Type 2 diabetes symptoms. Diagnosis and treatment of type 2 diabetes

This is an insulin-independent type of disease associated with a violation of carbohydrate metabolism within the body.

The pancreas produces the hormone insulin, the main action of which is aimed at lowering the level of glucose in the blood.

With this disease, the cells stop interacting with insulin, although the gland itself produces enough insulin for normal functioning.

non-insulin dependent diabetes- a diagnosis that does not give pronounced symptoms for a long time. Patients turn to doctors for help when their condition requires urgent action, although early detection of the disease allows you to avoid complications and remain active for many years.

Those at risk need to know the causes of the occurrence, as well as follow the rules to avoid serious health problems.

genetic predisposition

The group includes those who have relatives in the family suffering from this type of disease.

But do not worry ahead of time, since the hereditary factor is not the main one.

Only a fifth of all patients have a family history of this diagnosis.

Overweight

Obesity can often lead to the development of type 2 diabetes. The main reason for excess weight is low physical activity, nutrition with a predominance of "fast" carbohydrates.

Age

Doctors more often make this diagnosis for men and women after 40-45 years of age than for young or middle-aged people. However, doctors say that SD has "become younger" over the past decade.

Other factors

Acute and chronic diseases of the pancreas, liver, kidneys.

The risk group includes women who have polycystic ovary.

stress negatively affect the work of the pancreas, they are also attributed to the causes of this disease.

Viruses, infections, surgery can trigger the development mechanism, especially if the patient is at risk.

Women who gave birth to children weighing more than 4 kg Doctors advise regular monitoring of blood sugar levels.

Clinical picture of type 2 diabetes

Most often, the disease is manifested by the following pathological processes:

• Frequent urination;
• Thirst;
• dry mouth;
• Increased appetite, constant feeling of hunger;
• visual impairment;
• Rapid fatigue, weakness, decreased performance;
• Weight loss.

Symptoms in women and men, is there a difference?

In men"bell" may be problems with potency. Due to frequent urination, inflammation of the foreskin often occurs. Men are more likely to gain weight with the onset of the disease.

women more often worried about such signs as: itching in different parts of the body (including the genitals), vaginal infections that are difficult to treat, hair loss.

Common signs of type 2 diabetes

1. Frequent urination in type 2 diabetes, it is often combined with urinary incontinence - the nerve endings are damaged, and in the meantime, the tone of the bladder weakens.
2. The body, in an attempt to dissolve and remove excess glucose, takes fluid from the blood. The body, experiencing a lack of fluid, signals constant agonizing thirst. A person can drink 4-5 liters per day.
3. Dehydration causes dry skin, mucous membranes. They become flabby, there are small pimples, pustules.
4. Blockage of small blood vessels vision problems: fuzziness, blurring, feeling of a veil, decreased visual acuity. With the normalization of sugar levels in the early stages of the disease, vision is restored.
5. Peripheral circulatory disorders - the cause slow wound healing.
6. Fatigue, weakness due to the fact that the cells do not receive the energy they need. The person feels tired, drowsy.
7. Increased appetite, constant feeling of hunger- SD2 satellites. "Fast" carbohydrates (flour, sweets) sharply increase the level of glucose in the blood, but it also drops sharply. This causes a feeling of hunger, which makes you eat a lot and often. Despite this, the body can lose weight.

Nonspecific complaints in type 2 diabetes mellitus

Less common symptoms of "sweet" disease are often associated with other diseases, unsuccessfully trying to cure with an erroneous diagnosis. Problems with the intestinal tract (constipation, diarrhea), swelling, vomiting, dizziness, chills in type 2 diabetes are not the most common signs, but they also occur when the disease manifests itself.

But first things first:

• Feeling chilly, chills- a consequence of glucose deficiency in tissues or developing. Patients constantly get cold feet or hands, even if they are warmly dressed while in the room.
• Temperature spikes may be caused by an increase in sugar levels or complications of the diagnosis.
• Nausea, vomiting, as a sign of poisoning the body with ketone bodies, develop in the later stages of the disease.
• Bowel dysfunction manifested by discomfort in the abdomen, diarrhea, constipation, or a combination thereof.
• Complaints about edema occur at advanced stages of the disease, when it develops.

Important!

If you belong to one of the risk groups, observe one or more of the above symptoms, immediately consult a doctor and undergo an examination!

When is type 2 diabetes diagnosed?

The main diagnostic method is blood tests for:

1. Sugar level (normal indicators are considered
2. Impaired glucose tolerance (in a healthy person, two hours after taking 75 grams of sugar, indicators
3. The level of glycated hemoglobin (no more than 6.5%);

Important! Diagnosis of the disease can only be carried out with your doctor and only in laboratory conditions.

Treatment Methods

Dangerous Complications

Remember, constant monitoring of lifestyle is not only the right way to health, but also the ability to diagnose clinical manifestations in the early stages.

Type 2 diabetes is the most common form of the disease, diagnosed in more than 90% of the total number of diabetics. Unlike type 1 diabetes, this pathology leads to insulin resistance. This means that the cells of the human body are immune to such a hormone.

The main factors that lead to the development of the disease in children and adults are lack of physical activity, aggravated heredity and poor nutrition.

As for the symptoms, it practically does not differ from the clinical signs of type 1 diabetes, however, experts identify several specific manifestations, for example,. It is impossible to independently compare symptoms and treatment, as this can lead to serious complications, and death is not excluded.

Establishing the correct diagnosis requires an integrated approach and consists in the implementation of laboratory and instrumental examinations and analyzes, as well as diagnostic measures performed directly by the clinician.

The tactics of therapy are only conservative and are based on taking medications and lifelong adherence to a sparing diet. However, alternative treatment of type 2 diabetes is strictly prohibited.

Etiology

Such a disease belongs to the category of polyetiological, which means that several predisposing factors simultaneously affect its formation. Thus, the causes of type 2 diabetes are:

• diagnosing a similar pathology in any of the close relatives. If one of the parents suffers from such a disease, then the probability of its development in offspring is 40%;
• malnutrition - with type 2 diabetes, a violation of carbohydrate metabolism occurs. From this it follows that those who abuse potatoes and sugar, bread and sweets are subject to its development. In addition, this should also include the lack of plant foods in the diet. It is because of this that diet and treatment are two interrelated factors;
• the presence of excess body weight, namely obesity by visceral type. In this case, the main accumulation of fat is noted in the abdomen;
• or lack of physical activity in a person's life - most often this is due to sedentary working conditions, but it can also be associated with the course of a serious illness or with banal human laziness;
• the presence of such a pathology as - in such cases, the indicators of the tonometer show overestimated values ​​of blood tone;
• frequent overeating, especially at night;
• inflammation of the pancreas.

Despite the presence of a wide range of predisposing factors, experts from the field of endocrinology agree that the development of the disease is based on insulin resistance. At the same time, a large amount of such a pancreatic hormone circulates in the human body, but it has practically no effect on lowering blood sugar levels, because the cells remain insensitive to its influence.

Due to the fact that insulin is higher than normal, some patients believe that type 2 diabetes is insulin-dependent, but this is not so - it is insulin-independent, because insulin receptors, which are located on cell membranes, are immune to its effects.

Classification

Type 2 diabetes has several forms:

• with the emergence of insulin resistance and relative insulin deficiency;
• with the advantage of disrupting the secretion of such a hormone, which can occur with or without insulin resistance.

Depending on which segments will be affected by complications, there are:

• violation of the functioning of capillaries;
• damage to large blood vessels;
• toxic effect on the nervous system.

As the disease progresses, it goes through two stages:

• covert- is expressed in the complete absence of symptoms, but the presence of minor deviations in the laboratory data on the study of urine and blood;
• explicit- while clinical signs lead to a significant deterioration in a person's condition.

There are also the following stages of type 2 diabetes:

• light- symptoms are not expressed by any manifestations, but there is a slight increase in glucose;
• moderate- it is considered such if there is a slight appearance of symptoms and deviations of analyzes from the norm;
• heavy- manifested in a sharp deterioration in the patient's condition and a high likelihood of complications.

Depending on how the pathology proceeds, it will depend on whether type 2 diabetes can be cured.

Symptoms

The symptoms of type 2 diabetes are nonspecific and very much resemble the course of a similar type 1 disease. It is for this reason that primary diagnosis is difficult, and establishing the correct diagnosis requires a wide range of examinations.

Thus, the disease has the following symptoms:

• constant thirst, which forces a person to take in a large amount of liquid;
• severe itching of the skin, in particular, the inguinal zone. This feature is explained by the fact that glucose begins to be excreted along with urine, which makes the skin of this area irritable;
• an increase in body weight, while abdominal obesity will be observed - while fatty tissues accumulate in the upper body;
• frequent urge to urinate;
• a decrease in the resistance of the immune system - this leads to the fact that a person is more often exposed to diseases of a different nature;
• constant drowsiness and fatigue;
• slow wound healing;
• foot deformity;
• numbness of the lower extremities.

In addition to the above symptoms of type 2 diabetes, during the course of such a disease, there are also:

• increased facial hair growth;
• the formation of small yellowish growths on the body;
• disorder of all types of exchange;
• dysfunction of the pancreas;
• decrease in bone density.

All of the listed clinical manifestations of the disease are characteristic of type 2 diabetes mellitus in men, women and children.

It is always necessary to take into account the fact that type 2 diabetes in children and women during pregnancy is much more severe than in other people.

Diagnostics

Despite the fact that it is possible to determine the content of glucose in the blood and urine according to laboratory tests, the diagnosis also includes instrumental examinations and the doctor's personal work with the patient.

Primary diagnosis is aimed at:

• study by the endocrinologist of the life history and medical history of not only the patient, but also his relatives, which will make it possible to find out the origin of such a disease;
• implementation of a thorough physical examination - to detect the presence of obesity, changes in the skin and mucous membranes;
• a thorough questioning of the patient - to identify the first time of occurrence and the severity of symptoms in women and men.

Laboratory diagnosis of type 2 diabetes involves the following:

• general clinical blood and urine tests;
• blood biochemistry;
• samples for assessing the amount of glucose in the blood - do such a procedure on an empty stomach;
• tests that determine the presence of sugar and ketone bodies in urine;
• tests to detect C-peptides and insulin in the blood;
• glucose tolerance test.

