Complications of type 2 diabetes mellitus: disease development and treatment

In this article, I will look at what are the signs of type 2 diabetes in women, which a woman should pay close attention to in order to take timely action. What will help you cope with this illness. After all, preventing a disease is always easier than treating it later.

Diabetes mellitus is a dangerous disease, very common among our contemporaries, but not fatal if you know how to properly “get along” with such a disease. How dangerous is diabetes mellitus for the female half of humanity? Why does such a diagnosis sometimes come true?

First of all, diabetes is dangerous because it destroys the body’s proper metabolism and glucose levels, and also affects the heart capillaries, which subsequently stop properly “supplying” blood flow.

Features and principles of nutrition for type 2 diabetes mellitus

Type 2 diabetes mellitus causes a drop in glucose concentration and a lack of energy in the cells of the spinal cord due to insufficient supply of glucose to the cells of the patient’s body. Diabetes mellitus of this type develops in elderly or mature people and is directly related to the aging of the body or obesity. The task of a person with type 2 diabetes is to lose weight, then he will get rid of the disease. Losing 5 kg of weight will greatly improve insulin levels in the blood, so you should follow a low-calorie diet.

The main energy in the human body during nutrition comes from proteins, fats and carbohydrates. Fats contain more energy, almost twice as much as carbohydrates or proteins, so an effective low-calorie diet for type 2 diabetes would be a significant reduction in fat in the menu.

To remove as much fat as possible, you should follow several dietary rules:

1. Remove fat from meat and skin from poultry before cooking.
2. Carefully read the information on the product packaging, it will show the fat content.
3. Avoid frying foods in vegetable oil. It is better to use stewing, baking or boiling.
4. Adding mayonnaise or sour cream to salads significantly increases their calorie content.
5. Try to eat more raw vegetables than cooked ones.
6. Avoid chips and nuts - they are high in calories.

Some features of optimal nutrition for diabetics

1. In no case should you neglect breakfast.
2. You can’t go hungry and take long breaks from eating.
3. Last meal no later than 2 hours before bedtime.
4. Dishes should not be too hot or too cold.
5. During meals, vegetables are eaten first, and then a protein product (meat, cottage cheese).
6. If a portion of food contains a significant amount of carbohydrates, there must also be proteins or the right fats to reduce the rate of digestion of the former.
7. It is advisable to drink permitted drinks or water before meals, and not to wash them down with food.
8. When preparing cutlets, a loaf is not used, but you can add oatmeal and vegetables.
9. You cannot increase the GI of foods by further frying them, adding flour, breading them in breadcrumbs and batter, flavoring them with oil, and even boiling them (beets, pumpkin).
10. If raw vegetables are poorly tolerated, baked dishes, various pastes and pates are made from them.
11. You should eat slowly and in small portions, chewing your food thoroughly.
12. You should stop eating at 80% saturation (according to personal feelings).

Vascular lesions

The walls of the vascular bed need glucose for the normal course of all reactions. If there is excess glucose, it can begin to be deposited on the walls of blood vessels, increasing their permeability, making them thinner and more fragile. This creates conditions for the development of atherosclerotic lesions.

The microcirculatory system suffers the most. The first signs of damage to small vessels can be detected when examining the retina. There are signs of hypertension in the microvasculature (congestion of retinal vessels, swelling). Over time, complete detachment may occur, leading to blindness.

Diabetic foot is a special case of angiopathy. It is characterized by narrowing of the arteries and veins, reducing blood flow through them. The foot becomes cold to the touch, and the pulse wave is weakly transmitted through the arteries. Due to circulatory problems, ulcers and necrotic lesions begin to develop, ultimately leading to amputation of the foot.

What is the glycemic index (GI) and why does a diabetic need it?

This is an indicator of the ability of foods, once they enter the body, to cause an increase in blood sugar levels. GI acquires particular relevance in severe and insulin-dependent diabetes mellitus.

Each product has its own GI. Accordingly, the higher it is, the faster the blood sugar level rises after its consumption and vice versa. The GI gradation separates all products with high (more than 70 units), medium (41-70) and low GI (up to 40). Tables with the breakdown of products into specified groups or online calculators for calculating the GI can be found on thematic portals and used in everyday life.

All foods with a high GI are excluded from the diet with the rare exception of those that are beneficial for the body of a person suffering from diabetes (honey). In this case, the overall GI of the diet is reduced by limiting other carbohydrate foods. The usual diet should consist of foods with low (mostly) and medium (smaller share) GI indicators.

Table of food products by glycemic index

The lower the glycemic index of a product, the slower it is absorbed by the body, and this in turn leads to the fact that blood sugar remains normal or rises slightly. But this will not affect the patient's condition.

It must be remembered that a diagnosis of diabetes is not a death sentence. And this does not mean that the diet will be meager. Quite the contrary, the patient should not starve. It’s just that foods for type 2 diabetes should have a low glycemic index.

Table of prohibited products

Refined sugar is one of the products with an average GI value, but with a borderline value. That is, theoretically it can be consumed, but sugar is absorbed quickly, which means blood sugar rises quickly. Therefore, ideally it should be excluded from the diet or consumed in a limited manner.

What not to eat if you have diabetes, food table:

Polyneuropathy

A serious disease characterized by impaired sensitivity of all groups of nerves (mainly the limbs are affected). The reduction in sensations occurs like “stockings” and “gloves”: the process begins with the feet and hands and gradually moves to the entire limb.

Develops due to direct damage to the nerve trunks of the limb by glucose.

The main symptoms of the disease, in addition to anesthesia and paresthesia, is a burning sensation, which usually manifests itself at night. Due to a decrease in sensitivity and pain threshold, the number of injuries increases (patients simply do not feel the pain that they would feel if the nerves were in normal condition). The presence of all these symptoms indicates the development of a nervous complication of diabetes mellitus.

Treatment is recommended to be carried out comprehensively, including not only metabolic correction of the disease, but also physiotherapeutic procedures. Therapy takes quite a long time, and any error in diet or medication leads to its exacerbation.

Table of permitted products

Allowed foods for diabetes are a group that can be eaten without restrictions.

What can you eat if you have diabetes, food table:

Fully or partially limited products

• Baking, sweet desserts, honey, confectionery, preserves and jams (xylitol can be used), sugar, ice cream, curd mass, sweet cheese, sweet juices, sweet drinks, beer are excluded.
• Products made from flour (dumplings, dumplings, pancakes, pies).
• Sweet fruits and dried fruits: raisins, dried apricots, bananas, dates, figs, grapes, pineapple, persimmon, apricot, melon.
• Semolina and pasta.
• You should not eat fatty broths and fatty meats, fatty sauces, smoked meats, lard, ham, sausages and cream. Liver, egg yolks, and honey are allowed in limited quantities.
• It is better to avoid fried foods, eating spicy and too salty foods, and hot sauces.

