This is an automatically translated article.
Type 2 diabetes is a fairly common disease in Vietnam. Diabetes mellitus (diabetes mellitus) is a chronic disorder characterized by hyperglycaemia, metabolic disturbances and complications of kidney, nerve, eye damage and cardiovascular diseases. However, when treated for type 2 diabetes, the disease will be reduced, even brought back to almost completely cured.
1. Purpose of type 2 diabetes treatment
1.1. General purpose of treatment of type 2 diabetes Maintain fasting blood glucose, postprandial blood glucose almost equal to physiological level, achieve ideal HbA1c level, in order to reduce related complications, reduce mortality rate death from type 2 diabetes. Lose weight (for overweight or obese people) or maintain an appropriate weight for your body. 1.2. Specific goals in the treatment of type 2 diabetes The goal of type 2 diabetes treatment is to quickly bring blood glucose levels to the best management level, reaching the goal of bringing HbA1C to between 6.5 and 7.0%. in 3 month. Do not apply step 2 diabetes treatment methods but use early combination drugs. Specifically:
If HbA1c is over 9.0% and fasting plasma glucose is greater than 13.0 mmol/l, two combined blood glucose-lowering pills may be indicated. If the HbA1C is above 9.0% and the fasting blood glucose is greater than 15.0 mmol/l, immediate insulin treatment can be considered. In addition to regulating blood sugar, it is necessary to simultaneously pay attention to the balance of blood lipid components, parameters of blood coagulation, and maintenance of blood pressure measurements.
Điều trị tiểu đường để duy trì huyết áp ổn định
Monitor and evaluate blood sugar control status including fasting blood glucose level, postprandial blood glucose level, especially HbA1c level - measured every 3 to 6 months. The specialist must be familiar with the use of oral blood glucose-lowering drugs, the use of insulin, the combination of drugs in treatment and special notes on the patient's condition when treating diabetes. For health facilities that do not perform HbA1c testing, it is necessary to evaluate according to the average plasma glucose level. 1.3. Principles of Type 2 Diabetes Treatment Type 2 diabetes medications must be combined with diet and exercise. This is a trio of effective treatments for the disease. Treatment of hypoglycaemia must be combined with correction of lipid disorders and maintenance of reasonable blood pressure measurements, prevention and control of coagulation disorders. When insulin therapy is required (eg, in acute exacerbations of chronic diseases, infections, myocardial infarction, cancer, surgery).
2. Type 2 diabetes treatment regimen
2.1. Choosing drugs in the treatment of type 2 diabetes Things to pay attention to when choosing drugs to treat type 2 diabetes :
Adhere to the principles of disease treatment. In fact, depending on the patient's situation, the appropriate treatment for type 2 diabetes is decided. In the early stages of the disease, type 2 diabetes can be treated without drugs; If the treatment goal is not achieved, the use of drugs must be considered. The initial drug of choice for monotherapy should be based on the individual's body mass index (BMI), if BMI is less than 23, choose a sulfonylurea, if BMI is 23 or more, choose metformin. Principles of insulin treatment for type 2 diabetes when combining insulin and oral glucose-lowering drugs:
It is necessary to explain to the patient, understand and be reassured about the method of treatment of type 2 diabetes in combination with insulin, the direction Teach patients how to self-monitor when using insulin. Select the pen or syringe that is suitable for the type of insulin (1ml = 100 units or 1ml = 40 units; 1ml = 50 units of insulin).
Điều trị tiểu đường bằng việc phối hợp dùng thuốc theo đơn của bác sĩ
2.2. Indications for use of insulin Insulin therapy may be indicated at the first visit if the HbA1C level is above 9.0% and the fasting blood glucose level is above 15.0 mmol/l.
People with type 2 diabetes but having another acute disease such as severe infection, myocardial infarction, stroke... People with type 2 diabetes with kidney failure have contraindications to taking tablets hypoglycemia; patients with liver damage ... People with type 2 diabetes pregnant or gestational diabetes . Patients who have been treated for type 2 diabetes with oral glucose-lowering drugs do not respond to treatment; people who are allergic to blood glucose lowering pills ... 2.3. Treatment of diabetes with insulin Initiating insulin: Usually the sulfonylurea dose is reduced by 50% and taken only in the morning.
Insulin dosing is usually started with 0.1 UI/kg NPH type, given at bedtime or given twice daily with insulin mix, depending on plasma glucose and/or HbA1c levels. Adjust insulin dose:
When the sulfonylurea dose is increased to the maximum or insulin therapy reaches 0.3 UI/kg, it still does not lower blood sugar. Adjust insulin dose every 3-4 days or twice a week.
3. Prevention of type 2 diabetes
Type 2 diabetes is a really dangerous disease because it is difficult to detect, so apply diabetes prevention measures while your body is healthy:
Lose weight to avoid overweight and obesity. According to the results of many studies, type 2 diabetes will develop slowly and be easier to treat if the patient loses 5-7% of the body weight. Losing weight and increasing physical activity also helps the body to produce more insulin – the main reason for not getting diabetes.
Giảm cân giúp phòng tránh bệnh tiểu đường tuýp 2
Have a suitable diet, choose foods low in fat, sugar and sodium, drinks should choose low-calorie drinks. Replace foods made from white rice with whole grains or brown rice, if conditions do not allow, try to eat at a minimum of the above substances. Quitting smoking and stimulants create a healthy life to prevent the risk of type 2 diabetes. Check your blood pressure, cholesterol and blood regularly. People with type 2 diabetes often have high blood pressure and high cholesterol. Therefore, people with type 2 diabetes should maintain blood pressure below 130/80 mmHg to prevent diabetes comorbidities. Make a habit of having regular health check-ups every 3-6 months to detect diabetes and other diseases early, treating type 2 diabetes early is always better and easier. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also preeminent with examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.
Customers can directly go to Vinmec Health system nationwide to visit or contact the hotline here for support.
Articles refer to the source: Ministry of Health