To confirm the diagnosis, as well as to identify complications, the following instrumental examinations are performed:

• Ultrasound and MRI;
• duplex scanning of leg arteries;
• transcutaneous oximetry;
• rheoencephalography;
• rheovasography of the lower extremities;
• EEG of the brain.

Only after the endocrinologist has studied all the data obtained during the diagnosis, the doctor will be able to draw up the most effective tactic on how to treat type 2 diabetes on an individual basis for each patient.

Treatment

It is possible to eliminate such a disease using the following conservative methods:

• taking medications;
• adherence to diet therapy;
• regular but moderate exercise. It is recommended to do gymnastics, light jogging or hiking for no more than an hour three times a week.

Medical treatment for type 2 diabetes is aimed at taking:

• hormonal substances that increase insulin production;
• means for increasing the sensitivity of cells to glucose;
• preparations containing insulin - only with a long course of the disease.

Nutrition for type 2 diabetes provides for compliance with the following rules:

• complete exclusion of sweets, confectionery and flour from the menu;
• reduced carbohydrate intake;
• the minimum consumption of fats of both vegetable and animal origin;
• taking meals in small portions, but six times a day.

It is worth noting that it is not advisable to independently treat type 2 diabetes mellitus with folk remedies - this will only exacerbate the problem.

Compliance by the patient with all the rules regarding how to cure type 2 diabetes mellitus guarantees a favorable prognosis. With the development of complications, the likelihood that a person will receive a disability with type 2 diabetes is not excluded.

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Basic principles for the treatment of type 2 diabetes mellitus (DM-2):

• learning and self-control;
• diet therapy;
• dosed physical activity;
• oral sugar-lowering drugs (TSPs);
• insulin therapy (combined or monotherapy).

The use of TSP, as the main type of hypoglycemic therapy for CD-2, is contraindicated in:

• all acute complications diabetes mellitus (SD);
• severe lesions of the liver and kidneys of any etiology, occurring with a violation of their function;
• pregnancy;
• childbirth;
• lactation;
• blood diseases;
• acute inflammatory diseases;
• organic stage of vascular complications of diabetes;
• surgical interventions;
• progressive weight loss.

Pharmacotherapy of type 2 diabetes mellitus is based on the impact on the main pathogenetic links of this disease: impaired insulin secretion, the presence of insulin resistance, increased glucose production in the liver, and glucose toxicity. The action of the most common oral sugar-lowering drugs is based on the inclusion of mechanisms to compensate for the negative impact of these pathological factors (The algorithm for the treatment of patients with type 2 diabetes is shown in Fig. 9.1).

Figure 9.1. Algorithm for the treatment of patients with DM-2

In accordance with the application points, the actions of the TSP are divided into three main groups:

1) Increasing insulin secretion: stimulators of the synthesis and / or release of insulin by B cells - sulfonylurea preparations (PSM), nonsulfonylurea secretagogues (glinides).
2) Reducing insulin resistance (increasing insulin sensitivity): suppressing the increased production of glucose in the liver and enhancing the utilization of glucose by peripheral tissues. These include biguanides and thiazolindiones (glitazones).
3) Suppressing the absorption of carbohydrates in the intestine: inhibitors of a-glucosidase (Table 9.1.).

Table 9.1. Mechanism of action of oral sugar-lowering drugs

Currently, these groups of drugs include:

1. Sulfonylurea preparations of the 2nd generation:

• glibenclamide (Maninil 5 mg, Maninil 3.5 mg, Maninil 1.75 mg)
• gliclazide (Diabeton MB)
• glimepiride (Amaryl)
• gliquidone (Glurenorm)
• glipizide (Glibenez-retard)

• repaglinide (Novonorm)
• nateglinide (Starlix)

• metformin (Glucophage, Siofor, Formin Pliva)

• rosiglitazone (Avandia)
• pioglitazone (Actos)

• acarbose (glucobay)

Sulfonylureas

Currently, second generation PSMs are used in clinical practice, which have a number of advantages compared to first generation sulfonylurea drugs (chlorpropamide, tolbutamide, carbutamide): they have a higher hypoglycemic activity, have fewer side effects, interact less often with other drugs, are produced in more convenient form. Indications and contraindications for their administration are presented in Table. 9.2.

Table 9.2. Indications and contraindications for taking drugs

PSM therapy begins with a single dose before breakfast (30 minutes before meals) at the lowest dose, if necessary, gradually increasing it at intervals of 5-7 days until the desired reduction in glycemia is obtained. A drug with faster absorption (micronized glibenclamide - maninil 1.75 mg, maninil 3.5 mg) is taken 15 minutes before meals. Treatment of TSP is recommended to start with milder drugs, such as gliclazide (diabeton MB), and only later switch to more powerful drugs (maninil, amaryl). PSM with a short duration of action (glipizide, gliquidone) can be administered immediately 2-3 times a day (Table 10).

Glibenclamide (maninil, betanaz, daonil, euglucone) is the most commonly used sulfonylurea drug. It is completely metabolized in the body with the formation of active and inactive metabolites and has a double route of elimination (50% through the kidneys and a significant part in the bile). In the presence of renal insufficiency, its binding to proteins decreases (with hypoalbuminuria) and the risk of developing hypoglycemia increases.

Table 10. Characteristics of doses and administration of PSM

Glipizide (glibenez, glibenez retard) is metabolized in the liver with the formation of inactive metabolites, which reduces the risk of hypoglycemia. The advantage of sustained release glipizide is that the release of its active substance is continuous and does not depend on food intake. The increase in insulin secretion during its use occurs mainly in response to food intake, which also reduces the risk of hypoglycemia.

Glimepiride (amaril)- a new tableted sugar-lowering drug, which is sometimes referred to as the III generation. It has 100% bioavailability and causes the selective selection of insulin from B-cells only in response to food intake; does not block the decrease in insulin secretion during exercise. These features of the action of glimepiride reduce the likelihood of hypoglycemia. The drug has a double route of excretion: with urine and bile.

Gliclazide (diabeton MB) is also characterized by absolute bioavailability (97%) and is metabolized in the liver without the formation of active metabolites. The prolonged form of gliclazide - diabetone MB (a new form of modified release) has the ability to rapidly reversibly bind to TSP receptors, which reduces the likelihood of developing secondary resistance and reduces the risk of hypoglycemia. In therapeutic doses, this drug is able to reduce the severity of oxidative stress. These features of the pharmacokinetics of diabetone MB allow it to be used in patients with diseases of the heart, kidneys and the elderly.

However, in each case, the dose of PSM should be selected individually, keeping in mind the high risk of hypoglycemic conditions in the elderly.

Gliquidone stands out for its two most characteristic features: short-term action and minimal excretion through the kidneys (5%). 95% of the drug is excreted from the body with bile. Effectively reduces fasting and postprandial glycemia, and its short duration of action makes it easier to manage glycemia and reduce the risk of hypoglycemia. Glurenorm is one of the safest sulfonylurea derivatives and the drug of choice in the treatment of elderly patients, patients with concomitant kidney diseases and those with a predominance of postprandial hyperglycemia.

Given the clinical features of DM-2 in the elderly, namely, the predominant increase in postprandial glycemia, leading to high mortality from cardiovascular complications, in general, the appointment of TSP is especially justified in elderly patients.

Against the background of the use of sulfonylurea drugs, side effects may occur. First of all, this concerns the development of hypoglycemia. In addition, there is a possibility of gastrointestinal disorders (nausea, vomiting, epigastric pain, less often - the appearance of jaundice, cholestasis), allergic or toxic reactions (skin itch, urticaria, Quincke's edema, leuko- and thrombocytopenia, agranulocytosis, hemolytic anemia, vasculitis). There are indirect data on the possible cardiotoxicity of SCM.

In some cases, during treatment with tableted antidiabetic drugs, resistance to representatives of this group may be observed. In the case when the absence of the expected sugar-lowering effect is observed from the first days of treatment, despite the change of drugs and the increase in the daily dose to the maximum possible, we are talking about primary resistance to TSP. As a rule, its occurrence is due to a decrease in the residual secretion of its own insulin, which dictates the need to transfer the patient to insulin therapy.

Long-term use of TSPs (more than 5 years) can cause a decrease in sensitivity to them (secondary resistance), which is due to a decrease in the binding of these drugs to the receptors of insulin-sensitive tissues. In some of these patients, the appointment of insulin therapy for a short period of time can restore the sensitivity of glucoreceptors and allow you to return to the use of PSM.

Secondary resistance to tableted sugar-lowering drugs in general and to sulfonylurea drugs in particular can occur for a number of reasons: CD-1 (autoimmune) is erroneously diagnosed as type 2 diabetes mellitus, there is no use of non-pharmacological treatments for CD-2 (diet therapy, dosed physical loads), drugs with a hyperglycemic effect are used (glucocorticoids, estrogens, thiazide diuretics in large doses, l-thyroxine).

Exacerbation of concomitant or intercurrent diseases may also lead to a decrease in sensitivity to TSP. After stopping these conditions, the effectiveness of PSM can be restored. In some cases, with the development of true resistance to PSM, a positive effect is achieved through combined therapy with insulin and TSP or a combination of various groups of tableted sugar-lowering drugs.

Nonsulfonylurea secretagogues (glinides)

Table 11. Use of secretagogues

Indications for the use of secretagogues:

• newly diagnosed DM-2 with signs of insufficient secretion of insulin (without overweight);
• CD-2 with severe postprandial hyperglycemia;
• CD-2 in elderly and senile people;
• CD-2 with intolerance to other TSPs.

Repaglinide is excreted from the body mainly through the gastrointestinal tract (90%) and only 10% in the urine, so the drug is not contraindicated in the initial stage of renal failure. Nateglinide is metabolized in the liver and excreted in the urine (80%), so its use in patients with hepatic and renal insufficiency is undesirable.

The spectrum of side effects of secretagogues is similar to those of sulfonylurea drugs, since both of them stimulate the secretion of endogenous insulin.

biguanides

In diabetic patients, metformin improves lipid metabolism due to a moderate decrease in triglycerides (TG), low density lipoproteins (LDL), total cholesterol and LDL cholesterol in plasma. In addition, this drug has a fibrinolytic effect due to the ability to accelerate thrombolysis and reduce the concentration of fibrinogen in the blood.

The main indication for the use of metformin is CD-2 with obesity and/or hyperlipidemia. In these patients, metformin is the drug of choice due to the fact that it helps to reduce body weight and does not increase the hyperinsulinemia characteristic of obesity. Its single dose is 500-1000 mg, the daily dose is 2.5-3 g; the effective average daily dose for most patients does not exceed 2-2.25 g.

