Type 2 diabetes mellitus: symptoms of development, how to treat and how much they live with it

Excess weight in the second half of life, lack of movement, food with an abundance of carbohydrates have a much more negative impact on health than is commonly believed. Type 2 diabetes is an incurable, chronic disease. It develops most often due to the modern lifestyle - the abundance of products, the availability of transport, sedentary work.

The statistics of the disease fully confirms this statement: in developed countries, the prevalence of diabetes is ten times more than in the poor. The peculiarity of type 2 is a prolonged low symptom course. If you do not participate in regular clinical examinations or do not donate blood for sugar yourself, the diagnosis will be made too late, when numerous complications begin. Treatment in this case will be prescribed a much more extensive than the timely detection of the disease.

Why type 2 diabetes develops and who is affected

The diagnosis of "diabetes" is made when a fasting increase in glucose is detected on an empty stomach in the venous blood of the patient. A level above 7 mmol / l is sufficient reason to state that a disturbance of carbohydrate metabolism has occurred in the body. If measurements are taken with a portable glucometer, diabetes mellitus is indicated by indications above 6.1 mmol / l, in this case laboratory diagnosis is needed to confirm the disease.

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The onset of type 2 diabetes mellitus is most often accompanied by a violation of insulin resistance. Sugar from the blood penetrates the tissues due to insulin, when resistance is broken, cell recognition of insulin, which means that glucose cannot be absorbed and begins to accumulate in the blood. The pancreas seeks to adjust the level of sugar, strengthens its work. She eventually wears out. If untreated, after a few years, the excess insulin is replaced by its lack, and the glucose in the blood remains high.

Causes of diabetes:

  1. Overweight. Adipose tissue has metabolic activity and has a direct effect on insulin resistance. The most dangerous obesity in the waist.
  2. Lack of movement leads to a decrease in muscle need for glucose. If there are no physical activities, sugar in large quantities remains in the blood.
  3. Excess in the diet of readily available carbohydrates - flour products, potatoes, desserts. Carbohydrates without a sufficient amount of fiber enter the blood quickly, provoking increased pancreatic work and stimulating insulin resistance. Read our article on impaired glucose tolerance.
  4. Genetic predisposition increases the likelihood of type 2 disease, but is not an insuperable factor. Healthy habits eliminate the risk of diabetes even with poor heredity.

Violations in carbohydrate metabolism accumulate for a long time, so the factors of type 2 diabetes include age. Most often the disease begins after 40 years, now there is a tendency to reduce the average age of diabetics.

Forms and severity of diabetes

Diabetes is divided into primary and secondary. Primary diabetes is irreversible, depending on the form of the violations, there are 2 types:

  • Type 1 (E10 according to ICD-10) is diagnosed when the growth of blood sugar is due to the absence of insulin. This happens due to violations in the pancreas due to the effects of antibodies on its cells. This type of diabetes is insulin-dependent, that is, it requires daily insulin injections.
  • Type 2 (ICD-10 E11 code) at the beginning of development is characterized by an excess of insulin and strong insulin resistance. As severity increases, he is increasingly approaching type 1 diabetes.

Secondary diabetes occurs due to genetic disorders in the chromosomes, pancreatic diseases, and hormonal disorders. After a cure or medical correction of the disease — the cause of blood glucose returns to normal. Gestational diabetes is also secondary, it debuts during pregnancy and passes after childbirth.

Depending on the severity, diabetes is divided into degrees:

  1. A mild degree means that only a low-carb diet is sufficient to maintain sugar at a normal level. Drugs are not prescribed to patients. The first stage is rare due to late diagnosis. If time does not change lifestyle, a mild degree quickly becomes medium.
  2. The average degree is the most common. The patient needs money to reduce sugar. Complications of diabetes are not yet or they are mild and do not affect the quality of life. At this stage, there may be a lack of insulin due to the loss of part of the pancreatic functions. In this case, it is administered by injection. Lack of insulin is the reason why people lose weight with diabetes on normal caloric intake. The body cannot absorb sugar and has to break down its own fats and muscles.
  3. Severe diabetes is characterized by multiple complications. With improper treatment or lack thereof, changes in the vessels of the kidneys (nephropathy), eyes (retinopathy), diabetic foot syndrome, and heart failure due to angiopathy of large vessels occur. Suffering from type 2 diabetes and the nervous system, the degenerative changes in it are called diabetic neuropathy.

What is the difference of type 2 diabetes from the 1st

DifferencesType 1 diabetesType 2 diabetes
Start of violationsChildhood or adolescenceAfter 40 years
Disease progressionSharp rise of sugarLong development
Lifestyle effectsMissingIt is a decisive factor in the development of the disease.
Symptoms at the beginning of the diseaseBright, rapidly growingMissing or not expressed
Changes in the bloodantigensthere isNot
insulinNo or very littleAbove normal
Treatmenthypoglycemic agentsIneffective, can be prescribed only in the presence of obesity.Very effective, mandatory from the middle stage
insulinIs requiredPrescribed when medication is not enough

Symptoms of type 2 diabetes

In most patients, the symptoms of type 2 diabetes are so mild that it is impossible to suspect the disease. Most often, diabetes is detected by the results of routine blood tests.

