Types of Diabetes, diabetes type 1 – diabetes type 2

Question: Childhood obesity was diagnosed 2 degrees, but since neither analysis did not give up. always been pyshechkoyzh but moderate. the last year or two gaining weight 20kg. . and now weigh 170 with the growth of 91 kg. . (a month ago was 97 but was starving and did acupuncture) diet and sport specific results are not dayutsdala analysis of thyroid hormones, TSH 1.47, T3 0.86 T4 8.51, antibodies to thyroglobulin 0, antibodies to thyroid pereksidaze 0, endocrinologist said that the thyroid gland in normal and sent to the sugar curve results, fasting da 4,68, one hour after glucose load, 7,74, 2 hours, 5,41. In the urine through the 1,5 hours proteins, no sugar, carbohydrates -1020. mozhite what you say on this analysis. . violated if the carbohydrate metabolism, is there a predisposition to diabetes. . and what did all the extra pounds? but please do not write-read this section diagnosi

Answer: The section "Diagnostics" to your question is irrelevant:) In a small proportion of patients with obesity, it is not an independent problem, and one of the symptoms of other endocrine diseases. First and foremost, we are talking about a deficit of thyroid hormones (which you do not have) and Cushing's disease (excess adrenal hormones – to avoid possible to determine the content of the daily urinary free cortisol, endocrinologist see if the symptoms are similar to the disease). If the gross endocrine abnormalities have been identified – Obesity as if "by itself", and the diagnosis sounds "alimentary-constitutional obesity. In a situation where excess weight – from childhood, the reason – most likely (because if it were some kind of endocrine disease of the above, then for many years, it would give other symptoms and the diagnosis would have been raised). But with such obesity, some changes in lifestyle (eg, graduation, transfer to public transport on a car, a family) can lead to a shift in the balance between income and expenditure of calories and weight gain. The main methods that help reduce weight: 1. Lifetime low-fat diet (see FAQ in the "Obesity") 2. Increased physical aktivnosti3. Receiving drugs for weight reduction (within a few years) 4. In rare cases – surgery on the gastrointestinal tract. Elevated blood sugar (diabetes and prediabetes) – usually not the cause but the consequence of excess weight. To date, your sugar is normal, but obesity – a risk factor for diabetes, and weight loss reduces the risk.

FAQ

Question: Within 2 years saw the pill Yarin Novinet. She took more than 30 kilograms. My height 180 cm, before the tablets weighed 67 kg. now 98 kg. Lose weight can not even for a couple of kg. In the food itself is very limiting. I would like to see if you can drink away the course of tablets Miridiya, or Xenical? Can I drink if I have chronic pyelonephritis

Answer: The issue date. Yes, in Russia and other countries are allowed to use 2 main drug for weight loss – Meridia (sibutramine) and Xenical (orlistat). Food additives (such as "slimming tea" does not count – some of them creates the illusion of weight loss due to a diuretic effect, but a part – requires a very serious test for safety). To date, realized that these drugs (like many others) work until they accept. After discontinuation of the effect quickly disappears. So now erkomenduetsya TAKE THEM, IF overweight Expressions and Diets Exercise does not help, BUT TIME OF ADMISSION TO BE SEVERAL YEARS. Pyelonephritis is not a contraindication, but do not take drugs without a full-time consultation with a doctor (endocrinologist or dietitian) – at least to get the full information about the expected effects of medication, proper nutrition, etc.

