Insulin-dependent diabetes mellitus treatment. What is insulin-dependent diabetes mellitus? Insulin storage rules

Insulin dependent diabetes, according to experts, is a disease in which serious hormonal changes occur in the body, as a result of which glucose is not used as an energy source. This kind of situation occurs because a hormone called insulin is not produced in the required amount, therefore, the body loses its habitual sensitivity to its action.

According to experts, insulin-dependent occurs due to the sequential destruction of the cells of the pancreas itself, which are directly responsible for the production of insulin. As a rule, this ailment is diagnosed before the age of 40. In plasma, the level of the hormone gradually decreases, while the amount of glucagon, on the contrary, increases. It is possible to reduce this indicator only by means of insulin.

Symptoms

With such a diagnosis as insulin-dependent diabetes mellitus, patients complain of constant thirst, increased appetite and, at the same time, serious weight loss. In addition, increased irritability, insomnia, decreased ability to work, pain in the calf muscles, and also in the heart are often noted.

At the moment, experts distinguish the following stages of the onset and development of a disease such as insulin-dependent diabetes mellitus:

1. Genetic predisposition.
2. Impact of negative factors environment(very often it is they who become the cause of the development of the disease).
3. Inflammatory processes in the pancreas itself.
4. β-cells begin to be perceived by the immune system itself as foreign objects, that is, they are gradually destroyed.
5. β-cells are completely destroyed. Diagnosed by type.

Treatment

First of all, for all patients, without exception, doctors prescribe special diet... Its main principles are the daily calorie count and the observance of the required proportion of fats, carbohydrates and proteins. In addition, absolutely all patients almost constantly need insulin itself. As a rule, patients "with experience" quite independently cope with its introduction into the body. The operation is simple enough. Initially, it is necessary to constantly monitor For these purposes, a special apparatus can be purchased in almost every pharmacy. Then the patients, based on the concentration of glucose in the blood, select the required dosage of insulin. In a fairly simple way, they manage to maintain normal (recommended) sugar levels.

Conclusion

In our article, we examined what is insulin-dependent diabetes mellitus. Disability in this case, of course, is provided to all patients without exception. However, psychologists still recommend not to lose heart and, despite such an unpleasant ailment, to fight for your health.

Diabetes- a disease in which the body loses its ability to use glucose for energy, as a result of a violation of the quantitative level of the hormone insulin or a decrease in sensitivity to its action. It is one of the most common chronic diseases. Sometimes the predisposition to the disease is inherited. Risk factors depend on the type of disease.

Diabetes characterized by either insufficient secretion of the hormone insulin by the pancreas, or resistance of body cells to its effects. At diabetes mellitus cells are forced to use other sources of energy, which can lead to the appearance of toxic metabolic by-products in the body. Unused glucose builds up in the blood and urine, resulting in symptoms such as increased urination and thirst.

Treatment of the disease is aimed at establishing control over blood sugar levels. Approximately 10% of patients undergoing treatment for diabetes mellitus are dependent on the insulin injections they give themselves throughout their lives. The rest of the patients need a carefully selected diet and often oral antidiabetic drugs. Compliance with these measures enables most patients to lead a normal life. Complications of diabetes mellitus include diseases of the eyes, kidneys, cardiovascular and nervous system... Besides, diabetes weakens the body's immune system, which increases a person's susceptibility to infections such as cystitis. The disease is usually chronic in nature, methods of treatment leading to a complete recovery, on this moment does not exist.

There are two main forms diabetes mellitus: diabetes type I and type II.

Diabetes type II. This is a much more common type of diabetes. In this form, the pancreas continues to produce insulin, but the cells in the body become insensitive to its effects. This form of diabetes mainly affects people over the age of 40, the disease is more common among overweight people. The disease develops slowly, often it goes unnoticed for many years. Sometimes the disease can be controlled solely with the help of dietary correction, although there may be a need for oral hypoglycemic drugs and, rarely, for insulin injections.

