Diabetul zaharat

Diabetul zaharat este o boală cronică ce se caracterizează prin nivele ridicate ale glucozei în sânge (hiperglicemie). Boala apare atunci când pancreasul nu produce insulină suficientă, sau când organismul nu-şi poate utiliza eficient propria insulină produsă. Diabetul zaharat a devenit o problemă de importanţă majoră pentru individ, medicină şi societate. Aceasta deoarece este o boală frecventă, perfidă, de lungă durată şi devastatoare dacă nu este bine tratată.
Cele mai frecvente tipuri de diabet sunt: diabetul zaharat tip 1 şi diabetul zaharat tip 2.
În diabetul zaharat tip 1 (diabetul insulinodependent), pancreasul nu secretă insulină sau secretă o cantitate foarte mică. Celulele nu pot folosi glucoza din sânge şi astfel glicemia creşte. Afectează de obicei persoanele tinere, iar debutul este brusc. Simptomele şi semnele sunt: senzaţia de foame accentuată (polifagie), setea excesivă (polidipsie), eliminarea unor cantităţi mari de urină (poliurie), scăderea în greutate, oboseală.
În diabetul zaharat tip 2 (diabetul insulinoindependent), pancreasul secretă o cantitate insuficientă de insulină. Această secreţie scade în decursul timpului. La această deficienţă se adaugă şi un defect de utilizare a insulinei, numit rezistenţă la insulină, de aceea glicemia creşte. Afectează mai ales persoanele mature (peste 40 de ani), debutul este lent. Simptomele şi semnele sunt: poliurie, polidipsie, infecţii frecvente, vindecarea lentă a rănilor, înţepături sau furnicături la nivelul membrelor inferioare, iar în timp, şi la nivelul celor superioare, tulburări de vedere.
Persoanele cu risc de a dezvolta diabet zaharat tip 2, cu vârsta de peste 45 de ani, trebuie să-şi determine glicemia la intervale de 3 ani. Din categoria acestor persoane menţionăm:
– descendenţii (copiii) pacienţilor cu diabet zaharat tip 2;
– pacienţii cu hipertensiune;
– pacienţii cu dislipidemie;
– femeile cu istoric de diabet gestaţional sau care au dat naştere unor copii cu greutate la naştere peste 4 kilograme;
– obezii.
Diagnosticul şi tratamentul este stabilit de medic pentru fiecare pacient, în mod individual, pe baza stării sale de sănătate şi evoluţia în timp a bolii.
Reguli generale pentru dietă:
– aportul caloric zilnic trebuie adaptat în funcţie de vârstă, sex, talie şi de activitatea fizică desfăşurată;
– aportul caloric zilnic trebuie împărţit în 4-6 mese (în funcţie de numărul de gustări recomandat);
– evitaţi alimentele care conţin zaharuri rapide;
– renunţaţi la alcool şi reduceţi consumul de grăsimi;
– consumaţi alimente bogate în fibre;
– reduceţi aportul de sare mai ales dacă sunteţi hipertensiv.
Exerciţiul fizic: Creşte sensibilitatea celulelor la acţiunea insulinei, ajută la scăderea glicemiei şi stimulează circulaţia sângelui. Efortul moderat (de ex. mersul pe jos) practicat cu regularitate este preferabil unui efort mare, ocazional, care poate cauza scăderi severe ale glicemiei.
Dacă efectuaţi o activitate fizică intensă aveţi nevoie de un aport suplimentar de 10-15 g glucide la fiecare 30-40 minute de efort, pentru a evita hipoglicemia.

Dr. Liana David, Coordonator Compartiment

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