RECALL OF METFORMIN EXTENDED RELEASE

In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets.

As of October 2021, all of the affected medications have been pulled.

If you currently take this drug, talk with your doctor. They’ll advise whether you should continue to take your medication or if you need a new prescription.

Type 2 diabetesis a chronic medical condition in which the levels of sugar, or葡萄糖，，，，build up in your bloodstream.

Typically, the hormoneinsulinhelps move glucose from your blood to your cells, where it’s used for energy. But with type 2 diabetes, your body’s cells aren’t able to respond to insulin as well as they should. In later stages of the condition, your body may also not produce enough insulin.

Uncontrolled type 2 diabetes can lead to chronically high blood glucose levels, which can cause several symptoms and potentially lead to serious complications.

在2型糖尿病中，您的身体无法有效使用胰岛素将葡萄糖带入细胞。这会导致您的身体依靠组织，肌肉和器官中的替代能源。这是一种可能导致多种症状的链反应。

Type 2 diabetes can develop slowly. The symptoms may be mild and easy to dismiss at first. Theearly symptomsmay include:

As the disease progresses, the symptoms become more severe and can cause some potentially dangerous complications.

如果你的blood glucose levels have been high for a long time, the并发症可能包括：

胰岛素是一种天然存在的激素。您的pancreasproduces it and releases it when you eat. Insulin helps transport glucose from your bloodstream to cells throughout your body, where it’s used for energy.

If you have type 2 diabetes, your body becomesresistant to insulin。您的body is no longer using the hormone efficiently. This forces your pancreas to work harder to make more insulin.

随着时间的流逝，这可以损伤胰腺中的细胞。Eventually, your pancreas may not be able to produce any insulin.

If you don’t produce enough insulin or if your body doesn’t use it efficiently, glucose builds up in your bloodstream. This leaves your body’s cells starved for energy. Doctors don’t know exactly what triggers this series of events. It may have to do with cell dysfunction in the pancreas or with cell signaling and regulation.

While lifestyle choices are typically what trigger type 2 diabetes, you may be 更可能被诊断 with it if:

  • there’s agenetic predispositionto developing type 2 diabetes in your family
  • there’s agenetic predispositionto developingobesity在您的家庭中，这可能会增加胰岛素抵抗和糖尿病的风险
  • you are at least 45 years old
  • you are Black, Hispanic/Latino, Native American, or of Alaska Native descent

While the definitive trigger of type 2 diabetes is your body’s resistance to insulin, there’s usually a combination of factors that increase your risk of that resistance occurring.

Type 2 diabetes can be managed, and in some cases, reversed. Most treatment plans will include检查您的血糖水平，，，，and your doctor will tell you how often you should do it. The goal is to stay within a specific range.

Additional lifestyle changes your doctor will most likely advise to help treat your type 2 diabetes include:

  • eating foods rich infiberandhealthy carbohydrates-eating fruits, vegetables, and whole grains can helpkeep your blood glucose levels steady
  • eating at regular intervals
  • learning to listen to your body and learn to stop eating when you’re full
  • manage your weight and keep your heart healthy, which typically means keeping refined carbohydrates, sweets, and animal fats to a minimum
  • get about half an hour ofphysical activitydaily to help keep your heart healthy —exercisecan help to control blood glucose, too.

您的医生将解释如何识别过太高或太低的血糖的早期症状以及在每种情况下该怎么做。

Additionally, working with a dietician can help you learn which foods can help you manage your blood sugar — and which ones might cause it to become unbalanced.

Not everyone with type 2 diabetes needs to use insulin. If you do, it’s because your pancreas isn’t making enough insulin on its own, and it’s crucial that you take insulin as directed. There are other prescription medications that may help as well.

In some cases, lifestyle changes are enough to keep type 2 diabetes under control. If not, there are several medications that may help. Some of these medications include:

  • Metformin.This会降低你的血糖水平,改善何w your body responds to insulin. It’sthe first-line treatment对于大多数2型糖尿病的人。
  • Sulfonylureas.这se areoral medicationsthat help your body制作更多胰岛素。
  • Meglitinides.这se are fast-acting, short-duration medications that stimulate your pancreas to release more insulin.
  • 噻唑烷二酮。这se make your body more sensitive to insulin.
  • Dipeptidyl peptidase 4 (DPP-4) inhibitors.这se are milder medications that help reduce blood glucose levels.
  • Glucagon-like peptide-1 agonists.这se slow digestion and improve blood glucose levels.
  • Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors.这se help yourkidneys通过尿液去除体内糖。

Each type of medication listed above can cause side effects. It may take some time for you and your doctor to find thebest medication或治疗糖尿病的药物组合。

如果你的blood pressureorcholesterollevels are also not ideal, you may need medications to address those needs as well.

