Pancreatin for type 2 diabetes
Pancreatic diabetes does not always develop with inflammation of the pancreas. But if that happened, it has a number of features.
Pancreatitis and diabetes often develop at the same time.
In chronic pancreatitis, endocrine disorders occur, which can occur both in the form of hypoglycemia and in a form such as pancreatogenic diabetes mellitus. Hypoglycemia occurs with all symptoms typical of the disease, which include a constant feeling of hunger, weakness, pain, convulsions, or tremors throughout the body.
As for diabetes, it is not a type 2 disease, but a separate variant of it, which is isolated in type 3.
For example, such diabetes often develops in people of normal or even slim build, and in itself has nothing to do with obesity. There is also no association with insulin resistance or genetic predisposition. The increase in blood sugar often happens almost imperceptibly.
Symptoms that appear several years after the first abdominal pain is associated with changes in a large number of pancreatic cells.
Features of pancreatogenic diabetes are:
- low insulin requirement;
- rare ketoacidosis;
- increased susceptibility to infectious and skin diseases.
Mechanism of transition of pancreatitis to diabetes
Pancreatitis and diabetes do not always develop at the same time. The pathway linking chronic pancreatitis (CP) to diabetes is poorly understood. There is a little more information about acute pancreatitis (OP) because it is easier to diagnose.
With exacerbation of chronic pancreatitis, transient hyperglycemia develops, which is associated with pancreatic edema.
Statistics show that transient hyperglycemia in such situations occurs in 50% of cases, but stable lasts only in 15% after transmitted OP ..
Along with the worsening of the chronic form of the disease, transient hyperglycemia also develops, which is associated with pancreatic edema.
At the same time, trypsin levels rise in the blood and it reduces insulin production. As the seizure progresses, blood glucose levels return to normal.
causes
The risk of developing diabetes does not depend on the degree of pancreatic necrosis, but on what methods of surgical treatment have been used. For example, with pancreatoduodenectomy, the probability of developing postoperative diabetes reaches 50%.
The following causes of type 3 diabetes are distinguished:
- Chronic inflammation of the pancreas. It is caused by various factors, for example, lack of timely treatment of acute food poisoning, malnutrition, etc. The number of pancreatic enzymes, which destroy this organ, increases.
- surgery.
- Bad habits.
- Being overweight as a result of malnutrition.
- Other diseases of the pancreas and digestive tract, due to which endocrine function is impaired and blood glucose levels increase.
symptomatology
First, symptoms characteristic of pancreatic tissue damage appear:
- nausea without vomiting;
- frequent heartburn;
- bloating and bloating;
- epigastric pain;
- unstable stools, diarrhea or other digestive disorders.
This type of diabetes is mild. Tests show a relatively small increase in blood glucose. But there are often attacks of hypoglycemia. Over time, blood glucose begins to increase more intensely, there are already classic signs of diabetes, including constant thirst and dry skin.
Complications such as ketoacidosis or ketonuria are rare in this case. But complications from other organs can appear - diabetic neuropathy, impaired renal function, retinopathy.
Prevention and treatment of pancreatic diabetes
Therapy of chronic pancreatitis is carried out simultaneously with the treatment of diabetes. Includes the following parts:
- Dietary compliance. Since the disease is caused by metabolic disorders, it is necessary to adjust the diet so as to improve metabolism and eliminate hypovitaminosis and protein deficiency.
- Taking sugar-lowering medications. It is necessary to normalize carbohydrate metabolism, endo and exocrine system. To do this, take insulin - in small doses and for a short time, and then - sulfa drugs, for example, Diabeton.
- Postoperative replacement therapy, taking enzymes (eg pancreatin).
- Liver cell protection (prescribed Essential Forte).
- Autotransplantation of island cells.
Dietary rules for diseases
To avoid pathological changes in the cells of the pancreas of the body, it is necessary to completely eliminate a number of products ..
Products that can and can't
In addition to these diseases, the following are excluded from the diet:
- fatty meat;
- dairy products (cream, sour cream, full of fat in whole milk);
- any fast food;
- vegetables (radishes, garlic, onions, spinach);
- fruits - grapes, pineapple;
- legumes;
- spice;
- baking butter, chocolate, ice cream;
- ready-made sauces - mayonnaise, ketchup, soy sauce, tomato paste and even juice.
Forbidden rich fish and meat soup.
Plant nutrition
Sources of plant proteins are legumes. But with chronic pancreatitis they are banned, so a plant-based diet for these diseases is not prescribed.
Diet 9 for pancreatitis
Foods in which carbohydrates play the role of a natural preservative are excluded from the diet. These are bananas, dates, figs, tomatoes, grapes.
Sweet and sour berries and fruits are recommended - almost all citrus fruits (except grapefruit and lemon - contain too much acid), apples, kiwis, cherries, black currants, cranberries and lingonberries.
