Clinical Prof. Dr. Weerasak Sarinnapakorn, MD. Songkunwut Head of Endocrinology Internal Medicine Group Rajavithi Hospital Discussing diabetes treatment with Hfocus that treatment of diabetes, dietary behavior modification. exercise weight loss if obese is still at the heart of treatment. Medication treatment depends on the type of diabetes. If you have type 1 diabetes, which is mainly found in children or young people, insulin is needed. Type 2 diabetes is more common in obese or overweight adults. But found in obese children or younger people more. The cause of this type of diabetes is due to inappropriate eating habits and excess demand. Rarely exercise and obesity if you continue to live the same way. The disease may be progressive, which is identified by increased dosage or the need for insulin injections. However, if treating the underlying cause, such as choosing a healthier diet and the right amount, along with proper exercise and weight control, can improve the disease, such as improving blood sugar control or reducing the dosage. In cases where glucose levels are very high or if behavior modification is not able to control their glucose levels, it is necessary to use medications that include oral and injectable medications, including insulin. This may start with oral medications and insulin injections. It is used in patients whose pancreas is greatly reduced. When taking oral hypoglycemic drugs is ineffective or is contraindicated in the use of oral medications such as pregnant women
Examples of foods used to treat diabetes include:
- Healthy food dish 2:1:1 Have half a plate of vegetables, a quarter of a plate of rice, and preferably whole grains. Because brown rice has less sugar than white rice and glutinous rice, the other 1 in 4 dishes should eat protein foods such as fish, chicken or eggs. Choose lean meat, no skin, drink water, fresh milk, black coffee without sugar. Replace dessert with low-sugar fruits such as oranges (1 fruit), apples (1/2-1), rose apples (2), rambutans (3-4 fruits), etc. (eat only each type alternately). It is good for the body of diabetic patients.
- Controlling the daily calorie intake This may be a diet of 1,200-1,500 calories per day for females and 1,500-1,800 calories per day for males. But it may be more or less depending on body weight and physical activity per day. In the case of a very low calorie diet, such as 800 calories per day (Very low calories diet), this should be on the advice of your doctor. because the dose may need to be adjusted have a sugar level test and have food substitutes to obtain complete nutrients Sometimes people with diabetes eat flour, rice, bread, so much that they get used to it. If they eat less, they may feel that they are not full. But gradually reducing the rice, such as reducing ½ ladle and gradually adding vegetables, switching to high-fiber foods such as brown rice, will keep your stomach and not very hungry. After regarding 1-2 weeks, as the body adjusts, gradually reduce the rice ½ ladle increments until the recommended calorie intake may be able to maintain the change over the long term.
- intermittent fasting Intermittent fasting (IF) Studies have shown that reducing dinner intake improves weight loss and glycemic index. Therefore, it is advisable to eat less dinner and eat dinner earlier. Until now, many people have started to intermittent fasting called IF. There are many ways. But the formula for IF 16/8: Eating at 8-hour intervals and fasting at 16 intervals. Hour is a recommended formula for those who are starting to do IF because it’s easy to do. can continue And it doesn’t affect your daily life too much, but if you do IF, you should consult a doctor. Because it requires self-examination of sugar and medication adjustments. especially those who use drugs that cause low blood sugar or insulin.
- low carb diet By reducing sugar, rice, flour, bread, focusing on protein and fat foods. But should be good protein and good fats, such as fish, chicken, eggs, olive oil, which foods with low carbohydrate content are low carb diet and ketogenic diet, where the Low carb diet will eat 50-150 grams of carbohydrates per day, but the diet The ketogenic diet consists of no more than 50 grams of carbohydrates per day and protein no more than 20% of your calories, which in the short term may be good for weight loss. But the long-term weight loss results may not be different. In addition, eating such foods may have limitations that cannot be done in the long term and should consult a doctor, especially those with underlying medical conditions.
You should also know how to read nutrition labels. Choosing to eat out during the trip and on sick days
Clinical Prof. Dr. Weerasak Added that if you hurry to take care of your health and change your behavior from the beginning, you will be fully focused on changing your diet, exercising and losing weight in obese people. It will calm the symptoms of the disease (diabetes remission) is able to control sugar levels to normal without the use of medication. (Studies have shown that if 15 kg of weight can be lost in obese people with diabetes, there may be a 50% remission of diabetes, especially in those with diabetes up to 6 years), but it is not lost because if the behavior inappropriate come back Diabetes will return as before. Therefore, even if the disease has improved until there is no need for medication, but the sugar level must be checked. If the HbA1c level of less than 6.5% is maintained without medication for more than 3 months, diabetes may be considered remission. But it is important to monitor the recurrence of diabetes without being too complacent.
“The goal of treating diabetes is to have a healthy body. good health There are no complications from diabetes, in addition to normal or near-normal control of sugar levels. It also controls other risk factors including blood pressure, blood lipids, smoking cessation, weight loss, and has annual complications such as eye exams, urinalysis. Kidney function examination, foot examination, and if there are abnormal symptoms such as severe chest tightness, weak limbs, distorted mouth, slurred speech, foot ulcers, you should see a doctor immediately. In addition to behavior modification To take care of your feet, you need to keep checking your feet so that they don’t get hurt. or need to be treated because the wound will spread quickly take a long time to heal Diabetic patients therefore need to take care of their feet by choosing the right shoes. Fits the foot and can be adjusted in size. thick heel get good bumps Shoe head should not choose a pointed head that squeezes the toe. should not walk barefoot You may also find shoes for walking around the house. To prevent walking and stepping on a wound Avoid hot baths, as the numb feet can’t perceive how hot the water is. risk of harm Even toenail clippings, if the patient has vision problems, must have someone else cut them so they don’t touch the meat. If there is a blister or a blister should be taken care of by a doctor Because a small wound can spread so quickly that a finger is amputated. Foot amputation is possible, however, people who live with diabetes without complications are those who understand and know diabetes. and adapt to the disease If not adjusted at the cause to treat it, it will be the treatment at the end by adjusting the drug and increasing the drug to avoid complications. because food is a medicine what we eat or drink You can fight the disease or promote it to be more. including having knowledge Understanding Disease and Complications by coexisting with diabetes properly Many things are things that people with diabetes have to do on their own. for the patient himself that no one can do it for me,” confirmed Clinical Prof. Dr. Weerasak.
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