Diabetic Diet: Today we will discuss briefly on our most common disease and that is Diabetes, mostly its comes up with two critical stage and that is Type 1 Diabetes and Type 2 Diabetes so we have briefly explained on what are the symptoms and treatments of this disease.
What is Type 1 Diabetes?
The type 1 diabetes happens when the production of insulin the pancreas is insufficient because your cells suffer from autoimmune destruction. The pancreas loses the ability to produce insulin due to a defect in the immune system, causing our antibodies to attack the cells that produce the hormone. In this scenario, the body ends up attacking the cells that produce insulin because they no longer recognize them as being of the person. Type 1 diabetes occurs in about 5 to 10% of patients with diabetes. Type 1 diabetes patients require daily insulin injections to maintain normal blood glucose and life-threatening if insulin doses are not given daily. Type 1 diabetes, although occurring at any age, is more commonly diagnosed in children, adolescents, or young adults.
What is Type 2 diabetes?
It is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.
Symptoms of Type 1 Diabetes
- Willing to urinate several times a day
- Frequent hunger
- Constant sweat
- Weight loss (in some cases it occurs even with excessive hunger)
- Mood swings
- Nausea and vomiting
Unlike type 2 diabetes, where these symptoms install gradually, in type 1 diabetes they appear quickly, especially, frequent urination, excessive thirst and weight loss . If the diagnosis of type 1 diabetes is late, the body’s cells may not be able to get the glucose needed to produce all the energy they need. In this scenario, the body begins to break down fat and muscle to generate energy. When fat is used to produce energy, ketone bodies are produced and enter the bloodstream, causing an imbalance called diabetic ketoacidosis chemistry. The symptoms of diabetic ketoacidosis are:
A reddish, hot, dry skin; Loss of appetite, abdominal pain and vomiting; A strong, fruity odor on the breath, called ketone breath; Breathing fast and deep.
Symptoms of Type 2 diabetes
People with type 2 diabetes usually have no symptoms at first and may not have symptoms for many years The initial symptoms of diabetes caused by a high blood sugar may include:
- Infection in the bladder, kidney, skin or other infections that are more common or heal slowly
- Increased thirst
- Increased urination
- Blurry vision
- After many years, diabetes can lead to serious health problems, and as a result, many other symptoms.
Causes of Type 1 Diabetes
Type 1 diabetes develops because the body’s immune system destroys beta-pancreatic cells, which are responsible for making insulin. Therefore, people with type 1 diabetes can not make their own insulin in adequate amounts. Type 1 diabetes can happen because of a genetic inheritance in conjunction with environmental factors such as viral infections. Insulin is needed to get blood sugar into cells, where glucose can be stored or used as a source of energy. In type 1 diabetes, beta cells produce little or no insulin. This causes glucose to not enter the cells, accumulating in the blood and leading to type 1 diabetes.
Causes of Type 2 Diabetes
Insulin is a hormone produced in the pancreas by special cells called beta. The pancreas is below and behind the stomach. Insulin is needed to move the sugar in the blood (glucose) to the cells. Within cells, it is stored and subsequently used as an energy source.
When you have type 2 diabetes, adipocytes, hepatocytes, and muscle cells do not respond well to insulin. This is called insulin resistance. As a result of this, blood sugar does not enter these cells in order to be stored as an energy source.
When sugar can not enter the cells, a high level of this accumulates in the blood, which is called hyperglycemia. The body is unable to use glucose as energy. This leads to the symptoms of type 2 diabetes.
Typically, type 2 diabetes develops slowly over time. Most people with this disease are overweight or obese at the time of diagnosis. Increased fat makes it difficult for the body to use insulin in the right way.
Type 2 diabetes can also occur in thin people. This is more common in older adults.
Family history and genes play an important role in type 2 diabetes. Low activity, poor diet, and excessive body weight around the waist increase the risk of developing this disease.
Treatment of Type 2 Diabetes
The goal of treatment at the outset is to lower the high blood sugar level. The long-term goals are to prevent complications. These are health problems as a result of diabetes.
The most important way to treat and manage type 2 diabetes is by being active and eating healthy foods.
All people with diabetes should receive adequate education and support on the best ways to manage their diabetes. Ask your doctor about seeing a diabetes educator and a dietician.
LEARN THESE SKILLS
Learning diabetes management skills will help you live well with the disease. These skills help avoid health problems and the need for medical care. These skills include:
- How to evaluate and record your blood sugar level
- What, when and how much to eat
- How to increase your activity and control your weight safely
- How to take medications, if needed
- How to recognize and treat high and low blood sugar levels
- How to handle the days when you are sick
- Where to buy diabetes supplies and how to store them
Learning these skills can take several months. Keep learning about the disease, its complications and how to control and live with it. Stay current on new research and treatments.
