adult diabetes type 2 diabetes
management of dm type 2 : This information has been prepared by the Health Education for Citizenship group of the Spanish Society of Internal Medicine (SEMI). It aims to make patients better acquainted with their illnesses.
1. WHAT DOES THE DISEASE CONSIST OF?
Type 2 diabetes is a disease in which there is a disorder of glucose regulation in the body, but,
2. WHAT IS GLUCOSE?
Humans need to eat to live; The food that we take by mouth is modified by the juices of the stomach, pancreas and bile and they are transformed from complex substances into simpler ones that are absorbed in the intestine. From it they pass into the blood and through it and through the arteries they are distributed throughout the body, through all its organs and in them they reach their simplest elements, the cells, which need them to remain alive and perform their functions. For example, if the brain runs out of glucose we get dizzy, we can fall to the ground, lose consciousness and even have seizures; It is what is called a syncope due to hypoglycemia, that is, little of this sugar reaches the brain.
It is very important for the body to ensure an adequate amount of glucose to its cells; We already see what can happen to it if it is little, and if it is a lot, as it is a small molecule and can be eliminated through the urine passing through the kidney, it causes us to urinate a lot (we have polyuria) in addition to its accumulation in the body damages several organs especially the small glasses.
3. HOW DO WE BALANCE THE SUGAR WE HAVE IN THE BLOOD, WHAT WE CALL GLYCEMIA?
In the morning, fasting, it is between 80 and 120 milligrams per hundred milliliters. The body produces several hormones that regulate it, the fundamental ones are in the pancreas, including insulin, which makes blood glucose enter the cells, opens the door. Another is glucagon, which is capable of releasing it from the deposits we have in the body, for example in the form of glycogen, in the liver it already causes its levels to rise in the blood. There are more, but those are key.
4. SO WHAT IS DIABETES?
It is a disease in which the body has a lot of sugar in the blood (it usually has high blood glucose levels) because it lacks insulin, or it does not act well on the cells that need it, it is not able to open the door and consequently its levels rise in blood and escape through the kidney; As no one is able to urinate sugar alone, high blood glucose drags water away and poorly controlled diabetics urinate a lot (they have polyuria), and their urine tastes sweet.
5. AND WHY DO YOU GET DIABETES?
There are many types of diabetes and in most the weight of inheritance is great; there are families in which the children of a diabetic father are; they are often young and said to have type one diabetes, other times there are several diabetics in a family, among close relatives. They are usually mature or older people. They have type two diabetes. In addition to heredity, there are environmental factors that favor it, such as being obese, eating too much sweets, or sedentary lifestyle.
6. WHAT ARE THE CONSEQUENCES OF HAVING HIGH SUGAR IN THE BLOOD?
In addition to polyuria there is sometimes hunger and even weight loss; Its accumulation favors the body having excess acids and also the accumulation of glucose can damage small vessels, and these in turn different organs, for example the eyes, causing damage to the retina that implies loss of vision, if they are the kidney the patient loses proteins (proteinuria), and it can become malfunctioning (kidney failure) and accumulate substances that should be expelled such as urea or creatinine, and if the vessels of the nerves are altered, there is a polyneuritis, for which the patient may have tingles, lose the sense of touch and if the nerves that supply muscles are damaged, strength is lost.
7. WHAT CAN WE DO IF WE HAVE DIABETES?
You should be seen by your family doctor on a regular basis, who in addition to monitoring your blood sugar, glycemia, which is like specific information, or a still photo, which reports your level at that time, will study your hemoglobin glycosylated, which is like the video that explains how your blood glucose has been adjusted in the last weeks, and that it should be between 6 and 7. Your family doctor will screen you, follow-up, and tell you if you need to attend the unit of diabetes from the hospital to which it belongs; It will also offer you a therapeutic offer of the many that we have and that are highly effective: taking pills, hypoglycemic agents, or taking insulin injections; with them you will ensure the control of blood glucose. It will also monitor your cholesterol and how fluid your blood circulates. At the same time, he will adjust the calories in his diet, instructing him not to eat sweets, to do regular physical exercise without effort, and to monitor his blood pressure as well as not to smoke; These measures do not help to control your sugar but they are key so that the vessels of your organs do not fill with fat, that is, they do not have arteriosclerosis, which will avoid some of the complications that the disease can produce and that are important, such as damage to the coronary arteries of the heart or the vessels of the brain with development of stroke.
8. AND HOW DOES THE DISEASE EVOLVE?
The possible damage to the organs that we have mentioned should be evaluated, and prevent them from doing so, which can obtain good results in the field of sight, the kidney, the largest vessels or arteries: the coronary arteries or those that irrigate the brain, and also those of the nerves, and also in the liver, being able to prevent it from accumulating fat; blood sugar you should know that you can live with the disease for many years. Of course, you should also avoid infections, so you should not be exposed to sudden changes in ambient temperature, and you should get the vaccines that are indicated. Regular physical activity depends on you, avoiding being overweight and smoking, eating a healthy diet, controlling your blood pressure, attending check-ups, and complying with the prescribed treatment.
9. WHAT COULD I HAVE DONE TO NOT GET IT?
Type 2 diabetes has a family component and another environmental component. This means that the predisposition to suffer from diabetes is inherited and that environmental factors, such as a sedentary life and obesity related to a high consumption of calories in the diet, can determine the appearance of it.
Studies carried out in Spain indicate that approximately 14% of the population suffers from diabetes. Of that 14%, approximately half are unaware that they have diabetes, since it is a disease that can exist without producing symptoms for years.
Obesity is a preventable disease. It is known that a proper diet and physical exercise are capable of preventing its appearance. By adequate diet we understand a diet with an appropriate caloric intake that allows avoiding obesity and overweight.
According to the national dietary survey, the average Spaniard consumes a diet of 2,400 calories a day, which is an excess of 500 calories a day over daily needs. The most recommended type of diet that has shown the greatest benefits in preventing the onset of diabetes is the Mediterranean diet (use of extra virgin olive oil, consumption of fish, legumes and vegetables). Regarding physical exercise, it is recommended to carry out at least 150 minutes per week of moderate intensity exercise (brisk walking). This exercise can be done in fractions of 20 minutes.
10. FROM HERE ON, WHAT SHOULD I DO TO IMPROVE MYSELF?
Since obesity is an important risk factor for cardiovascular diseases, diabetes, joint problems and cancer.
Therefore, every patient with type 2 diabetes should go to a family medicine consultation, for treatment not only of diabetes and the other factors mentioned above. Good control of glucose, blood pressure and cholesterol levels can significantly reduce the complications associated with diabetes.
11. WHAT IS THE FORECAST?
Type 2 diabetes is a disease that cannot be cured and is progressive, meaning that over the years it is necessary to increase the medication to obtain the same control. Patients with poor control will develop complications after 10-15 years of disease evolution. These include retinal hemorrhages and retinal detachment, difficulty in perceiving pain and burning sensation and leg cramps, vascular problems such as myocardial infarction, stroke, kidney function disorders or acceleration of the onset of dementia.