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Diet 5 for diabetes
Treatment table no. 5 according to M. Pevzner is prescribed for patients with chronic pancreatitis or pathologies of the hepatobiliary system. The main points are combined with the nutritional needs for diabetes:
- Reduce fat intake, avoid fried, spicy, salty foods, canned meat and vegetables, smoked meats.
- Adherence to cooking rules. Cooking, sautéing, steaming, baking without crust are allowed.
- Food should be fractional, divided into 5-6 meals. With exacerbation of pancreatitis, all meals are served in liquid or semi-liquid form, with remission, cut into small pieces.
- Food that increases intestinal motility is excluded, it is digested for a long time, it can cause fermentation - fresh bread, legumes, cabbage, etc ..
It is important to drink enough fluids - 1.5 liters of clean water without gas per day.
For diabetes, fried, spicy, spicy foods should be discarded.
A diabetes diet should be fractional, divided into 5-6 meals.
Sweet and sour berries and fruits are recommended to be included in the patient's diet.
It is important to drink enough fluids - 1.5 liters of clean water without gas per day.
How to combine Tables 9 and 5?
This condition of the body, in which pancreatitis is accompanied by diabetes, requires a special approach to diet. But both therapeutic diets are quite close, suggesting a number of general rules and restrictions.
A few simple recipes
Proper nutrition plays an important role. But that doesn’t mean it should be monotonous. You can treat yourself to dessert from time to time.
Meat pudding
For cooking take lean meat, for example, beef - 150 g. It must be cooked and go through a meat grinder.
Also, for the pudding, you will need 1 egg, 1 tbsp. porridge, a little vegetable oil.
Semolina is pre-filled with boiled water (1/3 cup) so that it swells. Egg and spoon are added to the prepared minced meat, everything is mixed, salt to taste. Lubricate the mold with oil before placing it in the double boiler.
Vinaigrette
With pancreatitis, you can cook vinaigrette. You will need 100 g of potatoes, 90 g of beets, 60 g of carrots, 60 g of fresh cucumbers, salt to taste, 1 tbsp. cooking oil for topping.
Potatoes, beets, and carrots should be cooked separately from each other, cooled and cut into cubes. Peel a cucumber and cut it into cubes. You can add lettuce leaves if desired. The vegetables are mixed by adding salt and oil.
Dry porridge
For this dish, you will need 300 g of low-fat cheese and the same amount of apples, 2 eggs, 100 g of raisins, which are pre-washed and steamed in boiling water.
The apple must be peeled from the seeds and peeled, then grated in a small oven. Raisins, eggs and the resulting apple sauce are added to the curd mass, all thoroughly mixed, transferred to the parchment in the form and put in the oven, preheated to 180 ° C. Bake the cheese souffle for 40 minutes.
Bar drink
Prepare it from the dried fruits of this plant. Cooked immediately in a thermos. For 1 liter of boiling water, you need to take 4 tbsp. fruit. The drink is drunk for several hours. You can't add sugar to it.
Chronic pancreatitis and diabetes - two stages of the same disease?
Pancreatitis and diabetes are the two most serious diseases that go hand in hand. In this case, type 1 and 2 diabetes are often the results of advanced pancreatitis.
Prerequisite for the first symptoms of pancreatic disorders, in about 70%, is alcohol abuse, in 20% - liver disease, including gallstone complications, and in 10% - other causes, including regular eating disorders, stress, lack of rest, and individual reactions of the body to certain drugs and chemical compounds.
Early diagnosis and treatment of chronic pancreatitis is complicated by its gradual and rather slow development. Sometimes the process takes decades.
During this period, sharp cutting pains in the left hypochondrium are replaced by long drowsies during which the person feels healthy.
But this deceptive condition and any, even minor, eating disorders can cause acute inflammation of the pancreas, which over time turns into a chronic form.
Types of pancreatitis
The disease is found in acute and chronic forms ..
In the acute form, due to inflammation, the juice of the pancreas does not pass into the lumen of the duodenum but digests the tissues of the pancreas itself. This process causes necrotic changes in the cells of the diseased organ, and in particularly severe cases, the complete death of the entire gland.
Chronic pancreatitis, depending on the cause, is classified as follows:
- Primarily - it originally occurs in the pancreas for some reason.
- Secondary - is a consequence of diseases of other organs: cholecystitis, ulcers, enterocolitis.
- Post-traumatic - a consequence of mechanical stress or surgery.
The mechanism of diabetes
Type 1 and type 2 diabetes can arise from either form of the illness..
Type 1 diabetes mellitus, with pancreatitis, occurs due to the fact that inflamed pancreatic ducts do not pass digestive enzymes into the lumen of the duodenum 12 and only digestion begins, degeneration of cellular tissue into fatty, connective or complete death of organ fragments.
