Contents
- 1 Diabetes tipo 2 – Lo que necesitas saber para prevenirla, retrasarla y tratarla.
- 2 Diabetes tipo 2 – Cómo prevenirla, retrasarla y tratarla.
- 2.1 1. Los genes determinan algunos, pero no todos tus riesgos de contraer la diabetes tipo 2
- 2.2 2. Los factores de riesgo clásicos de la enfermedad cardíaca también aumentan tu riesgo
- 2.3 3. No todas las personas que sufren diabetes tipo 2 tienen sobrepeso o son obesas
- 2.4 4. El riesgo aumenta con la edad; sin embargo, nunca es tarde para hacer cambios saludables
- 2.5 5. Cuanto más te muevas, mejor
- 2.6 6. Los alimentos más saludables para prevenir la diabetes tipo 2 no traen etiquetas con información nutriciona
- 2.7 7. Aliviar el estrés puede disminuir el riesgo de padecer diabetes
- 2.8 8. Depende de ti el tratar tu diabetes
- 2.9 Comparte esto:
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- 2.11 Relacionado
Diabetes tipo 2 – Lo que necesitas saber para prevenirla, retrasarla y tratarla.
Diabetes tipo 2 – Cómo prevenirla, retrasarla y tratarla.
La diabetes tipo 2 en la actualidad y en la mayoría de los casos se admite que se trata de una enfermedad manejable, y también prevenible. Sin embargo, la diabetes tipo 2 continúa cobrándose un altísimo precio. Si no se la trata, la diabetes puede causar daños en la retina, provocar ceguera y destruir los riñones.
Con el paso del tiempo, los niveles de azúcar en sangre anormalmente elevados pueden reducir la circulación en las extremidades. Esto puede derivar, en última instancia, en amputaciones. Estudios recientes han vinculado la diabetes tipo 2 con un mayor riesgo de padecer demencia. Las personas con diabetes son, también, hasta cuatro veces más propensas a presentar enfermedad cardíaca.
Por fortuna, hay muchas cosas que puedes hacer para prevenir o retrasar la enfermedad. A continuación, lo que necesitas saber al respecto.
1. Los genes determinan algunos, pero no todos tus riesgos de contraer la diabetes tipo 2
Los investigadores han detectado aproximadamente unos 45 genes que están vinculados con la diabetes tipo 2. Sin embargo, aún no está claro cuál es el mecanismo exacto por el cual estos genes incrementan la susceptibilidad.
Una de las características de la diabetes tipo 2 es la resistencia a la insulina, es decir una respuesta insuficiente del organismo a la insulina, hormona que facilita la síntesis de la glucosa o del azúcar en sangre.
“La resistencia a la insulina puede ser la consecuencia de la evolución de un gen o genes ‘ahorrativos’. Estos genes surgieron para ayudar al organismo a acumular energía para tiempos de escasez, según afirma el Dr. Daniel Lorber, director de la División de Endocrinología del New York Hospital Queens.
No obstante, en nuestro mundo moderno, donde los alimentos están disponibles a la vuelta de cada esquina, esta evolución genética establece el escenario para la diabetes. La resistencia a la insulina, la obesidad y un deficiente control de la glucosa se hallan en los grupos familiares.
De modo tal que si cualquier familiar cercano presenta la enfermedad, tienes mayor riesgo de padecerla. Los hombres son, también, más propensos que las mujeres a desarrollar diabetes tipo 2.
2. Los factores de riesgo clásicos de la enfermedad cardíaca también aumentan tu riesgo
La hipertensión, los niveles elevados de triglicéridos y los niveles anormales de colesterol (tres factores de riesgo comunes para desarrollar enfermedad cardíaca) están estrechamente vinculados con la diabetes tipo 2.
Una de las razones es un estilo de vida poco saludable. “El sobrepeso y el sedentarismo incrementan las probabilidades de desarrollar tanto diabetes tipo 2 como muchos factores de riesgo para la enfermedad cardíaca”, afirma Lorber.
