How to treat diabetes?Of course, insulin.Everyone knows it, even those who are far from medicine.After all, diabetes (hereinafter diabetes) is when the sugar has increased.And insulin reduces this sugar.
In general, right.If you do not take into account some insignificant details, at first sight, but in reality important.
Insulin
Yes, insulin really reduces the high level of sugar (more precisely - glucose) in the blood plasma.
With type 1 diabetes, which is developing mainly at a young age, an absolute insulin deficiency is noticed: this hormone is not secreted (or secreted in low quantities) with some pancreatic structures, the Langganes are.
There is no insulin: there is no use of glucose and further metabolic processes are pathological.If insulin is introduced within the framework of replacement therapy, the situation can be corrected to a certain extent.
Under the influence of this drug, glucose enters where it should be - in a cage, where it is subjected to splitting.The metabolism is normalized.
Everything would be simple if it weren't that difficult.The fact is that in some cases the introduction of insulin can lead to great problems of its absence.The reason is hypoglycaemia, a strong drop of glucose in the blood plasma.
An insulin overdose affects very quickly and sometimes instantly.
The skin becomes pale, a blood pressure develops, a coma develops, from which the patient is very difficult to remove.
The cause of hypoglycaemia is not only overdose, but also improper administration of insulin.This drug should be administered only after taking a light food.Before the introduction of insulin, physical activity, stress are not desirable.
This is the reason why the dosage of insulin is carefully selected by the endocrinologist depending on the level of blood sugar (the glucose content in the plasma in the blood), which is determined by the laboratory means.
The daily dose depends on the level of blood sugar, the course of diabetes and is determined by the doctor individually for each patient.
A typical breakage of this dose is 30% before breakfast, 35% - before lunch, 25% - before dinner and 10% in the night.
Although these figures can vary according to the way of life, work.And to choose the right insulin with the diabetes first detected, a mellitus of newly detected diabetes can go for several days.The point of reference is the same: laboratory indicators.
Due to the high rice of hypoglycaemia, insulin is forbidden to introduce the workers of the ambulances into the preospedaliera phase, which cannot control blood sugar.
True, many portable devices have recently appeared, glycoometers, designed to measure blood sugar.
But, first of all, the reliability of the glylyometers sometimes leaves a lot to be desired.
And secondly, as already mentioned, the delayed introduction of insulin is not as frightening as its overdose.
Interestingly, the insulin used to treat diabetes is not homogeneous.
It can be pork, cattle (obtained from the pancreas of obstructed animals) and human, synthesized with genetic engineering.
Insulin is not the same in terms of action.If you need to reduce blood sugar as quickly as possible, short -term insulin is introduced.The effect occurs quickly, during the first 15-20 minutes, but does not last long.
The insulin of the average duration and extensive 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.
Saharasses
If insulin is produced only in the form of injection solutions (it is destroyed in the gastrointestinal tract), then the overwhelming number of drugs to lower sugar is represented by tablets for internal intake.
It should be noted that agents that insulin and sugar lawing for diabetes are not interchangeable.
More precisely, insulin is effective only with the type of diabetes greater than 1 type of mellitus.
And all agents who leave sugar are used only for 2 types of disease dependent on insulin.This type is based on the relative deficiency of insulin.This means that the total amount of insulin produced by the pancreas is normal or even increased.But he still lacks.
This happens with obesity in old age, when the quantity of adipose tissue has increased and the compensatory skills of the human body are low.
There are different types of sugar tablets.Everyone in one way or another change the course of biochemical reactions and therefore stimulate insulin production with beta cells.
At a certain moment, beta cells are exhausted, the relative insulin deficiency becomes absolute and further transition to the treatment of insulin is required.
Sometimes the base of diabetes mellitus can be an increase in the production of counterpine thyroid hormones, adrenal glands and pituitary glands.The action of these hormones is exactly the opposite of this insulin: they increase the level of glucose in the blood.
After the high level of codloxular hormones is confirmed by laboratory methods, specific injection agents that regulate their level are prescribed.
Glucose
It turns out that glucose in diabetes is no less important than insulin.This is particularly true for serious forms of the disease.
Timely introduction of glucose ahypoglycemic conditions- This is a question of life and death.After all, the blood sugar level should be increased as quickly as possible.For this, a 40% concentrated glucose is administered intravenously with a syringe.
IfThe patient is conscious, give him a hot tea drink with sugar.
But hyperglycaemia (high sugar) also requires glucose administration.