Treatment of Type 1 Diabetes
The treatment of correct type 1 diabetes involves maintaining a healthy life and controlling blood glucose in order to avoid possible complications of the disease. Major care for diabetes includes:
Physical activity is essential in the treatment of diabetes to keep blood sugar levels in check and to avoid the risks of weight gain. The practice of exercises should be performed three to five times a week. There are restrictions in cases of hypoglycaemia, especially for patients with type 1 diabetes. Therefore, people with very low blood glucose should not start physical activity, at risk of further lowering levels. On the other hand, if diabetes is uncontrolled, with very high glycemia, exercise can cause the release of counterregulatory hormones, further increasing glycemia. In all cases, patients with diabetes should always agree with their doctors on the best options. Remembering that the ideal is to favor light physical activities, because when the caloric expenditure is higher than the nutrient replacement after the training, there may be hypoglycaemia.
People with diabetes should avoid the simple sugars present in sweets and simple carbohydrates such as pasta and breads as they have a very high glycemic index . When a food has low glycemic index, it slows the absorption of glucose. But when the rate is high, this absorption is fast and speeds up the increase in blood glucose rates. Carbohydrates should make up 50-60% of the total calories consumed by the person with diabetes, preferring complex carbohydrates (nuts, nuts, whole grains) that will be absorbed more slowly.
When exercising, it is important to check the glycemic control before starting the activity, to choose the best food – if the blood glucose is too low, it is advisable to give preference to carbohydrates, as well as avoid them if you are high. The choice of food also depends on the type of exercise: long-term aerobic exercises (such as running and swimming) tend to lower blood glucose levels, requiring a greater intake of food.
Check blood glucose
All people with type 1 diabetes need to take insulin daily. However, it is important to do self-examination to check your glucose at home. To do this measurement is necessary to have at home a meter, a device capable of measuring the exact concentration of glucose in the blood. There are different types of appliances. Usually, the person drills the finger with a small needle called a lancet. A small drop of blood appears on the tip of the finger. The blood is placed in a reagent strip which is inserted into the apparatus. The results appear in about 30 to 45 seconds.
The doctor or other professional working with diabetes will help set a timeline for home-made tests. Your doctor will help you set patient glucose target goals, which should be based on test results to change your meals, activities, or medications and thus keep your glucose levels normalized. This can help identify high and low blood glucose levels before they cause problems.
Types of insulin
- Regular Insulin: It is a fast insulin and has a clear color. After it is applied, it starts from half to one hour, and its maximum effect is between two and three hours after application.
- Insulin NPH: is an intermediate insulin and has a milky color. The acronym NPH that say Neutral Protamine Hagedorn, being Hagedorn the surname of one of its creators and Protamina the name of the substance that is added to the insulin to delay its time of action. After being applied, its onset occurs between two and four hours, its maximum effect is between four to 10 hours and its duration is from 10 to 18 hours.
- Insulin analogue: Modified insulin molecules that our body naturally produces, and may have ultrarapid action or slow action. There are some types of ultrafast analogs available in the Brazilian market, they are: Asparte, Lispro and Glulisina. After being applied, its onset of action takes five to 15 minutes and its maximum effect is between one half and two hours. There are also two types of long action: Glargina and Detemir. Analogous Glargine insulin has an onset of action between two to four hours after it is applied, has no peak action and works for 20 to 24 hours. The analogue Detemir has an onset of action between one and three hours, action peak between six and eight hours and duration from 18 to 22 hours.
- Premix: consists of special preparations that combine different types of insulin in various proportions. It can be 90:10, ie 90% slow or intermediate insulin and 10% fast or ultrafast insulin. They can also have other proportions such as 50:50 and 70:30.
Insulin should be applied directly into the subcutaneous tissue (fat cell layer) just below the skin. The thickness of the skin is around 1.9 to 2.4 millimeters (mm) at the sites of insulin application. The needles used may be 4, 5, 6 or at most 8 mm. The application angle varies depending on the amount of fat in the area of application of the patient with diabetes. For example, in the case of a thin, low-fat person in the area of application, there is a greater risk of reaching the muscles when using a longer needle and a 90 ° application angle to the surface of the skin. In these cases, a shorter needle can be selected, a skin fold (skin) and applied at a 45 ° angle. Remember that the skin fold for people with diabetes is used to prevent the needle from reaching the muscles just below the adipose tissue, because in that place the insulin can be absorbed more quickly.