Diabetes can sometimes develop during pregnancy. This condition, called pregnancy diabetes, is usually treated with insulin to keep the mother and baby healthy. Pregnancy diabetes usually disappears after childbirth, but women who have it are at increased risk of developing type II diabetes in the future.

The causes of type II diabetes are less well understood, although genetic factors and obesity play an important role. Diabetes type II is a problem for society, which is becoming more acute due to the widespread prevalence of the disease, as well as due to an increase in the amount of food consumed by the population, which leads to an increase in the number of overweight people.

The combination of obesity, high blood pressure, diabetes, and high cholesterol levels is called metabolic syndrome.

The main symptoms of both forms of diabetes mellitus include:

Frequent urination;

Thirst and dry mouth;

Sleep disturbances caused by the need to go to the toilet frequently;

Decreased performance;

Visual impairment.

Diabetes can lead to the development of both short-term and chronic complications. Short-term complications usually respond well to treatment, but chronic complications are difficult to control, and their progression can lead to premature death of the patient.

One of the most common complications in the treatment of both types of diabetes is hypoglycemia, a condition in which blood sugar levels drop to dangerous levels. Hypoglycemia is often caused by a poor balance between food intake and insulin dose. The disease is more common in patients with type I diabetes, but it can also develop in patients with type II diabetes who take urea derivatives. Left without medical care hypoglycemia leads to loss of consciousness and coma.

Chronic complications. Chronic complications diabetes mellitus, which pose a major threat to the health of patients with this disease, eventually occur even in patients with well-compensated disease. Close monitoring of blood sugar levels lowers the risk of these problems, and early detection helps to establish control over their course.

In people suffering diabetes mellitus, increased risk of developing vascular diseases... Large blood vessels can be affected by atherosclerosis, the main cause of coronary artery disease and stroke. Elevated blood cholesterol levels, which contribute to the development of atherosclerosis, are common among patients with diabetes mellitus... In addition, diabetes is often linked to hypertension, another risk factor for cardiovascular disease.

Another chronic complication diabetes mellitus is the defeat of small blood vessels in all tissues and organs. In addition, diabetes increases the risk of developing cataracts.

If the blood supply to the nerves is impaired as a result of diabetes, the nerve endings may be damaged. In this case, a gradual loss of sensitivity may be observed, starting with the hands and feet, sometimes transmitted higher along the entire limb. Symptoms may also include dizziness when standing and erectile dysfunction in men. The loss of sensation, combined with poor blood supply, makes the legs more susceptible to ulceration and the development of gangrene.

Damage to the small blood vessels of the kidneys can lead to the development of chronic renal failure or its progression to the end stage of failure, which requires lifelong dialysis or a kidney transplant.
First, the doctor will direct the patient to pass urine for analysis to determine the presence of sugar in it. The diagnosis is confirmed with a blood test to check the level of sugar it contains. If the blood sugar readings are in the borderline range, the patient can repeat the blood test in the morning on an empty stomach. In addition, the patient can donate blood to determine the level of glycosylated hemoglobin - an altered form of pigment in red blood cells, the concentration of which is also increased with high readings of blood sugar levels for several weeks or months.

For every patient suffering diabetes mellitus The main goal of treatment should be to maintain blood sugar levels within acceptable levels. Treatment usually needs to be carried out throughout life, and the patient will have to deal with the issues of dietary and medication adjustments with full responsibility on a daily basis.

Diabetes type II. Many people with this type of condition can regulate their blood sugar levels by taking regular physical exercise and a healthy diet aimed at achieving ideal weight.

It is necessary to keep fat intake low and to obtain the required energy from complex carbohydrates to keep blood sugar fluctuations to a minimum. The diet should provide a fixed daily calorie intake, with constant proportions of protein, carbohydrates, and fat.

In addition, the patient should have their blood sugar measured regularly. If only adherence to the diet is not enough to maintain normal blood sugar levels, the patient may additionally be prescribed one or more antihyperglycemic drugs. Treatment is likely to start with oral medications such as sulfonylureas, which stimulate the secretion of insulin by the pancreas, or metformin, which helps body tissues absorb glucose. Other newer drugs, such as pioglitazone or rosiglitazone, can lower blood sugar levels by making cells more responsive to its effects.

