by Alessandra Montelli
Until a few years ago the 2 type diabetes it was defined adult diabetes (because it started after age 30) or non-insulin-dependent (because the treatment did not involve insulin injection). But today these two definitions are outdated because they no longer represent correctly the differences between the two types of diabetes: type 2 diabetes can also arise in childhood or adolescence, and in severe cases it is treated not only for via pharmacalogical and dietetics, but also through theinsulin injection.
What is that
In type 2 diabetes the insulin secretion it is inadequate.
Insulin levels are often very high, especially in the early stages of the disease, but the insulin resistance at the level of peripheral tissues and the increased production of glucose by the liver make the insulin levels inadequate to normalize i blood sugar levels. Insulin production subsequently drops, further exacerbating the hyperglycemia.
The disease usually it develops in adults and it becomes more frequent as we age. Blood sugar levels reach higher post-prandial values in the elderly than in younger adults, especially after ccarbohydrate rings and return to normal more slowly, in part due to the increased amount of accumulated abdominal fat and the reduction of muscle mass.
Diabetes is suspected for having typical symptoms and signs and confirmed by blood glucose measurement. It is done after an 8-12 hour fast (Fasting Plasma Glucose, fasting plasma glucose - FPG) or 2 hours after ingestion of a concentrated glucose substance (Oral Glucose Tolerance Testing - OGTT).
The values they indicate presence of diabetes I'm:
- FPG > 126 (>7,0)
- OGTT> 200 (> 11,1)
Instead, we have impaired glucose regulation, When:
- FPG is between 100 and 125
- OGTT is included 140-199
The abbreviations, we remember, mean: FPG = basal fasting blood glucose;
OGTT = oral glucose tolerance test, blood sugar at 2 hours.
The most common symptoms of type 2 diabetes are those ofhyperglycemia: in primis frequency of urinary e feeling of intense thirst which can progress to hypotension and dehydration.
A severe dehydration causes weakness, exhaustion, and changes in mental status. Symptoms arise based on fluctuations in blood sugar. Sometimes one may appear feeling of exaggerated hunger, especially when blood glucose values are high.
Hyperglycemia can also cause weight loss, nausea and vomiting, visual disturbances and can predispose to bacterial or fungal infections.
Sometimes type 2 diabetes it can be asymptomatic and is diagnosed by chance following routine tests.
The diet is usually tailored to individual needs of diabetic patients, who can thus control the fluctuations in blood glucose values.
Usually, the doctor suggests completing the specialist visit (from the diabetologist or internist) to one nutritional advice explaining what to eat and what to avoid. In general, those with type 2 diabetes must follow a low-fat diet saturated fatty acids and cholesterol and with modest quantities of carbohydrates, preferably coming from whole grains or ad high fiber content.
We also recommend limit calorie intake but still to eat regularly: this helps to reduce weight, one of the factors often associated with 2 type diabetes.
To facilitate the choice of foods recommended for diabetics, the FAND (Association of the country Diabetes) has drawn up dietary guidelines:
- it is good avoid: refined sugars, jams, sweets, sauces and fatty dressings such as butter, lard and margarine;
- you can consume in moderation: fruit, paying attention to the most sugary fruits (grapes, bananas, figs, persimmons, mandarins), dietetic baked goods for diabetics, chestnuts, potatoes, corn, legumes (to be consumed in combination with cereals);
- it's possible to eat: raw and cooked vegetables, fish, complex carbohydrates (bread, pasta, rice, rusks) and whole grains, olive oil, cheeses, leaner cold cuts (cooked ham, raw ham, bresaola, speck, roast turkey and chicken) , both red and white meat, skimmed milk and yogurt.
(Fonte: Merck Manual of Diagnosis and Therapy)