Treatment usually begins with 500-850 mg per day, if necessary, increasing the dose by 500 mg with an interval of 1 week, taken 1-3 times a day. The advantage of metformin is its ability to suppress nocturnal hyperproduction of glucose by the liver. With this in mind, it is better to start taking it once a day in the evening to prevent an increase in glycemia in the early morning hours.

Metformin can be used as monotherapy with diet in people with type 2 diabetes mellitus and obesity, and in combination with SSM or insulin. The indicated combination therapy is prescribed if the desired therapeutic effect against the background of monotherapy is not achieved. Glibomet is currently available, which is a combination of glibenclamide (2.5 mg/tab.) and Metformin (400 mg/tab.).

The most formidable potential complication of biguanide therapy is lactic acidosis. A possible increase in the level of lactate in this case is associated, firstly, with the stimulation of its production in the muscles, and secondly, with the fact that lactate and alanine are the main substrates of gluconeogenesis suppressed when taking metformin. However, it should be assumed that metformin, prescribed according to indications and taking into account contraindications, does not cause lactic acidosis.

Taking into account the pharmacokinetics of metformin, its temporary cancellation is necessary with the introduction of radiopaque iodine-containing substances, before the upcoming general anesthesia (at least 72 hours before), in the perioperative period (before surgery and a few days after it), with the addition of acute infectious diseases and exacerbation of chronic ones.

Metformin is generally well tolerated. Side effects, if they develop, then at the very beginning of treatment and quickly disappear. These include: flatulence, nausea, diarrhea, discomfort in the epigastric region, decreased appetite and a metallic taste in the mouth. Dyspeptic symptoms are mainly associated with a slowdown in the absorption of glucose in the intestine and an increase in fermentation processes.

In rare cases, there is a violation of the intestinal absorption of vitamin B12. An allergic reaction may occur. Due to the lack of a stimulating effect on insulin secretion, metformin rarely causes the development of hypoglycemia, even with its overdose and skipping meals.

Contraindications to the use of metformin are: hypoxic conditions and acidosis of any etiology, heart failure, severe violations of the liver, kidneys, lungs, old age, alcohol abuse.

When treating with metformin, it is necessary to control a number of indicators: hemoglobin (1 time in 6 months), the level of creatinine and serum transaminases (1 time per year), if possible - for the level of lactate in the blood (1 time in 6 months). With the appearance of muscle pain, an emergency study of blood lactate is necessary; normally, its level is 1.3-3 mmol / l.

Thiazolidinediones (glitazones) or sensitizers

The use of thiazolidinediones in patients with DM-2 opens up prospects for the prevention of cardiovascular complications, the development mechanism of which is largely due to the existing insulin resistance and lipid metabolism disorders. In other words, these drugs increase the sensitivity of peripheral tissues to the physiological action of their own endogenous insulin and at the same time reduce its concentration in the blood.

In the absence of secretion of endogenous insulin (SD-1) or with a decrease in its secretion (prolonged course of type 2 diabetes mellitus, accompanied by unsatisfactory compensation at the maximum dose of TSP), these drugs cannot have a sugar-lowering effect.

Currently, two drugs from this group are used: rosiglitazone (avandia) and pioglitazone (actos) (Table 12).

Table 12. The use of thiazolidinediones

80% of the drugs in this group are metabolized by the liver and only 20% is excreted by the kidneys.

Thiazolidinediones do not stimulate insulin secretion by the pancreas, therefore they do not cause hypoglycemic conditions and help reduce fasting hyperglycemia.

During treatment with glitazones, mandatory monitoring of liver function (serum transaminases) is required once a year. Other possible side effects include swelling and weight gain.

Indications for the use of glitazones are:

• newly diagnosed DM-2 with signs of insulin resistance (with the ineffectiveness of only diet therapy and physical activity);
• CD-2 with the ineffectiveness of medium therapeutic doses of PSM or biguanides;
• CD-2 with intolerance to other sugar-lowering agents.

Drugs of this class can be used in combination with sulfonylurea drugs, metformin and insulin.

α-glucosidase inhibitors

Currently, the only drug from this group is registered - acarbose (glucobay). Its use is effective at a high level of glycemia after a meal and at a normal fasting. The main indication for the use of glucobay is mild type 2 diabetes mellitus. Treatment begins with a small dose (50 mg with dinner), gradually increasing it to 100 mg 3 times a day (optimal dose).

With monotherapy with glucobay, hypoglycemic reactions do not develop. The possibility of using the drug in combination with other tableted sugar-lowering drugs, especially those that stimulate insulin secretion, can provoke the development of a hypoglycemic reaction.

Side effects of acarbose are flatulence, bloating, diarrhea; an allergic reaction is possible. With continued treatment and diet (exclusion of excessive consumption of carbohydrates), complaints from the gastrointestinal tract disappear.

Contraindications to the appointment of acarbose:

• intestinal diseases accompanied by malabsorption;
• the presence of diverticula, ulcers, stenosis, cracks in the gastrointestinal tract;
• gastrocardial syndrome;
• hypersensitivity to acarbose.

Development type 2 diabetes can go two ways.

1. The first way is when the perception of insulin by tissue cells is disrupted, and it is no longer suitable as a “key” that opens the entrance to glucose for cells, where it is processed or stored in reserve (for example, in the form of glycogen in liver cells). This disorder is called insulin resistance.
2. The second option is when insulin itself loses its ability to perform its actions. That is, glucose cannot enter the cells, not because the cell receptors do not perceive insulin, but because the insulin itself produced is no longer the “key” to the cells.

Type 2 diabetes symptoms

Type 2 diabetes often proceeds without visible manifestations, the person does not even know that he is sick.
Some symptoms may appear for a while and go away again.
Therefore, you need to carefully listen to your body.

Overweight and obese people should regularly donate blood for sugar.

• Increased sugar is accompanied by thirst, and, as a result, frequent urination.
• Severe dryness of the skin, itching, non-healing wounds may appear.
• There is general weakness, fatigue.
• Blood sugar levels should also be monitored by people over 40 years of age.

Forms of severity of type 2 diabetes

There are three forms according to severity:

• mild form - when diet and exercise or a minimum amount of sugar-lowering drugs is sufficient to achieve compensation;
• medium form - to maintain normoglycemia, several tablets of sugar-lowering drugs are required;
• severe form - when sugar-lowering drugs do not give the desired result and insulin therapy is connected to the treatment.

Treatment of type 2 diabetes mellitus: sugar-lowering drugs and insulin therapy

Treatment of type 2 diabetes includes several components - sports / physical education, diet therapy, and insulin therapy.

You can not neglect physical activity and diet. Since they help a person to lose weight and, thereby, reduce insulin resistance of cells (one of the causes of diabetes), and thus normalize blood sugar levels.
Of course, not everyone can refuse drugs, but without weight loss, no type of treatment will give good results.
But still, the basis of treatment is sugar-lowering drugs.

According to the mechanism of action, all sugar-lowering drugs are divided into several groups. Check them out below.


- The first group includes two types of drugs - Thiazolidinediones and Biguanides. The drugs of this group increase the sensitivity of cells to insulin, that is, reduce insulin resistance.
In addition, these drugs reduce the absorption of glucose by intestinal cells.

Medicines related to Thiazolidinedionam (Rosiglitazone and pioglitazone), to a greater extent restore the mechanism of action of insulin.

Medicines related to biguanides ( Metformin (Siofor, Avandamet, Bagomet, Glucofage, Metfogamma)), to a greater extent change the absorption of glucose by intestinal cells.
These drugs are often given to overweight people to help them lose weight.

- The second group of sugar-lowering drugs also consists of two types of drugs - Derivatives sulfonylurea and meglitinides.
The drugs of this group stimulate the production of their own insulin by acting on the beta cells of the pancreas.
They also reduce glucose stores in the liver.

Preparations of the group Sulfonylureas ( Maninil , Diabeton , Amaryl , Glurenorm , Glibinez-retard) in addition to the above effects on the body, they also affect insulin itself, thereby increasing its effectiveness.

Meglitinides (Repaglinide) Starlix)) enhance the synthesis of inulin by the pancreas, and also reduce postprandial peaks (increased sugar after eating).
Perhaps a combination of these drugs with Metformin.

- The third group of hypoglycemic drugs includes acarbose (Glukobay). This drug reduces the absorption of glucose by intestinal cells due to the fact that, by binding to enzymes that break down carbohydrates from food, it blocks them. And unsplit carbohydrates cannot be absorbed by cells. And this results in weight loss.

When the use of sugar-lowering drugs does not lead to compensation, it is prescribed insulin therapy.
There are different ways to use insulin. It is possible to use only long-acting insulin in combination with sugar-lowering drugs. Or, with the ineffectiveness of drugs, short-acting and extended-acting insulins are used.

The use of insulin can be permanent, or it can be temporary - with severe decompensation, during pregnancy, during surgery or serious illness.

Nutrition for type 2 diabetes

Diet is one of the key points in the treatment of type 2 diabetes and it is aimed at reducing excess weight and maintaining a normal body weight.

The basis of the diet is the rejection of fast or refined carbohydrates, such as sugar, sweets, jam, many fruits, dried fruits, honey, fruit juices, muffins.

A particularly strict diet at the beginning, when you need to lose weight, then the diet can be somewhat expanded, but fast carbohydrates for the most part are still excluded.

But remember that you should always have some foods containing fast carbohydrates on hand to stop hypoglycemia attacks.
Honey, juice, sugar are well suited for this.

Diet should not be a temporary phenomenon, but a way of life. There are many healthy, tasty and easy-to-make dishes, and desserts are not excluded.
A large selection of calorie- and carbohydrate-calculated diet meals can be found on our partner Dia-Dieta website.

The basis of nutrition should be foods that contain a lot of fiber and slow carbohydrates that slowly raise sugar and do not give such pronounced postprandial hyperglycemia.

It is necessary to reduce the consumption of foods high in fat - meat, dairy products.

It is worth giving up fried foods, steam, boil or bake in the oven.

Food should be taken 5-6 times a day, but in small portions.

Compliance with such a diet will not only help to reduce weight, but also keep it at a normal level, which will have a beneficial effect on the general condition of the body.

Physical activity in type 2 diabetes

Physical exercise is of great importance, but the load should be appropriate for the age and health of the patient.
It is important not to overdo it with the intensity, the load should be smooth and regular.

