How to treat diabetes?Of course, insulin.Everyone knows this, even those who are far from medicine.After all, diabetes (hereinafter - diabetes) is when sugar increases.And insulin reduces this sugar.
In general, correct.If you do not take into account some insignificant details, at first glance, but in reality important.
Insulin
Yes, insulin really reduces the high sugar level (more precisely: glucose) in blood plasma.
With type 1 diabetes, which is being developed mainly at an early age, absolute insulin deficiency is observed: this hormone is not secreted (or secreted in low quantities) with certain pancreatic structures, Langerganes are washed.
There is no insulin: there is no use of glucose, and additional metabolic processes are pathological.If insulin introduces within the framework of replacement therapy, the situation can be corrected to some extent.
Under the influence of this medicine, glucose enters where it is supposed to be, in a cage, where it is subject to division.Metabolism is normalized.
Everything would be simple if it weren't so difficult.The fact is that in some cases the introduction of insulin can lead to great problems that its absence.The reason is hypoglycemia, a strong fall in glucose in blood plasma.
An insulin overdose affects very quickly and sometimes instantly.
The skin becomes pale, blood pressure falls, a comma develops, from which the patient is very difficult to eliminate.
The cause of hypoglycemia is not only an overdose, but also the inadequate administration of insulin.This medicine should be administered only after taking a light food.Before the introduction of insulin, physical activity, tensions are not desirable.
That is why the dose of insulin is carefully selected by the endocrinologist depending on the level of blood glucose (the glucose content in the blood plasma), which is determined by laboratory means.
The daily dose depends on the level of blood glucose, the course of diabetes, and the doctor determines it 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 may vary according to the way of life, work.And to choose the correct insulin with diabetes in the first place, a mellite of barely detected diabetes can disappear for several days.The milestone is the same: laboratory indicators.
Due to the high hypoglycemia rice, insulin is prohibited from introducing ambulance workers in the prehospital stage, which cannot control blood glucose.
It is true that many portable devices, glycometers, designed to measure blood sugar have recently appeared.
But, first of all, the reliability of glucometers sometimes leaves much to be desired.
And secondly, as already mentioned, the delayed introduction of insulin is not so afraid as its overdose.
It is noteworthy that 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 it is necessary to reduce blood glucose as quickly as possible, short action insulin is introduced.The effect occurs rapidly, during the first 15-20 minutes, but it doesn't last long.
Insulin of the average duration 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.
Saharasses
If insulin occurs only in the form of injection solutions (it is destroyed in the gastrointestinal tract), then the overwhelming number of medications to reduce sugar is represented by tablets for internal intake.
It should be noted that agents that reduce insulin and diabetes sugar are not interchangeable.
More precisely, insulin is effective only with the type of diabetes above 1 type of twins.
And all agents yielding sugar are used only for 2 types of insulin dependent 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 increases.But it is still missing.
This happens with obesity in old age, when the amount of adipose tissue increases, and the compensatory capacities of the human body are low.
There are several types of sugar tablets.All of them in one way or another change the course of biochemical reactions and, therefore, stimulate the production of insulin with beta cells.
At a given time, beta cells run out, relative insulin deficiency becomes absolute and there is a need for an additional transition to insulin treatment.
Sometimes, the base of diabetes mellitus can be a greater production of contracted thyroid hormones, adrenal glands and pituitary glands.The action of these hormones is exactly the opposite of such insulin: they increase the blood glucose level.
After the high level of codexular hormones is confirmed by laboratory methods, specific injection agents are prescribed that regulate their level.
Glucose
It turns out that diabetes glucose is no less important than insulin.This is especially true for the serious forms of the disease.
Timely introduction of glucose inhypoglycemic conditions- This is a matter of life and death.After all, the blood sugar level should rise as quickly as possible.For this, a 40% concentrated glucose is administered intravenously with a syringe.