Limit:

• Potatoes, wheat cereal, white rice.
• Beets and carrots.
• The consumption of fats, even vegetable ones, is reduced as much as possible.

Replacing harmful products with healthy analogues

Features of treatment

Treatment of type 2 diabetes mellitus is based on the use of drugs that reduce the concentration of glucose in the blood, since today there are no sufficiently effective methods for increasing the sensitivity of cells to glucose. In addition, therapy for the disease involves correction of the patient’s weight in order to eliminate one of the main provoking factors causing the pathology – obesity.

Excess cholesterol is a trigger for the development of angiopathy of any location. This is most clearly seen in the table.

Adjustment of indicators is possible in three ways:

• taking medications;
• balanced diet;
• healthy lifestyle.

Effective treatment of type 2 diabetes mellitus involves the correction of concomitant diabetes diseases: obesity, hypertension, polyneuropathy, vascular disorders, and depressive states. The course of therapy is carried out inpatiently or at home, which depends on the severity of the problem and the presence of complications.

Diet therapy

First of all, when treating type 2 diabetes, a diet is prescribed. Its purpose is weight loss. Alcohol is prohibited for insulin-resistant diabetes because it is too high in calories, plus, in combination with certain drugs, it can provoke hypoglycemia and lactic acidosis. The goal of the diet is to normalize blood glucose levels. To do this, carbohydrates are sharply reduced in the diet in favor of proteins. All carbohydrates are divided into fast and slow. They start with the fast ones. They are found in refined sugar, jam, chocolate, ice cream, desserts, baked goods, and candies. There is a strict ban on them.

To make calorie counting easier, the concept of a bread unit is introduced - this is 10-12 g of carbohydrates in any product. One such unit (one apple or a glass of buckwheat porridge) increases blood sugar levels by 2.8 mmol/l. To utilize it, you need to inject 2 units of insulin. A diabetic can eat no more than 24 bread units per day. For one appointment – ​​5. This technique is taught in “Diabetes Schools” at endocrinology hospitals.

It is necessary to correctly calculate the required drinking ration (50 g per 1 kg of weight) in order to replenish the amount of fluid lost per day in urine, otherwise the blood will become viscous and prone to thrombus formation. Meals for type 2 diabetes mellitus should be fractional, with small portions. You can eat fruits and berries (slow carbohydrates), but only those that are low in starch and sugars. Excluded: potatoes, carrots, beets, bananas, grapes, melons.

Physical exercise

Treatment of type 2 diabetes involves dosed physical activity. The best way to start is a daily half-hour walk in the morning, lunch and evening. In second place is swimming. When choosing a sports activity, it is necessary to take into account the patient’s energy expenditure in order to be able to correct fluctuations in blood sugar if necessary.

Hypoglycemic drugs

Drug treatment of type 2 diabetes comes down to the use of drugs in two main categories: those that affect insulin synthesis and those that perform other functions. Examples of hypoglycemic drugs, the dosage regimen of which is developed by the doctor individually, are presented in the table.

Sulfonylurea derivatives

Drugs that stimulate the production of insulin by Langerhans beta cells.

Glinids

Medicines - activators of insulin synthesis, secondary glycemic control agents in the treatment of type 2 diabetes mellitus, enhance the effect of metformin.

Biguanides

The drugs are responsible for reducing the production of glucose by the liver and tissue resistance to glucose.

Glitazones

Medicines that reduce the production of glucose by the liver in type 2 diabetes, reducing tissue resistance to carbohydrates.

Alpha-glucosidase inhibitors

The drugs slow down the absorption of glucose in the intestine.

Glucagon-like peptide receptor agonists

Agents that activate glucose-dependent insulin secretion and reduce glucagon secretion.

Gliptins (dipeptidyl peptidase-4 inhibitors)

Drugs that block the synthesis of glucagon, which increases sugar, enhance the effect of digestive tract hormones that increase insulin production.

Gliflozins

A class of new generation oral hypoglycemic drugs for type 2 diabetes. Sodium-dependent glucose transporter (SGLT-2) inhibitors.

Insulin

If type 2 diabetes mellitus is decompensated, insulin therapy is prescribed. There are special syringe pens or insulin pumps that quickly and effectively solve the problem. This is an alternative to daily insulin injections according to the schedule recommended by your doctor.

Folk remedies

Type 2 diabetes is well corrected with folk remedies that balance the functioning of Langerhans cells. An example would be:

• cinnamon - improves metabolic processes, drink by adding a spoonful of spice to regular tea;
• chicory is a natural remedy that improves the condition of blood vessels and the nervous system, recommended for the prevention of type 2 diabetes: it contains minerals, esters, vitamins C and B1;
• blueberries - one tablespoon per glass of water, the solution is brought to a boil, filtered, cooled, drunk three times a day;
• walnut – reduces sugar due to zinc and manganese, calcium and vitamin D, which normalize water-salt metabolism;
• linden tea - prepared and used like blueberry tea, has a hypoglycemic effect, heals the entire body.

Folk remedies are used in the treatment of diabetes only as part of a complex of therapeutic measures, never as monotherapy.

Menu for a week for diabetes

Below is a menu based on generally accepted dietary recommendations. When creating a weekly menu for yourself with type 2 diabetes, try to diversify it more and include your favorite vegetables and fruits, meat and fish dishes, the allowed amount of sweeteners in jelly, drinks and casseroles.

A menu for type 2 diabetes may look like this:

Second option:

Third option:

Fourth option:

Fifth option:

Sixth option:

Seventh option:

Diet

First of all, a specialist should prescribe the right diet for patients with diabetes. At the first stage, some doctors do not prescribe medication, but only diet and some physical activity. You will have to give up most sweet foods, some fruits, butter, potatoes. It is necessary to reduce the consumption of carbohydrates, which increase sugar. Pastries, pies, and confectionery products should be completely excluded from your diet if you care about your health. It is acceptable to use sweeteners, but in small quantities, as they can also harm the body.

However, it is not enough to just go on a diet; you will need to divide your meals into small portions to make it easier for the body to absorb the foods. If you have diabetes, it is useful for breakfast to eat not very sweet fruits, pureed vegetables, low-fat cottage cheese, buckwheat or oatmeal, as well as bread. For lunch it is permissible to eat some kind of first course. This could be low-fat bean soup or fish. For the second course you can eat some meat. Fresh vegetable salads from seasonal vegetables are healthy, as well as fruits and squash caviar, and rye bread. It is better to eat fruits as sweets. For dinner you can eat vegetable salads and omelettes. If you are very hungry before bed, you can drink a little kefir or milk.