FAQ

Question: I have a large overweight. After reading the forum with horror to learn about the pitfalls in products in which I tried to struggle with weight and gained it safely. Could you briefly list the products are safe, as they eat and how to refill the salad. Or vegetables are only useful in its pure form? Diets are so contradictory, in the last year of struggle and diet I lost 7 kg, and won 15, already an excessive weight. I am in a panic, what to eat? Bad for it in terms of weight of the eggs? "Thank you

Answer: It must be remembered that the main sources of calories – it is not bread, sweets, and fats. Here are the generally accepted guidelines for low-calorie diet (see below) salad can fill with vinegar, lemon juice, unsweetened yogurt, some sauces (ketchup, Tkemali), some vegetables can be eaten in its pure form, without salad – then you will not be added to food surplus fats. Eggs – not "champions" for the calorific value (approximately equal to meat), but rich in cholesterol (have their limit at elevated levels of cholesterol in the blood). Here are the main recommendations: Group 1. Zoom potreblenieOvoschi (but without added fats) in the form of vegetable side dishes: cabbage, cauliflower, carrots, beets, turnips, radishes, cucumbers, tomatoes, sugar zelenNapitki (mineral water, tea) or sweetener ( "Bell", "Diet – Pepsi, Coca-Cola Light ", etc.). Group 2. Reduce consumption vdvoeHleb (black or white), cereals (rice, buckwheat, oat, etc.), potatoes, pasta, corn and soy products, crackers, dried (unsweetened), etc. are allowed in moderation: low-fat meat , fish, cheese, fruit, caramel, pastilaGruppa 3. These products are desirable to eliminate from the diet (contain lots of calories): Butter, vegetable (especially in salads, vinaigrettes and overheating of food), sour cream, mayonnaise, butter substitutes (Rama, etc.), bacon, sausages and frankfurters, sausages and pates, meats, fatty meat, oily fish, organ meats (liver, liver), chicken legs, skin of birds, fat ( "yellow" and processed) cheese, cream, fat cheese, ikraorehi and seeds, chocolate, cakes and pirozhnyeOsnovnye reasons failures while reducing weight: • Fat is calories, so even a small amount of "extra" fats (such as tea or tablespoon vegetable oil in a salad) can nullify the efforts to reduce the weight of the whole day. The need for fats in the adult small. It is fully covered by the meat, fish, cheese, soups, etc. But the flavoring fats (vegetable oil, sour cream, mayonnaise) – this is "extra" fats. • There are plenty of foods rich in fat (so-called. "Hidden fats). This ALL sausages, frankfurters, sausages, nuts, seeds, cheese with fat content> 15%, etc. Since these products can unconsciously get a lot of calories.

FAQ

Question: Tell me, please. I am 35 years old, in September 2006 was in the hospital with a diagnosis – the traumas neuroinfections, 4 months in hospitals. After the new year very strongly started to gain weight. In October 2006, weighed 78, in May 2007 – 92 kilos. Diets do not bring results. In our city there is no specialist in endocrinology. At my initiative, surveys were conducted: thyroid gland – normal. Adrenal ultrasound – right 25h18 mm, left 34h21 mm (and both increased). Blood test for thyroid hormones: T4sv. – 15,5 TSH – 5,1. Blood tests for adrenal hormones – cortisol 580 nmol / liter. Can you please tell as to whether this weight gain, and what should be treated.

Answer: main "endocrine" causes of obesity – lack of thyroid hormone (hypothyroidism) and increased cortisol levels (with the disease / Cushing's syndrome). Thyroid: T4 is normal, but elevated TSH. This state (subclinical hypothyroidism – cm. FAQ) can not cause excess weight, but requires monitoring. Cortisol normal. More accurately reflects its level is not the content of cortisol in the blood, and its amount in daily urine. You can do this analysis, but it is likely that he will be the norm, and will reduce weight, adjusting the power. This conversation is long, but be aware that vegetable (olive and sunflower) oil in salads, nuts and seeds, hot dogs and sausages – those "trap" in which patients often fall into trying to reduce weight, if the food would be more correct – diet begins to work and the weight will drop.