Sports activities increase the sensitivity of cells to insulin and, as a result, there is a decrease in sugar.

If you have a long load, then before starting it is recommended to eat 10-15g of slow carbohydrates to prevent hypoglycemia. Bread, apple, kefir are suitable as a snack.
But if the sugar has dropped sharply, then you need to take fast carbohydrates in order to quickly raise the glucose level.

Any physical activity should be excluded with sugar above 12-13 mmol / l. With such high sugar, the load on the heart increases, and in combination with the load, this becomes doubly dangerous.
In addition, exercising with such sugar can lead to its further growth.

It is advisable to control the level of sugar before the load, during and after it, in order to avoid unwanted fluctuations.

396 Comments

Hello. Please help me figure out what's wrong with me. Before pregnancy, elevated blood sugar of 6.25 from a vein on an empty stomach was revealed (further, all tests were also from a vein). I passed the GG-4.8%, the glucose tolerance test after two hours was 4.6., Insulin was in the region of 8, i.e. type 1 diabetes definitely cannot be, tk. C-peptide was also normal.
During pregnancy, she had gestational diabetes mellitus and a very strict diet with sugar control using a glucometer and a sensor. After pregnancy, this winter I passed a glucose test of 7.2 in an hour and 4.16 in two hours, the homa index floats from 2.2 to 2.78, and fasting sugar is often in the laboratory in the region of 5.9-6.1, but literally 2 weeks ago I passed and it was already 6.83, but I ate sweets at night (ice cream and an apple), but 8 hours before the fence on an empty stomach definitely passed. The last GG of 4.8% was handed over a week before this high sugar indicator and then sugar also handed over 5.96. Endocrinologists prescribed me Metformin at first 500 and then 850 mg at night, but I did not see a decrease in fasting sugar.
I am on a diet almost all the time (I confess, sometimes I allow too much in the form of ice cream or one cookie) and almost always the sugar in two hours on a glucometer is not higher than 6, but more often 5.2-5.7. I can't understand why my fasting sugar is so high if I'm not fat, but I do have belly fat (67kg and height 173cm)
I am worried about bad symptoms in the form of hunger, severe hair loss, sweating, fatigue, and often dizzy when I eat carbohydrates, although sugar at these moments is absolutely normal (I checked it with a glucometer many times).
I took blood tests and I still have high LDL cholesterol-3.31 (at a rate of up to 2.59) and there is an increase in hemoglobin 158 (normal up to 150), erythrocytes-5.41 (up to 5.1 normal) and hematocrit-47, 60 (norm up to 46). The doctor says that this is nonsense and suggested drinking more fluids, and I'm worried that this may be due to sugar and hypothyroidism. I’m afraid that everything complicates my condition, because cholesterol affects the pancreas, and hypothyroidism and diabetes in general often go together, and then Euthirox is canceled for me, then they are returned.
Tell me, please, what tests should I still pass in order to understand whether my diabetes is starting or is it still a violation of fasting glycemia?

1. Julia, good afternoon.
   Elevated hemoglobin, indeed, can be associated with a small amount of fluid you drink. How much do you drink per day? To be honest, I myself have the same situation, hemoglobin 153-156. I drink very little (less than a liter a day), it is difficult to force myself, although I know that I need more. So pay attention to this fact.
   Cholesterol, of course, is above the norm, but not critical to somehow affect the state of health. There is no point in taking cholesterol-lowering drugs. If possible, reconsider your diet - fatty meat, a lot of animal fats. Have you been tested for cholesterol before? Sometimes it happens that high cholesterol is a feature of the body, so it makes no sense to reduce it with drugs.
   Fatigue, sweating, dizziness - have you been tested for thyroid function? The symptoms are very similar to a malfunction in the thyroid gland. It may be necessary to increase the dose of euthyrox.
   You can check the heart, go to the cardiologist. Small increases in sugar may not cause such symptoms.
   While you have such a situation, you can definitely say that you definitely don’t have CD1. SD2 is questionable. How much metformin treatment is necessary, of course, the doctor decides, but so far there is no strict need for taking drugs, in my opinion. Perhaps such a development of the situation that the temporary use of metformin will help to establish the absorption of carbohydrates and then it can be abandoned.
   As long as you continue to drink the drug prescribed by your doctor, monitor your sugar levels. If you want to eat more carbohydrates, then it is better to do it in the morning, and not at night.
   You don’t need to take any tests yet, you have already passed all the main ones. Retake periodically (3 times a year) glykir.hemoglobin, well, measure sugar yourself.
   And one more thing - what kind of glucometer do you have? Does it measure in plasma or whole blood? Look at the ratio of plasma sugar to target blood. Doctors (especially of the old school) often rely on values ​​for whole blood.

   1. Thank you for the answer!
      Yes, something very strange is going on with the thyroid gland. After pregnancy on a dose of 50 (before I even alternated between 50 and 75 to keep the TSH around 1.5) fell to 0.08, i.e. the dose was too high. The doctor prescribed an ultrasound (it was good, without any traces of pathology, although there used to be a small nodule) and asked me not to drink Euthyrox for a month, to take an analysis. I did everything and after a month of cancellation I had a TSH of 3.16 at a laboratory norm of 4.2. The doctor again prescribed Etirox at a dose of 25 and my TSH began to decrease again, but pains immediately appeared in the top of the foot. I remembered that I already had this many years ago, when hypothyroidism had not yet been found, so I turned to another doctor and he canceled Euthyrox for 3 months. (legs, by the way, almost immediately passed) + Metformin canceled me too. After 3 months I have to check ttg, glycated and sugar.
      I now have a Contour Plus glucometer (calibrates by plasma), before that I had a Freestyle optium.
      Doctors brought tests only from the laboratory (from a vein).
      My high sugar of 6.83 was from a vein according to the laboratory (((and this scares me, because getting diabetes at the age of 35, when you have a small child in your arms, is very scary.

      1. Julia, your situation is not simple, because thyroid disorders are hormonal disorders, just like diabetes. Everything follows one after the other.
         It's too early to talk about diabetes. Retake periodically tests for GG, sometimes check sugar on an empty stomach at home.
         Sugar 6.8, especially one-time, does not speak in the direction of diabetes.
         It makes no sense to worry about this, severely limit your diet too. It is impossible to protect yourself from diabetes, like, for example, from the flu, by carrying out prevention and vaccinations. With DM2, the situation can be improved by diet, with DM1, the diet does not make sense.
         You have a small child, devote your time to him. Enjoy motherhood. It will be necessary to take measures to treat diabetes only in case of its manifestation, now all this will not bring any positive results. But unrest can do a disservice and cause an increase in sugar, even in the case when there is no diabetes.

         1. Yes, I would like to digress from all this, but the general state of health interferes: dizziness after eating, severe hair loss, sweating, etc. Not much fun, unfortunately.
            Today, tests for hormones have also arrived, and it seems that the abolition of Euthyrox provoked an imbalance, because. this did not happen before, the previous ones were taken in May on Euthyrox. Prolactin jumped strongly to 622 at a rate of up to 496, cortisol at the upper limit of normal, fasting insulin became even higher 11.60, glucose 6.08, and the Hom index is now 3.13, i.e. developed insulin resistance
            Now I don't even know what to do. I could not find a good doctor to deal with all the problems.

            Julia, what city are you from? If Moscow, Moscow region, then you can look for doctors. Unfortunately, I don't know about other cities.
            I tend to think that "dizziness after eating, severe hair loss, sweating, etc." not associated with such low sugar. It's more like a thyroid gland.
            These same symptoms can also give malfunctions in the work of the adrenal glands.
            Another question - have you been examined by a gynecologist? What about hormones in this area? Polycystic ovaries can lead to insulin resistance.
            Unfortunately, it is difficult to say right away - you have this and that. In your situation, there are such general symptoms that it is necessary to conduct a systematic examination in order to identify the real cause. This, of course, is not as fast as we would like.

            As for insulin resistance, this process has a genetic predisposition. It is impossible to stop it, if it turns out that you do not have polycystic disease, the correct dose of hormones for shields is selected. The glands, and insulin resistance does not go away, you will have to get used to living with it.
            Then treatment with metformin should make a difference.

            I couldn't hit the "reply" button on my last comment, so I'll post it here.
            I'm from Minsk and it looks like a good doctor here should be looked for like a treasure)) I signed up for the weekend with the advised endocrinologist ... we'll see.
            It seems to me that my problems with insulin are really hereditary, tk. in our family, all women have an active accumulation of belly fat. My sister is actively involved in sports, but the stomach still has a place to be.
            I don't have PCOS, but after pregnancy there were problems with the cycle and the gynecologist doesn't like my ultrasound with the endometrium. There is a suspicion that the swing with Euthyrox led to such a failure, because. he fell at my dosage of 50 mg to almost 0, but I didn’t know that.
            Today, a detailed analysis of the thyroid gland also came (I have not been drinking Euthyrox since September 12).
            If you can somehow comment, I will be very grateful.
            TSH-2.07
            Т3sv-2.58 (normal 2.6-4.4) reduced
            T3total-0.91 (normal 1.2-2.7) reduced
            T4total-75.90 norm
            T4sv-16.51 norm
            Thyroglobulin-22.80 norm
            Antibodies to TG- 417.70 (norm<115) повышено
            Antibodies to TPO - 12 norm
            I decided to take it in detail so that the doctor could look at all the tests in detail.
            Tell me, please, how can I check the work of the adrenal glands, what tests can I take?
            Thank you for your answers and for taking your time to be a stranger :)

            Julia, good afternoon.
            Stress and anxiety also affect the hormonal background, can also cause weakness, hair loss, sweating. Hormones such as catecholamines, which are synthesized in the adrenal glands, help us fight stress. They regulate the body's response to stressful situations. You can donate blood or urine for catecholamines - dopamine, adrenaline, norepinephrine and serotonin. I don’t know how it is in district clinics, but in private laboratories they are made everywhere.
            And first of all, you just need to choose the dosage of euthyrox. The thyroid gland has a huge impact on well-being. It is T3 that affects the activity of the cardiovascular system, its lack is manifested by an increase in cholesterol, weakness, and problems with concentration.
            Both the adrenal glands and the thyroid gland should be dealt with by one doctor.
            95% that all your unpleasant symptoms will go away as soon as the work of the thyroid gland improves.