Diabetes can be the cause of the patient's premature death, usually due to complications from the cardiovascular system. However, successful blood sugar control, coupled with a healthy lifestyle, makes it easier to achieve compensation for the disease, which allows sufferers to maintain near-normal lifestyles.

Insulin-dependent diabetes

(Type 1 diabetes mellitus)

Type 1 diabetes usually develops in young people between the ages of 18 and 29.

Against the background of growing up, entering an independent life, a person experiences constant stress, bad habits are acquired and rooted.

Due to certain pathogenic (disease-causing) factors- viral infection, frequent alcohol consumption, smoking, stress, eating semi-finished products, hereditary predisposition to obesity, pancreatic disease - an autoimmune disease develops.

Its essence lies in the fact that the body's immune system begins to fight with itself, and in the case of diabetes, the beta cells of the pancreas (islets of Langerhans), which produce insulin, are attacked. There comes a time when the pancreas practically ceases to produce the necessary hormone on its own or produces it in insufficient quantities.

The full picture of the reasons for this behavior of the immune system is not clear to scientists. They believe that both viruses and genetic factors influence the development of the disease. In Russia, approximately 8% of all patients have type 1 diabetes. Type l diabetes is usually a disease of the young, as it develops in most cases during adolescence or adolescence. However, this type of disease can also develop in a mature person. The beta cells of the pancreas begin to break down several years before the onset of the main symptoms. At the same time, a person's well-being remains at the level of the habitually normal.

The onset of the disease is usually acute, and a person himself can reliably name the date of the onset of the first symptoms: constant thirst, frequent urination, an insatiable feeling of hunger and, despite frequent eating, weight loss, fatigue, blurred vision.

This can be explained as follows. The destroyed beta cells of the pancreas are unable to produce enough insulin, the main action of which is to lower the concentration of glucose in the blood. As a result, the body begins to store glucose.

Glucose- a source of energy for the body, however, in order for it to enter the cell (by analogy: gasoline is needed for the engine to work), it needs a conductor - insulin.

If there is no insulin, then the cells of the body begin to starve (hence fatigue), and glucose, which comes from outside with food, accumulates in the blood. In this case, "starving" cells give a signal to the brain about a lack of glucose, and the liver enters into action, which from its own glycogen stores releases an additional portion of glucose into the blood. Struggling with an excess of glucose, the body begins to intensively excrete it through the kidneys. Hence the frequent urination. The body replenishes the loss of fluid by frequent quenching of thirst. However, over time, the kidneys cease to cope with the task at hand, therefore dehydration, vomiting, abdominal pain, and impaired renal function occur. The stores of glycogen in the liver are limited, so when they come to an end, the body will begin to process its own fat cells for energy. This explains the weight loss. But the transformation of fat cells to release energy is slower than with glucose, and is accompanied by the appearance of unwanted waste.

Ketone (that is, acetone) bodies begin to accumulate in the blood, the increased content of which entails conditions dangerous for the body - from ketoacidosis and acetone poisoning(acetone dissolves the fatty membranes of cells, preventing the penetration of glucose into the interior, and sharply inhibits the activity of the central nervous system) up to coma.

It is by the presence of an increased content of ketone bodies in the urine that type 1 diabetes mellitus is diagnosed, since acute malaise in a state of ketoacidosis leads a person to a doctor. In addition, people around can often feel the "acetone" breathing of the patient.

Since the destruction of the beta cells of the pancreas occurs gradually, an early and accurate diagnosis can be made even when there are no obvious symptoms of diabetes. This will stop the destruction and preserve the mass of beta cells that have not yet been destroyed.

There are 6 stages of development of type 1 diabetes mellitus:

1... Genetic predisposition to type 1 diabetes... At this stage, reliable results can be obtained through studies of genetic markers of the disease. The presence of antigens of the HLA group in a person greatly increases the risk of developing type 1 diabetes.