Table 9 for diabetes

Diet No. 9 was developed specifically for diabetics and has long been used in inpatient treatment of patients who strictly adhere to it at home. It was developed by the Soviet scientist M. Pevzner. It includes:

• 300 g of fruit;
• 80 g vegetables;
• 100 g mushrooms;
• 1 tbsp. natural fruit juice;
• 300 g of meat or fish;
• 200 g low-fat cottage cheese, 500 ml fermented milk products;
• 100-200 g of bran, rye, wheat bread mixed with rye flour or 200 g of cereals (ready-made), potatoes;
• 40-60 g fat.

Main dishes:

• Soups: vegetable, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, fish or light meat broth, mushroom soup with cereals and vegetables.
• Poultry, meat: rabbit, veal, chicken, stewed, chopped, boiled, turkey.
• Fish: pike perch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, baked in juice.
• Appetizers: vegetable mix, vinaigrette, jellied dietary fish and meat, vegetable caviar, unsalted cheese, seafood salad with butter.
• Sweets: desserts from berries, fresh fruits, berry mousses, sugar-free fruit jelly, sugar-free jam and marmalade.
• Egg dishes: soft-boiled eggs, egg white omelet, in dishes.

Diet for type 2 diabetes mellitus by day

Contrary to the skepticism of many, the weekly menu for people who have just embarked on the right path of dietary nutrition can be both tasty and varied, the main thing is that food becomes a priority in life.

Kidneys

Impaired blood circulation in small vessels located in the kidneys can lead to poor urine filtration. Substances that are not found in the urine of a healthy person (protein, glucose) can then be seen in it.

Impaired kidney function can lead to kidney failure. Signs of such complications are arterial hypertension, edema, as well as a clear increase or decrease in the amount of urine.

To prevent your condition from becoming critical, a diabetic should undergo an ultrasound of the kidneys at least once a year. If the development of kidney failure is missed, it may even eventually require a kidney transplant or chronic hemodialysis.

Products that normalize sugar

List of foods that will help normalize blood sugar:

1. Vegetables. Minerals, vitamins and antioxidants are found in fresh vegetables. To reduce sugar, experts recommend eating broccoli and red peppers. Broccoli fights inflammatory processes in the body, and red pepper is rich in ascorbic acid.
2. Jerusalem artichoke. Helps eliminate toxins, improves metabolism and reduces blood sugar.
3. Fish. Eating fish twice a week reduces the risk of developing diabetes. It is preferable to steam it or bake it in the oven.
4. Oatmeal. This dish contains soluble fiber, which normalizes blood sugar.
5. Garlic. This product affects the production of insulin, stimulating the pancreas. In addition, garlic contains antioxidants that have a positive effect on the functioning of the entire body.
6. Cinnamon. This spice contains magnesium, polyphenols and fiber, which reduce sugar levels in the body.
7. Avocado. The properties of avocados are of interest to many. This green fruit is rich in beneficial microelements, folic acid, proteins, monounsaturated fats and magnesium. Its regular use will increase immunity, improve the condition of skin and hair, and protect the body from the development of diabetes.

Hypoglycemic coma

Can develop in patients with any form of diabetes. Usually the condition is triggered by too much insulin taken, although coma is common during intense physical activity (for example, after a long run) or after drinking alcohol.

The condition is characterized by complete loss of consciousness, increased sweat and glandular secretion, and lack of pupillary response to light. Typically, the development of coma can begin with the appearance of precursors felt by the patient: sudden weakness, shortness of breath, severe dizziness. Patients sometimes manage to warn others that they are about to lose consciousness.

First aid for the development of this complication of diabetes mellitus is carried out by administering a 40% glucose solution to the victim. This procedure is also diagnostic, as it allows one to distinguish hypoglycemic coma from hyperglycemic coma. Usually after this, patients immediately regain consciousness. In frequent cases of the development of such a complication of diabetes mellitus, it is necessary to adjust the metabolism in a hospital setting.

Sweeteners

This issue remains controversial, since diabetic patients do not feel an urgent need for them, but use them only to satisfy their taste preferences and habit of adding sugar to dishes and drinks. In principle, there are no artificial and natural sugar substitutes with 100% proven safety. The main requirement for them is no increase in blood sugar or a slight increase in the indicator.

Currently, with strict blood sugar control, 50% fructose, stevia and honey can be used as sweeteners.

Fructose

Fructose 50%. Fructose does not require insulin to metabolize, so it is safe in this regard. It has 2 times less calories and 1.5 times more sweetness compared to regular sugar. It has a low GI (19) and does not cause a rapid increase in blood sugar.

The consumption rate is no more than 30-40 grams. per day. When consuming more than 50 g. fructose per day decreases the liver's sensitivity to insulin. Available in powder and tablet form.

Stevia

Stevia is a zero-calorie, sugar-replacement supplement made from the leaves of the perennial stevia plant. The plant synthesizes sweet glycosides, such as stevioside, a substance that gives the leaves and stems a sweet taste, 20 times sweeter than regular sugar. Can be added to prepared dishes or used in cooking. It is believed that stevia helps restore the pancreas and helps produce its own insulin without affecting blood sugar.

Officially approved as a sweetener by WHO experts in 2004. The daily norm is up to 2.4 mg/kg (no more than 1 tablespoon per day). If the supplement is abused, toxic effects and allergic reactions may develop. Available in the form of powder, liquid extracts and concentrated syrups.

Honey

Natural bee honey. Contains glucose, fructose and a small proportion of sucrose (1-6%). Insulin is needed to metabolize sucrose, but the content of this sugar in honey is insignificant, and therefore the burden on the body is small.

Rich in vitamins and biologically active substances, improves immunity. With all this, it is a high-calorie carbohydrate product with a high GI (about 85). For mild diabetes, 1-2 teaspoons of honey with tea per day is acceptable, after meals, slowly dissolving, but not adding to a hot drink.

Chronic complications

Even despite the treatment and compliance with all medical prescriptions, diabetes mellitus irreversibly leads to the development of permanent complications affecting all organs and systems. The process is irreversible, and treatment only slows it down somewhat.

Chronic complications of diabetes mellitus primarily affect well-vascularized organs such as the heart, kidneys, skin and nervous system.

Damage to the cardiovascular system manifests itself in the development of coronary heart disease and heart attacks. Over time, chronic heart failure develops, which further aggravates the condition.

The kidneys lose their ability to filter normally, which causes an increase in the amount of albumin excreted in the urine. This leads, firstly, to the appearance of hypoproteinemic edema, and secondly, to renal failure. Most often, this pathology is characteristic of complications of type 1 diabetes mellitus.

The skin is characterized by the development of trophic ulcers and necrosis.

Lesions of the nervous system are represented by paralysis and metabolic encephalopathy.

