type 2 diabetes
Introduction
Introduction to Type II Diabetes Type II diabetes is also called adult-onset diabetes, which occurs after 35 to 40 years of age, accounting for more than 90% of diabetic patients. In patients with type 2 diabetes, the ability to produce insulin is not completely lost. In some patients, insulin is even excessive, but the effect of insulin is greatly reduced. Therefore, insulin in patients is relatively lacking and can be stimulated by certain oral drugs. Insulin secretion in the body. Some patients with type 2 diabetes are mainly insulin resistant, patients are obese, insulin resistance, insulin sensitivity is decreased, blood insulin is increased to compensate for insulin resistance, but insulin secretion is still relatively insufficient compared with patients with high blood sugar. The early symptoms of these patients are not obvious, only mild fatigue, thirst, and large blood vessel and microvascular complications can often occur before the diagnosis is confirmed. Dietary therapy and oral hypoglycemic agents are more effective. Another part of the patients is mainly caused by insulin secretion defects, and it is clinically necessary to supplement exogenous insulin. basic knowledge Prevalence ratio: 8.3% (according to the latest statistics from the International Diabetes Federation (IDF), the prevalence of diabetes worldwide in 2013 is 8.3% among adults aged 20-79 years) Susceptible population: more than 35 to 40 years old, accounting for more than 90% of diabetic patients. Mode of infection: non-infectious Complications: cardiovascular disease, kidney damage, diabetic foot
Cause
Causes of type II diabetes
Genetic factors (30%):
Similar to type 1 diabetes, type 2 diabetes is also characterized by family onset. It is therefore likely to be related to genetic inheritance. This genetic characteristic type II diabetes is more pronounced than type 1 diabetes. For example, one of the twins has type 1 diabetes and the other has a 40% chance of developing the disease; but in the case of type 2 diabetes, the other has a 70% chance of developing type 2 diabetes.
Obesity (20%):
An important factor in type 2 diabetes may be obesity. Genetic causes can cause obesity, as well as type 2 diabetes. Excess fat in body-centered obese patients is concentrated in the abdomen, and they are more likely to develop type 2 diabetes than those whose fat is concentrated on the buttocks and thighs.
Age (15%):
Age is also a contributing factor to type 2 diabetes. Half of patients with type 2 diabetes often develop after 55 years of age. The prevalence of diabetes in older patients is also associated with the overweight of older people.
High calorie diet (10%):
Eating high-calorie foods and reducing the amount of exercise can also cause diabetes, which is thought to be caused by obesity.
Prevention
Type II diabetes prevention
Primary prevention
Establish a correct attitude to eating and adopt a reasonable lifestyle. Although there are certain genetic factors in diabetes, the key is life factors and environmental factors. Excessive calorie intake, overnutrition, obesity, and lack of exercise are important causes of the disease. Proper calorie intake, low salt, low sugar, low fat, high fiber, and sufficient vitamins are the best dietary compatibility.
Secondary prevention
Blood glucose is measured regularly to detect asymptomatic diabetes as early as possible. Blood glucose measurement should be included in the routine physical examination items of middle-aged and old people, even if it is normal, it should be measured regularly. Anyone with a history of diabetes, such as skin dysfunction, sexual dysfunction, poor vision, polyuria, cataract, etc., should be measured and carefully identified in time, in order to diagnose as early as possible, to win valuable time for early treatment.
Tertiary prevention
People with diabetes are prone to other chronic diseases, and patients are life-threatening due to complications. Therefore, it is necessary to strengthen the monitoring of chronic complication of diabetes, to achieve early detection, early prevention, and in the advanced stage, the effect is often poor. Early diagnosis and early treatment can often prevent the occurrence of complications, so that patients can live close to normal life for a long time.
Complication
Type II diabetes complications Complications cardiovascular disease kidney damage diabetic foot
Impaired glucose tolerance, acute complications such as ketoacidosis and chronic diseases such as cardiovascular, kidney, eye and nervous system.
Symptom
Symptoms of Type II Diabetes Common Symptoms Increased blood glucose levels, fatigue, polydipsia, weight loss, visual impairment, gastrointestinal emptying, diabetic foot lesions
The symptoms associated with type 2 diabetes are related to metabolic disorders, especially three more and one less. In type 2 diabetes, it is often not very obvious or only partially manifested; in addition, the performance is characterized by various acute and chronic complications. .
1, more urine
Because the blood sugar is too high, exceeding the renal sugar threshold (8.89 ~ 10.0mmol / L), the glucose filtered by the glomerulus can not be completely reabsorbed by the renal tubules, forming osmotic diuretic. The higher the blood sugar, the more urine sugar is excreted, and the more urine, the 24h urine volume can reach 5000~10000ml. However, in the elderly and those with kidney disease, the renal sugar threshold is increased, and the urine sugar is excreted. When the blood sugar is mildly moderate, the polyuria may not be obvious.
