Diabetes

Diabetes mellitus is a metabolic disorder characterized by increased blood sugar.

The disease is caused by defects in insulin production, defects in insulin action or both factors. In addition to increased blood sugar levels, the disease is characterized by the release of sugar in urine, abundant urine, increased thirst, fat disorders, protein and mineral metabolism and the development of complications.

Type

1. Type 1 diabetes (autoimmune, idiopathic): the destruction of pancreatic beta cells, which produces insulin.
2. Type 2 Diabetes mellitus - with dominant tissue uncertainty to insulin or major defects in insulin production with or without uncertainty.
3. Diabetes pregnancy sugar occurs during pregnancy.
4. Other types:
• genetic defects;
• Diabetes caused by drugs and other chemicals;
• diabetes caused by infection;
• Pancreatitis, trauma, removal of pancreas, acromegaly, izenko - kushinka, thyrotoxicosis and others.

X

• Easy Current: There are no complications.
• Average level of severity: there is damage to the eyes, kidneys, nerves.
• Severe current: Complications of diabetes remote.

Symptoms of diabetes

The main symptoms of the disease include manifestations such as:

• Many urine and increasing thirst;
• Increased appetite;
• General weakness;
• Skin lesions (for example, vitiligo), vagina and urinary tract are often observed in patients who are not immunodeficiency appearing;
• The Fuzzy of Vision is due to changes in the media flipping the eyes.

Type 1 diabetes usually starts at a young age.

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

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 condition is a recurrent determination of sugar levels and on other days).

The results of the analysis are normal (without 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 vein plasma - 4-6. 1 mmol/l.

Analysis produces 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;  
• Venous blood plasma more than 7. 0 mmol/l.

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

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

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

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 increased, in patients with insulinoma - increased significantly.

The immunoreactive insulin concentration is reduced by type 1, usually or increases with type 2.

Determining the concentration of glucose in the blood to diagnose diabetes is not performed on the background of acute disease, injury or surgical intervention, to the background of short-term administration of drugs that increase blood glucose concentration (adrenal hormones, thyroid hormones, thiazida, beta-blocker.

Glucose in urine in diabetes appears only after exceeding the "kidney threshold" (about 180 mg % 9. 9 mmol/l). Significant changes 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. This 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 dynamic disease of the disease.

Diabetes treatment

Proper physical activity and nutrition in treatment

In most patients with diabetes mellitus, observing nutrition suggestions and achieving a significant weight loss by 5-10 % of early sugar indicators, increasing the norm. One of the main conditions is physical work (for example, walking every day 30 minutes, swimming 1 hour 3 times a week). With glucose concentration in blood>13-15 mmol/l, physical activity is not recommended.

With mild and moderate physical energy that lasts no more than 1 hour, additional use of carbohydrates is required before and after load (15 g of carbohydrates can be easily digested every 40 minutes). With moderate physical energy that lasts more than 1 hour and intensive sports, it is necessary to reduce 20-50 % of the dosage of insulin, acting current and in the next 6-12 hours after physical activity.

Diet in the treatment of diabetes (Table No. 9) aims to normalize carbohydrate metabolism and prevention of fat metabolism.

Treatment with insulin preparations

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

• Ultra -Koro 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; the action period of 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 beginning of action is after 4 hours; the duration of action is up to 28 hours).

Insulin appointment mode is a strict and selected individual for each patient with a dialitologist or endocrinologist.

Methodology to introduce insulin

When insulin is introduced on the injection site, it is necessary to form a skin fold to get the needle into the skin, rather than into the muscle tissue. Folding the skin should be wide, the needle should enter the skin at a 45 ° angle if the skin thickness is less than the length of the needle.

When choosing a place for injection, the compacted skin area should be avoided. The injection place cannot be changed is not systematic. Do not injure under the shoulder skin.

• Short insulin preparations should be administered into the subcutaneous fat fiber of the front wall of the abdomen 20-30 minutes before meals.
• Long insulin preparations are introduced into the subcutaneous fat or back subcutaneous fat fibers.
• Ultra insulin injection -injection is done immediately before meals, and if necessary, current or immediately after meals.

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