如果你的body is unable to make enough insulin, you may need胰岛素疗法。You may only need along-acting injectionyou can take at night, or you may need to take insulin several times per day.

Learn about medications that can help you manage diabetes.

饮食is an important tool to help maintain optimalheart healthand在安全范围内的血糖水平。

这diet recommended for people with type 2 diabetes isthe same diet just about everyone should follow。它归结为一些关键动作：

  • Choose a variety of foods that are high innutrientsand low in空卡路里。
  • Work on being mindful about portion sizes and stopping eating when you’re full.
  • Readfood labelsclosely to understand the amount of sugar or carbs you could be ingesting in a serving size.

Foods and beverages to limit

If you’ve been diagnosed with type 2 diabetes, or even if you’re trying to avoid diabetes and manage your weight, there are certain foods and beverages that you should limit if possible. These include:

  • foods heavy insaturatedor反式fats (like red meat and full-fat dairy products)
  • processed meats(like hotdogs and salami)
  • margarineandshortening
  • refined baked goods (like white bread and cake)
  • 高糖，高度加工的零食（包装饼干和一些谷物）
  • sugary drinks(like regular soda and some fruit juices)

While no one food, enjoyed every so often, should knock you off your healthy path, it’s a good idea to talk with your doctor about dietary restrictions based on your blood sugar levels. Some people may need to monitor their glucose more carefully than others after eating these foods.

Foods to choose

Being diagnosed with type 2 diabetes does not mean carbs are off the table. Healthy碳水化合物可以为您提供能量和fiber。Some options include:

Fat is not off the table, either. Instead, it’s about choosing the right types of fat. Foods withheart-healthy omega-3 fatty acidsinclude:

You can get healthymonounsaturatedandpolyunsaturated来自多种食物的脂肪，包括：

Talk with your doctor about your personal nutrition goals. They may recommend you connect with a dietician who’s well-versed in optimal diets for diabetes. Together, you can come up with a diet plan that tastes great and suits your lifestyle needs.

尽管有一些无法控制的2型糖尿病的危险因素（如上所述，您的年龄和遗产），但某些生活方式的选择也可以使您面临更大的风险患2型糖尿病。其中一些包括：

  • 体重过多。当您的体重过多时，您很可能会有更多的脂肪组织make your cells more resistant to insulin。
  • Living a more sedentary lifestyle.Regular physical activity helps your细胞的反应better to insulin。
  • Eating a lot of highly processed foods.Highly processed foods can have a lot of hidden sugar and refined carbs. If your life requires a more “grab-and-go” type of eating style, talk with your doctor or a dietician about nutritious swaps.

You may also be at increased risk if you’ve hadgestational diabetesorprediabetes，，，，two conditions caused by elevated glucose levels.

Whether or not you have prediabetes, you should see your doctor right away if you think you may be experiencing symptoms of diabetes. Your doctor can get a lot of information from blood work.Diagnostic testing可能包括以下内容：

  • Hemoglobin A1C test.This testmeasures average blood glucose levels for the previous 2 or 3 months. You don’t need to fast for this test, and your doctor can diagnose you based on the results. It’s also called a glycosylated hemoglobin test.
  • Fasting plasma glucose test.This test measures how much glucose is in your plasma. You may need tofast for 8 hoursbefore taking it.
  • Oral glucose tolerance test.Duringthis test，您的血液被抽了三遍：在喝一剂葡萄糖后，1小时和2小时后。测试结果表明，您的身体在饮料前后的葡萄糖处理程度。

If you have diabetes, your doctor will provide you with information about how to manage the disease, including:

  • how to monitor blood glucose levels on your own
  • dietary recommendations
  • physical activity recommendations
  • information about any medications that you need

You may need to see an内分泌学家who specializes in the treatment of diabetes. You’ll probably need to visit your doctor more often at first to make sure your treatment plan is working.

While you can’t always prevent type 2 diabetes, there are a few lifestyle tweaks can help delay, or even prevent, the onset. This is true even if you have increased risk factors like prediabetes.

