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Ce este diabetul de tip 2?

3 ani ago
Chiroiu Mircea Ionut

Diabetul de tip 2 este o boala cronica in care organismul nu este in masura sa controleze in mod adecvat nivelurile de glucoza (zahar) din sange, ceea ce poate duce la glicemie periculos de mare (hiperglicemie).

Simptomele diabetului de tip 2 variaza de la setea crescuta, urinarea frecventa, oboseala extrema si vindecarea lenta a ranilor.

Pe masura ce boala progreseaza, se pot dezvolta complicatii mai grave, inclusiv tulburari ale pielii, disfunctii sexuale, boli renale, leziuni ale nervilor si pierderea vederii.

Diabetul zaharat tip 2 se dezvolta atunci cand pancreasul incepe sa produca mai putina insulina (un hormon care controleaza nivelul zaharului din sange) sau cand organismul devine mai putin sensibil la efectele insulinei, cunoscuta sub denumirea de rezistenta la insulina. Un simplu test de sange poate diagnostica diabetul de tip 2.

Dupa ce a fost verificat, tratamentul depinde de factori precum varsta, greutatea, nivelul de zahar din sange si cat de avansata este boala.

Pentru unii oameni, acest lucru ar putea insemna sa se bazeze doar pe modificari ale stilului de viata, cum ar fi pierderea in greutate, modificari dietetice si exercitii fizice.

Pentru altii, gestionarea diabetului de tip 2 poate necesita si insulina suplimentara si / sau medicamente pentru diabet.

Diabetul de tip 2 Simptome

In primele etape ale diabetului de tip 2, majoritatea oamenilor nu prezinta simptome evidente. Abia cand nivelul glicemiei devine foarte ridicat , incep sa apara simptomele. Lasat netratat, diabetul de tip 2 poate duce la complicatii grave si chiar debilitante sau complicatii care pot pune viata in pericol.

Simptome

Cele mai frecvente simptome ale diabetului de tip 2 includ: 1

  • Poliuria: o crestere a urinarii care apare atunci cand rinichii atrag apa din tesut, pentru a dilua excesul de glucoza in sange si a o alunga din corp. Rinichii nu sunt capabili sa reabsoarba acest fluid, ceea ce duce la urinare mai frecventa.
  • Polidipsia: setea excesiva. Pe masura ce corpul trage apa din tesuturi, corpul se deshidrateaza, ceea ce determina ca unor pacienti sa le fie sete mai tot timpul.
  • Oboseala extrema: Deoarece pancreasul produce prea putina insulina sau organismul nu este capabil sa o utilizeze corect, celulele din organism sunt private de glucoza care este principala sursa de energie. Rezultatul: oboseala si oboseala extrema.
  • Polifazie: Aceasta este foamea excesiva care apare atunci cand celulele nu sunt in masura sa acceseze glucoza, care declanseaza hormoni care trimit semnale foamei catre creier.
  • Neuropatie: amorteala, furnicaturi sau senzatia de intepaturi care apare in timp, deoarece excesul de zahar dauneaza nervilor.
  • Vindecarea lenta a ranilor: excesul de zahar din sange afecteaza circulatia, ingreunand accesul sangelui in zonele ranite pentru ca vindecarea sa aiba loc.

Schimbarea vederii: Atunci cand lichidul este extras din lentilele ochilor pentru a ajuta la diluarea glicemiei in sange, capacitatea de concentrare este afectata, iar vederea poate fi incetosata. Deteriorarea ochilor poate aparea chiar inainte de a exista un diagnostic de diabet.

Simptomele mai putin frecvente ale diabetului de tip 2 includ:

  • Gura uscata.
  • Piele uscata.
  • Acanthosis nigricans (pete de catifea inchisa in inghinarea axilelor, pliurile pielii si articulatiile degetelor si degetelor de la picioare).
  • Infectii frecvente.
  • Pierdere in greutate inexplicabila.

Complicatiile bolii

Atunci cand nu este gestionat bine, diabetul de tip 2 poate duce la o serie de complicatii grave, debilitante si chiar potentiale fatale; cele mai multe rezultate din deteriorarea vaselor de sange mici (daune microvasculare) sau deteriorarea vaselor de sange mari (leziuni macrovasculare).

  • Nefropatie (boala renala).
  • Neuropatie (leziuni nervoase care afecteaza cel mai adesea mainile si picioarele, dar pot duce si la disfunctie erectila).
  • Retinopatie (deteriorarea retinei ochiului care poate duce la pierderea vederii).
  • Boala arteriala periferica (o boala care afecteaza vasele din extremitatile inferioare si superioare).
  • Hipertensiune arteriala (hipertensiune arteriala).
  • Boala de inima.
  • Gastroparesis (leziuni nervoase care afecteaza stomacul).
  • Depresie.

Cauze

Diabetul zaharat de tip 2 este rezultatul uneia dintre cele doua situatii: fie pancreasul incepe sa elibereze prea putina insulina, un hormon eliberat in cateva minute de la mancare pentru a ajuta organismul sa pastreze glucoza, sau organismul nu este capabil sa raspunda adecvat la insulina (rezistenta la insulina).

