Specific therapy of diabetes type 2

The type 2 diabetic should receive a phase-appropriate, step-by-step therapy. The first stage and most important therapeutic measure is weight normalization, which should be achieved and maintained by a diabetes diet and regular physical activity (endurance training). Basically, there are two different therapeutic approaches to the drug therapy of diabetes mellitus.

The second stage comprises the start of drug therapy if the disease cannot be stopped by weight reduction. Overweight patients receive metformin (e.g. Glucophage® mode of action: delayed glucose absorption from the intestine and appetite reduction), normal-weight patients receive sulfonylureas (e.g. Euglucon N® mode of action): stimulation of insulin secretion from the pancreas) as oral antidiabetics.

If diabetes control is not satisfactory with the individual preparation, a second drug is added in the third therapy stage, usually acarbose (e.g. Glucobay® Mode of action: glucose cleavage in the intestine is delayed) or Glitazone (Mode of action: increase in the sensitivity of cells to insulin). If therapy with the above-mentioned drugs fails, conventional or intensified insulin therapy, i.e. injection of insulin, becomes necessary.

On the one hand, one tries to support the remaining function of the pancreas as much as possible with medication that one has to take, so that the amount of insulin still produced is sufficient for daily needs.
On the other hand, if the pancreas is no longer able to produce sufficient insulin, insulin can be injected from the outside in various forms.

Complications

Possible complications of insulin therapy are hypoglycaemia (low blood sugar) due to insulin overdose or increased physical activity. Possible signs of a hypoglycemic state are As the supply of glucose to the brain is no longer sufficiently guaranteed from a blood sugar level of less than 40 mgdl, such low blood sugar levels lead to a hypoglycemic shock. If the diabetic notices the signs of a Unterzuckerung, he should control his blood sugar and take if necessary glucose or fruit juices to itself.

Another possible complication is that fat cells accumulate under the skin at the injection sites and can cause hardening (lipodystrophy). Insulin resistance, i.e. an increased need for insulin due to insufficient action on the target organs, can occur. It is usually caused by overweight.

Diabetic secondary diseases, i.e. diseases resulting from diabetes, are caused by chronically elevated blood sugar levels and cause changes in the blood vessels. So-called microangiopathic changes, in which the small vessels of the body are affected, often occur in the kidneys, the retina and the nervous system. In addition, larger vessels can be affected in the context of macroangiopathy, such as the coronary arteries or the arteries of the legs, with the risk of heart attack and circulatory problems.

Tachycardia
Nausea
Weakness
Unrest
Headaches
Big appetite
Tremble
Sweating.