Recipes for type 2 diabetes

Soup with tomatoes and bell peppers

You will need: one onion, one bell pepper, two potatoes, two tomatoes (fresh or canned), a tablespoon of tomato paste, 3 cloves of garlic, ½ teaspoon of cumin, salt, paprika, about 0.8 liters of water.

Cut the tomatoes, peppers and onions into cubes, simmer in a saucepan with the addition of tomato paste, paprika and a few tablespoons of water. Grind the cumin using a masher or coffee grinder. Cut the potatoes into cubes, add to the vegetables, add salt and fill with hot water. Cook until the potatoes are ready.

A few minutes before it’s ready, add cumin and crushed garlic to the soup. Sprinkle with herbs.

Vegetable snack

We will need: 6 medium tomatoes, two carrots, two onions, 4 bell peppers, 300-400 g of white cabbage, a little vegetable oil, bay leaf, salt and pepper.

Shred the cabbage, cut the pepper into strips, tomatoes into cubes, onions into half rings. Simmer over low heat with the addition of vegetable oil and spices.

When serving, sprinkle with herbs. Can be used on its own or as a side dish for meat or fish.

Meatballs made from vegetables and minced meat

We will need: ½ kg of minced chicken, one egg, one small head of cabbage, two carrots, two onions, 3 cloves of garlic, a glass of kefir, a tablespoon of tomato paste, salt, pepper, vegetable oil.

Finely chop the cabbage, chop the onion, and grate the carrots on a fine grater. Fry the onion, add vegetables and simmer for 10 minutes, cool. Meanwhile, add the egg, spices and salt to the minced meat and mix.

Add the vegetables to the minced meat, mix again, form meatballs and place them in the mold. Prepare the sauce: mix kefir with crushed garlic and salt, pour over the meatballs. Apply a little tomato paste or juice on top. Place the meatballs in the oven at 200°C for about 60 minutes.

Angiopathy

This is the name for vascular complications, and they are divided into micro- and macroangiopathies. The main role in their development belongs to the high concentration of glucose in the blood.

Microangiopathies

This is the name for damage to small vessels (capillaries, arterioles and venules), through which oxygen and nutrients are exchanged. Microangiopathies include retinopathy (damage to the retinal vessels) and nephropathy (damage to the renal vascular network).

Retinopathy

This is a complication that occurs to a more or less mild degree in all patients with diabetes and leads to visual impairment. Diabetic retinopathy, more often than other late consequences, leads to disability, depriving a person of vision. For every 1 person blind due to other causes, there are 25 people blind due to diabetic vascular damage.

A long-term high concentration of glucose in the retinal vessels leads to their narrowing. The capillaries try to compensate for this condition, so in some places sac-like protrusions appear, through which the blood tries to exchange necessary substances with the retina. It turns out badly, and the retina suffers from a lack of oxygen. As a result, calcium salts and lipids are deposited in it, and scars and seals then form in their place. If the process is far advanced, retinal detachment may occur, resulting in blindness. Developed vitreous hemorrhages or glaucoma can also lead to blindness.

The disease manifests itself as gradually deteriorating vision, a decrease in the visual field (it becomes difficult to see on the sides). It is better to detect it in the initial stages, so it is important to undergo an examination by an ophthalmologist, ultrasound of the eyes, and examination of the retinal vessels every 6-12 months.

Nephropathy

This complication occurs in ¾ of diabetic patients and involves specific kidney damage, which ultimately leads to the development of chronic renal failure. It most often kills people with type 1 diabetes.

The first signs of diabetic kidney damage can be detected in a urine test 5-10 years after the onset of the disease.

In its development, nephropathy goes through 3 stages:

1. Microalbuminuria. There are almost no subjective sensations; blood pressure may only slightly increase. In urine collected over 24 hours using immunoenzyme, radioimmune and immunoturbidimetric methods.
2. Proteinuria. At this stage, a large amount of protein is lost in the urine. A deficiency of protein, which previously held fluid in the vessels, leads to the release of water into the tissues. This is how swelling develops, especially on the face. Also, in 60-80% of people, both “upper” and “lower” pressure increases.
3. Chronic renal failure. The amount of urine decreases, the skin becomes dry and pale, and high blood pressure is noted. Episodes of nausea and vomiting are common, and consciousness also suffers, causing the person to become less and less oriented and critical.

Macroangiopathies

This is the name of the condition when diabetes mellitus creates conditions in large vessels for the development of atherosclerotic plaques in them. This affects the vessels supplying blood to the heart (then angina pectoris and myocardial infarction occur), the lower extremities (this leads to gangrene), the brain (this causes the development of encephalopathy and stroke), and the abdomen (the development of mesenteric thrombosis).

Thus, diabetic encephalopathy is manifested by progressive weakness and decreased ability to work, mood swings, impaired attention, thinking and memory, and squeezing headaches.

Macroangiopathy of the lower extremities is manifested by difficulty moving the legs in the morning, which then goes away, increased fatigue of the leg muscles, a feeling of coldness in them and excessive sweating. Then the feet become very cold, go numb, the surface of the nails becomes dull and whitish. After this stage, the next stage develops, when a person begins to limp because it becomes painful for him to walk. These pains can also occur in a calm state. The skin on the legs turns pale and thins. The last stage of this complication is gangrene of the foot, fingers, and legs.

With less pronounced disorders of the blood supply to the legs, chronic trophic ulcers appear on them

What does a diet do for diabetes?

The benefits of a diet for diabetics should in no way be diminished, since a properly formulated diet and meals by the hour helps stabilize blood glucose levels and improves the general condition of the patient’s body. In addition, those diabetics who are overweight already by the end of the first month of following the diet observe a significant reduction in kilograms and volumes.

There are some simple tips to help you live your life to the fullest if you have type 2 diabetes:

1. More physical activity.
2. Less fatty and sweet. It is better to replace sweets with dietary desserts.
3. Quitting alcohol and smoking.
4. Tracking your own weight.
5. Following dietary recommendations.

It is recommended to adhere to diet No. 9 for life, as it is not harmful to health and prevents sudden surges in blood sugar, which leads to life-threatening complications, and also improves the functioning of the pancreas and improves the general well-being of the patient.
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Early complications

Early, or acute, complications pose an immediate threat to human life. Their development is characterized by a rapid onset, taking no more than two to three hours, less often – several days. Acute complications of diabetes mellitus, if appropriate medical support is not provided, often lead to the death of the patient. Because of this, knowledge of emergency care algorithms for the development of a particular coma is simply mandatory, both for the patient’s relatives and for the medical staff.

As mentioned above, acute complications of diabetes include coma. This term refers to a life-threatening condition in which there is no patient activity, unconditioned reflexes decrease or completely disappear, heart rhythm and respiratory activity are disrupted. They occur as a result of the predominance of inhibition processes in the cerebral cortex.

