Diabetes

Diabetes Mellitus is a metabolic disorder that characterizes the increase in blood sugar.

The disease occurs as a result of insulin production, damage in insulin action or both of these factors. In addition to the increased blood sugar level, the disease is manifested by releasing sugar in urine, abundant urination, increased thirst, fat, protein and mineral metabolism and complications.

Types

1. Type 1 diabetes (autoimune, idiopathic): Destruction of the Beta cell pancreas, which produce insulin.
2. Type 2 Diabetes Mellitus - with the prevailing insensibility of tissue to insulin or prevailing insulin production damage with or without insensitivity.
3. Diabetes gestational sugar occurs during pregnancy.
4. Other species:
• Genetic shortcomings;
• Diabetes caused by medicines and other chemicals;
• Diabetes caused by infections;
• Pancreatitis, trauma, pancreatic removal, acromegalia, izenko - kushinka, tyrotoxicosis and others.

Seriousness

• Simple current: No complications.
• Average degree of seriousness: There is eye damage, kidneys, nerve.
• Heavy current: far-in diabetes complications.

Diabetes symptoms

The main symptoms of the disease include such events as:

• Abundant urination and increased thirst;
• Increased appetite;
• General weakness;
• Skin lesions (for example, vitiligo), vaginals and urinary tracts are especially often seen in unruly patients as a result of immunodeficiency;
• Vague vision was caused by changes in the overflow media about the eye.

Type 1 diabetes usually start at a young age.

Type 2 diabetes are usually diagnosed in people over 35-40 years.

Diabetes diagnosis

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

To make a diagnosis, the blood glucose concentration is determined (important circumstance is repeated determination of the increased level of sugar and other days).

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

On an empty stomach or 2 hours after the test:

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

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

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

The hemoglobin level of glitched blood in diabetes exceeds 6, 7-7, 5%.

The C-peptide content allows you to evaluate the functional state of the beta cell. In patients with type 1 diabetes, this level usually decreases, in patients with type 2 - normally or increased, in patients with insulinom - increased sharply.

Immunoreactive insulin concentration decreases with type 1, usually or increased with type 2.

Determining blood glucose concentration for diagnosis of diabetes is not performed on the background of acute disease, injury or surgical intervention, in the background of the drug administration that increase blood glucose concentration, beta-blockers, etc. ), in patients with Cirros. The liver.

Glucose in urine in diabetes appears only after the "kidney threshold" exceeds (approximately 180 mg% 9, 9 mmol / l). Significant fluctuations in Prague and a tendency for increasing with age are characterized; Therefore, the definition of glucose in urine is considered an insensitive and unreliable test. The test serves as a gross reference point for the presence or absence of a significant increase in sugar (glucose) in the blood, and in some cases it is used for daily observation of the disease dynamics.

Diabetes Treatment

Physical activity and proper diet in treatment

In the significant part of patients with Melitus diabetes, observing food recommendations and achieving a significant reduction of body weight by 5-10% of the initial, blood sugar indicators improves to the norm. One of the main conditions is the regularity of physical effort (for example, walking a day 30 minutes, swimming 1 hour 3 times a week). Blucose concentration in Blood>13-15 mmol / l, physical activity is not recommended.

With light and moderate physical effort that lasts no more than 1 hour, additional use of carbohydrates is needed before and after load (15 g easily digestible carbs for every 40 minutes). With a moderate physical voltage that lasts more than 1 hours and intense sports, it is necessary to reduce by 20-50% of insulin dose, acting during and in the next 6-12 hours after physical activity.

Diet in the treatment of diabetes (Table 9) is focused on the normalization of carbohydrate metabolism and the prevention of fat metabolism.

Treatment of insulin preparations

Insulin preparations for the treatment of diabetes are divided into 4 categories, the duration of the action:

• Ultra -Koro action (beginning of action - after 15 minutes, the duration of the action is 3-4 hours).
• Fast action (start of action - after 30 min. - 1 hour; Duration of action 6-8 hours).
• The average duration of the action (start of action is after 1-2, 5 hours, the duration of the action is 14-20 hours).
• A long action (starting action is after 4 hours; the duration of the action is up to 28 hours).

Insulin appointments are strictly individual and are selected for each patient with dialogue or endocrinologist.

Insulin introduction methodology

When insulin is introduced at the injection site, it is necessary to form a skin crease so that the needle enters under the skin, not in muscle tissue. The skin assembly should be wide, the needle should enter the skin at an angle of 45 ° if the skin folding is less than the needle length.

When choosing a place for injection, compact skin areas should be avoided. Injected places cannot be changed unsystematized. Do not injections under the shoulder skin.

• Short-information preparations should be given in subcutaneous fat of the front wall of the abdomen for 20-30 minutes before meals.
• Dugoiffect insulin preparations are introduced into subcutaneous fat fiber thighs or buttocks.
• Insulin's injections Ultra -Short is spent immediately before eating, and if necessary, during or immediately after eating.

Heat and physical activity increase insulin absorption speed and is reduced cold.