Type 2 diabetes
Diabetes is defined by an excess of sugar in the blood (or hyperglycemia) beyond 1.26 g / l fasting or 2 g / l non-fasting. There are several types of diabetes are the two main type 1 and type 2.
Only type 2 diabetes (formerly called non-insulin dependent diabetes) is discussed in this chapter. Diabetes type 2 usually occurs from 40-50 years, and its onset is earlier and earlier due to eating habits and mode sedentary life. Patients with type 2 diabetes often combine several risk factors for cardiovascular disease should detect and prevent: overweight, hypertension, excess lipids in the blood inactivity.
Risks and consequences of type 2 diabetes
Diabetes is a chronic disease more common in industrialized countries. Prevalence (number of diabetics / population) of treated diabetes is estimated at 3.8%. Diabetes affects an estimated 3 million individuals (types 1 and 2 combined), but experts agree that this figure is grossly underestimated because one third of diabetics are unaware of their condition.
In fact, diabetes can initially remain completely silent. Its complications are, however, a major public health issue, in terms of both medical and economic. Cardiovascular complications are the leading cause of death in patients with type 2 diabetes.
Causes and origins of type 2 diabetes
Type 2 diabetes is due to a defect in glucose utilization by the cells of the body. Unlike type 1 diabetes, insulin produced by the pancreas is not lacking (the rate is normal), but may not be used by the cells of the diabetic patient to include a reference to sugar as fuel. We talk about insulin resistance and the result is an increase in blood sugar (hyperglycemia).
Signs and symptoms of type 2 diabetes
The onset of symptoms is usually insidious and completely silent. The diabetic patient who is unaware lives quite normally until complications reveal his illness. Screening by measurement of blood glucose is essential.
The complications of diabetes are the severity of the disease. The chronic excess sugar in the blood causes symptoms of irreversible damage to the eyes, kidneys and nerves: diabetic microangiopathy is responsible for blindness, renal failure or progressive loss of sensitivity feet. Vessels larger sizes are also affected and responsible for macroangiopathy (risk of myocardial infarction, stroke or amputation).
Type 2 diabetes Prevention
With what should we be confused?
Type 2 diabetes should not be confused with other types of diabetes, type 1. The latter (formerly called diabetes mellitus) occurs mostly in children and young adults and for 170,000 people. There is often a sudden weight loss, thirst and increased urination.
Diabetes insipidus in turn corresponds to a water leak due to a hormonal abnormality: urine volume can reach 10 l / day.
Is there a prevention possible?
Adopt a balanced diet adapted to their lifestyle should be a priority for any diabetic. Similarly, it is essential to perform regular physical activity (eg, walking 30 minutes three times per week), reduce other risk factors for cardiovascular disease by controlling weight.
The objective is to obtain a body mass index (ie your weight / your height squared) less than 25, by reducing cholesterol and stopping smoking. Vaccination against influenza is also part of the recommendations, diabetic subjects are more sensitive and more susceptible to infections.
Finally, diabetic feet should be reviewed regularly (skin deformations) and pampered (port shoe care, pedicures ...). An annual visit to the eye doctor and dentist complete prevention.
Type 2 diabetes Preparing consultation
When to consult?
The type 2 diabetes is most often asymptomatic for years.
Only testing can highlight hyperglycemia. This screening, in the form of a blood laboratory fasting is useful from 45 patients with another risk factor (overweight, hypertension, high cholesterol, family history ...) . Screenings are also regularly offered in pharmacies during campaigns.
What does the doctor in case of type 2 diabetes?
The doctor, in coordination with the specialist (diabetologist, endocrinologist) will confirm the diagnosis by blood tests and possibly other tests to detect an origin, risk factors or complications of diabetes. Risk factors for cardiovascular disease may be associated with diabetes are smoking, overweight or obesity, hypertension and disorders of fat. The initial assessment is therefore used to determine the treatment and monitoring of disease.
The main goal of diabetes treatment is to control blood glucose (blood sugar). Other treatments used to control weight, blood pressure and reduce fat levels in the blood, or to stop smoking. The treatment first call to the diet and the resumption of regular physical activity. If necessary, oral medications or insulin, as a transitional or permanent, may be indicated.
How to prepare my next visit?
Measurement by the patient capillary blood glucose on a drop of blood (self) is important in some cases between consultations. The glycemic goal set by the doctor and the rhythm monitoring. A blood test (glycated hemoglobin or HbA1c) every 3 months to check glycemic control.
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