            As for diabetes, believe me, life does not end when this diagnosis is made. As people with diabetes, we also live, work, travel, raise families, fly planes, ski, and so on. Well, we just can’t fly into space :). So do not waste time on unnecessary experiences, enjoy life, you have a family, a child - there is something to live and smile for!!!

            P.S. A little off topic - it's very nice that you are from Minsk. We love Belarus very much, we also visited Minsk, a very beautiful city. We are planning to come again. In general, we go to Vitebsk 2-3 times a year. Your place is very beautiful!

I am 56 years old, with a pressure of 195-100, I was admitted to the hospital by ambulance. During the research, it turned out that my sugar had risen to 10.5. I never knew about it before. They put DM2 and prescribed Metformin 2 times a day, 500 g, and antihypertensive drugs for pressure. I began to follow a diet to drink medicines, but very often my pancreas began to hurt in my left side. I drink pancreotin, allochol, mezim was prescribed when I was at the gastroenterologist, but the pain does not go away. I drank only water for half a day, I thought it would pass, but the pain does not go away. What do you recommend to drink?

1. Hello. Dad was recently diagnosed with type 2 diabetes, sugar was 19. And the doctors also cut off the tip of the thumb, because the legs didn’t feel anything at all and apparently the nails began to fall off. According to my father, it started about five years ago, as my feet get cold. When the doctors operated, they did not know that he had sugar. The operation went well, the legs warmed up a little, that is, they began to feel a little. And now, after a while, blisters appeared on my legs, burst and the skin is torn off. It hurts at night. We don't know what to do.

2. Mom is 60 years old, type 2 diabetes, insulin resistance, they gave insulin injections, her sugar was 14, her eyesight fell.
   tell me, is it possible to start physical training or should I wait until the body gets used to insulin and lowers sugar?
   Will training help avoid vascular problems?

3. Thanks for the article, useful information. I am 52 years old, I am overweight, unfortunately, my sugar is slightly elevated. I try to change my eating style, eat less sweets and starchy foods, and regularly measure my sugar at home with a glucometer ts circuit, this is also very important to always be on the alert and control my health

   Thanks for the article, it clarified many questions. My sister was recently diagnosed with mild type 2 diabetes, although there really were no symptoms, but she started doing sports more well, she dances, of course she keeps to a diet, we recently bought a circuit for her to control her sugar, she is going to the camp and we will calmer so, especially since it is very simple and she easily manages it.

4. Hello, my mother's sugar on an empty stomach 8yo eat scales up to 21yo on average from 10 to 14. She refuses insulin. Takes Glyformin. She also has a postoperative hernia above the navel. Maybe you still need to somehow persuade, force him to take insulin?

5. Hello, my mother, 41 years old, was admitted to the hospital with acute pancreatitis, she passed an analysis for sugar, sugar 14, endocrinology came and said you are insulin dependent and said now they will inject insulin, she refused, she is afraid that she will sit on it all her life, what to do help.

6. Good afternoon. My mother has had type 2 diabetes for many years. She did not treat herself, she did not follow diets. This fall I had a foot amputation. Gangrene set in. Now she eats semi-finished products - store-bought pancakes and dumplings. Sometimes he cooks a soup with the addition of a batch concentrate. He lives far away and I can’t convince him not to eat this muck. Takes diabetes and drinks pain pills. Sometimes checks (a couple of times a week) sugar. So far, he is holding on to 8. He categorically refuses insulin. The stump heals normally. And yet, it seems to me that this is all “more or less normal”, an apparent calm before another storm. In the discharge from the hospital, concomitant diseases were indicated, such as chronic renal failure, ischemic brain, chronic portable insufficiency. She flatly refuses to change her attitude. The question is, am I right or am I more ignorance escalation? If I'm right, then how long do diabetics live after amputation with such an attitude with such a diagnosis? If I can’t convince, then I can remember the argument exactly.

   1. Sveta
      Your situation is not easy - we can always decide for ourselves, but sometimes it is absolutely unrealistic to force or convince another person to change their lifestyle.
      Now on topic - your mom's comorbidities are a consequence of diabetes. Of course, compensation is needed to maintain health to the extent that everything is now.
      With a sugar of 8-9 mmol / l, it is possible to dispense with oral sugar-reducing agents (tablets) and a diet. If such sugars are kept in case of non-compliance with the diet, then if it is observed, everything should be in perfect order. Well, this is the case if the sugar really does not rise higher. But there are doubts about this, or mom hides, well, 1-2 measurements per week do not give a complete picture, since between these measurements sugar can range from 2 to 20 mmol / l.
      Mom was offered to switch to insulin? If yes, then tell her that with insulin therapy she will not have to follow a diet, there is an opportunity to compensate for all the carbohydrates eaten with a dose of insulin, but sugar will have to be measured more often, especially at first, until suitable doses are determined.
      That is, for a normal future life, there are two options:
      1. Pills and DIET are the basis of treatment for type 2 diabetes.
      2. Insulin and no diet, but more frequent monitoring.

      I really don’t want to write disappointing forecasts, but since there was gangrene on one leg - which speaks of the death of the vessels of the lower extremities, the probability of its occurrence on the other leg is very high. How will mom get around then?
      About CKD - ​​mom is not receiving dialysis yet? In many cities it is very difficult to achieve, people stand in long lines to save their lives, but not everyone waits for their turn, unfortunately. And then, finally, having received a place for dialysis, a person becomes attached to the house - since dialysis is done on certain days, at a certain time, this is a matter of five minutes. Therefore, several hours a day, at best once a week, will have to be devoted to trips to the hospital and this procedure. And the procedure itself is not pleasant - there are a lot of additional drugs for the rest of your life, since during dialysis a lot of substances needed by the body are washed out.
      And these are only those problems that are necessarily waiting for a person who does not have normal compensation. Maybe this will still encourage your mother to think about her future life - a more or less active and independent person who is on a diet or bedridden, who will be cared for by loved ones who have the right to their privacy, but measure sugar once a week and eating questionable snacks.
      Your mother - health and prudence, and patience to you!

7. Mom has type 2 diabetes. Takes metfogamma, metformin (depending on what is on sale). Sometimes in the morning sugar is below normal (according to the glucometer): about 2-3. Usually around 7-8. What is it can be and how much or as far as it is harmful? Thanks in advance for your reply.

   1. Dmitriy
      Reducing sugar to 2-3 mmol is already hypoglycemia. These reductions must be avoided. Especially if the mother herself does not feel low sugar, but only learns about it from a glucometer. Low sugars are dangerous in that measures must be taken immediately, without delay. When sugar levels are low, the brain does not receive enough oxygen, oxygen starvation occurs, which leads to the death of brain cells.
      In order for sugar to be approximately the same every day, you need to do everything at the same time - take drugs, eat a certain amount of carbohydrates. Follow up, perhaps on the eve of those days when sugar is low in the morning, mom eats little carbohydrates (less than usual), this leads to a decrease in sugar. You can't forget to eat.
      If cases of low sugars are regular, then you should consult a doctor. He will either postpone the drug to another time, or, most likely, reduce the dose of the drugs he takes.
      Well, physical activity also reduces sugar. Are there any factors contributing to these decreases on the eve of morning hypoglycemia (trips to the dacha, garden beds, just walking, cleaning around the house, etc.)

8. Hello. My father has type 2 diabetes. He is 65 years old, weight 125 kg. He doesn’t really want to be treated, but it’s difficult to force him. Since my knowledge is zero, and the patient has no zeal, I am in a stupor.

   Question about a specific situation
   he vomited yesterday afternoon, felt bad, refused an ambulance. (assumed that just poisoning). Then he slept all evening and all night.
   In the morning I asked to measure sugar and pressure, everything turned out to be elevated. 162 to 81, pulse 64, sugar 13.0.
   Please tell me what to do. Should I sound the alarm? What exactly to do?
   Thank you very much, urgent question.

9. Hello, all day long sugar is normal from 5 to 6. And on an empty stomach from 6 to 8 !!! How so? I go to bed at 6, and wake up at 7 ((((What happens at night? How to reduce or keep normal night sugar? In the afternoon, after any meal, sugar is always normal from 5 to 6. Please tell me. Thank you

10. hello, tell me please, I was diagnosed with DM2 4 months ago, i.e. in April, on an empty stomach, I donated blood was 8.6, they prescribed mitformin 850 one tablet in the evening and they kicked me off trying to be treated myself, I drink herbs sugar-reducing teas, I follow a diet sugar when something like 5.6 then 4.8 then 10 .5 I have a height of 168, I weigh 76.800 kg, I am doing exercises, now I was pulling out my teeth, the sugar has risen to 15, the pressure has dropped to 80/76, I feel bad, can I have some more pills to drink, please tell me

Type 2 diabetes is diagnosed in 90-95% of all diabetics. Therefore, this disease is much more common than type 1 diabetes. Approximately 80% of patients with type 2 diabetes are overweight, i.e. their body weight exceeds the ideal by at least 20%. Moreover, their obesity is usually characterized by the deposition of adipose tissue in the abdomen and upper body. The figure becomes like an apple. This is called abdominal obesity.

The main goal of the site is to provide an effective and realistic plan for the treatment of type 2 diabetes. It is known that fasting and strenuous exercise for several hours a day are excellent for this ailment. If you are ready to comply with a heavy regimen, then you definitely do not need to inject insulin. However, patients do not want to starve or “work hard” in physical education classes, even under pain of painful death from complications of diabetes. We offer humane ways to lower your blood sugar to normal levels and keep it consistently low. They are gentle on patients, but very effective.

Low Carb Type 2 Diabetes Diet Recipes

Below in the article you will find an effective type 2 diabetes treatment program:

• without starvation;
• without low-calorie diets, even more painful than complete starvation;
• without hard labor physical education.

Learn from us how to control type 2 diabetes, insure against its complications, and still feel full all the time. You don't have to go hungry. If you need insulin injections, then learn how to do them absolutely painlessly, and the dosages will be minimal. Our techniques allow in 90% of cases to effectively treat type 2 diabetes without insulin injections.

There is a well-known saying: “everyone has his own diabetes”, i.e., each patient has it in his own way. Therefore, an effective diabetes treatment program can only be individualized. However, the general strategy for treating type 2 diabetes is outlined below. It is recommended to use it as a foundation for building an individual program.

