General information about type 2 diabetes

Type 2 diabetes mellitus or reduced diabetes mellitus is a chronic disease of the pancreas. It is characterized by the fact that the interaction of the hormone insulin, produced by the beta cells of the pancreas, with the cells of the tissue is disturbed, as a result of which insulin cannot penetrate into the cells, but accumulates in the blood.

In diabetes of the second type, insulin is produced in a normal amount, and often in greater quantities than needed. But at the same time, due to the violation of its effects on cells or the violation of the susceptibility of tissue cells to insulin (insulin resistance), the cells starve without receiving insulin, and the insulin itself accumulates in the blood.

Type 2 diabetes is more common than type 1 diabetes. About 90% of all patients with diabetes mellitus are of the second type.

Diabetes mellitus type 2 is characterized by slow development. The disease can develop within a few months or even years, and the person does not even suspect it.

Most often, it is discovered by chance when a person passes a full physical examination.

Treatment of diabetes of the second type is selected by the doctor on the basis of tests, sugar - reducing drugs are used most often (for more information on treatment see the section "Treatment of diabetes of the second type") in conjunction with diet and exercise.

Compliance with a strict diet is very important in case of diabetes mellitus of the second type, diet therapy and optimal exercise significantly improve the patient's condition. And sometimes they give an opportunity to refuse sugar-reducing ones. drugs provided that the patient could bring his weight to normal and keeps it.

One important note

You can often find the expression the following expression - type 2 diabetes or insulin-independent diabetes.

But this is fundamentally wrong, since insulin therapy is also used for the treatment of type 2 diabetes, this happens in cases where own insulin ceases to be produced in the required amount.

Type 2 diabetes

Also, diabetes of the second type is sometimes called "elderly diabetes" and "obese diabetes." But the first definition is also not entirely true. Most often, type 2 diabetes develops in people aged 35 years and older, but occasionally it occurs in young people and even children.

People who are overweight and obese have a high risk of developing type 2 diabetes.

The risk of developing diabetes in obese people increases with age.

Diabetes of the second type is hereditary.

What happens in the body with type 2 diabetes?

As mentioned above, with the second type of diabetes mellitus, insulin is produced in full, and often in greater volume. But over time, especially with refusal of treatment or poorly chosen therapy, the volume of insulin produced by the pancreas decreases, there is a chance that insulin will be synthesized so little that insulin therapy will be needed, as in type 1 diabetes.

The development of type 2 diabetes can go two ways.

The first way is when the perception of insulin by tissue cells is disturbed, and it is no longer suitable as a "key" that opens glucose entry into cells, where it is processed or deposited in reserve (for example, in the form of glycogen in liver cells). Such a disorder is called insulin resistance.

The second option is when insulin itself loses the ability to perform its actions. That is, glucose cannot get into the cells, not because the cell receptors do not perceive insulin, but because the insulin itself is no longer the "key" to the cells.

Symptoms of type 2 diabetes

Diabetes of the second type often occurs without visible manifestations, a person does not even know that he is sick.

Some symptoms may appear for a while and pass again.

Therefore, we must carefully listen to your body.

Overweight and obese people should regularly donate blood for sugar.

Increased sugar is accompanied by thirst, and, as a result, frequent urination.

There may be severe dryness of the skin, itching, unhealed wounds.

There is a general weakness, fatigue.

Follow the level of sugar in the blood should be people after 40 years.

Forms of severity of diabetes of the second type

By severity can be divided into three forms:

  • easy form - when to achieve compensation it is enough to follow the diet and perform physical activities or the minimum amount of sugar - lowering drugs;
  • medium form - in order to maintain normoglycemia, a few tablets of sugar - reducing preparations are required;
  • severe form - when sugar - lowering drugs do not give the desired result and insulin therapy is connected to the treatment.