The body experiences an absolute lack of insulin, blood glucose levels increase, which has a destructive effect on all body systems.
Type 2 diabetes occurs with sufficient insulin production. But due to metabolic disorders, it does not fulfill its main function, creating a relative insufficiency.
Pathological changes accumulate over time and are divided into four stages:
- In the first stage, short-term exacerbations are intertwined with long drowsiness. Chronic inflammation develops in the gland, which is mostly latent with rare pain syndromes. This period can last up to 10-15 years.
- The second phase is characterized by more pronounced dysfunction of the digestive system. Inflammation causes an uncontrolled release of insulin into the blood, which can even lead to temporary hypoglycemia. The general condition is complicated by stool disorders, nausea, decreased appetite, gas formation in all parts of the gastrointestinal tract.
- Pancreatic functionality is critically reduced. If on an empty stomach, the tests do not reveal any deviations, the glucose in the blood plasma is determined far beyond the normal time interval after the meal.
- And in the last stage, secondary diabetes develops, which affects one-third of patients with chronic pancreatitis.
Characteristics of diabetes progression in chronic pancreatitis.
It would be logical to conclude that two diseases are much more difficult to treat than one. But practice shows the failure of such a conclusion. The secondary procedure has several features, thanks to which it can be well cured:
- It passes almost without ketoacidosis;
- Insulin treatment often results in hypoglycemia;
- It tolerates a low-carbohydrate diet well;
- In the first stage, oral medications for diabetes are quite effective ..
Prevention and treatment of pancreatic diabetes
Not every chronic pancreatitis necessarily causes the development of diabetes. With proper treatment and a strict diet, you can not only improve your pancreas but also prevent the onset of diabetes.
The endocrinologist selects the individual treatment in each individual case. Depending on the indicators of the production of digestive enzymes through the gland, the competent specialist prescribes replacement therapy based on enzyme drugs of similar action. As well as insulin injections if needed.
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Diet for pancreatitis and diabetes
You need to know that proper treatment and strict adherence to diet can lead to a complete cure of these severe ailments. Eat often and in small meals - 250-300 grams in one meal. Give preference to products that contain protein: soy, eggs, meat, fish, nuts.
The danger of complications of diabetes
Remove from the diet acidic foods that cause rapid secretion of gastric juice: sour, spicy, smoked, fried, containing alcohol, too hot or cold. In a word, all dishes. which can cause additional stress on pancreatic secretion.
Food should be steamed and consumed hot, not hot or cold.
If it is difficult to choose the right diet on your own, you can apply specially designed dietary recommendations collected under the names: table no. 5 for patients with pancreatitis and table no. 9 for diabetics. But before choosing this or that diet, it is necessary to consult a doctor.
Only taking into account all the features of the course of the disease and the general condition of the patient, the doctor gives the most accurate dietary recommendations.
Product selection
In different periods of the disease, the diet may vary slightly. Thus, for example, sweet and sour fruits or dishes based on rice, oatmeal and porridge are quite acceptable during a period of prolonged remission, completely excluded when the disease worsens.
Suitable products should be selected individually for each patient, taking into account:
- Personal preferences;
- Ability to observe glucose;
- Intolerance to any substance;
- Correction of partial absorption of nutrients.
In the acute period, it is strictly forbidden to eat foods high in sugar, fatty and smoked foods, pastries, fried foods, cereals: rice, oatmeal, porridge; raw fruits and vegetables, white bread.
A proper wellness diet always includes protein products, lean beef, chicken breast, low-fat fish, buckwheat porridge, gray dry bread, crackers, dryers, steamed vegetables, and fruits or a stew with a minimum amount of fat.
As for vegetable oils, it is better to use, in reasonable quantities, flaxseed and olive first cold-pressed, which have medicinal properties. It will also damage low-fat milk. Milk enriches the body with vitamins, minerals and helps alleviate inflammatory processes in the digestive tract.
Unfortunately, people are so arranged that understanding the full value of health, they still “dig with a rough spoon”. But the same folk wisdom has long since found a simple solution to the problem of the pancreas - hunger, cold, and peace.
By adhering to this simple rule and following a specially selected therapy, most patients can overcome many ailments and return to a healthy and complete state.
Pancreatin for type 2 diabetes mellitus
However, this mechanism is not a regularity. Many patients who already suffer from type 1 or type 2 diabetes develop pancreatitis. And people who have been diagnosed with chronic pancreatitis can avoid this complication.
Pancreas and diabetes
Pancreatin - a digestive enzyme designed to compensate for the lack of function of the exocrine organs of the pancreas.
The main active ingredient is pancreatin, which includes enzymes - lipase, proteinase, amylase. Due to these components, proteins, triglycerides, and starch are broken down.
According to the instructions for the drug, the drug is indicated for chronic pancreatitis, which allows taking Pancreatinum in diabetes complicated by this disease ..