Sin embargo, hay también otras razones. Existe nueva evidencia que sugiere que la diabetes causa inflamación de bajo nivel en las paredes de los vasos sanguíneos. Esto ocasiona un daño que aumenta el riesgo de sufrir enfermedades cardíacas.
Un estudio llevado a cabo por investigadores dinamarqueses en el 2014 reveló que el 40% de las personas recién diagnosticadas con diabetes tipo 2 tenían niveles elevados de proteína C reactiva, un marcador de la inflamación.
El daño de los vasos sanguíneos del riñón asociado con la diabetes puede ser la razón principal por la cual la diabetes y la hipertensión suelen manifestarse en forma simultánea.
Asimismo, en las personas diabéticas, los vasos sanguíneos que ya tienen algún grado de compromiso parecen ser más susceptibles al daño derivado de la acumulación de colesterol y la hipertensión. Conclusión: si presentas factores de riesgo para la enfermedad cardíaca, tienes un riesgo mayor de padecer diabetes.
3. No todas las personas que sufren diabetes tipo 2 tienen sobrepeso o son obesas
Dominique Wilkins, la superestrella de baloncesto de la NBA cuyos espectaculares lanzamientos le valieron el apodo de Human Highlight Film, se acababa de retirar a los 40 años, cuando se enteró sorprendido de que padecía diabetes tipo 2. Esta enfermedad, a menudo actúa como un asesino silencioso.
Al igual que tantos otros, Wilkins suponía que solo las personas con sobrepeso u obesas desarrollaban diabetes tipo 2, y él no pertenecía a ninguno de los dos grupos. “Es un mito peligroso creer que la diabetes tipo 2 es exclusivamente causada por el sobrepeso o la obesidad”, explica el Dr. Robert Lustig, endocrinólogo infantil de la University of California, San Francisco, quien se especializa en la investigación de la diabetes.
Un IMC (índice de masa corporal) poco saludable sí incrementa tu riesgo. El exceso de grasa corporal puede generar resistencia a la insulina, que luego puede devenir en diabetes tipo 2.
Sin embargo, aproximadamente el 20% de las personas obesas no muestra signos de la enfermedad. Y alrededor del 15% de las personas a las que se les diagnosticó diabetes tipo 2 tiene un peso normal. Esto es una prueba, como dice el Dr. Lustig, de que el exceso de peso no es la causa.
Conclusión: el sobrepeso o la obesidad son una buena razón para realizarse un análisis para el diagnóstico de diabetes tipo 2. Pero la delgadez no es excusa para ignorar tu riesgo.

4. El riesgo aumenta con la edad; sin embargo, nunca es tarde para hacer cambios saludables
Cuando se llega a la mediana edad, el riesgo se incrementa año a año. La mayoría de los nuevos casos de diabetes tipo 2 se diagnostican en personas de entre 45 y 64 años. No obstante, las características demográficas de la diabetes tipo 2 están cambiando a un ritmo acelerado.
Los investigadores solían denominar a la diabetes tipo 2 “diabetes del adulto”, porque casi siempre se manifestaba en personas mayores de 45 años. Ya no es más así. Se estima que, por año, se les diagnostica diabetes tipo 2 a unas 5,000 personas de 20 años e incluso menores.
En el 2012, se diagnosticaron unos 370,000 casos nuevos en personas de entre 20 y 44 años. “El riesgo de diabetes tipo 2 aumenta con la edad, pero el hecho de que se esté desarrollando en niños nos indica que también es una enfermedad derivada del ambiente, un ambiente tóxico en el que personas de todas las edades se alimentan mal y realizan muy poca actividad física”, afirma Lustig.
A cualquier edad, afirman los expertos, la introducción de algunos cambios puede hacer una gran diferencia. En un emblemático estudio denominado Diabetes Prevention Program (Programa de Prevención de la Diabetes), los investigadores evaluaron si un régimen de vida que incluía una dieta baja en calorías y 150 minutos de ejercicios semanales podrían prevenir o retrasar el inicio de la diabetes tipo 2.