This note is a continuation of the article "". Please read the base article first, otherwise things may not be clear here. Below are the nuances of effective treatment when type 2 diabetes has already been accurately diagnosed. You will learn how to control this serious disease well. For many patients, our recommendations are a chance to refuse insulin injections. In type 2 diabetes, diet, exercise, pills and/or insulin are first determined for the patient, taking into account the severity of their disease. Then it is constantly adjusted, depending on the previously achieved results.

Thank you for your work, which really helps to change the way of life. Gives a chance to reach the level of a healthy person. Several years ago I was diagnosed with type 2 diabetes. Didn't take medicine. In mid-2014, I started measuring my blood glucose levels. It was 13-18 mmol/l. Started taking medication. Took them for 2 months. Blood sugar dropped to 9-13 mmol/l. However, the state of health as a result of medication was very poor. I will highlight the catastrophic decline in intellectual capabilities. Therefore, in October, I decided to stop taking medications .. I immediately switched to the recommended one. Now, after three weeks of the new diet, my blood glucose is 5-7 mmol/l. Until I began to reduce it further, bearing in mind the recommendation not to make a sharp decrease in sugar, if before that it had been high for a long time. Actually, there is no problem to reduce sugar to normal - everything is determined by personal self-control when following a low-carbohydrate diet. I don't use medicines. Feeling much better. Restored intellectual abilities. Chronic fatigue is gone. Some of the complications associated, as I now found out, with the presence of type 2 diabetes began to weaken. Thank you again. Blessed are your works. Nikolay Ershov, Israel.

How to effectively treat type 2 diabetes

First of all, study the section “” in the article “”. Follow the list of actions that are indicated there.

An effective type 2 diabetes management strategy consists of 4 levels:

• Level 1: .
• Level 2: Low-carbohydrate diet plus physical activity.
• Level 3: Low Carb Diet Plus Exercise Plus.
• Level 4. Complex, neglected cases. Low-carbohydrate diet plus exercise plus insulin shots, with or without diabetes pills.

If a low-carbohydrate diet lowers blood sugar, but not enough, that is, not to the norm, the second level is connected. If the second one does not completely compensate for diabetes, they switch to the third one, that is, they add pills. In complex and neglected cases, when a diabetic begins to take care of his health too late, the fourth level is involved. Inject as much insulin as needed to bring blood sugar back to normal. At the same time, they diligently continue to eat according to. If a diabetic is diligent in dieting and exercising with pleasure, then usually small doses of insulin are required.

A low-carbohydrate diet is absolutely essential for all type 2 diabetics. If you continue to eat foods overloaded with carbohydrates, then there is nothing to dream of getting diabetes under control. The cause of type 2 diabetes is that the body does not tolerate the carbohydrates that you eat. A carbohydrate-restricted diet quickly and powerfully lowers blood sugar. But still, for many diabetics, it is not enough to maintain blood sugar in the normal range, as in healthy people. In this case, it is recommended to combine diet with physical activity.

In type 2 diabetes, it is necessary to carry out intensive therapeutic measures in order to reduce the load on the pancreas. Due to this, the process of “burning out” of her beta cells will slow down. All activities are aimed at improving the sensitivity of cells to the action of insulin, i.e., reducing insulin resistance. It is necessary to treat type 2 diabetes with insulin injections only in rare severe cases, no more than 5-10% of patients. This will be discussed in detail at the end of the article.

What do we have to do:

• Read the article "". It also describes how to deal with this problem.
• Make sure you have an accurate glucometer () and then measure your blood sugar several times every day.
• Pay special attention to controlling your blood sugar after meals, but also on an empty stomach.
• Switch to a low-carbohydrate diet. Eat only, strictly avoid.
• Engage in physical education. The best thing to do is jogging using the high-health jogging technique, especially for type 2 diabetics. Physical activity is vital for you.
• If a low-carb diet combined with physical education is not enough, that is, your sugar after eating is still elevated, then add another dose to them.
• If all together - diet, physical education and Siofor - do not help enough, then only in this case you will also have to inject extended insulin at night and / or in the morning on an empty stomach. At this stage, you can not do without a doctor. Because the scheme of insulin therapy is made by an endocrinologist, and not independently.
• Never give up a low-carbohydrate diet, no matter what the doctor who will prescribe you insulin says. Read . If you see that the doctor prescribes doses of insulin "from the ceiling", and does not look at your records of the results of blood sugar measurements, then do not use his recommendations, but contact another specialist.

Keep in mind that in the vast majority of cases, only type 2 diabetics who are too lazy to exercise will have to inject insulin.

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1. Task 1 of 11

   1 .

   
   What is the main treatment for type 2 diabetes?

   Right
   

   Wrong
   

   The main treatment for type 2 diabetes is. Measure your sugar with a glucometer - and see if it really helps.

2. Task 2 of 11

   2 .

   What sugar should you aim for after eating?

   Right
   

   Wrong
   

   Sugar after eating should be, as in healthy people - no higher than 5.2-6.0 mmol / l. This can really be achieved with . Also control sugar in the morning on an empty stomach. Fasting glucose levels before meals are less important.

3. Task 3 of 11

   3 .

   Which of the following is most important for managing diabetes?

   Right
   

   Wrong
   

   The most important thing and the first thing to do is. If the glucometer is lying, then it will drive you to the grave. No treatment for diabetes will help, even the most expensive and fashionable. An accurate glucometer is vital to you.

4. Task 4 of 11

   4 .

   Harmful pills for type 2 diabetes are those that:

5. Task 5 of 11

   5 .

   If a patient with type 2 diabetes suddenly and inexplicably loses weight, then this means:

   Right
   

   Wrong
   

   The correct answer is that the disease progressed to severe type 1 diabetes. You need to inject insulin, you can’t do without it.

6. Task 6 of 11

   6 .

   What diet is optimal if a patient with type 2 diabetes injects insulin?

   Right
   

   Wrong
   

   A low-carbohydrate diet allows you to get by with minimal doses of insulin. It provides the best blood sugar control. If a diabetic injects insulin, this does not mean that he can eat whatever he wants.

7. Task 7 of 11

   7 .

   The main cause of type 2 diabetes is:

   Right
   

   Wrong
   

8. Task 8 of 11

   8 .

   What is insulin resistance?

   Right
   

   Wrong
   

   Insulin resistance is poor (reduced) sensitivity of cells to the action of insulin. This is the main reason for the development of type 2 diabetes. Read, otherwise you will not be able to effectively be treated.

9. Task 9 of 11

   9 .

   How to improve outcomes of type 2 diabetes treatment?

   Right
   

   Wrong
   

   Feel free to eat meat, eggs, butter, poultry skins and other tasty dishes. These products normalize blood sugar in diabetes. They increase not “bad”, but “good” cholesterol in the blood, which protects blood vessels.

10. Task 10 of 11

    10 .

    What should be done to prevent heart attack and stroke?

    Right
    

    Wrong
    

    Feel free to eat red meat, chicken eggs, butter and other delicious foods. They increase not “bad”, but “good” cholesterol in the blood, which protects blood vessels. This is the real prevention of heart attack and stroke, and not the restriction of fat in the diet. What blood tests you need to take and how to understand their results, read.

11. Task 11 of 11

    11 .

    How do you know exactly which treatments for type 2 diabetes are helping?

    Right
    

    Wrong
    

    Trust only your glucometer! At first . Only frequent measurements of sugar will help you know which diabetes treatments really help. All "authoritative" sources of information often deceive diabetic patients for financial gain.

What not to do

Do not take sulfonylurea tablets. Check if the diabetes pills you have been prescribed are in the sulfonylurea class. To do this, carefully read the instructions, section "Active substances". If it turns out that you are taking sulfonylurea derivatives, then stop them.

Why these drugs are harmful is told. Instead of taking them, control your blood sugar with a low-carbohydrate diet, physical activity, Siofor or Glucophage tablets, and if necessary, insulin. Endocrinologists like to prescribe combination pills that contain sulfonylurea derivatives + metformin. Switch from them to “pure” metformin, i.e. Siofor or Glucophage.

Thirdly, type 2 diabetics usually delay starting insulin therapy until the last minute, and this is very stupid. If such a patient suddenly and quickly dies of a heart attack, then we can say that he was lucky. Because there are worse options:

• Gangrene and amputation of the leg;
• Blindness;
• Painful death from kidney failure.

These are the complications of diabetes that you wouldn't wish on your worst enemy. So, insulin is a wonderful remedy that saves from close acquaintance with them. If it is obvious that you cannot do without insulin, then start injecting it quickly, do not waste time.

In the event of blindness or amputation of a limb, a diabetic usually has several more years of disability. During this time, he manages to think well about what an idiot he was when he didn’t start injecting insulin on time ... You should not treat this method of treating type 2 diabetes with “oh, insulin, what a nightmare”, but “hooray, insulin!”.

Goals of Type 2 Diabetes Treatment

Let's look at a few typical situations to show in practice what the real goal of treatment might be. Please read the article “ ” first. It contains basic information. The nuances of setting treatment goals for type 2 diabetes are described below.

Let's say we have a type 2 diabetic who manages to control his blood sugar with help and enjoy exercising. He manages to do without pills for diabetes and insulin. Such a diabetic should aim to maintain his blood sugar at 4.6 mmol/L ±0.6 mmol/L before, during and after meals. He will be able to achieve this goal by planning meals in advance. He should try to eat different amounts of low-carbohydrate foods until he determines the optimal size of his meals. Need to learn. Portions should be of such a size that a person gets up from the table full, but not overeaten, and at the same time blood sugar is normal.

Goals you need to strive for:

• Sugar 1 and 2 hours after each meal - not higher than 5.2-5.5 mmol / l
• Blood glucose in the morning on an empty stomach is not higher than 5.2-5.5 mmol / l
• Glycated hemoglobin HbA1C - below 5.5%. Ideal - below 5.0% (least mortality).
• Indicators of "bad" cholesterol and triglycerides in the blood - within the normal range. "Good" cholesterol - may be higher than normal.
• Blood pressure all the time not higher than 130/85 mm Hg. Art., there are no hypertensive crises (you may also need to take supplements for hypertension).
• Atherosclerosis does not develop. The condition of the blood vessels does not worsen, including in the legs.
• Good blood tests for cardiovascular risk (C-reactive protein, fibrinogen, homocysteine, ferritin). These are more important tests than cholesterol!
• The loss of vision stops.
• Memory does not deteriorate, but rather improves. Thinking activity too.
• All symptoms of diabetic neuropathy disappear without a trace within a few months. Including diabetic foot. Neuropathy is a completely reversible complication.

