Il diabete di tipo 2 è un disordine cronico caratterizzato da anomalie a carico del metabolismo dei carboidrati, delle proteine, dei grassi. Per il concetto di diabete e per i criteri diagnostici leggi l'articolo "Diabete di tipo 1".
The incidence of type 2 diabetes is growing everywhere assuming epidemic proportions.
The reasons behind this increase are to be found in profound changes in lifestyle of people in recent decades: in particular, sedentary lifestyle, a diet rich in fat and low in fiber, obesity are the main causes.
Type 2 diabetes is the result of a state of insulin resistance at the level of muscle and fat tissue and the concomitant impaired insulin secretion. These contributing factors lead to increased blood glucose levels.
Diabetes mellitus type 2 endocrine-metabolic disorder is the most widely used: it affects il 5-10% della popolazione dei Paesi industrializzati e rappresenta quasi il 90% di tutti i casi di diabete mellito.
Per il metabolismo degli zuccheri è importante l' insulina , un ormone prodotto dalle cellule beta del pancreas.
Nella patogenes i del diabete tipo 2 si riconoscono 3 alterazioni fondamentali: a) un difetto relativo di secrezione insulinica; b) uno stato di insulino-resistenza a livello del tessuto muscolare e adiposo; c) uno stato di insulino-resistenza a livello epatico.
L' obesità è un potentissimo moltiplicatore dell'insulino-resistenza.
Nelle fasi iniziali della malattia diabetica, in risposta allo stato di insulino-resistenza, un compensatory increase in insulin secretion by pancreatic beta cells is able to maintain normal levels of circulating glucose. With the progress of the disease, the pancreatic insulin secretion is progressively reduced, causing hyperglycemia.
There is no doubt that the overweight el ' obesity are risk factors for type 2 diabte. It is obvious that the function
diet and physical activity must play in the treatment plan of patients with type 2 diabetes.
Exercise promotes weight loss, increases insulin sensitivity and improves cardiovascular performance which plays an important role in the treatment of type 2 diabetes.
Pharmacotherapy
As the behavioral and dietary therapy should remain the core of any therapeutic approach of patients with type 2 diabetes, the vast majority of these patients require, sooner or later, a pharmacological intervention.
The drugs are used in different secretagogues (stimulates the secretion of insulin), drugs that delay the absorption of carbohydrates (which meant a smaller increase in postprandial glucose) and medication "insulin sensitizers" (increased insulin sensitivity peripheral tissues and liver).
Insulin therapy
Although it is rare patients with type 2 has a total deficit of insulin secretion, very often you have to resort to the administration of this hormone particularly when neither the drugs nor diet can normalize blood glucose levels.
Prevention of type 2 diabetes
The risk for type 2 diabetes (DT2) increases with increasing age, there are also groups at increased risk and that the twins of patients with type 2 diabetes, the first-degree relatives (siblings and children) of patients with DT2, women with gestational diabetes, obese people, all those individuals with impaired glucose tolerance and hypertensive subjects.
The development of the condition of DT2 is a slow process. In utero you inherit the genes predisposed to insulin resistance, followed by a period in which insulin resistance develops in which the lifestyle (lack of physical activity, food abundant and rich in saturated fat) leads to a state of impaired glucose tolerance, eventually develops type 2 diabetes. Several studies
have demonstrated the effectiveness of an intervention based on diet, physical exercise, or both in reducing the incidence of new cases of DT2.
In particular, patients with diabetes in the family should always take a good lifestyle including a balanced diet and adequate exercise and without excess.
