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Diabetes

Diabetes mellitus is a metabolic disorder characterized by an increase in blood sugar.Diabetes mellitus tablets

The disease is the result of defects in the production of insulin, the failure of insulin or both factors. In addition to increased blood glucose levels, the disease is due to sugar release, abundant urination, increased thirst, fats, protein and mineral metabolism, and the development of complications.

Type

  1. Type 1 diabetes (autoimmune, idiopathic): destruction of beta cells of the pancreas that produce insulin.
  2. Type 2 diabetes mellitus - the dominant sensitivity of tissues to insulin or the dominant error of insulin production with or without insensitivity.
  3. Gestational sugar occurs during diabetes pregnancy.
  4. Other types:
    • genetic errors;
    • Diabetes caused by drugs and other chemicals;
    • Diabetes caused by infections;
    • Pancreatitis, trauma, pancreatic removal, acromegaly, izenko - kushinka, thyrotoxicosis and others.

Seriousness

  • Light current: No complications.
  • Average severity: Eyes, kidneys, nerves are damaged.
  • Severe current: far from diabetes complications.

Symptoms of diabetes

The main symptoms of the disease include:

  • Abundant urination and increased thirst;
  • Increased appetite;
  • General weakness;
  • Damage to the skin (such as vitiligo), vagina and urinary tract can be observed particularly as a result of the immune deficiency;
  • The obscurity of vision is caused by changes in the converting medium of the eye.

Type 1 diabetes usually begins at a young age.

Type 2 diabetes is usually diagnosed with people over 35-40.

Diagnosis of diabetes

Diagnosis of the disease is based on blood and urine testing.

To produce the diagnosis, we determine the concentration of glucose in the blood (an important circumstance is the increased sugar level and other days of other days).

The results of the analysis are normal (in the absence of diabetes)

On an empty stomach or 2 hours after the test:

  • Venous blood - 3, 3-5, 5 mmol/l;  
  • Capillary blood - 3, 3-5, 5 mmol/l;
  • Blood venous plasma - 4-6, 1 mmol/l.

Analysis results in the presence of diabetes mellitus

On an empty stomach:

  • Venous blood is more than 6, 1 mmol/l;  
  • Capillary blood is more than 6, 1 mmol/l;  
  • The venous blood plasma is more than 7, 0 mmol/l.

At any time of the day, regardless of meal time:

  • Venous blood over 10 mmol/l;  
  • Capillary blood is more than 11, 1 mmol/l;  
  • The venous blood plasma is more than 11, 1 mmol/l.

In diabetes, the level of glycated blood hemoglobin exceeds 6, 7-7, 5 %.

The C-peptide content allows you to evaluate the functional state of beta cells. For patients with type 1 diabetes, this level is generally reduced, and in types of diabetes, types of insulinoma in general or increased insulinoma - has suddenly increased.

The concentration of immunoreactive insulin is type 1, usually or type 2.

In the background of acute disease, injury, or surgical intervention, the blood concentration of glucose in the blood in the blood is the background of short-term administration of drugs, which increases the concentration of glucose in the blood (adrenal hormones, thyroid hormones, thiazides, etc. ). liver.

In the urine of diabetes, glucose appears only after the "kidney threshold" (about 180 mg % 9, 9 mmol/l) appears. Significant fluctuations in the threshold and tendency to grow with age; Therefore, the determination of glucose is considered an insensitive and unreliable test in the urine. The test serves as a gross reference point in the blood for the lack or lack of sugar (glucose) and, in some cases, to monitor the dynamics of the disease daily.

Treatment of diabetes

Physical activity and proper nutrition in treatment

In most patients with diabetes mellitus, observing eating recommendations and significant loss of body weight will be improved by 5-10 %, and blood glucose levels improve to standards. One of the main circumstances is the regularity of physical effort (for example, it goes 30 minutes a day, swimming three times a week). With the concentration of glucose in the bloodbene>13-15 mmol/l, physical activity is not recommended.

If the light and moderate physical effort lasts up to 1 hour, additional carbohydrates are required before and after the load (15 g easy to digest carbohydrates every 40 minutes). Because moderate physical efforts take more than 1 hour and intense sports, it should be reduced by 20-50 % of the dose of insulin, 6-12 hours after physical activity and in them.

In the treatment of diabetes (Table 9), the purpose of the diet is to normalize carbohydrate metabolism and prevent metabolism of fats.

Treatment with insulin preparations

Insulin preparations for the treatment of diabetes are classified into 4 categories with the duration of the effect:

  • Ultra -Coro Action (the operation starts -15 minutes after the operation is 3-4 hours).
  • Fast action (the start of action - after 30 minutes. - 1 hour; 6-8 hours of action).
  • The average duration of the operation (the operation starts 1-2, 5 hours, the duration of the operation is 14-20 hours).
  • Long action (the operation begins after 4 hours; the action of the action is up to 28 hours).

Insulin's appointment methods are strictly individual and is selected for patients with all dialitologists or endocrinologists.

Methodology for introduction of insulin

When the insulin is introduced at the injection site, a layer of skin should be formed to ensure that the needle is under the skin and not into the muscle tissue. The folding of the skin should be wide, the needle must enter the skin at an angle of 45 ° if the thickness of the skin is less than the length of the needle.

When selecting the injection site, the compressed skin areas should be avoided. Injection sites cannot be changed systematically. Do not injections injections under the shoulder skin.

  • Short-acting insulin preparations should be injected into the subcutaneous fat fiber of the first wall of the abdomen 20-30 minutes before a meal.
  • Long -acting insulin preparations are led into the subcutaneous fat fibers of the thighs or buttocks.
  • Ultra -short insulin injections are performed immediately before a meal, and if necessary, meals or immediately after a meal.

Heat and physical activity increases the absorption rate of insulin and the cold reduces it.