Suppose he tried to eat on a low-carbohydrate diet, and as a result of this, his blood sugar after eating turns out to be 5.4 - 5.9 mmol / l. The endocrinologist will say that this is excellent. But we will say that it is still above the norm. A 1999 study showed that in this situation, the risk of a heart attack is increased by 40%, compared with people whose blood sugar after eating does not exceed 5.2 mmol / l. We strongly recommend to such a patient to further reduce his blood sugar and bring it to the level of healthy people. Health running is a very enjoyable activity, and it works wonders in normalizing blood sugar.

If it is not possible to persuade a patient with type 2 diabetes to engage in physical education, then he is prescribed Siofor (Metformin) tablets in addition to a low-carbohydrate diet. The drug Glucofage is the same Siofor, but with prolonged action. It is much less likely to cause side effects - bloating and diarrhea. He also believes that Glucofage lowers blood sugar 1.5 times more efficiently than Siofor, and this justifies its higher price.

Years of experience with diabetes: a complex case

Consider a more complex case of type 2 diabetes. The patient, a long-term diabetic, follows a low-carbohydrate diet, takes metformin, and even exercises. But his blood sugar after eating still remains elevated. In such a situation, in order to lower blood sugar to normal, you must first find out after which meal blood sugar rises the most. This is done within 1-2 weeks. And then experiment with the time of taking the pills, and also try to replace Siofor with Glucophage. Read how to control high blood sugar in the morning on an empty stomach and after meals. In the same way, you can act if your sugar usually rises not in the morning, but at lunch or in the evening. And only if all these measures do not help well, then you have to start injecting “extended” insulin 1 or 2 times a day.

Suppose a patient with type 2 diabetes still had to be treated with “extended” insulin at night and / or in the morning. If he complies, then he will need small doses of insulin. The pancreas continues to produce its own insulin, although it is not enough. But if blood sugar falls too low, then the pancreas automatically shuts off insulin production. This means that the risk of severe is low, and you can try to lower your blood sugar to 4.6 mmol/L ±0.6 mmol/L.

In severe cases, when the pancreas has already completely “burned out”, patients with type 2 diabetes require not only injections of “extended” insulin, but also injections of “short” insulin before meals. In these patients, essentially the same situation as in type 1 diabetes. The treatment regimen for type 2 diabetes with insulin is prescribed only by an endocrinologist, do not do it yourself. Although it will be useful to read the article "" in any case.

Causes of non-insulin dependent diabetes - in detail

Experts agree that the cause of type 2 diabetes is primarily. The loss of the ability of the pancreas to produce insulin occurs only in the later stages of the disease. At the onset of type 2 diabetes, an excess amount of insulin circulates in the blood. But it does not lower blood sugar well, because the cells are not very sensitive to its action. Obesity is hypothesized to cause insulin resistance. And vice versa - the stronger the insulin resistance, the more insulin circulates in the blood and the faster the fat tissue accumulates.

Abdominal obesity is a specific type of obesity in which fat accumulates in the abdomen, in the upper body. A man who has developed abdominal obesity will have a waist circumference larger than the hip circumference. A woman with the same problem will have a waist circumference equal to 80% or more of her hip circumference. Abdominal obesity causes insulin resistance, and the two reinforce each other. If the pancreas is unable to produce enough insulin to meet the increased demand, type 2 diabetes occurs. In type 2 diabetes, there is not enough insulin in the body, but on the contrary, it is 2-3 times more than normal. The problem is that the cells react badly to it. Stimulating the pancreas to produce even more insulin is a dead end treatment.

The vast majority of people in today's abundance of food and a sedentary lifestyle are prone to developing obesity and insulin resistance. As fat accumulates in the body, the load on the pancreas gradually increases. Eventually, the beta cells can't keep up with producing enough insulin. The level of glucose in the blood becomes higher than normal. This, in turn, has an additional toxic effect on pancreatic beta cells, and they die en masse. This is how type 2 diabetes develops.

Differences between this disease and type 1 diabetes

The treatment of type 1 and type 2 diabetes is similar in many ways, but there are also significant differences. Understanding these differences is the key to successful blood sugar control. Type 2 diabetes develops more slowly and gently than type 1 diabetes. Blood sugar in type 2 diabetes rarely rises to “cosmic” heights. But still, without careful treatment, it remains elevated, and this causes the development of complications of diabetes, which lead to disability or death.

Elevated blood sugar in type 2 diabetes impairs nerve conduction, damages blood vessels, the heart, eyes, kidneys, and other organs. Since these processes usually do not cause obvious symptoms, type 2 diabetes is called the “silent killer”. Obvious symptoms may appear even when the damage has become irreversible - for example, kidney failure. Therefore, it is important not to be lazy to follow the regimen and perform therapeutic measures, even if nothing hurts yet. When it hurts, it will be too late.

Initially, type 2 diabetes is less serious than type 1 diabetes. At least the patient is not in danger of “melting” into sugar and water and dying painfully within a few weeks. Since there are no acute symptoms at first, the disease can be very insidious, gradually destroying the body. Type 2 diabetes is the leading cause of kidney failure, lower limb amputations and blindness worldwide. It contributes to the development of heart attacks and strokes in diabetics. They are also often accompanied by vaginal infections in women and impotence in men, although these are trifles compared to a heart attack or stroke.

Insulin resistance is in our genes

We are all descendants of those who survived long periods of famine. Genes that determine an increased tendency to obesity and insulin resistance are very useful in case of food shortage. This comes at the price of an increased tendency to type 2 diabetes in the well-fed time in which humanity lives now. several times reduces the risk of type 2 diabetes, and if it has already begun, it slows down its development. For the prevention and treatment of type 2 diabetes, it is best to combine this diet with exercise.

Insulin resistance is partially caused by genetic causes, i.e. heredity, but not only them. The sensitivity of cells to insulin is reduced if excess fat in the form of triglycerides circulates in the blood. Strong, albeit temporary, insulin resistance in laboratory animals is caused by intravenous injections of triglycerides. Abdominal obesity is a cause of chronic inflammation, another mechanism for increasing insulin resistance. Infectious diseases that cause inflammatory processes act in the same way.

The mechanism of the development of the disease

Insulin resistance increases the body's need for insulin. An elevated level of insulin in the blood is called hyperinsulinemia. It is needed to “push” glucose into cells in conditions of insulin resistance. To provide hyperinsulinemia, the pancreas works with increased load. Excess insulin in the blood has the following negative consequences:

• increases blood pressure;
• damages blood vessels from the inside;
• further enhances insulin resistance.

Hyperinsulinemia and insulin resistance form a vicious circle, mutually reinforcing each other. All the symptoms listed above are collectively called. It lasts for several years, until the beta cells of the pancreas “burn out” due to the increased load. After that, elevated blood sugar is added to the symptoms of the metabolic syndrome. And that's it - you can diagnose type 2 diabetes. Obviously, it is better not to lead to the development of diabetes, but to start prevention as early as possible, even at the stage of the metabolic syndrome. The best means of such prevention is, as well as physical education with pleasure.

How does type 2 diabetes develop? Genetic causes + inflammation + triglycerides in the blood - all this causes insulin resistance. This, in turn, causes hyperinsulinemia, an elevated level of insulin in the blood. This stimulates increased accumulation of adipose tissue in the abdomen and waist. Abdominal obesity raises blood triglyceride levels and exacerbates chronic inflammation. All this further reduces the sensitivity of cells to the action of insulin. In the end, the beta cells of the pancreas can no longer cope with the increased load and gradually die. Fortunately, breaking the vicious circle leading to type 2 diabetes is not that difficult. This can be done with a low-carbohydrate diet and exercise with pleasure.

We've saved the most interesting for last. It turns out that the bad fat that circulates in the blood in the form of triglycerides is not the fat you eat at all. Elevated triglyceride levels in the blood are not due to the consumption of dietary fat, but due to the consumption of carbohydrates and the accumulation of adipose tissue in the form of abdominal obesity. Read the details in the article "". In adipose tissue cells, it is not the fats that we eat that accumulate, but those that the body produces from dietary carbohydrates under the action of insulin. natural Dietary fats, including saturated animal fat, are vital and beneficial to health.

Insulin production in type 2 diabetes

People with type 2 diabetes who are newly diagnosed usually still produce some amount of their own insulin. What's more, many of them actually produce more insulin than lean people without diabetes! It’s just that the body of diabetics no longer has enough of its own insulin due to the development of severe insulin resistance. The generally accepted treatment for type 2 diabetes in this situation is to stimulate the pancreas to produce even more insulin. Instead, it is better to act to increase the sensitivity of cells to the action of insulin, i.e. alleviate insulin resistance ().

If properly and thoroughly treated, then many type 2 diabetics will be able to bring their sugar back to normal without insulin injections at all. But if not treated or treated by “traditional” methods of domestic endocrinologists (high-carbohydrate diet, sulfonylurea tablets), then sooner or later the beta cells of the pancreas will “burn out” completely. And then injections of insulin will become absolutely necessary for the survival of the patient. Thus, type 2 diabetes smoothly transitions into severe type 1 diabetes. Read below how to properly treat to prevent this.

Answers to frequently asked questions from patients

I have been suffering from type 2 diabetes for 10 years. For the last 6 years, I have been regularly treated twice a year in a day hospital. Berlition is being dripped on me, Actovegin, Mexidol and Milgamma are being injected intramuscularly. I feel that these funds do not bring much benefit. So should I go back to the hospital?

The main treatment for type 2 diabetes is. If you do not follow it, but eat a “balanced” diet that is overloaded with harmful carbohydrates, then there will be no sense. No pills or droppers, herbs, conspiracies, etc. will help. Milgamma is B vitamins in large doses. In my opinion, they bring real benefits. But they can be replaced with . Berlition is a dropper with alpha-lipoic acid. They can be tried for diabetic neuropathy, in addition to a low-carbohydrate diet, but by no means in place of it. Read. How effective are Actovegin and Mexidol - I don't know.

I was diagnosed with type 2 diabetes 3 years ago. I take Diaglazid and Diaformin tablets. Now I am losing weight catastrophically - my height is 156 cm, my weight has dropped to 51 kg. Sugar is high, although the appetite is weak, I eat little. HbA1C - 9.4%, C-peptide - 0.953 at a rate of 1.1 - 4.4. How would you recommend treatment?

