Glucose Tolerance Disorder (GTB) What Is Glucose Intolerance?
It is an assessment used when an individual’s blood sugar is found to be between normal blood sugar and diabetic blood sugar. In these people, their blood sugar levels may increase at certain times of the day, or they may be normal or even subnormal from time to time.
It is thought that the formation mechanism of Glucose Tolerance Disorder is the development of resistance against insulin use in tissues. The insulin hormone, which normally allows the sugar in the blood to enter the cells, cannot enter the cell due to insulin resistance, so the level of sugar in the blood remains high. In order to lower the remaining high blood sugar, the pancreas secretes more insulin hormone, but sugar cannot enter the cell again due to insulin resistance in the cells. In this case, the insulin value in the blood and the blood sugar value are also high. In time, the insulin reserve in the pancreas decreases and the disease passes from the Glucose Tolerance Disorder stage to the overt diabetes stage.
Studies have shown that especially in obese individuals, the accumulation of fat in the abdomen leads to a deterioration in glucose tolerance. The picture of glucose intolerance, which can be seen especially in adults, is an indication that type 2 diabetes will occur over time. It is seen in about 15% of adults in developed countries. The reason why this rate has increased in developed countries is a more sedentary life and increasing obesity.
Glucose Tolerance Disorder is seen especially in obese individuals with an increase in fat in the abdominal (abdomen and waist) region. One of the important factors in the relationship between obesity and Glucose Tolerance Disorder is age. As age progresses, glucose tolerance deteriorates. Therefore, individuals in this group should be meticulously examined for diabetes during routine check-ups and an oral glucose tolerance test should be performed in suspicious cases (OGTT- Oral Glucose Tolerance Test).
According to WHO (World Health Organization) criteria;
Prevention of Glucose Tolerance Disorder or prevention of transition from this stage to type 2 diabetes if it has occurred; It is possible by changing life habits.
Insulin resistance and GTB (Glucose Tolerance Disorder) improve after weight loss. Even in diabetic patients, weight loss can return blood sugar to normal. Exercise also improves Glucose Tolerance Disorder and insulin resistance independently of weight loss. Before moving on to dietary and lifestyle advice, it is useful to remember the following:
- Be careful in terms of Glucose Tolerance Disorder, especially in obese individuals with increased fat around the waist./li>
- If the fasting blood glucose value is between 110-126 mg/dl, an oral glucose tolerance test known as the “Loading Test” should be performed.
- Individuals with PCOS (polycystic ovary syndrome) in women should not be obese because they are at increased risk of developing diabetes. If these people have a thick waist circumference and a first-degree relative has a history of diabetes, they should apply to a health institution for evaluation.
If the diagnosis of Glucose Tolerance Disorder is diagnosed as a result of the examinations, diet and exercise are started. The person is allowed to lose weight and if necessary, drug support is applied.
The person should be taken on a diabetes diet. At the same time, they should be evaluated in terms of hypertension and hyperlipidemia, they should be removed from tobacco habits, and routine health checks should be taken in a system that can be controlled throughout life.
The principles of a person’s diet are listed below:
- In order to ensure blood sugar regulation, the number and frequency of meals should be arranged as 3 main meals + 3 snacks.
- At least a triple combination of five basic food groups (bread, meat, vegetables, fruit and milk) should be consumed at main meals. In between meals, a meal containing both carbohydrates and protein should be arranged, such as fruit and milk) or bread and cheese.
- Milk and yoghurt, especially cheese, must be eaten with low fat.
- In diabetes, fruits such as apples, peaches, cherries and quince, whose sugar is absorbed late, should be eaten. Fruits that raise blood sugar rapidly, such as grapes, watermelon, and melon, should be avoided.
- The amount of fat to be taken with meals should be adjusted so that the energy from fat is 25-30% of the total energy. What can be done for this; It is not to add oil to vegetable dishes cooked with minced meat or meat, to add oil not exceeding one or two teaspoons to salads, and to stay away from dishes fried in oil. The oil consumed should not be solid. Oil should be preferred in meals. Recently, a combination of soybean oil, hazelnut or sunflower oil and olive oil has been recommended.
- The diet should be rich in fiber. For this reason, when choosing foods from the bread group, whole wheat bread is preferred instead of normal bread, and legumes instead of potatoes are preferred, both increasing the amount of fiber consumed and creating a meal with a low glycemic index (blood sugar increase rate). In addition, blood fats such as cholesterol and triglycerin can be kept at optimal levels. We also recommend not to eat rice and bulgur. Consumed vegetables and fruits also significantly increase fiber intake.
- The diet should be balanced and sufficient in terms of vitamins and minerals. If food is taken from all food groups every day, deficiency does not occur. In addition, it is recommended to give B group vitamins (especially B12) as a preparation in diabetes. Additional chromium, vitamin E and selenium preparations can also be taken as the doctor deems appropriate.
- Artificial sweeteners can be used. Those containing aspartame should be preferred.
- Adequate fluid, especially water consumption should be paid attention, daily fluid intake should not be reduced below 1.5 liters. If the basic principles of diet therapy are followed and routine blood sugar monitoring is carried out by going to regular doctor checks, diabetes will be like a friend that the person will not be bothered to live with anymore. Elements such as exercise and foot care should not be skipped.
THINGS THAT SHOULD NOT BE CONSUMED
- Candy and sugary sweets;
- Jam, honey, molasses, cake, cake, chocolate;
- Solid fats (tallow, margarine);
- Cream, cream, fatty dairy products;
- Deli type foods (sausage, bacon, sausage, salami, etc.);
- Offals (such as liver, kidney, brain);
- Any kind of food prepared by frying or roasting in oil;
- Nuts, oilseeds (sunflower seeds, crocus.);
- Fruit juices, carbonated-sweetened beverages, alcoholic beverages;
- Prepared foods of unknown composition. (The labels of ready-made foods should be checked, and foods containing sugar should be avoided.)