How to treat diabetes?Of course, insulin.Everyone knows about it, even those who are far from medicine.After all, diabetes (below - diabetes) is when sugar increases.And insulin reduces this sugar.
Overall, right.If you do not consider any insignificant, at first glance, but in fact important details.
Insulin
Yes, insulin really reduces the high level of sugar (more precisely glucose) in blood plasma.
With type 1 diabetes, which develops mainly at a young age, the absolute insulin deficiency is noted that this hormone is not secreted (or secreted in low quantities) with certain pancreatic structures, Langergans are washed.
There is no insulin - no glucose use, and the larger metabolic processes are pathological.If you enter insulin within the replacement therapy, then the situation can be adjusted to some extent.
Under the influence of this medicine, glucose enters into where it is supposed - in a cell where it is subjected to separation.Metabolism normalizes.
Everything would be simple if it wasn't that difficult.The fact is that in some cases the introduction of insulin can lead to major problems than its absence.The cause is hypoglycaemia, a sharp decrease in glucose in the blood plasma.
Insulin overdose affects very quickly and sometimes instantly.
The skin becomes pale, blood pressure develops, a coma develops, from which the patient is very difficult to remove.
The cause of hypoglycaemia is not only an overdose but also improper administration of insulin.This medicine should only be administered after eating light food.Before the introduction of insulin, physical activity, stress is not desirable.
Therefore, the dose of insulin is carefully selected by the endocrinologist, depending on the level of glycemia (the glucose content of the blood plasma), which is determined by laboratory agents.
The daily dose depends on the level of glycemia, the course of diabetes and is determined by the doctor separately for each patient.
The typical breakdown of this dose is 30% before breakfast, 35% - before noon, 25% - before dinner and 10% at night.
Although these figures can vary depending on lifestyle, work.And to choose the right insulin with the first discovered diabetes, it is unlikely that diabetes mellitus can disappear within a few days.The main line is the same - laboratory indicators.
Due to the high hypoglycaemia rice, insulin is forbidden to introduce the ambulance stages of the stages of the transcendillas who cannot control glycemia.
It is true that many portable devices, glycometers designed to measure blood sugar have recently appeared.
But, first, the reliability of glycometers sometimes leaves a lot to be desired.
And secondly, as already mentioned, the delayed insulin administration is not as scary as its overdose.
It is remarkable that the insulin used to treat diabetes is not homogeneous.
It can be pork, livestock (derived from the pancreas of clogged animals) and a person synthesized with genetic engineering.
Insulin is not the same in terms of action.If it is necessary to reduce glycemia as quickly as possible, a short acting insulin is introduced.The effect occurs quickly, for the first 15-20 minutes, but does not last long.
Medium duration insulin and extended action is designed to create the necessary glycemic background during the day.The types of insulin and their combination are also prescribed by an endocrinologist, depending on a specific clinical situation.
Saharasi
If insulin is produced only in the form of injection solutions (it is destroyed in the gastrointestinal tract), then the predominant number of sugar-lowering drugs are represented by internal intake tablets.
It should be noted that insulin and sugar -reduced diabetes agents are not interchangeable.
More precisely, insulin is effective only in the type of diabetes over 1 type of sugar.
And all sugar lowering remedies are only used for 2 types of insulin dependent on the disease.This type is based on a relative insulin deficiency.This means that the total amount of insulin produced by the pancreas is normal or even increases.But still he is missing.
This happens with obesity in the elderly, when the amount of adipose tissue increases and the compensatory capabilities of the human body are low.
There are several types of sugar tablets.They all change the course of biochemical reactions in one way or another and thus stimulate the production of insulin with beta cells.
At some point, beta cells are exhausted, the relative insulin deficiency becomes absolute and needs an additional transition to insulin treatment.
Sometimes the basis of diabetes mellitus may be increased the production of opposite hormones of the thyroid gland, adrenal glands and pituitary gland.The action of these hormones is the opposite of such insulin - they increase blood glucose levels.
Once the high level of codoclular hormones is confirmed by laboratory methods, specific injection agents are prescribed to regulate their level.
Glucose
It turns out that glucose in diabetes is no less important than insulin.This is especially true for severe forms of the disease.
Timely administration of glucose atHypoglycemic conditions- It's a matter of life and death.After all, blood sugar levels should be increased as quickly as possible.For this concentrated 40% glucose is administered intravenously with a syringe.
IfThe patient is conscious, Give him a drink of warm tea with sugar.
But hyperglycemia (high sugar) also requires glucose.