Treatment of diabetes mellitus type two: sugar lowering drugs and insulin therapy

Treatment of type 2 diabetes includes several components - sports / physical culture, diet therapy, sugar lowering drugs and insulin therapy.

You can not neglect physical activity and diet. Since they help a person to lose weight and, thereby, reduce cell insulin resistance (one of the causes of diabetes), and thus normalize blood sugar levels.

Of course, not everyone can give up drugs, but without losing weight, no type of treatment will give good results.

Still, the basis of treatment are sugar - reducing drugs.

According to the mechanism of action all sugar - lowering drugs are divided into several groups.

- The first group includes two types of drugs - Thiazolidinediones and Biguanides. Preparations of this group increase the sensitivity of cells to insulin, that is, they decrease insulin resistance.

In addition, these drugs reduce the absorption of glucose by the intestinal cells.

The preparations belonging to the thiazolidinedione (rosiglitazone and pioglitazone), largely reduced insulin action mechanism.

Preparations related to biguanide (Metformin (Siofor, Avandamet, Bagomet, Glucophage, Metfogamma)), to a greater extent alter glucose absorption by the intestinal cells.

These drugs are often prescribed to overweight people so that they lose weight.

- The second group of sugar - reducing drugs also consists of two types of drugs - Sulfonylurea derivatives and Meglitinides.

Drugs in this group stimulate the production of insulin of its own by acting on the beta cells of the pancreas.

They also reduce the supply of glucose in the liver.

Drugs group Sulfonylureas (Mannino, Diabeton, Amaryl, Glyurenorm, Glibinez retard) in addition to the above effects on the body, also affect insulin itself, thereby increasing its efficiency.

Meglitinides group preparations (Repaglinide (Novonorm) and nateglinide (Starliks)) increase the synthesis of inulin by the pancreas and reduce postprandial peaks (high blood sugar after a meal).

Perhaps a combination of these drugs with Metformin.

- The third group of sugar lowering drugs includes Acarbose (Glucobay). This drug reduces the absorption of glucose by intestinal cells due to the fact that, by binding with enzymes that break down carbohydrates from food, it blocks them. And unsplit carbohydrates can not be absorbed by the cells. And due to this comes weight loss.

When the use of sugar - reducing drugs does not lead to the achievement of compensation, insulin therapy is prescribed.

There are different schemes for using insulin. It is possible to use only prolonged insulin in combination with sugar - reducing drugs. Or, with the ineffectiveness of drugs used insulins of short and prolonged action.

The use of insulin can be permanent, and can be temporary - with a strong decompensation, during pregnancy, during surgical operations or serious diseases.

Nutrition for type 2 diabetes

Diet is one of the key points in the treatment of type 2 diabetes and is aimed at reducing weight and maintaining normal body weight.

The basis of the diet is the rejection of fast or refined carbohydrates, such as sugar, sweets, jam, many fruits, dried fruits, honey, fruit juices, baking.

Particularly rigid diet at the beginning, when you need to lose weight, then the diet can be somewhat expanded, but fast carbohydrates are mostly excluded.

But remember that at hand should always be some foods containing fast carbohydrates to stop the attacks of hypoglycemia.

Honey, juice, and sugar are well suited for this.

The diet should not be a temporary phenomenon, but a way of life. There are many healthy, tasty and easy-to-serve dishes, and desserts are not excluded.

A large selection of dietary meals with an estimated calorie and carbohydrate content can be found on the website of Dia-Dieta - our partner.

The basis of the food should be foods that contain a lot of fiber and slow carbohydrates, which slowly raise sugar and do not give such a pronounced postprandial hyperglycemia.

It is necessary to reduce the consumption of foods with high fat content - meat, dairy products.

It is necessary to abandon fried foods, cook for a couple, boil or bake in the oven.

Food should be taken 5-6 times a day, but in small portions.

Observing such a diet will not only help reduce weight, but also keep it at a normal level, which will have a beneficial effect on the general condition of the body.