Todos los participantes tenían sobrepeso y prediabetes. Un grupo siguió el programa que fomentaba un estilo de vida saludable. El otro grupo comenzó a tomar metformina, el fármaco comúnmente utilizado para reducir el nivel de azúcar en sangre.
Transcurridos tres años, el grupo que siguió el programa redujo el riesgo de desarrollar diabetes en un 58%; le fue mucho mejor que al grupo que tomaba la medicación, que redujo el riesgo en un 31%, en comparación con el grupo control que recibía placebo.
“A los mayores de 60 les fue aún mejor, ya que disminuyeron el riesgo en más del 70%” mediante el programa de estilo de vida saludable, comenta M. Kaye Kramer, profesora adjunta del Departamento de Epidemiología de la University of Pittsburgh. “Sabemos, a partir de los datos obtenidos, que podemos prevenir o retrasar la diabetes tipo 2. Es cuestión de que las personas tomen el riesgo con seriedad”.
5. Cuanto más te muevas, mejor
La glucosa es uno de los combustibles clave del organismo, explica John Dubé, profesor adjunto de Medicina en la University of Pittsburgh. Si no somos activos, los niveles de glucosa en sangre pueden aumentar y causar daños en todo el organismo.
Aquí es donde el ejercicio es fundamental. “Los ejercicios aeróbicos como andar en bicicleta o caminar a paso ligero hacen que los músculos esqueléticos se contraigan y utilicen la glucosa en circulación”, explica Dubé. El ejercicio reiterado en realidad entrena a los músculos para responder mejor a la insulina, la hormona que ayuda al organismo a convertir la glucosa en energía.
Los ejercicios de resistencia, como levantar pesas, son también importantes para entrenar a los músculos para responder a la insulina, pero el ejercicio aeróbico es el que reporta mayores beneficios.
Cuando Dubé y sus colegas alentaron a 55 adultos sedentarios a participar en un programa de ejercicio aeróbico, descubrieron que la sensibilidad a la insulina mejoró drásticamente en el estudio de cuatro meses de duración. Cuanto más intenso sea el ejercicio, mayor la mejoría.
“No necesitas ir a un gimnasio. Realmente, no lo necesitas”, dice la superestrella de la NBA Wilkins, quien controla su diabetes haciendo ejercicios a intervalos, jugando baloncesto con sus hijos y realizando caminatas de dos millas con su esposa.
“Tan solo debes caminar y ponerte en movimiento”. La mejor receta depende de tu situación inicial. “Si eres muy sedentario, aunque sea un poquito de actividad extra, como dar una vuelta a la manzana caminando o diez minutos de bicicleta fija, puede ayudar a que tus músculos utilicen la glucosa en forma más eficiente”, agrega Dubé.
“Si ya eres bastante activo, haz algo extra para disminuir aún más tu riesgo de padecer diabetes tipo 2. El objetivo debería ser realizar al menos 30 minutos de actividad todos los días o la mayor cantidad de días posible”.
6. Los alimentos más saludables para prevenir la diabetes tipo 2 no traen etiquetas con información nutriciona
La mayoría de los expertos recomienda una dieta saludable para el corazón para prevenir o retrasar la diabetes tipo 2. “La diabetes tipo 2, por el hecho de dañar los vasos sanguíneos, aumenta tu riesgo de padecer enfermedades cardíacas.
Por ello, cuanto más hagas para proteger tu corazón, mejor”, asegura Marjorie Cypress, presidenta de asistencia médica y educación en salud de la American Diabetes Association (Asociación Estadounidense de Diabetes).
“Y como la diabetes tipo 2 está asociada con el sobrepeso y la obesidad, una dieta baja en calorías que le permita a las personas perder peso también las ayudará a disminuir el riesgo”.
Todos los participantes del Programa de Prevención de la Diabetes tenían sobrepeso, y la mayoría de los beneficios que experimentaron estuvieron asociados con la pérdida de aproximadamente el 7% de su peso corporal.