2. Starting moment. Beta cells are affected by various pathogenic (disease-causing) factors (stress, viruses, genetic predisposition, etc.), and the immune system begins to form antibodies. Insulin secretion has not yet occurred, but the presence of antibodies can be determined using an immunological test.

3. Stage of prediabetes. The destruction of the beta cells of the pancreas by the autoantibodies of the immune system begins. Symptoms are absent, but impaired insulin synthesis and secretion can already be detected with a glucose tolerance test. In most cases, antibodies to the beta cells of the pancreas, antibodies to insulin, or both types of antibodies are detected at the same time.

4. Decreased insulin secretion. Stress tests can reveal violation tolerance To glucose(NTG) and impaired fasting plasma glucose(NGPN).

5. "Honeymoon. At this stage, the clinical picture of diabetes mellitus is presented with all of the listed symptoms. The destruction of the beta cells of the pancreas reaches 90%. Insulin secretion is sharply reduced.

6. Complete destruction of beta cells. Insulin is not produced.

It is possible to independently determine whether you have type 1 diabetes only at the stage when all the symptoms are present. They arise at the same time, so it will not be difficult to do this. The presence of only one symptom or a combination of 3-4, for example, fatigue, thirst, headache and itching, does not yet indicate diabetes, although, of course, it indicates another ailment.

To identify yourself with diabetes mellitus, laboratory tests are needed for blood and urine sugar, which can be carried out both at home and in the clinic. This is the primary way. However, it should be remembered that an increase in blood sugar in itself does not mean the presence of diabetes mellitus. It can be caused by other reasons.

Psychologically, not everyone is ready to admit that they have diabetes, and a person often pulls to the last. And yet, if you discover that you have the most alarming symptom - "sweet urine", it is better to go to the hospital. Even before the advent of laboratory tests, English doctors and ancient Indian and Eastern practitioners noticed that the urine of diabetic patients attracts insects, and called diabetes "sweet urine disease."

Currently, a wide range of medical devices is being produced aimed at self-monitoring of blood sugar levels by a person - glucometers and test strips to them.

Test strips for visual control are sold in pharmacies, are easy to use and available to everyone. When buying a test strip, be sure to pay attention to the expiration date and read the instructions. Before using the test, you must thoroughly wash your hands and dry them dry. There is no need to wipe the skin with alcohol.

A disposable needle, it is better to take a round section or use a special lancet, which is attached to many tests. Then the wound will heal faster and be less painful. It is best not to pierce the pad, since this is the working surface of the finger and constant touching does not contribute to the rapid healing of the wound, and the area is closer to the nail. It is better to massage your finger before the injection. Then take a test strip and leave a swollen drop of blood on it. It is worth noting that you should not add blood or smear it on the strip. Wait until a sufficient drop has swell to capture both halves of the test field. To do this, you need a watch with a second hand. After the time indicated in the instructions, wipe the blood off the test strip with a cotton swab. In good light, compare the changed color of the test strip with the scale that is usually found on the test box.

Such a visual method for determining blood sugar levels may seem inaccurate to many, but the data are quite reliable and sufficient to correctly determine whether the sugar is high, or to establish the required dose of insulin for the patient.

The advantage of test strips over a glucometer is their relative cheapness. Nevertheless, Meters have several advantages over test strips. They are portable, lightweight. The result appears faster (from 5 s to 2 minutes). The drop of blood may be small. You do not need to wipe the blood off the strip. In addition, glucometers often have an electronic memory in which the results of previous measurements are entered, so this is a kind of diary of laboratory tests.

Currently, two types of blood glucose meters are produced. The former have the same ability as the human eye to visually determine the color change of the test field.

And the work of the second, sensory, is based on the electrochemical method, with the help of which the current that occurs when chemical reaction blood glucose with substances applied to the strip. Some blood glucose meters also measure blood cholesterol levels, which is important for many people with diabetes. Thus, if you have the classic hyperglycemic triad: frequent urination, constant thirst and unquenchable hunger, as well as a genetic predisposition, everyone can use a glucometer at home or buy test strips at the pharmacy. After that, of course, you need to see a doctor. Even if these symptoms do not speak of diabetes, in any case, they are no coincidence.