Physical activity in diabetes of the second type

Exercise is of great importance, but the load must correspond to the age and health of the patient.

It is important not to overdo the intensity, the load should be smooth and regular.

Sports activities increase the sensitivity of cells to insulin and, as a result, sugar decreases.

If you have a long load, before starting it is recommended to eat 10-15g of slow carbohydrates to prevent hypoglycemia. Bread, apple, kefir will be suitable as a snack.

But if the sugar has dropped dramatically, then you need to take fast carbohydrates to quickly raise the level of glucose.

It is necessary to exclude any physical activities with sugar above 12-13mmol / l. With such high sugar increases the load on the heart, and in conjunction with the load it becomes doubly dangerous.

Moreover, classes with such sugar can lead to its further growth.

It is desirable to control the sugar level before the load, during and after it, in order to avoid undesirable fluctuations.

What can and can not eat with type 2 diabetes?

In diabetes of the second type, nutrition plays a very important role. Since diabetes of the second type in most cases is associated with overweight or obesity of varying degrees, the nutrition of diabetic patients should lead to the normalization and further maintenance of normal body weight.

With proper nutrition, it is sometimes possible to refuse sugar - reducing drugs. But this should be done only as prescribed by the attending physician.

The essence of the diet in diabetes of the second type is to reduce the consumption of carbohydrates, especially, "fast" carbohydrates. The "fast" carbohydrates include sugar, jam, jams, sweets, fruit juices, etc.

Ordinary sweets can be replaced with sweets on sugar substitutes in a small amount. But it should be remembered that such products still contain a large amount of carbohydrates, both from the flour and from the sugar substitutes themselves (for example, if waffles or cookies are made on fructose).

It is also necessary to refuse such cereals as semolina and rice, potatoes, wheat flour, white bread and various pastries, some fruits (bananas, mangoes, dates, figs).

It is highly undesirable to use animal fats. Refuse fatty meat (pork) and fish, replace them with more dietary types - boiled beef, steamed cod. Completely give up fat and reduce the consumption of butter, mayonnaise, fatty dairy products, nuts. For salad dressing, use not mayonnaise or sour cream, but a small amount of olive oil with lemon juice, fatty kefir and cottage cheese replace with low-fat or low-fat products.

The basis of the food should be vegetables (with the exception of potatoes), low-fat varieties of meat and fish, low-fat cheeses and dairy products, cereal bread.

On the basis of these products you can cook a lot of tasty and healthy dishes.

According to the method of preparation, preference should not be given to fried dishes, but boiled, stewed, steamed.

Meat, fish, poultry bake well in the oven.

Delicious and vitamin-rich dishes are obtained in a double boiler.

Sugar - reducing drugs

Thiazolidinedione

Indications for use

They are used in diabetes mellitus type 2 with the ineffectiveness of diet therapy, both as monotherapy and when combined with sugar - reducing drugs of other groups.

The action of drugs in this group is aimed at increasing the sensitivity of tissue cells to insulin. Thus, they reduce insulin resistance.

In modern medical practice, two drugs of this group are used: Rosiglitazone and Pioglitazone.

The mechanism of action of these drugs is as follows: they reduce insulin resistance by increasing the synthesis of cells - carriers of glucose.

Their action is possible only if you have your own insulin.

In addition, they lower the level of triglycerides and free fatty acids in the blood.

Pharmacokinetics

The drugs are rapidly absorbed in the gastrointestinal tract. The maximum concentration in the blood is reached in 1-3 hours after ingestion (rosiglitazone in 1-2 hours, pioglitazone in 2-4 hours).

Metabolized in the liver. Pioglitazone forms active metabolites, it provides a longer effect.

Excreted mainly by the kidneys.

Contraindications

Type 1 diabetes.

Pregnancy and lactation.

Liver diseases in the period of exacerbation. ALT level exceeding the norm by 2.5 times or more.

Age under 18 years.