To dilute too sweet blood, the body requires an increased amount of fluid, so there may be thirst or dry mucous membranes. With increasing water consumption, the amount of urine increases.

Due to high sugar, blood circulation in the smallest capillaries is disturbed, fungi are activated. Patients with diabetes can feel itching on the skin and mucous membranes, thrush becomes more frequent in women. Wounds begin to heal worse, skin lesions appear in the form of inflamed areas or small pustules.

Insufficient nourishment of tissues due to strong insulin resistance is manifested by a feeling of fatigue, muscular weakness.

Signs of long-term diabetes mellitus type 2 - constantly cold, ulcerated limbs, hypertension, heart and kidney failure, visual impairment.

How can I treat the disease

Therapy for type 2 diabetes is standard; immediately after identifying the disease, the endocrinologist prescribes diet and drugs to reduce sugar. If the patient manages to stop the disease at the initial stage, and willpower allows you to strictly follow a strict diet, medications can be canceled. If all the recommendations of the doctor regarding nutrition and the level of activity are observed, the disease does not give complications, which allows the diabetic to feel as good as healthy people.

Drug treatment

Group of drugsMechanism of actionDrug namesNegative influence
BiguanidesThey inhibit glucose production by the liver, reduce insulin resistance and absorption of sugars from the gastrointestinal tract.Siofor, Glykon, Langerin, Glucophage, GliforminIncrease the risk of lactic acidosis, adversely affect the absorption of vitamin B12.
GlitazonesStimulate the utilization of glucose in the tissues.Avandia, Roglit, PiglarIncrease weight due to fluid retention and growth of adipose tissue.
Sulfonyl Urea DerivativesEnhance insulin synthesis.Glidanil, Glidiab, GlucobeneWith long-term use, they lose their effectiveness.
Glucosidase inhibitorsInhibit the breakdown of saccharides in the intestine.Glukobay, DiastabolPossible reactions from the gastrointestinal tract: bloating, diarrhea, nausea.
SGLT2 Protein InhibitorRemove excess sugar through urine.Forsiga, Jardins, InvokanaRisk of infections of the genitourinary system.

The specific treatment drug and its dosage are selected by the doctor depending on the state of pancreas, insulin resistance, the weight of the patient and associated diseases.

Insulin use

Insulin injections are prescribed when medication methods fail to bring sugar back to normal. This happens with the progression of diabetes, which is accompanied by a decrease in the synthesis of its own hormone. Insulin therapy for type 2 diabetes is reasonable if the level of glycated hemoglobin becomes higher than 9% if the diet is followed and sugar-reducing agents are used.

Temporarily, insulin can be prescribed for the time of intensive treatment of diabetes complications, before surgeries and during the postoperative period, in case of heart attacks and strokes, severe infectious diseases, and the child is born.

On average, with type 2 diabetes, they switch to insulin 9 years after diagnosis. This statistic includes both disciplined patients who do not need insulin for decades, as well as people who do not want to change their lifestyle.

Timely addition of insulin to the treatment regimen helps to preserve residual pancreatic functions, improves diabetes compensation, and delay the onset of complications.

Insulin-dependent severe type 2 diabetes mellitus often turns out to be without the necessary treatment because of the fear of injections and fear of an overdose of the drug. Indeed, excessive doses of short insulin can lead to hypoglycemic coma. But diabetes mellitus prescribed basal, long insulin, which must be administered once or twice a day in the same volume. To cause a dangerous decrease in glucose with such injections is unlikely. And the shots themselves using syringe pens with proper technique are almost painless.

The need for exercise

Most of the glucose in the body is consumed during intensive muscle work. Therefore, in order to speed up the flow of sugar from the blood into the tissues, exercise is necessary. Hour training three times a week reduces insulin resistance, helps to cope with obesity.

When treating diabetes, aerobic exercise is preferred. To determine the required intensity, you need to count the pulse at rest (in the morning, without getting out of bed).

The frequency of heart contractions (HR) for aerobic exercise is calculated by the formula: (220 - age - heart rate in the morning) * 70% + heart rate in the morning. If a diabetic is 45 years old, and his morning pulse is 75, during classes you need to maintain the level (220-45-75) * 70/100 + 75 = 150 beats per minute. Slow running, any aerobics in the fitness club, swimming, dancing, skiing and many other activities will do.

You need to choose the type of activity depending on personal preferences and availability, as you will have to deal with type 2 diabetes throughout your life. For older people and patients with obesity, the desired heart rate provides fast walking. It is desirable to start with it even with a low level of fitness, constantly switching to more intense loads.