There should be a rotation between the sites of application, as this behavior decreases the risk of complications in the region of application, such as hypertrophy (hardened points below the skin) or atrophy (depressions in the skin relief caused by fat loss). The ideal is to wait 20 to 30 days to reapply at the same point. The distance between two points of application should be about three centimeters (two fingers).
In the abdomen, insulins can be absorbed more quickly than in the arms and thighs. The choice of needles may follow the following recommendations: because in that place the insulin can be absorbed more quickly. There should be a rotation between the sites of application, as this behavior decreases the risk of complications in the region of application, such as hypertrophy (hardened points below the skin) or atrophy (depressions in the skin relief caused by fat loss).
The ideal is to wait 20 to 30 days to reapply at the same point. The distance between two points of application should be about three centimeters (two fingers). In the abdomen, insulins can be absorbed more quickly than in the arms and thighs. The choice of needles may follow the following recommendations: because in that place the insulin can be absorbed more quickly. There should be a rotation between the sites of application, as this behavior decreases the risk of complications in the region of application, such as hypertrophy (hardened points below the skin) or atrophy (depressions in the skin relief caused by fat loss).
The ideal is to wait 20 to 30 days to reapply at the same point. The distance between two points of application should be about three centimeters (two fingers). In the abdomen, insulins can be absorbed more quickly than in the arms and thighs. The choice of needles may follow the following recommendations: such as hypertrophy (hardened spots below the skin) or atrophy (depressions in the relief of the skin caused by fat loss). The ideal is to wait 20 to 30 days to reapply at the same point. The distance between two points of application should be about three centimeters (two fingers). In the abdomen, insulins can be absorbed more quickly than in the arms and thighs.
The choice of needles may follow the following recommendations: such as hypertrophy (hardened spots below the skin) or atrophy (depressions in the relief of the skin caused by fat loss). The ideal is to wait 20 to 30 days to reapply at the same point. The distance between two points of application should be about three centimeters (two fingers). In the abdomen, insulins can be absorbed more quickly than in the arms and thighs. The choice of needles may follow the following recommendations:
- Needles with 4, 5 or 6 mm can be used by obese and non-obese adults and generally do not require skin folding, especially for 4 mm needles.
- In general, when short needles (4, 5 or 6 mm) are used, applications should be made at a 90 ° angle. However, when the application is performed on the limbs or in lean abdomens, a skin fold may be made to ensure that there is no intramuscular injection, even with needles of 4 and 5 mm. In this case, injections with a 6 mm needle should only be used with a skin fold or at a 45 ° angle.
- There is no medical reason to use needles longer than 8 mm.
For children and adolescents:
- Needles with 4, 5 or 6 mm can be used. There is no medical reason to use longer needles
- Children and adolescents with diabetes who are thin and those who inject into the arms and legs may need to do a skin fold, especially when using 5 or 6 mm needles. When a 6 mm needle is used, the 45 ° angle application can be performed in place of the skin fold
- For most children, except for those who are very thin, a 4 mm needle can be inserted at 90 ° without the need for a skin fold. If only one 8-mm needle is available (which can happen to users of syringes), perform the skin fold and, in addition, insert the needle at a 45-degree angle.
For pregnant women:
- The appearance of ecmoses (purple spots) is common at the site of insulin application
- Short needles (4, 5 or 6 mm) can be used by pregnant women
- When only one 8 mm needle is available, the abdominal region should be avoided and the application performed with the skin fold and at a 45 ° angle
- It is prudent to perform the skin fold at all places of application
- To avoid complications, it is recommended to avoid the application of insulin in the abdominal region, especially around the navel, in the last trimester of gestation. The application of insulin in the gluteal region (buttocks) to the lean pregnant women is recommended. The region of the flanks of the abdomen can also be used as long as the skin fold is made.
The best places for insulin application are:
Thigh (front and outer side)
Arm (back of upper third)
Gluteus (upper and lateral of the buttocks).
My blood sugar test is over 100 mg / dl. I have diabetes?
Not necessarily. Fasting blood glucose testing is the first step in investigating diabetes and tracking the disease. The normal values of fasting glucose are between 75 and 110 mg / dL (milligrams of glucose per deciliter of blood). Being slightly above or below these values indicates only that the individual has a fasting blood glucose level. This works as an alert that the insulin secretion is not normal, and the doctor should follow up with the research requesting a test called the glycemic curve, which defines whether the patient has glucose intolerance, diabetes or just an altered outcome.