Diabetes

Symptoms of diabetes|type 1 vs type 2 diet food Treatment of diabetes

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symptoms of diabetes
symptoms of diabetes

diabetic food list

Knowing what to eat in diabetes is important to keep the blood sugar rate constant, avoiding hypoglycemia and hyperglycemia.

In diabetes, it is recommended to increase the consumption of fiber-rich foods in all meals since they help to control blood glucose, and foods high in fats and sugars should be avoided since they favor the increase of sugar levels in the diet. blood worsening diabetes

Not only is feeding important, doing physical activity such as walking for 30 to 60 minutes daily helps control blood sugar, because the muscle uses glucose during exercise. Before exercising, the individual should make a small snack so that the sugar does not go down a lot during exercise, avoiding dizziness, nausea and discomfort.

Fruits that must be ingested
Foods that must be ingested
Foods that must be ingested
Fruits that must be ingested

The table below helps the patient with diabetes to find out which foods are allowed, which foods are prohibited and which foods should be avoided:

symptoms of diabetes
type 1 vs type 2 diabetes
diet diabetic food list diabetes
Treatment of diabetes

Allowed

Prohibited

Avoid

Legumes such as beans, lentils, chickpea, sweet potatoes, rice and wholemeal pasta.Fritters like French fries, fried egg, pastries, breaded.Baubles, puff pastry, white rice and potato
Fruits such as apple, pear, orange, peach, kiwi, melon, grapefruit, strawberries; always preferably with the shell.Vegetables such as lettuce, broccoli, zucchini, chayota, mushrooms, onion, tomato, spinach, tomato, cauliflower, chile, eggplant.Fruits such as dates, fig, coconut, raisins, grapes, watermelon, banana, pineapple.Vegetables like beets and squash.Canned fruits such as figs and peaches, jams.
Whole grains such as sugarless muesli, flaxseed, chia.Vegetable fat, sweets in general, sweet popcorn.Salted popcorn
Low-fat meats such as chicken, fishing, rabbit, seafood.Sausages such as bacon, salami, mortadella, chorizos, ham, lard.Pork meat.
Complex carbohydrates such as bread, cake or a wholemeal sponge cake, whole pancakes.Simple carbohydrates such as cakes, bread type white bread, sweet biscuits, sponge cakes, potatoes, corn, corn flakes, pretzels, pancakes, waffles.Sweets and jellies.
Stevia or stevia sweetener.Sugar, honey, mashed sugar, jams, syrup, sugar cane, paper.Sweeteners with aspartame and sucralose.
White cheeses low in fat, cottage cheese.Cream of milk, butter, yellow cheeses.Cottage cheese, cream cheese like Philadelphia.
Water, natural fruit juice with sugar.Alcoholic beverages, industrialized juices and soft drinks.Pasteurized juices and diet sodas.
Milk and nonfat yogurts.Milk and full yogurts.Greek yogurts.

The ideal thing for a diabetic is to always eat small portions of food for 3 to 3 hours, making 3 main meals and 2 to 3 snacks per day (mid-morning, mid-afternoon and before bedtime), always trying to eat Always perform at the same time and avoid spending a lot of time without eating.

The fruits allowed in diabetes should not be consumed in isolation, they should be accompanied with other foods and, preferably, at the end of a main meal such as breakfast, lunch or dinner, always in small portions that correspond to around 100 g of fruit. It is important to prefer the consumption of the whole fruit and not in juice, because the fiber content is lower.

symptoms of diabetes

Recent studies indicate that early detection and treatment of diabetes symptoms can decrease the possibility of complications of diabetes.

Next, we will explain a little more about the reason for these symptoms:

Each of the cells of the body needs energy to survive. People get the energy by converting the food they eat into fats and sugars ( glucose ). This glucose travels through the bloodstream as a normal component of the blood. The blood cells then take a small amount of glucose from the blood to use it as energy. The substance that allows the cell to take glucose from the blood is a protein called insulin .

Insulin is produced by the beta cells found in the pancreas . The pancreas is an organ that is located near the stomach.

When blood glucose increases, beta cells secrete insulin into the bloodstream and distribute it to all cells in the body. Insulin adheres to proteins on the surface of the cell and allows sugar to pass from the blood to the cell, where it is converted into energy.