Rationale for use
Diabetes and chronic pancreatitis are interrelated.
With the loss of exocrine function of the pancreas, there is exocrine insufficiency (production of enzymes is reduced), which can cause a complication - pancreatogenic diabetes mellitus.
The chronic inflammatory process in pancreatitis leads not only to exocrine insufficiency but also to the destruction of the islets of Langerhans. Exocrine pancreatic failure is particularly common in type 2 diabetes.
Pancreatogenic diabetes is characterized by the following symptoms:
- dyspeptic symptoms;
- epigastric pain;
- increased blood glucose;
- skin diseases;
- frequent infections.
The combination of diabetes and chronic pancreatitis requires a special approach to treatment tactics.
Methods of treatment
Due to the fact that the development of diabetes depends on the presence of chronic pancreatitis in the patient, the treatment of the disease is to eliminate the main cause - pancreatitis.
The basis of therapy is a strict diet and diet. Drug treatment is complex and involves the use of enzyme preparations. It is recommended to take pancreatin for type 2 diabetes.
Treatment of pancreatogenic diabetes requires compensation of exocrine pancreatic insufficiency, which can be achieved by using pancreatin or its analogs: Festal, Mezim, Creon.
Effect of pancreatin on diabetes
The naming of enzymes in diabetes contributes to:
- improve carbohydrate metabolism;
- stabilization of glycated hemoglobin;
- increased glycemic control;
- reduce the risk of complications of diabetes;
- improving the quality of life of patients and improving their well-being.
According to research by German scientists, pancreatin therapy for exocrine pancreatic insufficiency in type 2 diabetes can be used in conjunction with hypoglycemic agents and does not affect the patient’s glycemic profile. Such treatment is considered very effective and safe.
Use
In diabetes, pancreatin should be taken in strict accordance with the recommendations of the official instructions for the drug ..
The single daily dose is determined in terms of lipase, according to the age of the patient and the complexity of the disease.
The average daily lipase requirement for an adult patient is 150,000 units. In case of complete pancreatic insufficiency - 400 thousand units.
It is recommended to take pancreatin tablets after a meal, 3 times a day. The duration of therapy is determined by the doctor and can range from a few days to several months or years.
Concomitant use of drugs with iron-containing preparations may reduce iron absorption.
MEZIM, FESTAL, PANCREATIN, ENZIBENE can cause a complication of diabetes. - Treatment by the method of Dr. Skachko Boris
Skachko Boris
Mezim, festal, pancreatin, enzymes in diabetes mellitus cause complications!
The pancreas is involved in the digestion of all major sources of energy (proteins, fats and carbohydrates). This ensures the complete assimilation of digestive products in the cells. It is important to maintain a balance of both components.
The balance should also be observed from the side of the exocrine function of the pancreas, whose enzymes (proteases, lipases, and aldolases) ensure the digestion of food in the gastrointestinal tract. This is also the case with the endocrine function of the pancreas, which provides a reduction in blood sugar through the hormone insulin. And regulation of other types of metabolism of energy substrates (proteins, fats).
What happens to type 1 or type 2 diabetes? Impaired glucose uptake into cells occurs when insulin is insufficiently produced in the pancreas (type 1 diabetes mellitus) or when the pancreas produces defective insulin, impaired insulin receptor sensitivity, and liver resistance to insulin (type 2 diabetes). This is a standard situation with high blood sugar.
How can mesime, festal, pancreatin, enzymes, and other enzyme preparations affect this situation? Very simple. The intake of additional digestive enzymes into the body not only speeds up but also speeds up the digestive process.
This causes an imbalance in the activity of the exocrine and endocrine pancreas. And a rapid rise in blood sugar and stress on the pancreas. Which worsens diabetes mellitus, both type 1 and type 2. Because.
requires either more sugar-lowering drugs, in the case of type 2 diabetes. Or the introduction of additional units of insulin in type 1 diabetes.
What will you get if you do not take the enzyme preparation if you have diabetes? Activation of intestinal microflora, decay process (protein food), or fermentation (carbohydrate food). Absorption of toxic substances into the blood, overloading the possibilities of detoxification function of the liver and kidneys. In general, good is not enough. Especially if there is type 1 diabetes.
What happens when enzyme preparations (pancreatin, mezim, festal, enzyme) are taken by people who do not have diabetes? On the one hand, improving the digestive process reduces bloating and swelling. On the other hand, replacement therapy leads to a gradual decrease in the ability of the pancreas, its exocrine function.
And it translates a person into a constant use of enzyme preparations. And the increase in the absorption of digestive products into the blood overloads the endocrine function of the pancreas, and in the future there will be type 2 diabetes.
A sharp increase in blood viscosity can lead to more serious consequences - increased heart risk, risk of developing a hypertensive crisis, myocardial infarction, stroke.
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