Complications of this kind tend to develop rapidly, so it is extremely difficult to predict their occurrence. Treatment of patients with this pathology should be carried out in a hospital (first in intensive care until the patient is brought out of a coma, and then in a specialized department).

What types of comas are there?

Lactic acid coma

With excessive accumulation of lactic acid, diabetics develop lictic acidotic coma. It occurs mainly in older people. The complication is characterized by the development of acidosis. It is provoked due to chronic failure of the heart, kidneys or liver.

Symptoms of lactic acidosis coma include:

• loss of consciousness;
• weakening of reflexes;
• stopping the flow of urine into the bladder;
• disruptions in the functioning of the respiratory and vasomotor systems;
• decrease in pressure.

In intensive care, the patient will be administered solutions to reduce the degree of intoxication in combination with diuretics and insulin. It is equally important to eliminate the underlying cause of coma.

Diagnostics

The basic method for diagnosing type 2 diabetes is a blood sugar test. It is performed on an empty stomach in the morning - 12 hours before the test, you must stop eating, alcohol, smoking, not engage in physical or strong emotional stress, and also not take medications and be relatively healthy. Chronic diseases in the acute phase, as well as infections and other problems, can distort the results of the study. If the analysis shows that the blood glucose level is in the range from 5.5 to 7 mmol/l, the patient has problems with insulin resistance and, accordingly, prediabetic syndrome is present. At values ​​above 7 mmol/l, there is a high probability of having diabetes, naturally, if the initial recommendations are followed before the test.

As a complement to the above analysis, a stress test is performed - immediately after donating blood on an empty stomach, the patient is given a dose of seventy-five grams of glucose and blood is taken every 30 minutes for two hours for analysis with the study of its peak values. With values ​​in the range of 7.8–11 mmol/L, a doctor can diagnose prediabetes. Above 11 mmol/l - there is a high probability of diabetes.

As an alternative to the basic method, the patient can take a blood test for glycated hemoglobin - it costs much more, but is more accurate and practically does not depend on adverse external factors, such as food intake/medication, physical activity, etc. A result in the range of 5.7–6.5 percent is suspected of diabetes. Values ​​above 6.5 percent confirm the presence of diabetes in the patient.

In addition to the main tests, the doctor conducts a differential symptomatic diagnosis of the patient (the presence of polydipsia/polyuria and other signs), and must also exclude various pathologies of a different spectrum that cause hyperglycemia (ultrasound, ECG, Rehberg test, ultrasound, capillaroscopy, examination of the fundus and electrolyte composition of the blood ).

If the main diagnosis of diabetes mellitus is confirmed, the doctor identifies the type of this disease - first, additional subtypes are checked (gestational, secondary, etc.), and if they are absent, a C-peptide test is performed, which will indicate metabolic or autoimmune forms of diabetes.

Causes of type 2 diabetes

Unlike type 1 diabetes with its insufficiency of insulin production, in type 2 disease the hormone is released sufficiently, often even above normal, but it practically does not lower blood sugar, since tissue cells do not perceive it well. However, over time, the function of the islets of Langerans, which hyperactively produce insulin, gradually decreases and the risk of transition from type 2 to type 1 diabetes increases.

Modern medicine claims that type 2 diabetes is caused by a combination of genetic and life factors, and the vast majority of cases of this disease are detected in people with increased body weight and obesity.

The classic causes of type 2 diabetes mellitus, taking into account the above factors, are:

1. Genetic problems . Studies show that 20 percent of children whose parents had type 2 diabetes develop a similar disease.
2. Obesity of varying degrees . Abdominal obesity causes tissue insulin resistance, with a concomitant increase in load on the pancreas.
3. Age-related changes . Physiologically, over time, all tissues of the body of an elderly person gradually acquire insulin resistance and, if there is a predisposition to type 2 diabetes, the risks of developing the disease after 40 years of age rapidly increase, especially in obese people.
4. Viral infections . A variety of viral infections can “start the process,” especially if they affect a person several times a year.
5. Problems with the pancreas . Pancreatitis, cancer and other diseases, especially chronic ones, cause secondary type 2 diabetes.
6. Depression and stress . Constant stressful situations and subsequent depression are an additional risk factor.

Diabetes mellitus type 1

This type of diabetes occurs in people with a genetic predisposition to the disease and is associated with an absolute deficiency of insulin. The first signs of such diabetes in women appear in childhood. Girls with type 1 diabetes are usually moody, extremely thin, drink a lot and are constantly hungry. Without treatment, children are developmentally delayed and may die.

Features and manifestations of type 1 diabetes mellitus in women:

• the disease rarely occurs in people over 30 years of age;
• girls experience puberty late (menstruation begins at 16-17 years old, women suffer from infertility);
• the patient is extremely sensitive to hunger. This feeling is accompanied by dizziness, loss of consciousness, profuse sweat;
• patients complain of dry skin, constant cracks in the skin that do not heal well.

GI products in diet therapy

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The glycemic index is an indicator that reflects the effect of a certain product on increasing blood sugar levels after consumption. Low GI foods contain carbohydrates that are difficult to break down, which are not only necessary for the patient, but also give him a feeling of fullness for a long time.

Diabetics need to choose from those food categories that have a low GI. Food with an average value can be included in the diet only occasionally, no more than twice a week. High GI foods can raise glucose levels to 4 mmol/l in a fairly short period of time.

The glycemic index of foods is divided into three categories. But in addition to this value, you need to pay attention to the caloric content of food. So, some food has a value of zero units, but at the same time contains bad cholesterol and high calorie content.

A clear example of this is lard, which does not contain carbohydrates and has 0 units, but is strictly contraindicated for diabetics. GI division:

• 0 – 50 units – low;
• 50 – 69 units – average;
• over 70 units – high.

There is a special table of products with indexes to make it easier for the patient to create a menu for himself. Some products after heat treatment can significantly increase the index - these are beets and carrots. In their raw form they are allowed, but in boiled form they are prohibited.

The therapeutic diet allows you to prepare dishes from the following vegetables:

1. onion;
2. all varieties of cabbage - white and red cabbage, Brussels sprouts, cauliflower, broccoli;
3. garlic;
4. eggplant;
5. tomato;
6. green and green beans;
7. lentils;
8. peas;
9. squash;
10. cucumber.

Many people are accustomed to having potatoes on their table. But if you have a “sweet” disease, it is better to avoid it due to the high GI. In very rare cases, when you still decide to use the tubers, they should first be soaked in water overnight. Thus, you can get rid of starch and slightly reduce the index.

Vegetables for diabetics are a source of vitamins, microelements and fiber. Not only fresh salads are prepared from them, but also side dishes, as well as complex dishes. You can diversify the taste with greens - spinach, lettuce, oregano, basil, dill and parsley.

