DIABETES OF TYPE 2 TREATMENT

 
Since type II diabetes is a heterogeneous process, and patients may have other concomitant diseases, treatment must be individualized. The most common error in treatment - treat type II diabetes as a "borderline state" or completely ignore the treatment. atients with fasting glucose levels greater than 140 mg / dl, or glucose levels afternoon more than 200 mg / dL, even without typical symptoms, increased risk of diabetic complications. Recent publications paid special attention to issues concerning intensive treatment of diabetes to prevent complications in patients with type II.

Optimal treatment strategy of type II diabetes is to normalize blood glucose levels by increasing insulin sensitivity. Unfortunately, at present in the United States there is no drug that directly increases insulin sensitivity. Intervention in the way of life on a diet and exercise, can dramatically increase insulin sensitivity in patients sufficiently motivated.

The first step is to install a specific exercise program to comply with the outdoors. Insulin sensitivity can be increased simply by introducing a daily routine of brisk walking for 20 minutes. Exercise program must meet the image of the patient's life and his daily routine.

The optimal program requires that the patient was engaged in the physical therapy group. Interference in the diet is the initial assessment of the patient's dietician, and individual follow-up visits to the doctor or the classroom. The goal should be modest, but still provide for the permanent loss of body weight (if necessary).

Treatment of type 2 diabetes mellitus

Treatment of type 2 diabetes is complex, and its components are: diet, exercise stress, patient education and self-management diabetes medication (oral hypoglycemic drugs as monotherapy, combination therapy with oral medication - drugs with different mechanisms of action, combination therapy with oral glucose-lowering drugs insulin or insulin use only), prevention and treatment of late complications of diabetes.

Diet for type 2 diabetes must meet the following requirements:
a) be the physiological composition of products (about 60% of total calories should be carbohydrates accounted for 24% - from fat and 16% - for whites);
b) the energy value of food must be subkaloriynoy (about 1,600-1,800 calories daily calories);
a) 4-5x a meal a day;
d) excluding food digestible carbohydrates and replace them with sweeteners or sugar substitutes;
e) the food must contain a sufficient amount of fiber or fibers (at least 25-30 grams a day);
e) of the total fat of 40-50% should be fats of vegetable origin (1 / 3 of the total amount of fat should account for saturated fat, 1 / 3 - polunenasyschennye and 1 / 3 - unsaturated fats).

Multiple (4-5-fold) meals during the day can more adequately modulate the relationship between insulin levels and glucose levels, approaching those indicators, which take place in a healthy person during the day.
Physical activity and exercise therapy are essential component of therapy in patients with type 2 diabetes. Amount of exercise should be determined taking into account the patient's age, state of the cardiovascular system and the compensation of carbohydrate metabolism. They positively affect the course of diabetes and help maintain stable compensation of carbohydrate metabolism with a marked reduction of excess body weight. Regular exercise, regardless of its length, normalize lipid metabolism, improve microcirculation, activate fibrinolysis, increased secretion of catecholamines normalize in response to a stressful situation, which ultimately prevents the development of vascular complications (angiopathy). Patients with diabetes who regularly engaged in physical culture, marked by the stabilization and even regression of vascular complications of diabetes.

The task of teaching patients with type 2 diabetes is their motivation to change lifestyle and habits that accompanied the patient throughout their lives to the development of diabetes. This applies primarily to the diet (taking almost 50% of daily caloric intake in the second half of the day or dinner), sleep and rest, to reduce physical inactivity by regular exercise, to quit smoking and taking excessive doses of alcohol and Implementation all those activities which are components of a healthy lifestyle. Self-monitoring of diabetes and its achievement will contribute to compensate the delay of vascular complications of diabetes.