Side effects

There have been some cases of elevated ALT, as well as the development of acute liver failure and hepatitis while taking thiazolidinediones.

Therefore, it is necessary to evaluate the functioning of the liver before taking the drugs and conduct periodic monitoring while taking thiazolidinediones.

Reception of thiazolidinediones can promote increase in body weight. This is observed both in monotherapy and in the combination of thiazolidinediones with other drugs. The reason for this is not exactly known, but most likely it is due to the accumulation of fluid in the body.

Fluid retention not only affects the increase in body weight, but also causes edema and worsening cardiac activity.

With strong edema, it is advisable to use diuretics.

Heart failure often develops with a combination of thiazolidinediones with other sugar - reducing drugs, including insulin. With monotherapy thiazolidinedione or insulin, the risk of heart failure is very small - less than 1%, and when combined, the risk increases to 3%.

Perhaps the development of anemia in 1-2% of cases.

Mode of application

Pioglitazone is taken 1 time per day.

Taking the drug is not associated with eating.

The average dosage is 15-30mg, the maximum dosage is 45mg per day.

Rosiglitazone is taken 1-2 times a day.

Taking the drug is not associated with eating.

The average dosage is 4 mg, the maximum dosage is 8 mg per day.

Biguanides

Indications for use

It is used in patients with diabetes mellitus type 2, suffering from obesity, and in patients with type 1 diabetes mellitus in combination with insulin therapy.

Currently, one drug of the Biguanide group is used - Metformin (Siofor, Avandamet, Bagomet, Glucophage, Metfohamma).

Metformin helps to reduce body weight, an average of 1-2 kg per year.

Type 2 diabetes

Mechanism of action

Metformin changes the absorption of glucose by the intestinal cells, which leads to a decrease in blood sugar.

Also, metformin helps reduce appetite, which in turn leads to a decrease in body weight.

Pharmacokinetics

The maximum concentration of metformin reaches 1.5-2 hours after administration.

Its accumulation is observed in the liver, kidneys and salivary glands.

Excreted by the kidneys. With the violation of the kidneys may accumulate drug.

Contraindications

Hypersensitivity to the drug.

Pregnancy and lactation.

Disorders of the liver.

Disorders of the kidneys.

Heart failure.

Respiratory failure.

Age over 60 years.

Side effects

Perhaps the development of anemia.

Nausea, vomiting.

Hypoglycemia.

Additionally

It is necessary to use the drug with caution in acute infections, surgery and exacerbation of chronic diseases.

You should stop taking the drug for 2-3 days before the operation and return to the reception 2 days after the operation.

Perhaps a combination of metformin with other sugar - lowering drugs, including insulin.

Sulfonyl Urea Derivatives

Indications for use

Type 2 diabetes.

Mechanism of action

Derivatives of drugs of sulfonylurea are secretogenic . They act on the beta - cells of the pancreas and stimulate the synthesis of insulin.

They also reduce the deposition of glucose in the liver.

The third effect these drugs have on the body is that they act on insulin itself, increasing its effect on the cells of the tissues.

Pharmacokinetics

Today, second-generation sulfonylurea derivatives are used.

Preparations of this group are excreted through the kidneys and liver, with the exception of glurenorm , which is excreted through the intestines.

Contraindications

Diabetes mellitus insulin-dependent.

Chronic kidney disease.

Chronic liver disease.

Pregnancy and lactation.

Side effects

Due to the fact that these drugs increase the secretion of insulin, with their overdose, increase appetite, which leads to an increase in body weight. It is necessary to accurately select the minimum dosage at which the hypoglycemic effect is achieved, in order to avoid drug overdose.

An overdose of drugs may further lead to the emergence of resistance to sugar - lowering drugs (that is, the effect of sugar - lowering drugs will be greatly reduced).

Drugs in this group can cause hypoglycemia. You can not increase the dosage of drugs without consulting a doctor.

