Diabetes mellitus is a metabolic disorder characterized by an increase in blood sugar.The disease occurs as a result of defects in insulin production, a lack of the action of insulin or both of these factors. In addition to the increase in blood sugar, the disease is manifested by the release of sugar in the urine, abundant urination, increased thirst, fat disorders, proteins and mineral metabolism and the development of complications.
GuysType 1 diabetes (autoimmune, idiopathic): destruction of beta cells in the pancreas, which produce insulin.Diabetes type 2 mellitus - with the predominant insensitivity of insulin tissues or a predominant defect in insulin production with or without insensitivity.Diabetes gestational sugar occurs during pregnancy.Other types:genetic defects;diabetes caused by medicines and other chemicals;diabetes caused by infections;Pancreatitis, trauma, elimination of the pancreas, acromegalie, Izenko - Kushinka, thyrotoxicosis and others.
SeverityEasy current: there are no complications.A means of severity: there are damage to the eyes, kidneys, nerves.Severe current: distant complications of diabetes.
Diabetes symptomsThe main symptoms of the disease include manifestations such as:Abundant urination and increased thirst;Increase in appetite;General weakness;Skin lesions (for example, vitiligo), vagina and urinary tract are particularly often observed in patients not struck due to emerging immunosficiary;The vagueness of the vision is caused by changes in the backgrounds of the eye.Type 1 diabetes usually starts at a young age.Type 2 diabetes is generally diagnosed in people over 35 to 40 years old.
Diabetes diagnosisThe 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 an 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:Venous Blood - 3, 3–5, 5 mmol / L; Happy Blood - 3, 3–5, 5 mmol / L;Blood venous plasma - 4–6, 1 mmol / L.
Analysis leads to the presence of diabetes mellitusOn an empty stomach:venous blood of more than 6, 1 mmol / l; hair blood over 6, 1 mmol / l; Venous blood plasma is greater than 7, 0 mmol / L.At any time of the day, whatever the time to eat:venous blood over 10 mmol / l; hair blood over 11, 1 mmol / l; Venous blood plasma is greater than 11, 1 mmol / L.The level of glycated blood hemoglobin in diabetes exceeds 6, 7 to 7. 5%.The content of the peptide C allows you to assess the functional condition of beta cells. In patients with type 1 diabetes, this level is generally reduced, in type 2 diabetes patients - normally or increased, in patients with insulinoma - has increased sharply.The concentration of immunoreactive insulin is reduced with type 1, normally or increased with type 2.The determination of the concentration of glucose in the blood to diagnose diabetes is not carried out in the context of acute diseases, injuries or surgery, in the context of short -term administration of drugs that increase the concentration of blood glucose (adrenal hormones, thyroid hormones, thiazides, beta, etc. ), in patients with patients with patientsZirrose. liver. Glucose in the urine in diabetes only appears after having exceeded the "renal threshold" (around 180 mg% 9, 9 mmol / l). Significant threshold fluctuations and a tendency to increase with age are characteristic; Consequently, the definition of glucose in the urine is considered to be 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 certain cases is used for the daily observation of the dynamics of the disease.
Diabetes treatment
Physical activity and good nutrition in treatmentIn a large part of patients with diabetes mellitus, observing food recommendations and reaching a significant decrease in body weight from 5 to 10% of the initial, blood sugar indicators improve to the standard. 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 Sang>13–15 mmol / L, physical activity is not recommended.With a light and moderate physical effort which does not last more than an hour, additional use of carbohydrates is necessary before and after load (15 g of easily digestible carbohydrates for 40 minutes). With moderate physical effort that lasts more than an hour and intensive sports, it is necessary to reduce by 20 to 50% of the dose of insulin, acting for and within 6 to 12 hours after physical activity.The diet in the treatment of diabetes (Table 9) aims to normalize the metabolism of carbohydrates and the prevention of fat metabolism.
Treatment with insulin preparationsInsulin preparations for the treatment of diabetes are divided into 4 categories, by the duration of action: Ultra -Koro action (the start of the action - After 15 minutes, the duration of the action is 3 to 4 hours).Quick action (the start of the action - After 30 min. - 1 hour; duration of action 6-8 hours).The average duration of the action (the start of the action is after 1 to 2, 5 hours, the duration of the action is 14 to 20 hours).Long action (the start of the action is after 4 hours; the duration of action is up to 28 hours).Insulin appointments are strictly individual and are selected for each patient with a dialogue or an endocrinologist.
Methodology to introduce insulinWhen insulin is introduced on the injection site, it is necessary to form a skin fold so that the needle enters under the skin and not in muscle tissue. The skin fold should be wide, the needle should enter the skin at an angle of 45 ° if the thickness of the skin fold is lower than the length of the needle.When choosing a place for injection, compacted skin areas must be avoided. The injection places cannot be modified non -systematic. Do not inject under the skin of the shoulder.Short insulin preparations should be administered in the subcutaneous fat fiber of the wall before the abdomen 20 to 30 minutes before eating.Long-term insulin preparations are introduced into the subcutaneous fat fiber of the thighs or buttocks.Ultra-Rasinus insulin injections are carried out 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.