When making a diagnosis, the type of diabetes is determined first, then the severity of the disease (mild, moderate and severe). The clinical picture of type 1 diabetes is often accompanied by various complications.

1. Persistent hyperglycemia- the main symptom of diabetes mellitus, provided that high blood sugar levels persist for a long time. In other cases, not being a diabetic characteristic, transient hyperglycemia may develop in a person during infectious diseases, v post-stress period or for eating disorders, such as bulimia, when a person does not control the amount of food eaten.

Therefore, if at home with the help of a test strip it was possible to identify an increase in blood glucose in oneself, do not rush to conclusions. You need to see a doctor - he will help determine the true cause of hyperglycemia. Glucose levels in many countries of the world are measured in milligrams per deciliter (mg / dl), and in Russia in millimoles per liter (mmol / l). The conversion factor from mmol / l to mg / dl is 18. The table below shows which values ​​are critical.

Glucose level. Content mmol / l and mg / dl

Diabetes is diagnosed with the following indicators: fasting capillary blood glucose is more than 6.1 mmol / l, 2 hours after eating - more than 7.8 mmol / l or at any time of the day is more than 11.1 mmol / l. Glucose levels can be changed repeatedly throughout the day, before and after meals. The concept of the norm is different, but there is a range of 4-7 mmol / L for adults healthy people on an empty stomach. Prolonged hyperglycemia leads to damage to the blood vessels and tissues that they supply.

Signs of acute hyperglycemia are ketoacidosis, arrhythmia, disturbed state of consciousness, dehydration. If you find yourself with a high blood sugar level, accompanied by nausea, vomiting, abdominal pain, severe weakness and clouding of consciousness or an acetone odor of urine, you must immediately call ambulance". Probably, this is most likely a dia6etic coma, therefore urgent hospitalization is necessary!

However, even if there are no signs of diabetic ketoacidosis, but there is thirst, dry mouth, frequent urination, you still need to see a doctor. Dehydration is also dangerous. While waiting for the doctor, you need to drink more water, preferably alkaline, mineral (buy it at the pharmacy and keep a supply at home).

Possible causes of hyperglycemia:

* a common mistake during analysis;

* incorrect dosage of insulin or hypoglycemic agents;

* violation of the diet (increased consumption of carbohydrates);

* infection, especially when accompanied by high fever and fever. Any infection requires an increase in insulin in the patient's body, so the dose should be increased by about 10%, after informing your physician. When taking pills for the treatment of diabetes, their dose should also be increased, after consulting a doctor (perhaps he will advise a temporary switch to insulin);

* hyperglycemia as a consequence of hypoglycemia. A sharp decrease in sugar leads to the release of glucose stores from the liver into the blood. It is not necessary to reduce this sugar, it will soon normalize itself, on the contrary, the dose of insulin should be reduced. It is also likely that with normal sugar in the morning and during the day, hypoglycemia can appear at night, so it is important to choose a day and conduct the analysis at 3-4 in the morning.

Symptoms of nocturnal hypoglycemia are nightmares, palpitations, sweating, chills;

* short-term stress (exam, visit to the dentist);

* menstrual cycle. Some women experience hyperglycemia during certain phases of their cycle. Therefore, it is important to keep a diary and learn how to determine such days in advance and accordingly adjust the dose of insulin or diabetes pills;

* probable pregnancy;

* myocardial infarction, stroke, trauma. Any operation causes an increase in body temperature. However, since in this case the patient is most likely under the supervision of doctors, it is necessary to inform about the presence of diabetes;

2. Microangiopathy - the general name of lesions of small blood vessels, violation of their permeability, increased fragility, increased tendency to thrombosis. With diabetes it manifests itself in the form of the following concomitant diseases:

* diabetic retinopathies- damage to the arteries of the retina, accompanied by minor hemorrhages in the area of ​​the optic nerve head;

* diabetic nephropathy- damage to small blood vessels and arteries of the kidneys in diabetes mellitus. It is manifested by the presence of protein and blood enzymes in the urine;

* diabetic arthropathy- joint damage, the main symptoms are: "crunch", pain, limited mobility;

* diabetic neuropathies, or diabetic amyotrophy. This is a nerve damage that develops with prolonged (over several years) hyperglycemia. At the heart of neuropathy is ischemic nerve damage caused by metabolic disorders. Often accompanied by pain of varying intensity. One of the types of neuropathy is sciatica.