Desde luego, perder peso es mucho más difícil. Lorber intenta abrirse camino entre la confusión que genera la competencia de dietas diciéndoles a sus pacientes que sigan el plan “menos de todo”. “Para las personas que tienen sobrepeso”, afirma, “la clave es consumir menos calorías”.
El consejo de Lustig es el siguiente: evita los alimentos procesados, que suelen contener azúcar y sal agregados. En su lugar, planifica tu dieta en torno de alimentos integrales con un mínimo grado de refinación: arroz integral, trigo integral y otros granos no procesados, nueces y semillas, frijoles y buenas porciones de frutas y verduras.
7. Aliviar el estrés puede disminuir el riesgo de padecer diabetes
El estrés doméstico o laboral puede ser un factor que contribuya a desarrollar diabetes. En un estudio dirigido por el psicólogo de la University of Colorado Mark Whisman en el 2014, los investigadores descubrieron que los hombres con matrimonios inestables tenían mayor propensión a sufrir la enfermedad que aquellos que tenían uniones más dichosas.
Otro estudio publicado el año pasado reveló que el estrés crónico es un factor que contribuye a los efectos nocivos de una dieta con alto contenido de grasas/azúcares y puede aumentar la cantidad de grasa abdominal e incrementar el riesgo de resistencia a la insulina.
“Las hormonas del estrés, como el cortisol y la norepinefrina, pueden ligarse a los receptores de las células, incluidas las células musculares y adiposas, y cambiar la forma de respuesta”, comenta Kirstin Aschbacher, profesora adjunta de Psiquiatría de la University of California, San Francisco, quien dirigió el estudio.
“Si tienes riesgo de desarrollar diabetes tipo 2, es aconsejable que tomes ciertas medidas para manejar el estrés”. La actividad física, que aporta diversos beneficios, puede ser de gran ayuda, al igual que la meditación, el yoga y los ejercicios de respiración.
8. Depende de ti el tratar tu diabetes
El Dr. Daniel Lorber atiende a muchos pacientes que sufren de diabetes. “Como médicos, aconsejamos, orientamos, prescribimos, alentamos. Sin embargo, la única persona que trata la diabetes es la persona que la padece”.
El consejo es que si corres riesgo de contraer diabetes, llegó la hora de hacerte un análisis. Si tienes prediabetes o diabetes, elabora con tu médico un plan de tratamiento que incluya una dieta saludable, ejercicio físico y medicación, si la necesitas.
A continuación detallamos 4 análisis para detectar la diabetes
Los médicos se valen de diversos análisis de sangre para diagnosticar la diabetes tipo 2. Tu médico puede recomendar la realización de más de uno, en especial si tu riesgo es mayor.
1. A1C, el análisis más conveniente. El análisis A1C utiliza una gota de sangre, tomada por medio de un dispositivo de punción, para medir el nivel promedio de glucosa en sangre de los últimos dos o tres meses.
Una medición con un valor de 6.5 o superior indica la presencia de diabetes. Resultados que oscilen entre 5.7 y 6.4 indican prediabetes. El análisis A1C es frecuentemente empleado para verificar el grado de eficacia con la que se controla el nivel de azúcar en sangre.
2. Random plasma glucose (RPG, Análisis aleatorio de glucosa en plasma). Utilizando una muestra de sangre tomada de un dedo con un dispositivo de punción, este análisis muestra el nivel de azúcar en sangre en el momento en el que se realiza el análisis. Lecturas de 200 mg/dL o superiores sugieren la presencia de diabetes.
3. Fasting plasma glucose (FPG, Análisis de glucosa plasmática en ayunas). En este análisis, la sangre es extraída luego de haber ayunado al menos ocho horas. Un resultado de 126 mg/dL o superior indica diabetes.
4. Oral glucose tolerance test (OGTT, Análisis oral de tolerancia a la glucosa). Este análisis se realiza antes de ingerir una bebida azucarada y, nuevamente, luego de transcurridas dos horas desde la ingesta. Una lectura de 200 mg/dL o superior indica diabetes.
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