Diabetes

Diabetes mellitus is a metabolic disorder characterized by an increase in blood sugar.

The disease occurs due to defects in the production of insulin, a defect in the action of insulin or both these factors. In addition to the increase in blood sugar level, the disease manifests itself from the release of sugar in the urine, abundant urination, augmented thirst, by fatty metabolism disorders, proteins and minerals and the development of complications.

Types

1. Type 1 diabetes (autoimmune, idiopathic): destruction of the beta cells of the pancreas, which produce insulin.
2. Type 2 mellitus diabetes - with the predominant insensitivity of insulin tissues or a predominant defect in the production of insulin with or without insensitivity.
3. Diabetes gestational sugar occurs during pregnancy.
4. Other types:
• genetic defects;
• Diabetes caused by drugs and other chemicals;
• diabetes caused by infections;
• Pancreatitis, trauma, removal of pancreas, acromegalia, izenko - Kushinka, thyrotoxicosis and others.

Severity

• Easy current: there are no complications.
• Average degree of gravity: there is damage to the eyes, the kidneys, to the nerves.
• Severe currection: distant complications of diabetes.

Symptoms of diabetes

The main symptoms of the disease include manifestations such as:

• Abundant urination and increase in thirst;
• Increase in appetite;
• General weakness;
• Leather lesions (for example, vitiligo), vagina and urinary tract are particularly observed often in patients not rejected due to emerging immunodeficiency;
• The conflict of vision is caused by changes in the medium of the eye.

Type 1 diabetes usually starts at a young age.

Type 2 diabetes is generally diagnosed in people for over 35-40 years.

Diagnosis of diabetes

The diagnosis of the disease is based on blood and urine tests.

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

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

On an empty stomach or 2 hours after the test:

• venous blood - 3, 3–5, 5 mmol/l;  
• Capillary blood - 3, 3–5, 5 mmol/l;
• Blood venous plasma - 4–6, 1 mmol/l.

The analysis causes the presence of diabetes mellitus

On an empty stomach:

• venous blood greater than 6, 1 mmol/l;  
• capillary blood greater than 6, 1 mmol/l;  
• The venous blood plasma is greater than 7, 0 mmol/l.

At any time of the day, regardless of the time to eat:

• venous blood more than 10 mmol/l;  
• capillary blood greater than 11, 1 mmol/l;  
• The venous blood plasma is greater than 11, 1 mmol/l.

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

The content of the CE peptide allows to evaluate the functional status of the beta cells. In patients with type 1 diabetes, this level is generally reduced, in patients with type 2 diabetes - normally or increased, in patients with insulinoma - significantly increased.

The concentration of immunoreactive insulin is reduced with type 1, normally or increased with type 2.

Determining the concentration of glucose in the blood to diagnose diabetes is not performed against the background of acute diseases, injuries or surgical interventions, against the background of short -term administration of drugs that increase the concentration of glucose in the blood (admire hormones, liver thyroid hormones.

Glucose in the urine in diabetes appears only after exceeding the "renal threshold" (about 180 mg % 9, 9 mmol/l). Significant fluctuations in the threshold and the tendency to increase with age are characteristic; Therefore, the definition of glucose in the urine is considered insensitive and unreliable test. The test acts 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 the daily observation of the dynamics of the disease.

Diabetes treatment

Physical activity and correct nutrition in the treatment

In a significant part of patients with diabetes mellitus, observing dietary recommendations and reaching a significant reduction in body weight by 5-10 % of the initials, blood sugar indicators improve up to the norm. One of the main conditions is the regularity of physical effort (for example, walking 30 minutes daily, swimming 1 hour 3 times a week). With the concentration of glucose in the blood13–15 mmol/l, physical activity is not recommended.

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

The diet in the treatment of diabetes (table n. 9) aims to normalize the metabolism of carbohydrates and the prevention of fat metabolism.

Treatment with insulin preparations

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

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

The insulin appointment methods are strictly individual and are selected for each patient with a dialyser or endocrinologist.

Methodology to introduce insulin

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

When choosing a place for injection, you need to avoid compact skin areas. Injection places cannot be changed non -systematic. Not injections under the skin of the shoulder.

• Corto -azione -action insulin preparations must be administered in the subcutaneous fat fiber of the front wall of the abdomen 20-30 minutes before eating.
• The long -term insulin preparations are introduced into the subcutaneous fat fiber of the thighs or buttocks.
• Ultra -short insulin injections are performed immediately before eating and, if necessary, during or immediately after eating.

Heat and physical activity increase the absorption rate of insulin and the cold reduces it.