Manifestations of the gastrointestinal tract are possible in the form of nausea, rarely vomiting, diarrhea or constipation.

Sometimes allergic reactions in the form of urticaria and itching occur.

Perhaps the development of anemia of reversible nature.

Mode of application

The main part of the preparations of the sulfonylurea derivatives group have a hypoglycemic effect for 12 hours, so they are usually taken twice a day.

Reception is possible three times a day with preservation of a daily dosage. This is done for a smoother drug action.

Additionally

Gliclazide and glimepiride have a long-lasting effect, so they are taken once a day.

Meglitinides (Nesulfanilurea secretagogues)

These are prandial glucose regulators, they cause an increase in insulin secretion by acting on the beta cells of the pancreas.

Two drugs of this group are used - Repaglinide (Novonorm) and Nateglinide (Starlix).

Indications for use

Insulin-dependent diabetes mellitus with the ineffectiveness of the diet.

Mechanism of action

Stimulate insulin production.

Their action is aimed at reducing prandial hyperglycemia, that is, hyperglycemia after eating.

On the reduction of sugar on an empty stomach, they are not suitable.

Pharmacokinetics

Hypoglycemic effect of drugs begins 7-15 minutes after taking the pill.

The hypoglycemic effect of these drugs is not long, so you need to take them several times a day.

Derive mainly by the liver.

Contraindications

Diabetes mellitus insulin-dependent.

Pregnancy and lactation.

Age under 18 years.

Chronic kidney disease.

Chronic liver disease.

Side effects

Manifestations of the gastrointestinal tract are possible in the form of nausea, rarely vomiting, diarrhea or constipation.

Sometimes allergic reactions in the form of urticaria and itching occur.

Rarely, drugs of this group can cause hypoglycemia.

Perhaps an increase in body weight while taking medications.

Perhaps the development of addiction to Meglitinida.

Mode of application

Repaglinide is taken half an hour before meals 3 times a day (mostly before each meal).

The maximum single dose - 4 mg daily - 16 mg.

Nateglinide is taken before meals for 10 minutes, 3 times a day.

Additionally

Perhaps a combination with sugar - reducing drugs of other groups, for example, with metformin.

Acarbose (α glycosidase inhibitors)

Indications for use

Insulin-independent diabetes.

Insulin-dependent diabetes mellitus in combination with insulin therapy.

As a prevention of type 2 diabetes in people with impaired glucose tolerance.

Mechanism of action

Reduce the absorbability of glucose by the intestines due to the fact that they bind to carbohydrate-splitting enzymes, and prevent these enzymes from splitting. And undigested carbohydrates are not absorbed by intestinal cells.

Does not affect the level of synthesized insulin, therefore, eliminated the risk of hypoglycemia.

It promotes weight loss due to the fact that it prevents the absorption of carbohydrates in the intestine.

Pharmacokinetics

It has two peaks of activity - after 1.5 - 2 hours after taking the drug and after 16-20 hours.

Absorbed by the gastrointestinal tract. Excreted mainly through the intestines, less through the kidneys.

Contraindications

Acute and chronic diseases of the gastrointestinal tract during exacerbations.

Liver diseases, including cirrhosis.

Pregnancy and lactation.

Age up to 18 years - take with caution.

Side effects

From the gastrointestinal tract - nausea, vomiting, abdominal distension.

When eating carbohydrates may develop flatulence in the background of the drug.

Allergic reactions - urticaria, pruritus.

Perhaps the appearance of edema.

Mode of application

Take one hour before meals three times a day.

Start with the minimum dosage and gradually increase the dose taken.

Additionally

Surgery, trauma, infectious diseases may require temporary discontinuation of the drug and the transition to insulin therapy.

Strict adherence to a diet with a reduced content of "fast" carbohydrates is necessary.

The action of the drug has a dose-dependent effect - the higher the dose, the less carbohydrates are absorbed.

