Monday, May 16, 2011

Drug-Free Treatment for Type 2 Diabetes

Drug-free treatment - an important part of the patient with diabetes, especially when it comes to treatment and prevention of type 2 diabetes mellitus.

 Key measures of non-drug treatment of diabetes can be characterized as "healthy way of life" - the normalization and maintenance of normal body weight, nutritional therapy (individual meal plan), not smoking and excessive alcohol consumption and regular exercise.

    Treatment of food (nutritional therapy) occupies an important place on the stage of prevention, treatment of diabetes, as well as prevention / slowing the progression of diabetic complications.

    Goal of nutritional therapy - to achieve and maintain target blood glucose, cholesterol, blood pressure, normal body weight with regard to the specifics needs and preferences of individual patients. All dietary restrictions should be based on scientific evidence.

    Clinical studies of the effectiveness of nutritional therapy have shown that adequate nutrition leads to a reduction in HbA1c by 1% in patients with type 1 diabetes and 1.2% in patients with type 2 diabetes, and the effectiveness of individual food plan depends on the length of diabetes - the earlier intervention started, so it efficiently. Meta-analysis of studies of NT in people without diabetes, indicating a decrease in LDL cholesterol by 15-25 mg / dl.

Meta-analysis of clinical trials and expert opinion also confirmed the important role of lifestyle changes in the treatment of hypertension.

Is very important to support physician or other, so our advice on lifestyle changes and / or food should be specific and consistent, and support - regular.

• Patients who are overweight (particularly in patients with type 2 diabetes) to assist in lifestyle modifications - reducing daily caloric intake, primarily - at the expense of fat (no more than 30% of daily calories), the development plan for regular physical activity. Goal - a persistent reduction in body weight by 5-7%. Additional possible gives medical therapy of obesity, while a BMI over 35 kg/m2 is recommended the use of bariatric surgery, which also has a positive effect on diabetes control. Available data do not allow us to recommend a diet for patients with severely restricting carbohydrates, starvation or drastic reduction of daily calories (less than 800 kcal / day).

• As a foundation food (50-60% of daily calories) in patients with diabetes are recommended to complex carbohydrates with plenty of fiber (vegetables, fruits, legumes, whole grains, dairy products low in fat). The key point in achieving normoglycemia, especially in patients treated with insulin injections, is the allowance of carbohydrates in the diet (perhaps use different systems of counting). Restriction of foods with a high glycemic index may bring additional benefits compared with simple light carbohydrate, but not necessarily demand it. If the patient uses the simple carbohydrates, this should be taken into account in treatment. Instead of table sugar and may safely use nekaloriynyh sweeteners, but is not recommended to use fructose in large amounts.

• We recommend limiting consumption of saturated fats (less than 7% of daily calories), particularly in patients with dyslipidemia, and the introduction of the diet of fish dishes (2 or more times per week).

• In the absence of proteinuria, the recommended protein content in food - 15-20% of daily calories.

• If a patient with diabetes, drinking alcohol, it is considered safe moderate drinking (no more than 15 g in terms of pure alcohol per day for women and no more than 30 grams - for men).

• Patients are often asked to advise the "vegetable" for the treatment of diabetes, many of our patients take a variety of dietary supplements and surcharges. Patients should be informed that the scientific evidence on the usefulness of certain herbs and nutritional supplements in people with diabetes do not exist. In addition, their possible side effects and interactions with other drugs are not known.

• A mandatory moment is training in proper behavior during hypoglycemia, as well as measures to prevent it (if you exercise, concomitant diseases, changes in the usual mode of day, etc.).

• Physical activity is especially important for overweight and obesity. It should be regular, with a gradual increase of the intensity of the load and taking into account patient preference and existing comorbidities.

1 comment:

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