FAQ

Question: I'm 26 years old, not giving birth. For several years I have extra weight. Between the ages of 22 I started to gain weight, about 5-6 kg per year. Has tried different diets, drugs, phys. exercises, all to no avail. In this view quite a healthy lifestyle and eating not much. Is it possible to find the cause of the problem and a way to eradicate it? What should undergo examination, etc., to understand the reason for weight gain

Answer: In the relatively small (<10%) percentage of cases, excess weight is linked with overt endocrine disease ( "gross deviation from the norm"). Usually, this lack of thyroid hormone (hypothyroidism) or an excess of adrenal hormones (Cushing's syndrome). To remove them better to address an endocrinologist, than do it yourself. If "gross violations" have been identified, the cause is usually a combination of predisposition to excess weight and conditions of life in which the intake of calories into the body more than their consumption. A set of weights may occur after the drive, the cessation of sports activities, changes in diet, the emergence of a new job, buying a new TV, etc. A number of people stress cause increased appetite. In this situation, the basis of treatment – correction of power (to reduce the calorie), and increased physical activity (but fitness and t. Subsection effective only if your business is at least 4-5 hours per week). Backup methods – use of drugs for weight loss (but it must be long – so it makes sense only if the lack of effectiveness of diet) and surgery (with a very large excess weight). On a diet – a long conversation, but the best is the one that you can observe all his life (because if a diet with a short sharp caloric restriction reduced weight, but then returns to its original or even higher). Frequent "traps" that interfere with our patients to reduce weight – it is unobtrusive source of large quantities of calories: vegetable oil in salads, hot dogs, sausage, nuts and seeds, chocolate and cakes, cheese with fat content> 15%, etc.

FAQ

Question: Dear Doctor, help me. Five years ago I had a normal weight. But then I lost weight very rapidly, literally for 2-3 months. At my height was 162 weight 54kg, 45kg and now. What are the only tests I have not yet passed, all normal. Checked the stomach, intestines, hormones, all in perfect order. Be tested for all kinds of parasites – nothing. But recruiting at least a couple of kg. I did not succeed. Maybe tells how to do this? Or prompt where to go

Answer: Deficiency of weight may be a "feature" of the organism (but then he had his youth and for many years), and may be a consequence of certain diseases (including, endocrine). Apparently, a survey would have to identify these diseases, if they were. There is the option of depression (leads to the "unexplained" weight loss). If you feel the mood of the reduced in recent years – visit neuropsychiatrist to understand. More difficult to say something – at a distance and with a minimum of data.

FAQ

Question: I know that diet in diabetes should be varied. However, I have five years restricting your diet to not gain weight, since leading a sedentary lifestyle. In grain units. it looked like this: breakfast-3 XE, 2nd breakfast-1 XE, XE-3 lunch, dinner-3 XE, bedtime 1HE. with no fat, only -2 slices of black bread a day, only meat in the soup, once a day, no cereals, rolls and sweets, except for yogurt and 1-2 vanilla cheese per day. Lot of vegetables. With this diet, I felt great, easy to transfer any heat, doing daily exercises. But each. SRI times. doctor telling me that I do not eat and that such a diet can damage the kidneys. Hemoglobin I declined. The beginning is a must-have become and cereals and meat. By HEH everything remained roughly as (+2-3 he). But even sedentary work and immobility. life, that's corrected to 4 kg. This significantly-now suffering from the heat in summer, more meteozavisimost, I feel is not as easy as before. A better way to return to the old diet, despite the reduced hemoglobin? At my height (156 cm), a weight (53 kg) is very noticeable.

Answer: First, your diet has not been glycoprivous: 11 XE – this is quite normal for a girl (assuming that you have correctly calculated the HEH and is not included in the carbohydrate-containing vegetables and meat products (only rissole chops and have a little carbohydrate). Secondly, you must understand that he and calories – not the same thing! main sources of calories – this fat (0 HEH). The flesh, too, no carbohydrates, and calories are . I would suggest to reduce the weight limit foods high in fat (see FAQ about the diet in diabetes and overweight, with type 1 diabetes). To prevent anemia consume enough ( "universal") of meat, but if confirmed, that iron deficiency anemia (low iron in the blood), in any case, you need a course of iron supplementation, and the lack of it usually occurs not because of lack of consumption, but due to constant losses (eg, heavy menstrual bleeding, stomach ulcer, etc.). But anemia are different (not only iron-), and therefore requires the establishment of its type and purpose of the treatment.

