetes 2 in children is quite worrying, probably due to the increase in childhood obesity rates. Obesity is very common in people with type 2 diabetes, so even moderate weight gain can increase your susceptibility to diabetes. Adipose tissue around the abdomen and on the upper body (apple shape) has been linked to insulin resistance, heart disease, high blood pressure, stroke and elevated cholesterol. The pear-shaped body, with a thickness distributed around the hips and thighs, is less associated with these diseases. Smokers are more susceptible to type 2 diabetes and its complications. Between 25% and 33% of all patients have a family history of the disease, and people whose first-generation relatives were diabetics are at 40% risk throughout their lives.
What is insulin?
Insulin is a vital hormone produced by the pancreas in beta cells. Insulin plays the key to passing sugar (glucose) into the cells.
In diabetes, the pancreas produces too little insulin to allow all the sugar we ingest from food from the blood to pass into the muscles and other cells that produce energy. If sugar cannot enter the cells and be used it accumulates in the blood. Therefore, the basic feature of diabetes is high blood sugar, which in the long run causes damage to the eyes, nerves, kidneys and blood vessels, which we call chronic complications of diabetes.
How does insulin work?
In order for the human body to function normally, it needs energy. The body needs food to produce energy. Energy is produced by the human body in cells.
To create energy, the body needs the following food ingredients: carbohydrates, fats and proteins.
Carbohydrates are the best source of energy for the human body. Carbohydrates include starch (flour, potatoes, rice, fruit), sugar and glucose.
Glucose is the basic source of energy for the human body. Glucose is stored in the liver and muscles in the form of a substance called glycogen, which serves as an “energy reserve”. Glucose in the blood comes from food (from carbohydrates) and from the liver (glucose reserve from glycogen). In addition to storing, the liver produces small amounts of glucose (the production process is called gluconeogenesis).
After a meal, carbohydrates from digestion enter the bloodstream and go to the cells through the blood. Some cells (muscle and fat cells) need help to receive blood sugar and use it to create energy.
The liver needs help in the process of storing glucose in glycogen. Insulin serves as a key that opens the door to cells and allows blood sugar to enter the cell. The cell produces energy for its work from sugar. It lowers blood sugar and returns it to normal.
The use of drugs in the form of tablets primarily makes sense in type 2 diabetes, when the patient, despite a changed diet and activity, fails to achieve satisfactory blood sugar levels. Various active substances are used to treat diabetes with tablets.
If your blood sugar level cannot be satisfactorily regulated by a special diet, increased physical activity and taking pills, you will also need insulin, or you will switch to insulin therapy altogether.
It is certainly worth mentioning that certain circumstances, conditions, stress, changes in diet, changes in the type of insulin and the concomitant use of certain medications may change insulin needs. Conditions / circumstances in which the need for insulin is reduced, and it is necessary to reduce the total daily insulin dose are weight loss, increased physical exertion, first trimester of pregnancy, breastfeeding, smoking cessation, alcohol consumption, hepatic insufficiency, gastroparesis and concomitant use of OHL, salicylate , sulfonamides, fluoxetine, MAO inhibitors, some ACE inhibitors (captopril, enalapril), fibrates, ATII blockers, nonselective beta blockers, anabolic steroids and octreotides. In some patients with type 2 diabetes, due to significant weight loss and regular high-intensity exercise, insulin treatment may be discontinued altogether.
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