Fruits are an equally important component of diet therapy. The daily allowed amount should not exceed 150 - 200 grams. Juices cannot be made from fruits even with a low index. With this treatment, they are deprived of fiber and glucose suddenly enters the blood.

The following fruits and berries are allowed on the diet:

• cherry;
• apricot;
• pear;
• nectarine;
• persimmon;
• black and red currants;
• all varieties of citrus fruits - orange, lemon, grapefruit, tangerine, pomelo and lime;
• gooseberry;
• cherries;
• peach.

There are many valuable substances in dried fruits; no more than 50 grams per day are allowed. Dried fruits are good to add to porridge, thereby creating a complete food dish. Dried fruits with low GI - dried apricots, prunes and figs.

Meat, offal, fish and seafood are also a daily part of the menu. At the same time, fish should be present in the weekly diet at least three times. Lean varieties of meat and fish are selected. The skin and remaining fat, which contain no vitamins, but only bad cholesterol, are removed from them.

Endocrinologists recommend the following products:

1. chicken;
2. rabbit meat;
3. turkey;
4. beef;
5. quail;
6. chicken liver;
7. beef liver;
8. beef tongue;
9. beef lungs.

There are no restrictions on the choice of seafood. For fish, you can choose pollock, hake, pike or perch.

Cereals are a source of energy, so they give you a feeling of fullness for a long time. Some of them have a high GI, particularly white rice. An alternative would be brown (brown) rice, whose GI is 50 units. It cooks a little longer - about 45 minutes.

Pearl barley is considered the most valuable grain; its GI is only 22 units. Other types of cereals are also allowed:

• barley grits;
• buckwheat;
• oatmeal;
• wheat porridge.

By the way, the thicker the porridge, the lower its index.

Expert opinion

Guseva Yulia Alexandrova

Specialized endocrinologist

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There are few restrictions on dairy and fermented milk products. All of them are based on the fat content of the products. Therefore, it would be rational to refuse sour cream, margarine and butter.

Vision

One of the most unpleasant and quite common complications of diabetes is impaired visual acuity. Its first sign is a violation of the retina of the eye, because of this, the sharpness begins to decrease. An annual vision test with an ophthalmologist helps to notice this process in a timely manner.

Thus, timely examination of the fundus, which will most accurately show changes, can help preserve a person’s vision. We should not forget that the risk of developing blindness in a diabetic patient is much higher than that of a healthy population. Diabetics are also more likely to develop cataracts.

Hyperglycemic coma

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A comatose state provoked by a strong decrease in glucose utilization is called hyperglycemic. It is common to both types of diabetes and develops for the following reasons:

• late diagnosis of the disease;
• incomplete compensation of diabetes;
• non-compliance with the medication schedule;
• poorly designed diet;
• reaction to the use of diuretics or prednisolone.

The symptoms of hyperglycemic coma become more pronounced every hour. Among them the most basic can be identified:

• frequent urination;
• general weakness;
• nausea to the point of vomiting;
• constant feeling of thirst and dry mouth;
• fast fatiguability;
• itching of the skin;
• headache.

Short-acting insulin is used as treatment. Hyperglycemic coma is often accompanied by ketoacidosis. After relief of the complication, the patient will undergo a strict diet and adjustment of the treatment regimen.

Hepatitis C in diabetes

Diet therapy

The main goal of introducing diet and physical activity into therapy is the desire to normalize disturbed metabolic processes in the body (carbohydrate, fat, protein and water-salt) in order to bring the patient’s condition closer to normal. Thus, it is possible not only to normalize all processes, but also to adjust the patient’s weight. When losing weight, special emphasis is placed on low-carbohydrate or balanced diets.

At the same time, it is completely wrong to completely refuse food and such a technique as fasting for diabetes is unacceptable.

We do not exclude the fact that with high-quality fasting (in the process of following all recommendations, total control and supervision of the patient by a real practicing specialist in this field!) you can achieve amazing results.

BUT! At the moment, we cannot say for sure that there are many such specialists in Russia. Moreover, those who simply extract money from unfortunate people also consider themselves to be professional specialists. They manipulate a person’s fear, driving him into a dead end, frightening him with scary stories about unfortunate people who were treated with traditional methods and could not live a “decent” and long life. At the same time, they talk about the incredible healing of people after a 40-day fast, so much so that the unfortunate person begins to completely believe this “doctor,” because the patients are surrounded by supposedly miraculously cured sufferers who tell him about their false destinies.

Let us remind you! The most difficult thing about fasting is starting and ending the process correctly. With the wrong fasting technique, you can greatly harm the entire body! The consequences of such methods, developed by crooked-handed and sweet-voiced “specialists”, are actually terrible. Therefore, before you entrust your life, health and a fabulous amount of money to someone, check all regulatory documents and their authenticity, because you can print ready-made review forms on any color printer.

And remember that none of them is responsible for your life and health, because you yourself agree to such experiments.

Nobody forced or forced you. At the same time, all checks usually bear the inscription: “Voluntary donation in the amount of ....”

But let's return to our topic.

So, in order to lose excess weight, which significantly interferes with normalizing all metabolic processes, improving your health and almost completely forgetting about diabetes, you need to clearly understand that:

• Without desire, aspiration and willpower, nothing will come of it
• It is important to follow all the recommendations of your doctor (but do not swallow pills that are “useful” in the most extreme case, when it is simply impossible to live without their intervention)
• It is necessary to diversify your life with a love of training (love working out in the gym, because without them it will be more difficult for you to join the ranks of healthy people living a full life)
• Eat right (watch what and how much you consume)
• Never be discouraged (despondency is the enemy of any person, which drives him into an even more serious state - depression)
• Remember that all the diseases that have grabbed hold of us progress against the background of a complex stressful state (do not let negative emotions cloud your consciousness)
• Any diet should be adjusted depending on the current state (if you have already lost a certain amount of kilograms, usually 10 or more, then you need to reduce the total number of daily calories, etc.)

Diabetics should completely avoid:

• sugar and sugar syrups (jam, condensed milk)
• confectionery products (sweets, cookies, pastries, cakes, etc.)
• white baked goods
• fruits and dried fruits (you can drink compotes, but without sugar)
• beer, spirits and sweet wines
• sweet drinks (including packaged store-bought juices with sugar)

The cooking process is also important! Eating highly fatty, deep-fried foods is dangerous not only for diabetics, but also for healthy people. Try to cook dishes by simmering the ingredients in a small amount of oil and fat. It is better to eat fresh vegetables and herbs; when cooking, try not to cook them a little. It is best to steam or bake foods in their own juices in the oven. Give preference to lean varieties of meat, fish and other seafood. It is also not recommended to rely on salt.

Drink more water! The body must not be dehydrated. In diabetics, all excess sugar and oxidation components after metabolic processes are excreted in an abundance of urine. This is why the process of urination may be difficult and they often urinate more often than others. At the same time, be careful with any tea drinks. Remember that any tea is a diuretic.

