Overview Type 2 Diabetes

Overview Type 2 Diabetes
Diet and exercise are crucial in the management of the ABC's (A1C, blood pressure and cholesterol), diabetes type 2

To effectively manage A1C (hemoglobin A1C), and levels of blood sugar, it is important to understand how to balance food intake, physical activity and medication. Making healthy food choices every day has both immediate and long-term. With education, practice and the help of a dietitian and / or diabetes educator, it is possible to eat well and manage diabetes.

This article discusses the diet in the treatment of type 2 diabetes. The role of diet and activity in managing blood pressure and cholesterol are considered separately. (See "Patient information: High blood pressure, diet and weight" and "Patient information: High cholesterol and lipids (hyperlipidemia)".)

The articles deal with other aspects of type 2 diabetes is also available. (See "Patient information: Diabetes mellitus type 2: Overview" and "Patient information: Diabetes mellitus type 2: Insulin treatment" and "Patient information: The Self-monitoring of blood glucose in diabetes mellitus" and "Patient information: Hypoglycemia (low blood sugar) in diabetes mellitus "and" Patient information: Diabetes mellitus type 2: alcohol, exercise and medical care "and" Patient information: Preventing complications in diabetes mellitus.)

WHY IS important to plan?

Many factors affect how well diabetes is controlled. The patient, including how and what we eat, how often your blood sugar is monitored, physical activity level, and accuracy and consistency of the dose of the drug control many of these factors. Even small changes can affect glycemic control.

The consumption of a constant amount of food each day and take medication as directed can greatly improve glycemic control and reduce the risk of diabetic complications such as heart disease, kidney disease and nerve damage. In addition, these measures impact weight control. A dietitian can help create a plan that is tailored for the medical needs of a person, lifestyle and personal preferences.

Type 2 diabetes and MEAL CALENDAR

Consistently eating the same time each day is important for some people, especially those who take long-acting insulin (eg ANLP) and oral medications that reduce blood sugar (sulfonylurea or meglitinides). If a meal is missed or delayed in these models, you are at risk for hypoglycemia.

People who use intensive insulin therapy in humans (those on multiple daily injections), and take other oral medicines for diabetes (eg insulin sensitizers such as metformin) have more flexibility in meal timing. With these arrangements, skipping or delaying a meal, usually do not increase the risk of hypoglycemia.

Food and meals high in fat (eg, pizza) may be eaten occasionally, although blood glucose levels should be monitored more closely. A meal rich in fat is broken down more slowly than low fat. When using rapid-acting insulin before a meal, can the frequency of sugar in the blood is low shortly after eating and then rise hours later.

Weight loss - Many people with type 2 diabetes are overweight. Even losing a little weight (5 to 10 percent of total body weight) can help the body produce and use insulin more efficiently. In fact, eating fewer calories can reduce the level of sugar in the blood even before the first pound is lost.

There are several strategies that can help you lose weight, such as eating fewer calories, exercise, medication and surgery weight loss weight loss. These treatments are discussed in detail in a separate article. (See "Patient information: Treatment of weight loss).

The recommended intake of calories - the calories needed to maintain weight depends on age, gender, height, weight and activity level. General:

Men, active women - 15 calories / pound
Most women, sedentary men and adults over 55 years - 13 cal / lb
Sitting for women obese adults - 10 cal / lb
Pregnant women, lactating women - 15 to 17 cal / lb
To lose 1 to 2 pounds per week (a safe rate of weight loss), subtract 500 to 1000 calories from total calories needed to maintain weight.

For example, an overweight man who weighs 250 pounds would need to eat 2500 calories per day to maintain her weight. To lose 1 to 2 pounds a week, he should eat 1500 to 2000 calories per day. What weight is lost, the recommended calorie intake should be recalculated.

Type 2 diabetes, food and weight

Your weight is a direct reflection of what you eat and how active you are. Eating a large number of calories per day can help control blood sugar levels and maintain body weight. For people who are overweight or obese to lose weight by eating fewer calories or increasing activity levels can improve glycemic control and lower blood pressure and cholesterol.

Avoiding weight gain - weight gain is a possible side effect of intensive treatment with insulin in type 2 diabetes. Weight gain is a side effect of some oral medications used for people with type 2 diabetes. To avoid weight gain, the following tips are recommended.

Measure your weight regularly (eg once a week). The weight gains of over 2 to 3 pounds indicate a need to reduce the amount you eat or increase activity. Do not increase the weight of 10 pounds or more to act.
As blood glucose control improves, it may be necessary to reduce the intake to 250 calories 300 calories per day to prevent weight gain.
If blood sugar is often low at any time of day, reduce the dose of insulin or dose of the drug rather than adding a snack.
Exercise - Regular exercise can help you lose weight and keep it. The recommended amount of exercise is 30 minutes per day most days of the week. (See "Patient information: Exercise.")

People who take insulin or oral medications to lower blood sugar in the blood should check your blood sugar before and after exercise. If the task is heavy and prolonged (more than thirty minutes), blood sugar checks every quarter (if the exercise regime is new and will be used again). Frequent monitoring can help to get an idea of what effect exercise has on blood sugar.

If blood sugar is low during the exercise, eat a snack according to the guidelines below. (See "Patient information: Hypoglycemia (low blood glucose) in diabetes mellitus.)

If blood sugar is 51 to 70 mg / dl (2.8 to 3.8 mmol / L), eat 10 to 15 grams of fast acting carbohydrates (such as 1 / 2 cup fruit juice, 6 to 8 Hard Candy, 3 tablets at 4 glucose) .
If the level is below 50 mg / dl (2.7 mmol / L), eat 20 to 30 grams of fast acting carbohydrates.

Test after 15 minutes, and repeat treatment if blood sugar is too low. If your next meal is more than an hour, eat another 15 grams of carbohydrates and 1 gram of protein (for example, crackers with cheese or half a slice of bread with peanut butter). It is important to not eat too much because it can increase the levels of blood glucose above the target level and lead to weight gain in the long term.