Exista o serie de factori de risc pentru diabetul de tip 2:

  • Obezitate: Aceasta este una dintre cauzele majore ale diabetului. Excesul de grasime corporala poate provoca rezistenta la insulina.
  • Stil de viata sedentar: Activitatea fizica ajuta organismul sa foloseasca insulina, astfel incat miscarea prea mica pe parcursul zilei poate creste riscul de diabet de tip 2.
  • Genetica: Istoricul familial este un indicator mai semnificativ al riscului de diabet de tip 1.
  • Varsta: Riscul de diabet de tip 2 creste odata cu varsta.
  • Etnicitate: diabetul de tip 2 tinde sa fie mai frecvent la persoanele afro-americane, american-mexicane, native americane, indigene hawaiene, insula din Pacific si asiatice americane – in special la cei care au supraponderale si sedentare.
  • Consumul de tutun: Fumatul poate creste glicemia si poate duce la rezistenta la insulina. Conform Centrelor de Control si Prevenire a Bolilor, fumatorii au mai multe sanse de 30% pana la 40% sa dezvolte diabet de tip 2 decat nefumatorii.

Diagnostic

Diabetul este diagnosticat cu unul sau mai multe dintre urmatoarele teste de sange, care pot fi repetate daca rezultatele sunt neconcludente:

  • Test de zahar din sange: O masurare a zaharului din sange dupa opt ore de la ultima masa.
  • Test de toleranta la glucoza: Un test al raspunsului organismului la zahar efectuat prin faptul ca o persoana bea o bautura care contine 75 de grame de zahar pe parcursul a doua ore, dupa care se masoara glicemia.
  • Hemoglobina A1c: analizeaza nivelul de glucoza pe parcursul a trei luni.
  • Test aleator de zahar din sange: Test de sange efectuat pe cineva care prezinta simptome de diabet, cum ar fi setea crescuta, oboseala, urinarea crescuta.

Tratament

Oricine este diagnosticat cu diabet zaharat tip 2 va fi recomandat sa faca anumite modificari ale stilului de viata. In functie de cat de avansata este boala si de alti factori individuali, tratamentul poate include, de asemenea, insulina suplimentara si / sau medicamente.

Modificari ale stilului de viata

Modificarile simple pot merge mult spre mentinerea diabetului de tip 2 sub control si poate chiar inversarea cursului sau.

  • Pierderea in greutate: Pierderea a doar 5% pana la 10 la suta din greutatea corporala poate imbunatati considerabil controlul zaharului din sange, conform Johns Hopkins Medicine. (De fapt, scaderea kilogramelor poate avea un efect atat de profund de glucoza din sange, incat pentru persoanele diagnosticate cu prediabet, aceasta cantitate de pierdere in greutate poate scadea riscul de a progresa spre diabetul de tip 2 cu 58 la suta.)
  • Modificari dietetice: O dieta echilibrata, cu continut scazut de carbohidrati si bogata in legume non-amidonice, proteine ​​slabe si grasimi sanatoase poate sustine pierderea in greutate, precum si controlul glicemiei.
  • Exercitiu fizic: Activitatea fizica poate juca un rol esential in gestionarea zaharurilor din sange si prevenirea complicatiilor diabetului. De asemenea, exercitiile fizice regulate pot ajuta la pierderea in greutate. Conform ADA, adultii cu diabet ar trebui sa obtina cel putin 150 de minute de activitate fizica aeroba cu intensitate moderata pe saptamana. 7
  • Incetarea fumatului: Lovitura obisnuita va ajuta la controlul glicemiei.

Daca modificarile stilului de viata nu dau rezultate, exista diferite categorii de medicamente care pot fi administrate (inhibitori DDP-4,  Mimetice cu incretina, Inhibitori selectivi ai transportorului 2 de sodiu-glucoza (SSGT-2), Analogii de amilina, sulfonilureice, biguanide, Inhibitori alfa-glucozidazei, Tiazolidindionele, meglitinide).

Insulina

Daca modificarile stilului de viata si medicatia nu sunt suficiente pentru a controla nivelul de zahar din sange, poate fi necesara insulina suplimentara. Insulina se administreaza de obicei cu un ac si o seringa de mai multe ori pe zi.

Unele persoane cu diabet zaharat de tip 2 care iau medicamente orale pot avea nevoie de o singura injectie de insulina in fiecare zi. Altii pot avea nevoie de injectii de insulina de doua, trei sau de patru ori pe zi pentru a-si atinge tintele glicemiei.

De asemenea, insulina poate fi administrata printr-o pompa de insulina sau un plasture care este purtat pe corp.

Testarea zaharului din sange

Testarea frecventa a glicemiei este o piatra de temelie a gestionarii eficiente a diabetului, oferind o imagine despre cat de eficiente sunt dieta, exercitiile fizice, insulina si / sau medicamentele in reglarea nivelului de glucoza.

Rezultatele testelor pot furniza de asemenea, informatii valoroase unui medic pentru a ajuta la ajustarea planului dvs. general de ingrijire. Testarea glicemiei utilizeaza un dispozitiv mic care poate masura nivelul glucozei prin analizarea unei picaturi de sange prelevate de la un deget.

Chiroiu Mircea Ionut

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