YeahThe patient is awareThey give it a glass of hot tea with sugar.
But hyperglycemia (high sugar) also requires glucose administration.
The conclusion is that glucose accumulates in plasma in large quantities.But the cell does not receive this glucose.Pathological mechanisms of glycogenesis are launched: the synthesis of glucose from fat and proteins, which decompose intensely.
To prevent this from happening, glucose is introduced intravenously as part of the polarization of the mixture called the SO.This mixture includes 5% glucose, insulin and one of potassium drugs.Insulin contributes to the penetration of glucose into a cage, and at the same time "pira" of 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 to increase urine liberation in diabetes, the diabetic uretic that is called that.
It is due to the high concentration of blood plasma and secondary renal damage.Glucose is lost together with the urine.In this case, the image of SO became a positive false image: the blood glucose level 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 exit to avoid these "scissors" lies in the timely administration of gouts of glucose solutions.
Certification and alkalization
Urinalism is, in the first place, the loss of liquid, which quickly leads to dehydration or dehydration.Along with this, excess blood glucose 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 deplorable treatment.Dehydration and ketoacidosis are mutually loaded.
To eliminate dehydration, a rehydration is carried out: replacement of liquid deficiency.Diabetes reissue implies a massive intravenous infusion, up to 3 liters per day or more, of several solutions.
In addition to the previous glucose, an ordinary solution of isotonic sodium chloride (saline solution) is administered, as well as other solutions that contain sodium, chlorine, magnesium, potassium ions.
The replacement of liquid deficiency normalizes the balance of acids and base bases, and largely eliminates acidification in tissues - acidosis.The effective ways of combating acidosis are the infusion of sterile alkalinal solutions.These include sodium bicarbonate, or, simply, soft drinks.If the patient's condition allows it, preferably abundant to drink alkaline in the form of alkaline mineral waters.
Other drugs
Diabetes mellitus is a systemic disease.This means that the pathology is not limited only to 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 glasses and capillaries is altered, which leads to secondary lesions of internal organs, mainly, eye retina (retinopathy) and kidneys (nephropathy).To eliminate angiopathy, the intravenous drip administration of several medications that improve systemic blood circulation is carried out.
Together with these medications, medications of a specific effect are prescribed that affect 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 leg.
The treatment of these ulcers requires the use of local antiseptics and antibiotics.Diabetics more frequently that the rest are sick with cardiovascular-infiovascular diseases, hypertension, angina, complicated by myocardial infarction.
In the treatment of these diseases, Cardiotonics are used, which positively affect myocardial, antiasterosclerotic and hypotensive medications (blood pressure reducers).With diabetes, not only desirable, but also required to take several mineral complexes in the form of pharmaceutical drugs and biologically active food additives.
Diabetes diet
Proper nutrition in the treatment of diabetes is as important as drugs.Diet breach reduces the effectiveness of these medications to zero.This is especially true for the first type of diabetes, where the slightest nutrition errors are loaded with serious consequences.Basic requirements for the dietary diet of diabetics:
- Fractional food intake in small portions 4-5 times;
- A balanced relationship of proteins, fats and carbohydrates;
- The number of calories accepted with food must be equal to the number of consumption;
- With obesity: reduction of excess weight.
In this sense, easily digestible carbohydrates, fatty meat, sweets, strong tea, coffee, butter, grapes are contraindicated.Instead of white bread, black, instead of sugar, sugar, diabetic substitutes.
Diet preference should be given to cereals (Sarracene wheat, oatmeal, wheat), light vegetable soups, fresh vegetables.A diet for each patient is developed individually by a dietitian.
Conclusion
Of course, this article has no instructions for self -medication, which can be expensive with diabetes diabetes.It should be noted that it is impossible to completely cure insulin -dependent diabetes.Unfortunate, but a fact.But the correct and regular treatment, the protection regime, food and physical restrictions will help return to a complete life and avoid unwanted complications.