A person with type 2 diabetes or gestational diabetes can not produce a sufficient amount of insulin or the one they produce is not “sensitive,” meaning that the body can not use it properly. A person with type 2 diabetes produces nothing or very little insulin.

Without the necessary insulin, the cells of the body can not use the glucose that is in the blood and they begin to be hungry while the glucose is accumulating in the sanguineous torrent.

In response to this lack of energy in the cells, the brain sends signals that tell the body to eat more. Meanwhile, other body cells try to get energy by breaking down fat cells and muscle. The liver can convert muscle proteins into glucose. Then a vicious cycle begins: It creates more glucose but can not be transformed into energy because there is not enough insulin to carry glucose from the bloodstream to the cells of the body.

When there is a lot of glucose in the blood, the body tries to get rid of it by means of urine. The urine of healthy people, does not contain sugar. In people with diabetes, excess glucose absorbs water just like a sponge would. People produce excessive amounts of urine because of all this water. All this urine makes the person feel thirsty, so he takes water too much.

All of the above is due to a lack of insulin that causes people with diabetes to develop the classic symptoms of diabetes: They lose weight but have a lot of appetite, drink excess water and go to the bathroom constantly.

type 1 vs type 2 diabetes

There are different types of diabetes in which the treatment, the trigger, the evolution and the symptomatology in the diagnosis are quite distant, that is why we explain the types of diabetes focusing on type 1, type 2 diabetes, its definition and its differences.

Diabetes mellitus is a metabolic disorder that is characterized by the presence of hyperglycemia (elevation of blood glucose concentration) as a direct result of a lack of insulin, insulin insufficiency or both.

Etymologically the word diabetes derives from the Latin and Greek classics which means “spending of sugar” and with it the doctors of the first century d. of C. wanted to describe the disease that was manifested by these essential findings, large volume of sweet-tasting urine (polyuria), intense thirst (polydipsia) and weight loss despite a greater appetite (polyphagia).

Diabetes mellitus is classified into four categories based on the underlying mechanism that causes hyperglycemia:

  • Type 1: formerly called insulin-dependent diabetes mellitus DMID or infant-juvenile onset diabetes. There is an absolute insufficiency of insulin. Exogenous insulin is required for glycemic control.
  • Type 2: formerly called non-insulin-dependent diabetes mellitus NIDDM or diabetes or diabetes onset at maturity: insulin resistance with varying defects in destruction. There is no destruction of pancreatic B islets. It is usually associated with more advanced ages, frequently from the age of 40, but it is also diagnosed in children and adolescents with obesity, which, together with gestational diabetes and family history of diabetes, are associated in type 2 diabetes. based on diet, avoid sedentary life, sometimes with oral drugs and also with insulin.
  • Gravidic diabetes or gestational diabetes, of appearance in pregnancy.
  • Other types of diabetes:
  • genetic defects in the function of pancreatic islets (so-called adult-onset diabetes in MODY youth where insulin secretion is altered but defects in the action of insulin are scarce).
  • Genetic defects in the action of insulin (alterations in the insulin receptor)
  • Endocrinopathies: excessive hormonal secretion as occurs in Cushing’s syndrome (due to excessive cortisol), acromegaly (excessive production of growth hormones in adults).
  • Drugs or chemical substances: glucocorticoids, interferon …
  • Diseases of the exocrine pancreas: pancreatitis, trauma, surgery, infection, and pancreatic cancer.
  • Other genetic syndromes such as Down syndrome, Klinefelter and Turner syndrome.

In order to analyze diabetes, it is important to take into account certain qualities that distinguish it:

  • It is a chronic disease that has no cure and needs constant care in order to optimize metabolic control without detriment to the quality of life.
  • It is very frequent, it affects a wide margin of the population and its incidence and prevalence increase constantly using terms of the epidemic.
  • It can affect a wide range of ages, from young children to the elderly. The incidence of type 2 diabetes has increased in children, together with the increase in childhood obesity.
  • The medical advances in their treatment have increased the longevity and improved the quality of life of people with diabetes thanks to the self-control of blood glucose, to the use of these data to modify the pharmacological guideline and the habits of life to fulfill the therapeutic plan.
  • Diabetes can affect many organs and can cause serious complications derived from the elevation of blood glucose and its damage to blood vessels and nerves, causing the vasculopathy and neuropathy that we know as chronic complications (retinopathy, nephropathy, cardiovascular disease, and neuropathy). In addition, people with diabetes can suffer acute complications from intercurrent diseases and treatment (hypoglycemia, ketosis.