Autonomic neuropathy is most common in type l diabetes. (symptoms: fainting, dry skin, decreased tearing, constipation, blurred vision, impotence, lower body temperature, sometimes loose stools, sweating, hypertension, tachycardia) or sensory polyneuropathy. Paresis (weakening) of muscles and paralysis are possible. These complications can manifest themselves in type 1 diabetes up to 20-40 years, and in type 2 diabetes - after 50 years;

* diabetic enuephalopathy... Due to ischemic damage to the nerves, intoxication of the central nervous system often occurs, which manifests itself in the form of constant irritability of the patient, states of depression, instability of mood and moodiness.

3. Macroangiopathy - the general name for lesions of large blood vessels - coronary, cerebral and peripheral. This is a common cause of early disability and high mortality in diabetes patients.

Atherosclerosis of the coronary arteries, aorta, cerebral vessels often occurs in patients with diabetes mellitus. The main reason for the appearance is associated with increased insulin levels as a result of treatment of type 1 diabetes mellitus or impaired insulin sensitivity in type 2 diabetes.

The defeat of the coronary arteries occurs in diabetic patients 2 times more often and leads to myocardial infarction or development ischemic disease hearts. Often, the person does not feel any pain, and then sudden myocardial infarction follows. Nearly 50% of people with diabetes die from myocardial infarction, with the risk of developing the same for both men and women. Myocardial infarction is often accompanied by this condition., with only one a state of ketoacidosis can cause a heart attack.

Lesion of peripheral vessels leads to the occurrence of the so-called diabetic foot syndrome. Ischemic lesions of the feet are caused by impaired blood circulation in the affected blood vessels of the lower extremities, which leads to trophic ulcers on the skin of the lower leg and foot and the occurrence of gangrene mainly in the area of ​​the first toe. In diabetes, gangrene is dry, with little or no pain. Lack of treatment can lead to limb amputation.

After determining the diagnosis and determining the severity of diabetes mellitus you should familiarize yourself with the rules of a new lifestyle, which from now on will need to be led in order to feel better and not aggravate the situation.

The main treatment for type 1 diabetes are regular insulin injections and diet therapy. A severe form of type I diabetes mellitus requires constant monitoring by doctors and symptomatic treatment of complications of the third degree of severity - neuropathy, retinopathy, nephropathy.

Insulin-dependent diabetes mellitus is a rather serious disease characterized by persistently elevated blood sugar levels. This disease begins its development due to dysfunction of the pancreas, which stops producing insulin.

The disease is divided into three categories depending on the severity, however, it is type 1 diabetes that is the most difficult and difficult to treat form of the disease. The main signs of insulin-dependent diabetes mellitus are very strong thirst, frequent urination, fatigue and weakness of the whole body. When the first symptoms of this ailment appear, its immediate cure is required.

Type 1 diabetes can only be diagnosed based on blood tests that show the exact glucose level and the amount of insulin in the body. After the diagnosis is made, the doctor draws up a course of treatment. It includes diets, injections of insulin preparations, physical activity, and more.

Development of insulin-dependent diabetes

Insulin-dependent diabetes mellitus (type 1) mainly develops in the body of young people. The main reason for its appearance is damage to the pancreas, which stops the secretion (production) of insulin. Also, provocateurs of the onset of this disease can be viral infections and a hereditary predisposition to diabetes.

Symptoms

Any diabetes mellitus cannot be cured, and regardless of its type, it has the same symptomatology, which consists of the following symptoms:

• frequent urination (more than 3 liters per day);
• intense thirst;
• weakness;
• weight loss;
• fatigue.