Diaglazide is a sulfonylurea derivative. These are harmful pills that finished off (exhausted, “burned”) your pancreas. As a result, your type 2 diabetes progressed to severe type 1 diabetes. Give the endocrinologist who prescribed these pills a big hello, rope and soap. In your situation, insulin can no longer be dispensed with. Start stabbing him quickly, until irreversible complications develop. Learn and do. Diaformin also cancel. Unfortunately, you found our site too late, so now you will inject insulin for the rest of your life. And if you are too lazy, then within a few years you will become disabled from the complications of diabetes.

My blood test results: fasting sugar - 6.19 mmol / l, HbA1C - 7.3%. The doctor says it's prediabetes. Registers me as a diabetic, prescribed Siofor or Glucophage. The side effects of the pills are scary. Is it possible to somehow recover without taking them?

Your doctor is right - it's prediabetes. However, in such a situation, it is possible and even easy to do without pills. Go to, try to lose weight at the same time. But don't go hungry. Read articles, and. Ideally, along with the diet, you also have to do it.

Does the maximum amount of sugar after a meal matter? I have it the highest half an hour after dinner - it goes off scale for 10. But then after 2 hours it is already below 7 mmol / l. Is this more or less normal or completely bad?

What you describe is not more or less normal, but not good at all. Because in the minutes and hours when blood sugar is high, the complications of diabetes are in full swing. Glucose binds to proteins and disrupts their work. If you pour sugar solution on the floor, it will become sticky and difficult to walk on. In the same way, proteins coated with glucose “stick together”. Even if you don't have diabetic foot, kidney failure, or blindness, you still have a very high risk of a sudden heart attack or stroke. If you want to live, then diligently follow our type 2 diabetes treatment program, do not be lazy.

My husband is 30 years old. He was diagnosed with type 2 diabetes a year ago and had a blood sugar of 18.3. Now we keep sugar only with a diet not higher than 6.0. The question is - do I need to inject insulin and / or take some kind of pills?

You didn't write the main thing. Sugar is not higher than 6.0 - on an empty stomach or after a meal? Fasting sugar is bullshit. Only sugar after meals matters. If you are good at controlling post-meal sugar with your diet, then keep up the good work. No pills or insulin needed. If only the patient did not break from the "hungry" diet. If you indicated fasting sugar, and after eating you are afraid to measure it, then this is sticking your head in the sand, as ostriches do. And the consequences will be appropriate.

Within a year, I was able to control type 2 diabetes through diet and exercise, losing weight from 91 kg to 82 kg. I recently broke loose - I ate 4 sweet eclairs, and even washed down cocoa with sugar. When I later measured sugar, I was surprised, because it turned out to be only 6.6 mmol / l. Is this a remission of diabetes? How long can it last?

Sitting on a "hungry" diet, you have reduced the load on your pancreas. Thanks to this, she partially recovered and managed to withstand the blow. But if you return to an unhealthy diet, then the remission of diabetes will end very soon. Moreover, no physical education will help if you overeat carbohydrates. Stable control of type 2 diabetes allows not low-calorie, but. I recommend that you go for it.

I am 32 years old and was diagnosed with type 2 diabetes 4 months ago. I switched to a diet and lost weight from 110 kg to 99 kg with a height of 178 cm. Thanks to this, sugar returned to normal. On an empty stomach, it is 5.1-5.7, after eating it is not higher than 6.8, even if you eat a little fast carbohydrates. Is it true that with a diagnosis of diabetes, I will have to take pills later and then become dependent on insulin? Or can you just stick with the diet?

It is possible to control type 2 diabetes for life with diet, without pills and insulin. But for this you need to observe, and not the low-calorie “hungry” diet that is promoted by official medicine. From a starvation diet, the vast majority of patients break down. As a result, their weight rebounds and the pancreas “burns out”. After several such jumps, it is really impossible to do without pills and insulin. In contrast, a low-carbohydrate diet is filling, delicious, and even luxurious. Diabetics follow it with pleasure, do not break down, live normally without pills and insulin.

Recently, I accidentally took a blood test for sugar during a physical examination. The result was increased - 9.4 mmol / l. A doctor friend took Maninil tablets from the table and said to take them. Is it worth it? Is it type 2 diabetes or not? Sugar is not too high. Please, advise how to be treated. Age 49 years, height 167 cm, weight 61 kg.

You are lean and not overweight. Skinny people don't get type 2 diabetes! Your disease is called LADA - type 1 diabetes in a mild form. Sugar is really not too high, but much higher than normal. This problem should not be left unattended. Start treatment so that complications do not develop on the legs, kidneys, and vision. Don't let diabetes ruin the golden years ahead of you.

I am 37 years old, programmer, weighed 160 kg. I keep my type 2 diabetes under control with a low-carb diet and physical education, I have already lost 16 kg. But it is difficult to do mental work without sweets. Is it long? Will I get used to it? And the second question. As far as I understand, even if I lose weight to the norm, I follow my diet and play sports, I will still switch to insulin sooner or later. How many years will pass before that?

So that you do not yearn for sweets, I advise you to take supplements. First, chromium picolinate as described. And then there's my secret weapon, powdered L-Glutamine. Sold in sports nutrition stores. If you order from the USA using the link, it will be cheaper by one and a half times. Dissolve a heaping teaspoon in a glass of water and drink. The mood quickly rises, the desire to overeat disappears, and all this is 100% harmless, even beneficial for the body. Read more about L-glutamine in Atkins' book "Bio Supplements". Take when you feel an acute desire to "sin" or prophylactically 1-2 cups of the solution every day, strictly on an empty stomach.

My mother decided to get tested because she was worried about pain in her leg. They found sugar in the blood 18. The diagnosis is insulin-independent diabetes. HbA1C - 13.6%. Glucovans tablets were prescribed, but they do not reduce sugar at all. Mom lost a lot of weight, her ankle began to turn blue. Did the doctors prescribe the right treatment? What to do?

Your mother already has type 2 diabetes has progressed to severe type 1 diabetes. Start injecting insulin immediately! I hope it's not too late to save my leg from amputation. If mom wants to live, then let her study and diligently fulfill it. Refuse injections of insulin - do not even dream! Doctors in your case have shown negligence. After you normalize sugar with insulin injections, it is advisable to complain about them to higher authorities. Glucovans cancel immediately.

I have type 2 diabetes for 3 years now. Height 160 cm, weight 84 kg, lost 3 kg in 3 months. I take Diaformin tablets, I keep a diet. Fasting sugar 8.4, after eating - about 9.0. HbA1C - 8.5%. One endocrinologist says to add Diabeton MB tablets, another says to start injecting insulin. Which option to choose? Or treated differently?

I advise you to quickly switch to and strictly observe it. Also get busy. Continue taking Diaformin, but don't start Diabeton. Why Diabeton is harmful, read. Only if after 2 weeks on a low-carb diet your post-meal sugar remains above 7.0-7.5, then start injecting. And if this is not enough, then you will also need injections of fast insulin before meals. If you combine a low-carbohydrate diet with exercise and diligently follow the regime, then with a probability of 95% you will do without insulin at all.

I was diagnosed with type 2 diabetes 10 months ago. At that time, fasting sugar was 12.3 - 14.9, HbA1C - 10.4%. I switched to a diet, I eat 6 times a day. I eat protein 25%, fat 15%, carbohydrates 60%, the total calorie content is 1300-1400 kcal per day. Plus exercise. I have already lost 21 kg. Now I have fasting sugar 4.0-4.6 and after eating 4.7-5.4, but more often below 5.0. Isn't this too low?

Official blood sugar standards for diabetics are 1.5 times higher than for healthy people. That's probably why you're worried. But we on the site recommend that all diabetics strive to keep their sugar exactly like people with a healthy carbohydrate metabolism. Read. You just get it right. In that sense, there is nothing to worry about. Another question - how long can you hold out like this? You are following a very strict regimen. Control diabetes by severe hunger. I'm betting that sooner or later you will break and the "bounce" will be a disaster. Even if you don't break, what's next? 1300-1400 kcal per day is too little, does not cover the needs of the body. You will have to increase the daily caloric content of the diet or you will begin to stagger from hunger. And if you add calories at the expense of carbohydrates, then the load on the pancreas will increase and sugar will go up. In short, go to . Add daily calories from protein and fat. And then your success will last for a long time.

So you've read what an effective type 2 diabetes treatment program is. The main remedy is a low-carbohydrate diet, as well as physical activity according to the method of physical education with pleasure. If proper diet and exercise are not enough, then drugs are used in addition to them, and in extreme cases, insulin injections.

We offer humane methods to control blood sugar, and at the same time effective. They give the maximum chance that a patient with type 2 diabetes will comply with the recommendations. However, in order to effectively treat your diabetes, you will need to invest time and make significant life changes. I want to recommend a book that, although not directly related to the treatment of diabetes, will increase your motivation. This book is "Younger Every Year".

Its author, Chris Crowley, is a former lawyer who, after his retirement, learned to live for his own pleasure, and in a regime of austerity of money. Now he is diligently engaged in physical education, because he has an incentive to live. At first glance, this is a book about why it is advisable to exercise in old age to slow down aging, and how to do it right. More importantly, she says For what lead a healthy lifestyle and what benefits you can get from it. The book has become a reference book for hundreds of thousands of American pensioners, and the author has become a national hero. For readers of the site, the site "information for thought" from this book will also be very useful.

Patients with type 2 diabetes in the early stages may experience “jumps” in blood sugar from high to very low. The exact cause of this problem is considered to be unproven yet. A low-carbohydrate diet perfectly “smoothes out” these jumps, so that the well-being of patients improves quickly. However, from time to time blood sugar can drop to 3.3-3.8 mmol/L. This applies even to those patients with type 2 diabetes who are not treated with insulin.

If with type 2 diabetes you are ready to do anything, as long as you don’t have to “sit down” on insulin, great! Follow a low-carbohydrate diet carefully to reduce stress on your pancreas and keep your beta cells alive. Learn how to enjoy exercising and do it. Conduct periodically. If your sugar is still elevated on a low-carb diet, experiment with.

Wellness jogging, swimming, cycling or other types of physical activity are ten times more effective than any sugar-lowering pills. In the vast majority of cases, Insulin has to be injected only for those patients with type 2 diabetes who are too lazy to exercise. Physical activity is a pleasure, but insulin injections are an inconvenience. So “think for yourself, decide for yourself”.