It is also recommended to have four or five meals a day; meals are divided into small portions.

When following a diet, you should also remember the vitamin balance. In diabetics, many nutrients that do not have time to be absorbed in time are also washed out of the body in the urine, and if the patient adheres to a diet, the amount of vitamins is sharply reduced, especially in the off-season or winter. To ensure the normal course of redox processes, it is important to consume a sufficient amount of fresh vegetables and herbs, which contain fiber. Sometimes an endocrinologist may prescribe some additional vitamin complex.

Smoking, which increases the already high level of lipid peroxidation in diabetes, is strictly prohibited. You should also not drink alcohol, even in small doses. All this has an extremely detrimental effect on the functions of all organs, the central and peripheral nervous systems.

How to correctly calculate your daily calorie intake

We understand perfectly how doctors work in city and regional hospitals. Such a salary does not at all encourage them to conduct a more thorough analysis and work with each patient who comes to the hospital with this or that question. Therefore, most likely, when working with a patient, the doctor will limit himself to some general recommendations and advice. To get more specific and high-quality advice, you have to contact either a paid clinic or look for answers to your questions yourself.

In both the first and second cases, no one will give you any guarantees, because in a paid clinic you will have to pay literally every breath you take (as long as your finances allow), and if you search for information on your own, you can come across groundless, empty, stupid and even dangerous advice that is far from based on factual information.

Therefore, in this article we will post one method that, thanks to some calculations, will allow you to calculate your individual daily calorie intake. To do this, you only need to have a few knowledge (know: weight, height, age, gender and activity level).

Of course, you can limit yourself to studying the simpler information contained in the table below, but it is much more important to conduct detailed analysis and calculations in order to identify your own criteria.

Daily norm

Why does the total number of calories consumed decrease with age?

The thing is that the older a person is, the slower his metabolism. All metabolic processes slow down and, accordingly, to normalize and supply the body with energy, a smaller amount of “fuel” - food - is required. Therefore, people over the age of 40 who are overweight are at a particular increased risk of developing metabolic syndrome or prediabetes.

Calculation of individual criteria

• activity level

From the table below, select the definition that suits you and write down its coefficient separately.

When determining your activity level, you need to be as honest as possible. The accuracy of subsequent calculations depends on this.

• Total metabolism per day

He calculates according to a formula taking into account gender differences.

For men: 66.47+(13.7×weight/kg)+(5×height/cm)-(6.76×age)

For women: 655.1+(9.6×weight/kg)+(1.8×height/cm)-(4.7×age)

For example, the weight of a fifty-six-year-old woman of average height is 115 kg, her daily norm will be: 655.1+(9.6×115)+(1.8×168)-(4.7×65)=1756 kcal/day

However, we should not forget that rapid weight loss is fraught with negative consequences, especially for a diabetic, who, even with his diagnosis, has already experienced a serious disruption in lipid, carbohydrate, purine, and water-salt metabolism.

Normal, healthy weight loss for overweight and diagnosed obesity is only possible by 4 or 5 kg per month!

The indicator obtained at this stage is only a rough, dirty criterion that requires further polishing and cutting, because such a daily norm is very arbitrary!

• Calorie norm

Calculated using the formula : total metabolism per day x activity level

It turns out, 1756 × 1.2 (a person is inactive, does not engage in heavy physical labor and leads a predominantly “sedentary” lifestyle) = 2107.2 kcal/day

In other words, a person should consume approximately 2108 calories, but to lose weight he needs to subtract 500 kcal from this amount. We get 1608. The optimal option will be presented to us by calculating the calorie corridor, which will allow us to determine the low and high limits.

Low limit: 1608-250=1358

High limit: 1608+100=1708

This way we will get approximate guidelines in order to vary the calorie content of the daily diet within acceptable limits. In this case, the level and speed that are characteristic of healthy, smooth weight loss are achieved.

Norm of proteins, fats and carbohydrates

But when drawing up a diet, planning appropriate treatment for type 2 diabetes, it is necessary to maintain a balance of various substances and microelements. The daily diet should contain: carbohydrates - 45-60%, fats - 20-35%, proteins - 10-16% of the daily requirement.

How to determine their exact number for a specific person?

In this matter, we will be helped by the previously obtained calorie corridor indicators (low and high limits) in order to calculate the nutrient corridor.

Low level:

• proteins 1358×0.10÷4=33.95
• fats 1358×0.20÷9=30.17
• carbohydrates 1358×0.45÷4=152.77

High level:

• proteins 1708×0.16÷4=68.32
• fats 1708×0.35÷9=66.42
• carbohydrates 1708×0.60÷4=256.2

In addition, when creating your menu, it would be a good idea to classify foods according to their usefulness for a diabetic. The glycemic index of foods will help with this.

Secondary signs of pathology

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Secondary symptoms of the disease develop mainly with long-term diabetes mellitus. These include the following manifestations:

• skin itching and peeling of the dermis;
• weakened immune defense, tendency to colds and bacterial diseases;
• loss of visual acuity;
• decreased sensitivity of the limbs;
• development of skin wounds and ulcers that are difficult to treat.

The intensity of symptoms depends on the individual characteristics of the patient’s body and the stage of diabetes mellitus.

General information about the disease

Doctors say that obese women are most susceptible to diabetes . It is a disorder of the digestive tract that can act as a provoking factor for the disease.

It is also worth mentioning the gestational form of diabetes, which occurs only in women during pregnancy. The body's sensitivity to insulin decreases due to a radical hormonal imbalance.

However, glucose levels return to normal literally within 2-6 weeks after the baby is born. Accordingly, treatment for the gestational form of diabetes is not prescribed, but medical supervision is mandatory.

It is believed that diabetes among women affects mainly women over 40 who are overweight or already obese.

However, diagnosing the disease at an early stage is almost impossible .

Doctors have introduced the concept of “prediabetes” in this regard. This is a condition when the sugar level is slightly elevated, but there are no other manifestations of the disease. Insulin levels are also normal. If you do not pay attention to this fact and do not follow the doctor’s recommendations, then with a high degree of probability type 2 diabetes will be diagnosed in the future.

Late consequences

The appearance of the first late consequences of diabetes mellitus usually occurs several years after the first diagnosis. Their main danger lies in the slow but constant deterioration of the patient’s well-being. Even correctly selected and comprehensive treatment is not always able to lead to positive results. Doctors consider the following diseases to be late consequences.

Retinopathy

Retinopathy is damage to blood vessels in the eye that leads to disruption of normal blood circulation. Because of this, a person experiences dystrophy and atrophy of the optic nerve, the retina detaches, and blindness often occurs. The main danger of this condition is its asymptomatic occurrence.