  • 饮食。这best kind of diet to prevent type 2 diabetes is a diet rich in fruits, vegetables, healthy carbs, healthy fats, and very little refined sugar.
  • Exercise.根据 2018 Physical Activity Guidelines for Americans ，成人每周的最佳运动量为150分钟，每周5天每天30分钟。体育活动指南还建议结合肌肉增强和有氧活动。
  • Weight management.Keeping a moderate weight is a good way 避免慢性并发症 ，，，，including type 2 diabetes.

For many people, type 2 diabetes can be effectively managed. If not properly managed, it can affect virtually all of your organs and lead to serious complications, including:

Hypoglycemia

Hypoglycemia当您的血糖低时可能会发生。症状可能包括摇晃，头晕和说话困难。通常，您可以通过使用“快速固定”食品或饮料（例如果汁，软饮料或硬糖）来解决此问题。

Hyperglycemia

Hyperglycemiacan happen when blood sugar is high. It’s typically characterized by frequent urination and increased thirst. Monitoring your blood glucose carefully, and staying active, can help prevent hyperglycemia.

Complications during and after pregnancy

如果怀孕期间患有糖尿病，则需要仔细监测病情。控制不善的糖尿病可能：

It can also increase your baby’s risk of developing diabetes during their lifetime.

管理2型糖尿病requires teamwork. You’ll need to work closely with your doctor, but a lot of the results depend on your choices.

您的doctor may want to perform periodic blood tests to determine your blood glucose levels. This will help determine how well you’re managing the condition. If you take medication, these tests will help gauge how well it’s working.

您的doctor may also recommend家庭监控系统在访问之间测试自己的血糖水平。他们会向您解释您应该多久使用一次以及您的目标范围应该是什么。

Because diabetes canincrease your risk of cardiovascular disease，，，，your doctor may want to monitor your blood pressure and blood cholesterol levels. If you have symptoms of heart disease, you may need additional tests. These tests may include an心电图（ECG或EKG）or a cardiac stress test.

It may also be helpful to bring your family into the loop. Educating them about the warning signs of blood glucose levels that are too high or too low will allow them to help in an emergency.

儿童中2型糖尿病是一个日益严重的问题。根据American Diabetes Association (ADA)，，，，around 193,000 Americans under age 20 have类型1or type 2 diabetes.

One2016 studyfound that the incidence of type 2 diabetes in youth has increased to about 5,000 new cases per year. Anotherstudy from 2017also showed a significant increase, particularly in minority races and ethnic groups.

如果你的child has beendiagnosed with diabetes，他们的医生需要在建议特定治疗之前确定是1型还是类型2。

就像生活方式选择可以帮助成人管理甚至扭转其2型糖尿病诊断的方式一样，你可以帮助降低孩子的风险by encouraging them toeat welland tobe physically activeevery day.

这 疾病控制与预防中心（CDC） report the following statistics about diabetes in the United States:

  • Over 30 million people have diabetes. That’s around 10 percent of the population.
  • 1 in 4 people has no idea they have diabetes.
  • 糖尿病前期影响了8410万成年人，其中90％的人没有意识到这一点。
  • Non-Hispanic Black, Hispanic, and Native American adults are about twice as likely to have diabetes as non-Hispanic white adults.

这艾达reports the following statistics:

  • 2017年，糖尿病花费了3270亿美元的直接医疗费用和降低生产率。
  • 这average medical expenses for people with diabetes are about 2.3 times higher than they’d be in the absence of diabetes.
  • Diabetes is the seventh leading cause of death in the United States, either as the underlying cause of death or as a contributing cause of death.

这 World Health Organization (WHO)Trusted Source reports the following statistics:

  • 这2014 global prevalence of diabetes was 8.5 percent for adults.
  • In 1980, only 4.7 percent of adults worldwide had diabetes.
  • Diabetes directly caused about 1.6 million deaths worldwide in 2016.
  • 糖尿病几乎占成年人心脏病发作和中风的风险。
  • 糖尿病也是肾衰竭的主要原因。

Type 2 diabetes is a condition that’s created when glucose levels build up in your bloodstream. It’s a common condition that’s often triggered by certain lifestyle choices. But the likelihood of a diagnosis can also be increased by genetics, age, and heritage.

可以随着某些生活方式的改变，可以管理（甚至可以逆转）2型糖尿病。对于更严重的情况，可以使用药物。

If you’ve been diagnosed with type 2 diabetes, talk with your doctor about developing a treatment plan that works for your lifestyle. Because this condition is so common, there’s a plethora ofresourcesandfirst-person accounts为了帮助您进行管理或摆脱2型糖尿病的旅程。

Read this article in Spanish.