However, diabetics of the first type of the disease have several more symptoms that help to distinguish it from other types of diabetes mellitus;

• cramps of the calf muscles;
• long-term treatment of infectious diseases;
• severe itching of the genitals;
• prolonged wound healing.

Diagnosing insulin-dependent diabetes

Experts give everyone one piece of advice, which is the need for regular screening for diabetes. In particular, this recommendation applies to the following population groups:

• people over 45;
• people who are overweight and / or have a hereditary predisposition to the disease;
• women who have given birth to a child weighing more than 4.5 kg.

The diagnosis of insulin-dependent diabetes is based on the symptoms of the disease and laboratory tests. Diagnosis of the first type of disease implies the following tests:

• glucose tolerance test;
• analysis of the composition of urine;
• determination of C-peptide and insulin in the blood;
• a complete blood count.

Treatment

Insulin-dependent diabetes mellitus requires careful complex treatment, which should also include a number of special measures. Although doctors completely disprove the fact that diabetes is curable, they still force their patients to adhere to a whole list of rules. The first is a strict diet.

Diet is not considered the main treatment for this disease, but it is she who helps the diabetic to avoid various complications and maintain his already depleted body in a normal state. It is necessary to clarify right away that insulin-dependent diabetes mellitus has nothing to do with diet for weight loss, but most likely implies the use of healthy and proper food, which limits the flow of sugar into the body.

The composition of the diet required for the treatment of this disease may vary depending on several factors. For example, if a person is allergic to a certain food or has a large body weight, then the menu will differ slightly from the generally established one. If the patient is of normal weight, then in this case, a strict diet is not required. The correct insulin dose is needed for treatment.

Diet for insulin-dependent diabetes and its features

Type 1 diabetes mellitus, or rather its treatment, requires a reduction in the amount of high-calorie foods on the menu. Such "dangerous" products include all types of canned food, smoked meats, sweets, sour cream, nuts and mayonnaise. In addition to all of the above, potatoes, sweet fruits, milk, corn, pasta and bakery products should be excluded from the diet. In principle, it is not required to completely eliminate this food from your life, and in some cases it will be enough just to limit their presence in the daily diet.

Exercise for Type 1 Diabetics

There is currently no answer to the question of how to cure type 1 diabetes. But in the case of this disease, sports exercises provide a uniform decrease in blood glucose, normalize blood circulation and increase tissue sensitivity. internal organs and the whole body to insulin. In case of diabetes, preference should be given to metered, measured and regular physical activity, which will ensure not only good health, but also allow you to keep the whole body in good shape.

Insulin-dependent diabetes and medications

Diabetics often require replacement therapy, namely, treatment with insulin. At the moment, there are several types of insulin in medicine, and they differ from each other in the rate of absorption into the bloodstream and in the duration of their action.

1. Short-acting insulin: This form of insulin takes effect very quickly. The activity lasts only a few hours. Such medicine, like Actrapid, enters the bloodstream and lowers glucose levels within 20 minutes after injection, and the duration of the drug's effect is observed for two to four hours.
2. Long-acting insulin: Long-acting insulin can be active for up to 36 hours, but its effect does not occur until 14 hours after injection.
3. Intermediate-acting insulin: Intermediate-acting insulin contains substances that significantly inhibit its activity. The drug Protafan enters the bloodstream no earlier than 1-2 hours after injection, and the duration of its effect is approximately 10 hours.

Treatment for type 1 diabetes with insulin drugs involves replacing the activity of the pancreas. This process consists of two components: determining the level of sugar in the blood and setting the required adequate dose.

The most difficult thing is to designate the correct time for the next insulin dose. To do this, you will need to learn how to combine the moment of eating and taking insulin, which in turn will make it possible to maintain the sugar level in the body at a certain level.

Any type 1 diabetic must adhere to the insulin regimen, without which no correct treatment can be compiled.

This drug regimen is worked out by the doctor and takes into account the general condition of the patient, the sensitivity of the body to the components of the drugs, the weight of the diabetic, and much more. In view of this, in modern medicine there is no general single treatment regimen for type 1 diabetes mellitus, and any attempts to independently determine the insulin dose are strictly prohibited.

