Definition
Type 2 diabetes mellitus is a metabolic pathology that consists of the defect of insulin secretion, typical of patients who have a poor sensitivity to peripheral hormone tissues; the disease is the insulin-independent form of diabetes, since pancreatic beta-cells for insulin synthesis retain some of their activity. Most patients with type 2 diabetes mellitus are obese.
Causes
The causes of type 2 diabetes mellitus essentially reside in the alteration of insulin, intended both as a decrease in the amount of hormone in the blood, and as a decrease in its activity. Diabetes can be heavily influenced by the genetic component and by an unbalanced diet, rich in sugars; clearly, even obesity, a sedentary lifestyle and an incorrect lifestyle can help to accentuate the problem.
Symptoms
Hyperglycemia and glycosuria, elements that characterize type 1 diabetes mellitus, in the insulin-independent form are present only long after the onset of the disease; in fact, type 2 diabetes mellitus is generally diagnosed by chance, since it begins, at least initially, asymptomatically. In the advanced stage, type 2 diabetes mellitus can cause hypertriglyceridemia and hyperuricemia.
Diet and Nutrition
Natural Care
Information on Type 2 Diabetes - Type 2 Diabetes Treatment Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Type 2 Diabetes - Type 2 Diabetes Drugs.
drugs
It is possible to prevent the degeneration of type 2 diabetes mellitus, but the metabolic disease must be diagnosed early, when it is still in a "precarious" phase, called prediabetic; in case of genetic predisposition, it is strongly recommended to undergo periodic glycemic checks, just to treat the disease in the bud. Blood glucose tests are also recommended after the age of 40, especially in the case of obesity, dyslipidemia and a sedentary lifestyle.
The hypoglycidic diet, rich in fiber - above all soluble - associated with a correct lifestyle and constant exercise are the building blocks of diabetes prevention.
It seems obvious, but following the rules of nutrition education and practicing sport prevent type 2 diabetes mellitus and its complications, which can also be serious (infections, thrombosis, hemorrhage, pancreatitis, blindness, severe alteration of kidney function, ulcers, atherosclerosis).
The drug treatment aims to control the symptoms of diabetes and avoid serious complications, especially long-term ones.
The drugs most commonly used in treatment for type 2 diabetes mellitus are essentially oral hypoglycemic agents; the other form of diabetes (type 1) instead requires insulin injections to maintain regular blood sugar levels.
Oral hypoglycemic agents to treat type 2 diabetes mellitus
Type 2 diabetes mellitus is insulin-independent and the cause lies essentially in the decrease in the synthesis of insulin and the lack of sensitization to its action. In this case, the most indicated drugs are oral hypoglycemic agents, which must however only be taken when medical nutritional therapy for diabetes brings no observable benefit after at least three months.
Sulfonylureas : by blocking the potassium channels, these drugs favor membrane depolarization; the entry of calcium ions stimulates pancreatic beta cells to produce insulin. They must not be taken during pregnancy or in case of kidney or liver disease: these are very powerful drugs, which can cause severe hypoglycemia if used beyond the doses prescribed by the doctor. Sulfonylureas are indicated for the treatment of non-obese diabetic patients.
- Glipizide (eg Minidiab, Glurenor): initially, it is recommended to take 2.5-5 mg a day, before breakfast or lunch. Do not exceed 20 mg a day. Before breakfast, the dose cannot exceed 15 mg. Consult your doctor.
- Glicazide (eg Diabrezide, Diamicron): when the antidiabetic diet and exercise are not enough to guarantee the right blood glucose levels, this drug is a valid aid to avoid spikes in blood sugar. It is recommended to take two 80 mg tablets a day, each half an hour before the main meals.
- Glibenclamide (eg. Daonil, Euglucon): at the beginning of antidiabetic therapy, it is recommended to take half a 5 mg tablet (corresponding to 2.5 mg), before the main meal, with a generous glass of water. It is possible to gradually increase the dose; do not exceed 2-3 tablets per day (10-15 mg).
- Gliquidone (eg Glurenor): in general, the indicative dose is between 30 mg (1 tablet) and 120 mg per day. Consult your doctor.
Very similar to sulfonylureas, but of new generation, glinids (Repaglinide), whose difference essentially consists in their short duration. For example Novonorm, Prandin, NovoNorm, Enyglid.
Biguanids : unlike sulfonylureas, biguanides are indicated for the treatment of type 2 diabetes mellitus in obese patients. These drugs do not stimulate the pancreatic beta cells to produce insulin, rather they sensitize the peripheral tissues by decreasing hepatic gluconeogenesis, and glucose absorption, as well as enhancing peripheral uptake of the same.
- Metformin (eg Metforal, Glucophage, Eucreas, Efficib, Avandamet, Glibomet): generally, start therapy with a 500 mg tablet, to be taken orally 2-3 times a day, during or after main meals, without exceeding 3 g per day. There are also 850 mg and 1 g tablets available. Consult your doctor. The drug is also available in a formulation with other active ingredients, such as Vildagliptin (eg Galvus) and sitagliptin (dipeptidyl-peptidase 4 inhibitors), Rosiglitazone (PPAR gamma receptor activator: eg Avandia, Avandamet) and Glibenclamide (inhibits the canal at potassium)
- The pharmacological specialty "Komboglyze" is formulated with metformin and saxagliptin (inhibitor of dipeptidyl peptidase 4) and is indicated for the treatment of type 2 diabetes mellitus if metformin alone does not have an optimal effect for the patient. It is recommended to take one tablet (2.5 mg saxagliptin / 850 or 1000 mg metformin) twice a day, during main meals.
Glitazones or thiazolidinediones : these drugs decrease gluconeogenesis and increase the sensitivity of cells to insulin. They are not indicated for overweight or obese patients, since weight gain is a typical side effect associated with water retention.
- Pioglitazone (eg Actos, Glustin): at the beginning, it is recommended to take small doses (half a tablet, equivalent to 15 mg) or one whole tablet a day, all at once, with or without food. Consult your doctor.
Alpha-glucosidase inhibitors (solution for injection or tablets) : these are latest-generation antidiabetic drugs that act by inhibiting the activity of the enzyme alpha-glucosidase (which promotes the reabsorption of glucose); consequently, intestinal glucose absorption is reduced. Furthermore, these active ingredients act by enhancing the action of the hormone glucagon-like-peptide 1, a stimulator of insulin synthesis. The drugs that belong to this category are exenatide and sitagliptin.
- Exenatide (eg. Byetta): the drug, available in 5-10 mcg pre-filled pens, can be formulated with other antidiabetic drugs, such as metformin and / or sulfonylureas. It is recommended to inject the drug on the thigh or belly: generally, it is recommended to inject a dose of 5 mcg, twice a day for 30 days. After this period, increase the dose to 10 mcg, twice a day, an hour before breakfast and lunch.
- Sitagliptin (eg Ristaben, Xelevia, Januvia, Tesavel): available as tablets, it is recommended to take 100 mg of active, once a day, during a meal or between meals. The drug can be formulated in combination with sulfonylureas or metformin to treat advanced type 2 diabetes mellitus: in this case, the risk of hypoglycemia increases.