Perhaps a combination with other sugar - lowering drugs. It should be remembered that acarbose enhances the effect of other sugar - reducing drugs.

Shameful questions about diabetes

Is it impossible to eat sugar, and insulin should be prick all my life?

According to the data for 2015, 4.4 million Russians have diabetes, among which there are about 30 thousand children and teenagers. And the number of cases is constantly growing. Many of us have relatives, friends or friends who are familiar with the problem firsthand, but not everyone knows how this disease is manifested and how to live with it.

Diabetes - is it when you can not eat sweets and constantly need to check blood sugar levels?

Roughly speaking, it is. By the way, diabetics can eat foods with sugar, but in limited quantities, the main thing is to monitor blood sugar levels. Need to be checked several times a day. It is important to understand that diabetes is not a sweet tooth disease. Thus, the onset of type 1 diabetes is not associated with excessive consumption of sweets. It develops when a person's immune system attacks his own pancreas, which is why it no longer produces insulin. In the case of type 2 diabetes, sugar is only indirectly the cause of the disease - by itself it does not cause diabetes. Typically, type 2 diabetes occurs in overweight people, which is often caused by unlimited intake of high-calorie foods, including sweets.

What else, besides sugar, should be limited? For example, you can simply replace sugar with honey - is it useful?

To make a plan for a healthy diet in diabetes and take into account the peculiarities of your body, it is best to contact a nutritionist. But there are general recommendations. For example, it is advisable to eat three times a day at the same time and give up fatty and high-calorie meals. It is necessary to switch to "healthy" carbohydrates, which are contained in fruits, legumes (beans, peas and lentils) and low-fat dairy products.

In diabetes, it is important to consume a lot of fiber, which is found in nuts, vegetables, whole -wheat flour and wheat bran. Fish can be a good alternative to meat: it is advisable to eat it twice a week, but not to fry, but to steam or bake. But to replace sugar with honey will not work - it is even more harmful for a person with diabetes than sugar. The same story with agave nectar and maple syrup, which the stores offer as a healthy alternative to sugar.

And how to understand which products are harmful, and which ones you need to lean on?

For example, using the glycemic index is an indicator of the rate at which carbohydrates contained in a product are absorbed by the body and increase blood sugar levels. But there are many nuances and difficulties. You should also carefully study the labels of products - however, manufacturers sometimes do not indicate the actual amount of sugar, for example, in juices. In this case, pay attention to whether honey, sucrose, glucose, dextrose, fructose, maltose, molasses and hydrolyzed starch are indicated in the product - this is all the same sugar, only under a different name. Also, some manufacturers indicate the amount of added sugar in the product, but do not indicate how much fructose it contains. Therefore, it is better to replace all fruit drinks, juices and smoothies with fresh fruits, which have a lower glycemic index.

It is important to keep in mind that many low-fat foods also contain sugar. When choosing what to buy and eat, keep in mind that ideally you need to consume no more than about 25 grams of sugar per day. The maximum daily intake of sugar for children 4–7 years old without diabetes is 19 g (5 teaspoons of sugar), for children 7–10 years old - 24 g (6 teaspoons of sugar), for anyone older than 11 years, 30 g (7 teaspoons of sugar).

People with diabetes should avoid high-fat dairy products, processed meat products (say goodbye to sausages and bacon) and baking. It is important to understand that for a person with diabetes, not only foods with a high sugar content, but also fatty and high-calorie foods are harmful. In general, if you adhere to the basic principles of a healthy diet, watch the portion size and the amount of carbohydrates - you are on the right track.

If you accidentally ate (well, could not resist) something sweet and harmful - what will and what to do?

Two hours after eating, your blood glucose level will peak - and you may feel tired. In this situation, you need to measure the level of sugar as you usually do, and adjust the insulin dose. Such breakdowns and concessions, if they arise from times to times, interfere with the control of blood sugar levels.