2, drink more
Mainly due to hyperglycemia, the plasma osmotic pressure is significantly increased, combined with polyuria, excessive water loss, intracellular dehydration, increased hyperglycemia, further increase plasma osmotic pressure, stimulate thirst center, leading to thirst and polydipsia. Drink more to further increase polyuria.
3, eat more
The mechanism of eating more is not very clear. Most scholars tend to have a decrease in glucose utilization (difference in glucose concentration in arteriovenous blood before and after in and out of tissue cells). When the normal person is fasting, the difference of glucose concentration in arteriovenous blood is reduced, which stimulates the feeding center and produces hunger. After eating, the blood sugar rises, the difference in arteriovenous blood increases (greater than 0.829mmoL/L), the feeding center is inhibited, and the stomach is full. The center is excited and the feeding requirements disappear. However, due to the absolute or relative lack of insulin or tissue insensitivity to insulin, the ability of tissue to take up glucose is reduced. Although blood glucose is at a high level, the difference in glucose concentration between arteriovenous blood is small, and the tissue cells are actually in a state of starvation. ", thereby stimulating the feeding center, causing hunger and eating more; in addition, the body can not fully utilize glucose, a large amount of glucose is excreted from the urine, so the body is actually in a semi-starved state, and energy deficiency also causes appetite hyperactivity.
4, weight loss
Diabetes patients have normal or even increased appetite and food intake, but their weight loss is mainly due to absolute or relative lack of insulin or insulin resistance. The body can not fully utilize glucose to produce energy, resulting in increased fat and protein decomposition, excessive consumption, and negative nitrogen balance. The weight gradually declines and even loses weight. Once diabetes is properly treated and well controlled, weight loss can be controlled and even picked up. For example, if a person with diabetes continues to lose weight or lose weight during treatment, it may indicate poor metabolic control or other chronic wasting diseases.
Examine
Examination of type 2 diabetes
Type II diabetes is caused by the inability of insulin to function effectively (less binding to the receptor). Therefore, not only the fasting blood glucose should be checked, but also the blood glucose should be observed 2 hours after the meal, especially the islet function test.
Fasting blood glucose in normal people: 3.9-6.1 mmol/L, and blood glucose below 7.8 mmol/L for 2 hours after meal. For example, fasting blood glucose 7.0 mmol / liter, blood glucose 11.1 mmol / liter 2 hours after a meal, can diagnose diabetes. For example, fasting blood glucose is 6.1-7.0 mmol/L, and blood glucose between 7.8-11.1 mmol/L after 2 hours of meal is impaired in glucose regulation, which is a manifestation of early diabetes. The urine sugar test is for reference only and cannot be used to diagnose diabetes and medication. Islet function test: The tester observed changes in blood glucose, insulin and C-peptide after oral administration of 75 g of glucose water 300 ml.
Diagnosis
Diagnosis and diagnosis of type II diabetes
Diagnostic criteria for type 2 diabetes
1, have diabetes symptoms. Diabetes can be diagnosed by any of the following: a, fasting blood glucose 7.8mmol/L; b, blood glucose 11.1mmol/L at any time of the day; c, fasting blood glucose <7.8mmol/L, but oral 75% glucose tolerance test Two hours of blood glucose 11.1mmol / L.
2, no symptoms of diabetes. Diabetes can be diagnosed by any of the following: a, two fasting blood glucose 7.8mmol / L; b, 1 and 2 hours of blood glucose in the first oral 75g glucose tolerance test are 11.1mmol / L, repeat glucose tolerance The blood glucose level was 11.1mmol/L for two hours or that the fasting blood glucose was 7.8mmol/L.
3. Impaired glucose tolerance. Fasting blood glucose <7.8mmol / L, two hours after oral administration of 75g glucose, blood glucose between 7.811.1mmol / L.
Diagnose based on
Type II diabetes is caused by the inability of insulin to function effectively (less binding to the receptor). Therefore, not only the fasting blood glucose should be checked, but also the blood glucose should be observed 2 hours after the meal, especially the islet function test.
The specific values are as follows: normal human fasting blood glucose: 3.9-6.1mmoL / L, blood glucose 7.8-8.9mmoL / L 2 hours after a meal. If fasting blood glucose 7.0mmoL/L, blood glucose 11.1mmoL/L 2 hours after a meal can diagnose diabetes. For example, fasting blood glucose is 6.1-7.0mmoL/L, and blood glucose is between 7.0-11.1mmoL/L 2 hours after a meal is abnormal glucose tolerance, which is the manifestation of early diabetes. The urine sugar test is for reference only and cannot be used as a basis for returning medication.
Islet function test: The tester observed the changes of blood sugar, insulin and C peptide after taking 100 g of steamed bread or 300 ml of 75 g of sugar water.
Differential diagnosis of type 2 diabetes
Should be differentiated from type 1 diabetes.