Weight Control

Question: Dear Oleg, Thanks for your reply, GV and sugar in a child (measured the fasting glucometer – 4,3) Just pediatrician can not understand why a child's large weight gain (800-1100-1300). But a question I have. During the pregnancy I put Gestational diabetes (after loading 100 g: 5,83-11,27-10,03 mmol). To put IGT impaired glucose tolerance, because the expense of a balanced diet sugar kept within normal limits. Before pregnancy, I strongly gaining weight (quit smoking + unhealthy diet), resulting in IIstepeni obesity (BMI 33). Previously, blood sugar stayed within 4 during pregnancy OK. 5,5-6, and now – 5.1 (regardless of whether I eat sugar and other carbohydrates, fast or not). I hoped that after birth the sugar back to normal (as before). Endocrinologist, cat. observed pregnancy, said that after all this mozhe "haunt" and fraught with SD. Question: 1. Could sugar to rise due to weight gain? (all other tests are normal) 2. how lose weight through breastfeeding, and whether it is possible now, without prejudice to the child (3 months).

Answer: 1. Yes, overweight – one of the major risk factors for gestational diabetes and type 2 diabetes (the disease have a common origin, and therefore increases the risk of gestational SD 2 diabetes in the future). 2. To reduce the weight to dieting with a moderate decrease in caloric value – it is possible and breastfeeding. General principles of the diet outlined in the FAQ section "Hormones" – "Obesity" – look. There will be more questions – write.

Weight Control

Question: I 44 года weight of 135 kg height 180've heard that with the aid of preporatov testosterone can fight obesity was tested for free testosterone 16,6 prolactin 136 in consultation with the physician received advice to lose weight through diet thyroid gland normeHotelos would try to use any or preporaty testosterone as well and to increase libido. What do you suggest

Answer: This question is asked quite often (especially after the TV E. Malysheva, created the false impression that the preparations of testosterone lose weight). In fact, these drugs alter the ratio of fat and muscle tissue (which, of course, good), but the weight does not change. Ie, your 135 kg will remain with you: (The use of these drugs useful in androgen-deficient states, but due to lack of accuracy and reliability of modern methods for determining free and total testosterone levels, even gross abnormalities diagnosed reliably, and the border – there is no : (On the other hand, weight reduction through diet and physical exercise also improve the level of testosterone.

FAQ

Question: My daughter's 18 years of weight-105 kg at 165 cm growth hormone in normal (although the results of tests your doctor has not yet shown) striae on the breast and belly, very big breasts, diet does not work precisely, it can not greatly limit yourself, but trying. Since she was studying at university, you can not eat regularly throughout the day, what doctor to contact? Can irregular meals lead to this result? What tests should take in such cases? Sugar normal.

Answer: To exclude hormonal causes of obesity (they occur in less than 10% of patients) is sufficiently determine the level of TSH in the blood (a reflection of the thyroid gland) and free cortisol (but only in the daily urine!). If these figures are normal – then the weight loss may be used 4 groups of methods: – Reduction in caloric intake (but it is done so that there is no feeling of hunger) – Physical exercise (at least 3-4 hours per week, with individual selection of the program loads which are not contraindicated, but quite intense). – Long-term (several years) receiving drugs to reduce weight-Operation for gastro-intestinal tract (stomach reduction, etc.) Call for treatment should be an endocrinologist or dietitian. But all this makes sense to speak only with your daughter, and if she comes to the doctor and say: "I want to lose weight – please help me." Regular or irregular supply is important, but not very large.

FAQ