How to treat diabetes?Of course, insulin.Everyone knows about this, even those who are far from medicine.After all, diabetes (hereinafter - diabetes) is when sugar is increased.And insulin reduces this sugar.
In general, right.If you do not take into account some insignificant, at first glance, but actually important details.
Insulin
Yes, insulin really reduces the high level of sugar (more precisely - glucose) in blood plasma.
With type 1 diabetes, which is mainly developing at a young age, absolute insulin deficiency is noted-this hormone is not secreted (or secreted in low quantities) with certain pancreatic structures, langerganes arewashes.
There is no insulin - there is no utilization of glucose, and further metabolic processes are pathological.If you introduce insulin in the framework of replacement therapy, then the situation can be corrected to a certain extent.
Under the influence of this drug, glucose enters where it is supposed to be - in a cage, where it is subjected to splitting.The metabolism is normalized.
Everything would be simple if it were not so difficult.The fact is that in some cases the introduction of insulin can lead to big problems than its absence.The reason is hypoglycemia, a sharp drop in glucose in blood plasma.
An overdose of insulin affects very quickly, and sometimes instantly.
The skin turns pale, blood pressure drops, a coma develops, from which the patient is very difficult to remove.
The cause of hypoglycemia is not only an overdose, but also the improper administration of insulin.This drug should be administered only after taking a light food.Before the introduction of insulin, physical activity, stresses are not desirable.
That is why the dosage of insulin is carefully selected by the endocrinologist depending on the level of glycemia (the content of glucose in the blood plasma), which is determined by laboratory means.
The daily dose depends on the level of glycemia, the course of diabetes, and is determined by the doctor individually for each patient.
A typical breakdown of this dose is 30% before breakfast, 35% - before lunch, 25% - before dinner, and 10% at night.
Although these figures can vary depending on the mode of life, work.And in order to choose the right insulin with the firstly detected diabetes, a hardly detected mellitus of diabetes, can go away for several days.The landmark is the same - laboratory indicators.
Due to the high rice of hypoglycemia, insulin is prohibited from introducing ambulance workers at the prehospital stage, who cannot control glycemia.
True, recently many portable devices, glycometers, designed to measure blood sugar, have appeared.
But, firstly, the reliability of glycometers sometimes leaves much to be desired.
And secondly, as already mentioned, the delayed introduction of insulin is not as scary as his overdose.
It is noteworthy that insulin used to treat diabetes is not homogeneous.
It can be pork, cattle (obtained from the pancreas of clogged animals) and human, synthesized with genetic engineering.
Insulin is not the same in terms of action.If it is necessary to reduce glycemia as quickly as possible, short -acting insulin is introduced.The effect occurs quickly, during the first 15-20 minutes, but does not last long.
Insulin of average duration and extended action is designed to create the necessary glycemic background during the day.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 sugar-lowering drugs are represented by tablets for internal intake.
It should be noted that insulin and sugar -lowering agents for diabetes are not interchangeable.
More precisely, insulin is effective only with the type of diabetes above 1 type of mellitus.
And all sugar -lowering agents are used only for 2 insulin -dependent types of the disease.This type is based on relative insulin deficiency.This means that the total amount of insulin produced by the pancreas is normal, or even increased.But still he is missing.
This happens with obesity in old age, when the amount of adipose tissue is increased, and the compensatory capabilities of the human body are low.
There are several types of sugar -down tablets.All of them in one way or another change the course of biochemical reactions, and thereby stimulate the production of insulin with beta cells.
At a certain moment, beta cells are depleted, relative insulin deficiency becomes absolute, and there is a need for a further transition to insulin treatment.
Sometimes the basis of diabetes mellitus may be increased production of contrainsular thyroid hormones, adrenal glands, and pituitary gland.The action of these hormones is exactly the opposite of such 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 especially true for severe forms of the disease.
Timely introduction of glucose athypoglycemic conditions- This is a matter of life and death.After all, the blood sugar level should be raised as quickly as possible.For this, a concentrated 40% glucose is administered intravenously with a syringe.
IfThe patient is conscious, they give him a drink of warm tea with sugar.
But hyperglycemia (high sugar) also requires the administration of glucose.
The bottom line is that glucose accumulates in plasma in large quantities.But the cell does not receive this glucose.Pathological mechanisms of glyoogenesis are launched - the synthesis of glucose from fats and proteins, which are intensively decomposed.
To prevent this from happening, glucose is introduced intravenously as part of the so -calledpolarizing the mixture.This mixture includes 5% glucose, insulin, and one of the drugs of potassium.Insulin contributes to the penetration of glucose into a cage, and at the same time it “pulls” potassium along with him.This is the most important intracellular element that controls almost all metabolic processes in the cell.
Another state when glucose is vital is increased urine release in diabetes, the so -calledDiabetic urethics.
It is due to the high concentration of blood plasma and secondary kidney damage.Glucose is lost along with the urine.In this case, the so -calledA 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 drip administration of glucose solutions.
Certification and alkalization
Urinalism is, first of all, the loss of fluid, which quickly leads to dehydration or dehydration.Along with this, 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 proceeds extremely difficult, and in the absence of treatment ends deplorable.Dehydration and ketoacidosis mutually burden each other.
To eliminate dehydration, a rehydration is carried out - replenishment of fluid deficiency.Reedation for diabetes involves massive, up to 3 liters per day or more, intravenous infusion of various solutions.
In addition to the above glucose, an ordinary isotonic sodium chloride solution (saline) is administered, as well as other solutions containing sodium, chlorine, magnesium, potassium ions.
The replenishment of fluid deficiency normalizes the balance of acids and bases in the body, and largely eliminates acidification in tissues - acidosis.Effective ways to combat acidosis are the infusion of sterile alkalizing solutions.These include sodium bicarbonate, or, simply, soda.If the patient's condition allows, preferably plentiful 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 the pancreas alone - 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, which leads to secondary lesions of the internal organs - primarily, eye retina (retinopathy) and kidneys (nephropathy).To eliminate angiopathy, intravenous drip administration of various drugs that improve systemic blood circulation is carried out.
Along with these drugs, medications of a specific effect are prescribed that affect metabolic processes in nerve fibers.
Violation 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 local antiseptics and antibiotics.Diabetics more often than the rest are sick with cardiovascular diseases-atherosclerosis, hypertension, angina pectoris complicated by myocardial infarction.
In the treatment of these diseases, cardiotonics are used, which positively affect the myocardium, antiasterosclerotic and hypotensive (reducing blood pressure) drugs.With diabetes, not only desirable, but also required to take various vitamin-mineral complexes in the form of pharmaceutical drugs and biologically active food additives.
Diet for diabetes
Proper nutrition in the treatment of diabetes is as important as drugs.Failure to comply with the diet reduces the effectiveness of these drugs to zero.This is especially true for the 1st type of diabetes, where the slightest errors in nutrition are fraught with serious consequences.Basic requirements for the dietary 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 accepted with food should be equal to the number of consumed;
- With obesity - reduction of 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 -substitutes for diabetics.
Preference in the diet should be given to cereals (buckwheat, oatmeal, wheat), light vegetable soups, fresh vegetables.A diet for each patient is developed individually by a dietitian.
Conclusion
Of course, this article is in no way instructions for self -medication, which can be expensive with diabetes with diabetes.It should be noted that it is impossible to completely cure insulin -dependent diabetes mellitus.Regrettable, but a fact.But the correct, regular treatment, protective regime, food and physical restrictions will help return to a full life and avoid unwanted complications.