Try to eat less sweets. This does not mean that they should be abandoned once and for all (this is a myth). Sometimes you can afford a little sweet, but only as a delicacy and in any case not to satisfy hunger and a quick snack. And for some people with diabetes, sugary drinks or glucose tablets are even necessary when blood glucose levels are too low.

Switching to sweets marked "for people with diabetes" is also not worth it: they contain fructose and sorbitol, saturated and trans fats. They also, like regular sugar, affect blood sugar levels and are often even more nutritious than ordinary sweets. It is better to buy chocolate with a high cocoa content (you don't eat much of it anyway) or chocolate with fruit rather than nutty filling (nut is more nutritious) - eat it slowly and slowly, enjoying the taste.

Insulin injections will have to do every day until the end of life - or only when the sugar level rose?

With type 1 diabetes, injections will have to be done daily. If you do not use insulin, the person will simply die. And no, this is not "insulin addiction": if you say the opposite, then you will have to admit that air is a narcotic for all people, because they cannot live without it. In type 2 diabetes, sugar-reducing pills can be prescribed first, but if they do not help, then insulin is prescribed.

Can you do sports in diabetes or do you need to protect yourself from any physical activity?

Everything is individual here - more precisely, only a doctor can tell you. However, it is known that in case of diabetes, moderate exercise is beneficial, since muscle movement leads to increased absorption of sugar by muscle cells - and due to this, the level of sugar in the blood decreases. For people with type 2 diabetes, training is necessary: they help control weight. It is recommended to spend 150 minutes a week on any aerobic activity (exercises that increase heart rate and make you sweat) - fast walking, easy jogging, cycling, aqua aerobics, tennis and the most common badminton will do.

During workouts, you must take precautions and remember that moderation is important in everything: due to too much physical exertion, sugar levels can drop dramatically. By the way, there are specially trained dogs abroad who sense a dangerous drop in blood sugar levels during a workout and let the owner know about it.

People with diabetes are said to heal any wounds worse. It's true?

Often this is true. High blood glucose levels caused by diabetes damage blood vessels and nerve endings. Because of this, blood and circulation in the arms and legs are poorly circulating - this greatly complicates the process of skin repair and wound healing. Moreover, if the wound is open and has not healed for several months, in some cases gangrene may develop. Exactly for this reason it is very important for a person with diabetes to control open wounds, abrasions, cuts and blisters on the legs and be sure to treat them properly.

Does diabetes affect your sex life?

Yes. Approximately 50% of men and 25% of women experience sexual problems or loss of sexual desire due to diabetes. In men, diabetes can lead to diabetic neuropathy and, as a result, to problems with erection and orgasm (one of three men with diabetes suffers from erectile dysfunction). All violations occurring must be discussed with the doctor, he will tell you which of the problems are treatable. In women, diabetes can provoke inflammation of the genital organs, the appearance of thrush and cystitis.

Well, children can give birth or the child will also be born with diabetes?

To give birth or not is up to you. But whether a child has diabetes depends on many factors. In most cases, type 1 diabetes develops when a child inherits a predisposition from both parents. If the father has type 1 diabetes, the likelihood that the child will have diabetes is about 6%. If a woman with type 1 diabetes gives birth to a child under 25, then for a child the risk of developing this disease is 4%, and if after that, then 1%. If both parents have type 1 diabetes, then the risk of developing diabetes for a child is 10–25%.

If a woman has type 2 diabetes (diagnosed before age 50), then the risk that the child will have diabetes is 14%. If he was diagnosed after 50 years, the risk of developing diabetes in a child is 8%. If both parents have type 2 diabetes, then the risk of its occurrence in a child is 50%.

Can I make sure I don't have diabetes?

Of course, but only in the case of type 2 diabetes — type 1 diabetes cannot be prevented. You need to eat right and be physically active. If you are overweight, then from the age of 40 you also need to regularly check blood sugar levels and monitor blood pressure.