Effective folk remedies

In evidence-based medicine, herbs are not used in the treatment of diabetes. Their healing properties depend on the region of growth, collection time, proper drying and storage. Therefore, the effect of plants cannot be confirmed by research, as it happens when new drugs are introduced to the market. The only thing that manufacturers guarantee is safety when used according to the instructions.

To use folk remedies for treatment can only with mild form of diabetes or as an addition to medications in the middle stage.

As a hypoglycemic agent use:

  • St. John's wort;
  • pharmacy chamomile;
  • blueberry shoots;
  • aspen bark;
  • field horsetail;
  • haricot beans;
  • cinnamon

From parts of medicinal plants prepare infusions and decoctions. The usual daily dose - a teaspoon or tablespoon in a glass of water. Cinnamon is used as a spice - added to drinks, desserts or meat dishes - See the article on the use of cinnamon for diabetes.

How to eat at the 2nd type of diabetes

At the heart of type 2 diabetes is a distortion of the metabolism, the cause of which is, inter alia, and improper diet. Diet is prescribed for almost all serious diseases, and in most cases is ignored by patients. In diabetes, this approach is not applicable. Here nutrition is the basis of treatment. Sugar-lowering drugs without a diet cannot cope with high glucose levels.

As part of the food for diabetics easily digestible, fast carbohydrates should be a minimum (about fast and slow carbohydrates). To understand the abundance of foods will help the table of glycemic index (GI). The higher the GI, the more dramatic the rise in sugar will occur after a meal, which means that insulin resistance will increase, there will be damage to the vessels, and the patient will feel worse.

Products with slow carbohydrates are allowed. Their presence in the diet is limited depending on the degree of diabetes and the presence of excess weight. Calculates a safe amount of carbohydrates, which is allowed to consume per day. For the first time, a kitchen scale and nutritional value tables will be required for a diabetic with type 2 disease. Over time, diabetics learn to determine “by eye” how much carbohydrate is in a serving.

Food with a low-carb diet should be fractional. Every 4 hours the body needs to receive nutrients. Carbohydrates are distributed evenly to all meals.

Can I go fasting

One alternative treatment for diabetes is the so-called “wet” fasting. It provides for a complete rejection of any food and an unlimited amount of water. A period without food should be quite long - at least a week. The purpose of starvation is to achieve ketoacidosis, that is, the splitting of fat cells with the release of acetone into the blood. Proponents of medical fasting claim that the body without food goes from the usual carbohydrate metabolism to fat, pancreatic cells get time to rest and recover.

In fact, this statement is far from the truth. When the glucose reserves in the human body run out, the sugar level in the blood is maintained by gluconeogenesis. The body by complex chemical reactions extracts sugar from fats and proteins. Fat deposits at the same time really melt, but at the same time the muscles are destroyed. The pancreas also will not be able to rest - it is difficult to get the sugar to be delivered into the cells, which means that insulin will be needed. It is possible to achieve fat splitting with much smaller losses, using a low carbohydrate diet with a normal caloric content.

Fasting treatment is a danger for diabetics who take glucose-lowering drugs.They can easily have hypoglycemia, which literally in a matter of hours passes into a coma. Prohibited starvation and in the presence of complications - heart and kidney failure, vascular diseases.

Prevention of type 2 diabetes

The second type of diabetes can be prevented even with poor heredity. To do this, it is enough to maintain a weight close to normal, to include in the daily routine compulsory exercise, do not overeat, do not starve and limit fast carbohydrates - sweets and flour.

Includes diabetes prevention and periodic blood tests. Glucose is donated at least once every three years. With a genetic predisposition or unhealthy lifestyle - every year.

There is also a laboratory analysis that can detect minimal metabolic disorders, the glucose tolerance test. Such pathological changes at the initial stage can be completely cured. If you miss the time, may develop diabetes.


Whether diabetes will progress will depend on the patient himself. Doctors claim that their contribution to the treatment of this disease does not exceed 20%.

To lengthen the years of life and prevent complications will help:

  1. The control of glycated hemoglobin, a decrease in the index from 10 to 6% gives 3 years of life.
  2. Keeping pressure low. With an upper pressure of 180 for a diabetic of 55 years, 19 years of life have been released. Reducing to 120 extends life expectancy to 21 years.
  3. A normal amount of cholesterol in the blood will give an extra couple of years.
  4. Smoking shortens life by 3 years.

The average data on life expectancy with type 2 diabetes at the present time is as follows: a 55-year-old man who follows his illness will live 21.1 years, a woman - 21.8 years. Without treatment and control of diabetes, these numbers are reduced to 13.2 and 15, respectively. Moreover, the patient receives not just an additional 7 years, but also the opportunity to spend them actively, without suffering from multiple complications.

Watch the video: Understanding Type 2 Diabetes (December 2019).