Very rarely, patients note a sharp decrease in visual acuity and the appearance of floating spots in the eyes. Diagnosis of this problem requires a mandatory examination of several specialists at once, as well as the passage of a host of laboratory and instrumental examination methods.

To stop the harmful effects of retinopathy on the body, it is necessary to take measures to compensate for concomitant diseases. Typically, anticoagulants, vitamin complexes, and vasodilators are prescribed for this purpose. In advanced cases, laser coagulation of the retina or hyperbaric oxygenation is performed. However, to date there are no drugs that could completely stop the development of this disease.

Diabetic angiopathy

Angiopathy is a disease that occurs due to damage to blood vessels. Also, the cause of this condition can be a disorder in the regulation of the nervous system.

Among the most dangerous consequences of such a complication is complete blindness.

Angiopathy can occur in both adults and children. The mechanism for the development of this disease is simple: excessive amounts of glucose in the blood damage the walls of blood vessels, which impairs the conductivity of capillaries. Because of this, blockage of blood vessels occurs, which interferes with normal metabolism.

The manifestation of diabetic angiopathy depends on the type of disease, and the severity of the disorders depends on the duration of the disease and the correctness of treatment. This condition can occur absolutely anywhere. It can be recognized by bleeding from the gastrointestinal tract, changes in the condition of the skin, impaired attention, deterioration of visual acuity and many other symptoms.

Polyneuropathy

Polyneuropathy is a disease in which peripheral areas of the nervous system are damaged. It occurs against the background of the destruction of individual distal areas that are responsible for the conduction of impulses. Over time, the disease progresses and begins to spread to nearby areas. It can be recognized by the paralysis of individual systems. Symptoms of polyneuropathy are as follows:

• Changes in behavior;

• Decreased visual acuity or complete blindness;
• The appearance of lameness;
• Constant feeling of itching and burning in the extremities;
• Attention and memory disorders;
• Bleeding in the esophagus;
• Disorientation in space.

Diabetic foot

Diabetic foot is a condition in which ulcers form on the lower extremities. They occur due to the destruction of blood vessels under the influence of high concentrations of glucose in the blood. All this is complicated by improper care, wearing uncomfortable shoes and excessive stress.

If left untreated for a long time, this condition may require complete or partial amputation of the limb. Diabetic foot can be complicated by:

• Ulcers - injuries to soft tissues, which are characterized by weeping wounds and high pain;
• Necrosis – death of limb tissue, which impairs blood circulation throughout the body;
• Osteomyelitis – death of bone tissue followed by the development of a purulent process. It occurs against the background of the spread of infection;
• Foot deformity - changes in the position of sore toes, arches of the foot or muscle atrophy;
• Sepsis - the entry of infections or dead tissue into the bloodstream.

Self-control

The next thing that is used in the treatment of type 2 diabetes mellitus after dietetics and standardized physical activity is self-control!

To do this, you can either print this page with tabular data, or sketch them out yourself in your personal diary.

Self-control (standard from 1993)

The European standard, developed in 1993 by the insulin-dependent diabetes group, suggests monitoring the following biochemical parameters:

• Glucose level

Blood sugar levels vary throughout the day and are directly related to the quality and quantity of foods consumed.

If you consume food rich in fast carbohydrates, then, of course, your blood sugar level will increase greatly. If you eat foods with slow carbohydrates, then the “sugar” level will also rise, but not critically. Gradual normalization will occur within 5 hours after eating food.

More details about carbohydrate-containing products and the process of their interaction with our “inner world” can be found in the article:

Fast and slow carbohydrates

Therefore, control must be carried out, as you may have guessed, throughout the day. Usually the first blood draw occurs in the morning on an empty stomach before breakfast. Then after every meal. At home, glucometers can help you measure your glucose levels.

For inpatient or sanatorium treatment, an additional control method is an analysis of glycated hemoglobin. You can also take a similar test during outpatient treatment if you receive a direct referral from your attending endocrinologist.

Compensation of carbohydrate metabolism

Looking ahead, we note that more intense self-control in order to stop hyperglycemia or hypoglycemia is necessary before, during and after training or any physical activity. Very often, patients consult a doctor at a critical moment who do not take this fact into account when working in their garden.

Remember: digging beds for planting, landscaping the area, caring for and harvesting crops - all this refers to increased physical activity. During this time and after work, you need to monitor your health especially often.

If you forget about this, then set an alarm clock that beeps every 30 - 40 minutes!

• Total cholesterol, triglycerides

A portable express blood cholesterol analyzer, which has several test strips, will help you measure your total cholesterol level at home. Similar devices allow you to find out not only the level of “bad cholesterol” (LDL cholesterol, low-density lipoprotein cholesterol) and “good cholesterol” (HDL cholesterol, high-density lipoprotein cholesterol), i.e. show the amount of triglycerides as well as the level of glucose in the blood.

Typically, such a set consists of several items: a lancet (a pen with a needle at the end), the device itself, which measures readings, and a set of test strips, which act like a litmus test when a drop of blood is taken on a strip soaked in a special chemical solution incoming react upon contact with human blood.

It is necessary to draw blood for analysis strictly on an empty stomach! (with a twelve-hour fast)

The strip is inserted into the niche of the device and all that remains is to wait for the information to be made public, which will be reflected on the monitor in the form of symbols, which the attached instructions will allow you to decipher.

It is not necessary to buy an expensive express analyzer. You can take a referral from an endocrinologist and donate blood as part of a laboratory analysis.

• Body mass index

To calculate BMI (body mass index), you need to know your height and weight.

Formula: BMI=weight/kg÷height/m2

Thus, if a person’s weight is 95 kg with a height of 175 cm, then: 95 ÷ (1.75 × 1.75) = 31

And then we check the diagnostic table, which also reflects the level of risk of developing endocrine diseases in combination with cardiovascular and other types of complications in the presence of overweight and obesity.

If the methods described above do not help normalize the patient’s condition, then insulin therapy , which is indicated in the following cases:

• ketoacidosis, diabetic coma;
• fast and strong weight loss;
• the occurrence of intercurrent diseases;
• surgical intervention in critical condition of the patient;
• pregnancy and lactation;
• lack of effect from other treatment methods.

Only a doctor can prescribe this type of treatment for type 2 diabetes!

Female influence on symptoms

Women's and men's bodies function differently.
This is due to anatomical and physiological characteristics that affect the course of many diseases. Diabetes affects the fair sex 20–30% more often. This trend is typical for type 2 disease. The reason lies in the peculiarities of lipid metabolism and the functioning of the endocrine system. The female body is subject to monthly cyclic bleeding, which is controlled by hormonal fluctuations.

Constant changes in the values ​​of estrogen and other sex hormones affect carbohydrate, lipid and protein metabolism. Conditions are created for the progression of endocrine pathology and “sweet” diseases, among others.