Diabetes type 1

It is characterized by the autoimmune destruction of the beta cells of the pancreas, by insulinitis mediated by antibodies against the beta cells of the islets and by complete insulinopenia, which translates into a forced need for exogenous insulin.

It represents between 5-10% of cases of diabetes and its maximum incidence occurs between 10-15 years.

The factors that are associated with its appearance are: environmental, genetic and autoimmune. According to this theory, a series of environmental factors such as viruses (mumps, rubella) and chemical substances induce an aggression of the pancreatic beta cells by the immune system. Due to a genetic predisposition, some people are more sensitive to environmental factors. So we know that in twins if one suffers from the disease, the brother’s risk rises 25-50%. If the father or mother suffers from diabetes, the risk is also increased, greater if the affected one is the father and also depends on the age of the mother at the time of delivery without the exact reason being known.

Of the patients with type 1 diabetes, 85% have antibodies against circulating islet cells, anti-insulin antibodies, especially against glutamic acid decarboxylase inside the beta cells.

We use the determination of C-peptide to check if the patient is able to secrete endogenous insulin. If there is no C-peptide, total beta-cell failure has been diagnosed, with type 1 diabetes diagnosed with more than 90% of beta cells destroyed forever, with a variable rate of destruction in infants and children faster than in adults.

We also know the association of type 1 diabetes with other autoimmune diseases: Hashimoto’s thioroiditis, celiac disease, Addison’s disease, Graves disease, pernicious anemia …

His presentation is sharp and often acute with a picture of ketoacidosis.

Type 2 diabetes

Type 2 diabetes is more common than type 1 diabetes and accounts for up to 90% or more of all diabetes cases.

People who have a high risk of suffering from type 2 diabetes are:

  • Those who are obese (more than 20% above their ideal body weight)
  • They have a family member with diabetes.
  • They belong to an ethnic risk group.
  • They have been diagnosed with gestational diabetes or have given birth to a newborn of more than 4.1 Kg.
  • They have a high blood pressure 140/90 mmHg or higher.
  • They have a low HDL (good cholesterol) concentration lower than 35 mg / dl.
  • They have a high concentration of triglycerides, greater than 250.
  • Sedentary life.
  • Consume large amounts of alcohol.
  • They had altered fasting glucose values ​​(100-125) or altered glucose in the overload test (less than 199 at 2 hours).
  • Advanced age. More than 40% of diabetic patients are 65 years of age or older.
  • The use of concomitant medications such as diuretics and corticosteroids increase the risk of type 2 diabetes.

Having a slower onset (sometimes discovered over several years) is considered to be a milder diabetes that is often controlled with diet, exercise and oral drugs. However, patients with type 2 diabetes are at the same risk of serious complications as patients with type 1 diabetes.

DIFFERENCES BETWEEN DIABETES TYPE 1 AND TYPE 2

Although both type 1 and type 2 diabetes are characterized by hyperglycemia they present different signs and symptoms.

DIFFERENCES BETWEEN DIABETES TYPE 1 AND TYPE 2
DIFFERENCES BETWEEN DIABETES TYPE 1 AND TYPE 2

what causes diabetes

Causes of diabetes The aging of the population and changes in lifestyles are the two factors that most influence the progressive increase of diabetes . Thus, the change in eating habits and the growing sedentary lifestyle and increased physical inactivity, which cause obesity , have as a direct consequence that the disease is increasing in almost everyone.

There are conditions that increase the likelihood of developing diabetes: advanced age and the presence of other diseases such as obesity and high blood pressure , as well as the family history of diabetes, are factors that significantly influence the development of this disease.

In some cases, diabetes may be secondary to some specific circumstance: alcohol consumption (especially in males), some drugs (corticosteroids, anti-inflammatories, contraceptives in women), kidney diseases, and others.

