Diabetes

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

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

Types

1. Type 1 diabetes (autoimmune, idiopathic): destruction of the beta cells of the pancreas that produce insulin.
2. Type 2 diabetes request - with the predominant insensitivity of tissues to insulin or a predominant defect in the production of insulin with or without insensitivity.
3. Diabetes gestational sugar occurs during pregnancy.
4. Other species:
• genetic defects;
• diabetes caused by drugs and other chemicals;
• diabetes caused by infections;
• Pancreatitis, trauma, pancreatic removal, acromegaly, osceno - kushinka, thyrotoxicosis and others.

Weight

• Easy current: No complications.
• Medium severity: there is eye damage, kidneys, nerves.
• Heavy currents: distant complications of diabetes.

Symptoms of diabetes

The main symptoms of the disease include such manifestations as:

• Abundant urination and increased thirst;
• Increased appetite;
• General weakness;
• Skin lesions (eg vitiligo), vagina and urinary tract are especially observed in patients who are not rushed as a result of emerging immunodeficiency;
• The blurred vision is caused by changes in the confusing environment of the eye.

Type 1 diabetes usually starts at a young age.

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

Diagnosis

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

In order to diagnose, the concentration of glucose in the blood is determined (an important circumstance is repeatedly determined by an increased level of sugar in 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 leads to diabetes mellitus

On an empty stomach:

• Venous blood more than 6, 1 mmol/l;  
• Capillary blood more than 6, 1 mmol/l;  
• The plasma of venous blood is more than 7, 0 mmol/l.

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

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

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

The C-peptide content allows you to evaluate the functional state of beta cells. In patients with type 1 diabetes, this level is usually reduced in patients with type 2 diabetes - usually or increases in patients with insulin - it increases sharply.

The concentration of immunoreactive insulin is reduced by type 1, usually or increased by type 2.

Determination of blood glucose concentration for diagnosis of diabetes is not performed against the background of acute illness, injury or surgical intervention, against the background of short-term administration of drugs that increase the concentration of glucose in the blood (adrenal hormones, thyroid hormones, thiazides, beta-locks. liver.

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

Diabetes

Physical activity and proper nutrition in the treatment

In a significant proportion of patients with diabetes mellitus, observing dietary recommendations and reaching a significant reduction in body weight by 5-10 % of the original blood sugar indicators are improved to normal. One of the basic conditions is the regularity of exercise (such as walking every day 30 minutes, swimming 1 hour 3 times a week). With the concentration of glucose in the blood>13-15 mmol/l is not recommended physical activity.

With a mild and moderate exercise of no more than 1 hour, additional use of carbohydrates before and after loading (15 g easily digestible carbohydrates for every 40 minutes) is required. With moderate exercise with a duration of more than 1 hour and intensive sports, it is necessary to reduce by 20-50 % of the dose of insulin, acting during the next 6-12 hours after physical activity.

The diet in the treatment of diabetes (Table 9) is aimed at normalizing carbohydrate metabolism and prevention of fat metabolism.

Insulin treatment

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

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

Insulin appointment regimens are strictly individual and are selected for each patient with a diaptologist or endocrinologist.

Insulin introduction methodology

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

When choosing an injection site, sealing skin areas should be avoided. Injection sites cannot be modified unsystematic. No injections under the skin of the shoulder.

• Short-act insulin preparations should be administered in the subcutaneous fat fibers of the anterior wall of the abdomen 20-30 minutes before eating.
• Long -effective insulin preparations are introduced into the subcutaneous fat fibers of the thighs or buttocks.
• Ultra -bryag injections are performed immediately before meals and, if necessary, during or immediately after meals.

The heat and physical activity increase the rate of absorption of insulin and the cold decreases it.