The bottom line is that glucose accumulates in plasma in large quantities.But the cell does not receive this glucose.Pathological mechanisms of gliogenesis are launched - the synthesis of glucose from fat and proteins that decompose intensively.
To prevent this, glucose is introduced intravenously as part of the so -called polarizing mixture.This mixture includes 5% glucose, insulin and one of the potassium drugs.Insulin contributes to the penetration of glucose into a cage and at the same time it "pulls" potassium with it.This is the most important intracellular element that controls almost all metabolic processes in the cell.
Another condition, when glucose is vital, is an increased release of urine in diabetes, the so -called diabetic urethra.
This is due to the high concentration of blood plasma and secondary damage to the kidneys.Glucose is lost with urine.In this case, the so -called false positive picture - the level of glucose in the blood is reduced without insulin.
In fact, it is a potentially dangerous condition called scissors endocrinologists due to the discrepancy between laboratory indicators and objective data.The only way to avoid these "scissors" lies in the timely administration of drip solutions.
Certification and Alkalization
First is the loss of fluid that quickly leads to dehydration or dehydration.At the same time, excess glucose in the blood is transformed into ketone bodies (acetone and other compounds) that have an acidic reaction.
This process is called ketoacidosis.
It continues extremely difficult and in the absence of treatment it ends in depth.Dehydration and ketoacidosis are overloaded.
In order to eliminate dehydration, rehydration is carried out - filling in fluid deficiency.The aging for diabetes involves massive, up to 3 liters per day or more, intravenous infusion of various solutions.
In addition to the upper glucose, a simple isotonic solution of sodium chloride (saline) is applied, as well as other solutions containing sodium, chlorine, magnesium, potassium ions.
Filling the fluid deficiency normalizes the balance of acids and foundations in the body and largely eliminates tissue acidification - acidosis.Effective ways to combat acidosis are the infusion of sterile alkalizing solutions.These include sodium bicarbonate or, simple, soda.If the patient's condition allows, preferably the abundant drinking of alkali in the form of alkaline mineral waters.
Other medicines
Diabetic sugar is a systemic disease.This means that the pathology is not limited to the pancreas - in one way or another, almost all organs and tissues suffer.To a large extent, this is due to diabetic angiopathy - the lesion of blood vessels and capillaries.
At the same time, blood circulation in these vessels and capillaries is disturbed, leading to secondary lesions of the internal organs - above all, the retina of the eyes (retinopathy) and the kidneys (nephropathy).In order to eliminate angiopathy, intravenous drip administration of various drugs is performed that improve systemic circulation.
Along with these drugs, drugs with a specific effect are prescribed that affect the metabolic processes in the nerve fibers.
Disruption of blood circulation in the capillary network is often complicated by trophic ulcers with a predominant localization on the inside of the lower leg.
Treatment of these ulcers requires the use of topical antiseptics and antibiotics.Diabetics more often than the rest are patients with cardiovascular disease-atherosclerosis, hypertension, angina, complicated by myocardial infarction.
Cardiotonics are used in the treatment of these diseases, which have a positive effect on myocardium, anti -asterosclerotic and hypotensive (blood pressure decreased) drugs.With diabetes, not only desirable but also requires to take various vitamin-mineral complexes in the form of pharmaceutical drugs and biologically active nutritional supplements.
Diabetes
Proper nutrition in the treatment of diabetes is as important as medicines.Failure to follow the diet reduces the effectiveness of these drugs to zero.This is especially true for the first type of diabetes, where the smallest eating mistakes are fraught with serious consequences.Basic requirements for the diet diet of diabetics:
- Fractional intake of food in small portions 4-5 times;
- A balanced ratio of proteins, fats and carbohydrates;
- The number of calories taken with food must be equal to the number of consumed;
- With obesity - reducing excess weight.
In this regard, easily digestible carbohydrates, fatty meat, sweets, strong tea, coffee, butter, grapes are contraindicated.Instead of white bread - black instead of sugar - sugar - replacement diabetics.
Preference in the diet should be given to cereals (buckwheat, oatmeal, wheat), light vegetable soups, fresh vegetables.A diet for each patient develops individually by a nutritionist.
Conclusion
Of course, this article is by no means instructions for self -self -testing, which can be expensive in diabetes with diabetes.It should be noted that it is impossible to cure completely insulin -dependent diabetes mellitus.Unfortunately, but a fact.But proper, regular treatment, protective regimen, food and physical restrictions will help you return to full life and avoid unwanted complications.