It is worth distinguishing the two fundamental types of diabetes to differentiate their causes :

  • In type 1 diabetes, two possible mechanisms of disease are considered. On the one hand, the most frequent cause of diabetes I am usually autoimmune, that is, the individual’s defenses progressively destroy the beta cells of the pancreas, which is where insulin is produced, and therefore the patient with this type of diabetes does not produce insulin. That’s why your treatment always has to be with this one. It is not clear yet if the stimulus for their defenses to destroy these cells is generated by a virus. A small percentage of type 1 diabetics do not have an autoimmune mechanism, so it is considered to be of unknown cause.
  • In type 2 diabetes, that of the adult, multiple mechanisms are known by which it develops. It seems that one of the causes of type 2 diabetes is an interaction between a lower production of insulin and an insulin resistance in the tissues of the body. Aging itself produces a decrease in the production of insulin, some drugs, some pancreatic diseases such as chronic pancreatitis , obesity that decreases insulin’s ability to act due to greater peripheral resistance due to fat.

Treatment of diabetes

The goal of diabetes treatment is not so much to control blood sugar but to decrease the mortality rate. Always insist on the modification of lifestyle. This change can control the numbers without the need for medication, especially in the early stages of diagnosis and if the level of glycosylated hemoglobin (HbA1C) is below 8.5%, although the overall goal will be below 7%.

If the diabetes is uncontrolled, in the initial phase it is very important to achieve the disappearance of the symptoms derived from hyperglycemia: polyuria, polydipsia, fatigue. When HbA1C is above 8.5% it is recommended to start with drugs such as metformin.

Acute decompensation of the disease should be avoided, and the onset or progression of chronic complications should be delayed: both in the large arteries and heart (macroangiopathy), and in small arteries in the kidney, retina, and nerves (microangiopathy).

You have to individualize objectives; Although there are some general and common measures for all patients, each diabetic needs an individualized treatment.

Treatment of non-pharmacological diabetes

Weight loss is the key factor in reducing the risk of diabetes in people at high risk and overweight. Without having to reach an ideal weight, a moderate reduction of 5-10% can be very beneficial for the control of diabetes.

Dietary control, avoiding refined sugars (“sweet” and derivatives), smoking abstinence if you are a smoker, and physical activity, are other essential measures to reduce the risk of complications.

Treatment of pharmacological diabetes

The treatment of pharmacological diabetes is based on the use of “pills”, sometimes associated with insulin.

The reference antidiabetic drug for the treatment of diabetes is metformin. There are other groups of drugs whose utility will be valued by the doctor in each case; These are sulfonylureas, such as gliclazide, glibenclamide, glinides, and thiazolindiones or glitazones.

Two new drug groups belonging to a new class of diabetes treatments are also available. Some are the DPP-4 inhibitors, such as sitagliptin, vidagliptin; and the others, the so-called GLP-1 analogs, such as exenatide and liraglutide.

The insulin

When it is not possible to control diabetes with the measures referred to above, the use of insulin is essential. Around 5-10% of diabetic people need treatment with insulin since the diagnosis.

Basically, insulin are classified by their mode-duration of action in:

  • Regular insulin (fast action): start 30 to 60 minutes – maximum 2-4 hours – duration 5 to 7 hours.
  • Intermediate (slow action): start 1 to 2 hours – maximum 5-7 hours – duration 12 to 13 hours.
  • Mixtures, sharing characteristics of the previous ones.
  • Rapid analogues (start 15 min / duration 4 h), intermediate (start 2 h / duration 15 h) and slow (start 2 h / duration 18 h).

All are subject to inter and intraindividual variability, so the dose adjustment has to be done in a specific way for each patient, according to the measurement of blood glucose levels.

Other aspects to consider in the treatment of diabetes

In addition to specific measures aimed at controlling sugar, other risk factors such as hypertension and cholesterol must always be kept under control. In most cases it is also necessary to use drugs to treat these problems.

The benefit of pharmacological treatment is highest in high-risk patients, that is, those who have the worst controlled diabetes and have other associated risk factors, such as hypertension, smoking , cholesterol, obesity ….

It is essential to comply well with the treatment prescribed by the doctor and be as scrupulous as possible in the follow-up of dietary measures. You have to know the side effects and learn to recognize hypoglycemia and how to treat them.

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