The bottom line is that glucose accumulates in plasma in large quantities.But the cell does not receive this glucose.Pathological mechanisms of glioogenesis are launched: the synthesis of glucose from fats and proteins, which are intensely decomposed.
To prevent this from happening, glucose is introduced intravenously as part of the so called polarizing the mixture.This mixture includes 5% of glucose, insulin and one of the potassium drugs.Insulin contributes to the penetration of glucose in a cage and at the same time "pulls" potassium with him.This is the most important intracellular element that controls almost all metabolic processes in the cell.
Another state in which glucose is vital is an increase in the release of urine in diabetes, the diabetic uretics so called.
It is due to the high concentration of blood plasma and secondary kidney damage.Glucose is lost together with the urine.In this case, the false positive picture: the level of glucose in the blood is reduced without insulin.
In fact, this is a potentially dangerous condition called endocrinologists with "scissors" due to the discrepancy between laboratory indicators and objective data.The only way out to avoid these "scissors" lies in the timely administration of drips of glucose solutions.
Certification and alkalization
Oralism is, first of all, the loss of fluid, which quickly leads to dehydration or dehydration.Together with this, the excess of glucose in the blood is transformed into ketone bodies (acetone and other compounds) which have an acid reaction.
This process is called ketoacidosis.
It proceeds extremely difficult and in the absence of deplorable terms.Dehydration and ketoacidosis are shaking each other.
To eliminate dehydration, rehydration is carried out - refueling liquid deficiency.The editorial staff for diabetes involves a massive intravenous infusion, up to 3 liters per day or more, of various solutions.
In addition to the aforementioned glucose, a normal isotonic sodium chloride solution (saline solution) is administered, as well as other solutions containing sodium ions, chlorine, magnesium, potassium.
The refueling of the lack of fluids normalizes the balance of acids and bases in the body and largely eliminates the acidification in the tissues - acidosis.Effective ways to combat acidosis are the infusion of sterile alkalicating solutions.These include sodium bicarbonate or simply firm.If the patient's condition allows, preferably abundant alkaline drinking in the form of alkaline mineral waters.
Other drugs
Diabetes mellitus is a systemic disease.This means that the pathology is not limited to pancreas only - in one way or another, almost all organs and fabrics suffer.To a large extent, this is due to diabetic angiopathy: the lesion of blood vessels and capillaries.
At the same time, the blood circulation in these pots and capillaries is disturbed, which leads to secondary injuries of the internal organs - mainly, eyepiece (retinopathy) and kidneys (nephropathy).To eliminate angiopathy, the intravenous dripping of various drugs that improve the circulation of systemic blood is performed.
Together with these drugs, drugs of a specific effect are prescribed that influence metabolic processes in nerve fibers.
The violation of blood circulation in the capillary network is often complicated by trophic ulcers with a predominant location inside the lower part of the leg.
The treatment of these ulcers requires the use of local antiseptics and antibiotics.The most often of others of others are sick of cardiovascular-terosclerosis, hypertension, Angina pectis complicated from the myocardial infarction.
In the treatment of these diseases, cardiotonic are used, which positively influence myocardium, antiasticosclerotic and hypotensive drugs (reducing blood pressure).With diabetes, not only desirable, but also to take various vitamin mineral complexes in the form of biologically active drug additives.
Diet for diabetes
Proper nutrition in diabetes treatment is as important as drugs.Failure to comply with the diet reduces the effectiveness of these zero drugs.This is particularly true for the first type of diabetes, in which the minimum errors in nutrition are full of serious consequences.Basic requirements for diabetic diet diet:
- Fractional intake of food in small portions 4-5 times;
- A balanced relationship of proteins, fats and carbohydrates;
- The number of calories accepted with food should be the same as the number of consummates;
- With obesity - reduction of excess weight.
In this regard, easily digestible carbohydrates, fatty meat, desserts, strong tea, coffee, butter, grapes are contraindicated.Instead of black - black bread, instead of sugar - sugar, replace for diabetics.
The preference in the diet should be administered to cereals (buckwheat, oatmeal, wheat), light vegetable soups, fresh vegetables.A diet for each patient is developed individually by a dietician.
Conclusion
Of course, this article is in no way instructions for the car -mediation, which can be expensive with diabetes with diabetes.It should be noted that it is impossible to completely treat diabetes mellitus dependent on insulin.Deplorable, but a fact.But correct and regular treatment, the protective regime, food and physical restrictions will help to return to a full life and avoid unwanted complications.