Place of introduction

Insulin preparations are injected subcutaneously, but some do intramuscular injections, which is not prohibited, but not recommended. Intramuscular injections can complicate the absorption of components into the bloodstream, which in itself reduces the effectiveness of the drug. At that moment, when the doctor organizes the patient's treatment, he will necessarily show the places where the drug can be injected.

New treatment method

Currently, the treatment of type 1 diabetes mellitus is accompanied by the use of insulin pumps, which are electronic devices that accurately determine the level of sugar in the blood. Also, these devices carry out dosed injections of an insulin preparation, which simplifies and facilitates the cure of this ailment. In addition, using the pump, you can accurately control the level of glucose in the body and significantly reduce the risk of any complications of the disease.

Insulin storage rules

Type 1 diabetes is not curable and therefore requires constant medication that must be stored properly. The drugs must be stored under certain conditions and therefore every diabetic must know the following:

• an open bottle with the drug is allowed to be stored at room temperature for no more than 5-6 weeks;
• it is forbidden to store medicines near a heat source;
• regularly shaking the medicine leads to the appearance of flakes and a film inside the vial (in in this case the drug becomes unusable);
• keep insulin preparations away from sunlight.

Correctly formulated treatment enables the patient to live a full life, and the disease will not become a sentence. In order not to face complications of type 1 diabetes mellitus, you should follow the doctor's instructions, it is advisable to independently measure the sugar level in the body every day using devices such as glucometers.

A disease such as diabetes mellitus is widespread and occurs in adults and children. Non-insulin dependent diabetes mellitus (NIDDM) is diagnosed much less frequently and belongs to diseases of a heterogeneous type. In non-insulin-dependent patients with diabetes mellitus, there is a deviation in insulin secretion and impaired sensitivity of peripheral tissues to insulin, this deviation is also known as insulin resistance.

Non-insulin-dependent diabetes mellitus requires regular medical supervision and treatment, since serious complications are possible.

Causes and mechanism of development

The main reasons for the development of non-insulin dependent diabetes mellitus include the following unfavorable factors:

• Genetic predisposition. The factor is the most common and often causes insulin-independent diabetes in the patient.
• Improper diet that provokes obesity. If a person consumes a lot of sweets, fast carbohydrates, while there is a shortage of foods with fiber, then he is at risk of developing non-insulin dependent diabetes. The probability increases several times if, with such a diet, an addicted person leads a sedentary way of life.
• Decreased insulin sensitivity. Pathology can occur in three ways:
  • deviation of the pancreas, in which the secretion of insulin is disturbed;
  • peripheral tissue pathologies that become insulin resistant, which provokes impaired glucose transport and metabolism;
  • disruptions in the functioning of the liver.
• Deviation in carbohydrate metabolism. Insulin-dependent type 2 diabetes mellitus over time activates glucose metabolic pathways that are not dependent on insulin.
• Disrupted protein and fat metabolism. When protein synthesis decreases and protein metabolism increases, then a person experiences a sharp weight loss and muscle wasting.

An insulin-independent type of diabetes mellitus develops gradually. First, tissue sensitivity to insulin decreases, which subsequently causes increased lipogenesis and progressive obesity. With non-insulin dependent diabetes mellitus, arterial hypertension often develops. If the patient is insulin independent, then his symptoms are mild and ketoacidosis rarely develops, in contrast to the patient who is dependent on insulin injections.

The main symptoms

Non-insulin dependent diabetes is characterized by mild clinical picture, but at the same time, damage from several body systems at once is possible. This type of diabetes mellitus is detected, as a rule, by accident, when the urine glucose test is taken during a routine examination. The table shows the main symptoms that appear in different body systems in non-insulin-dependent diabetes mellitus.

Often, against the background of non-insulin dependent diabetes mellitus, myocardial infarction occurs, which is manifested by thrombosis of the coronary arteries. In most cases, patients with NIDDM do not immediately notice the development of a heart attack, which is explained by impaired autonomic innervation of the heart. In a patient who is independent of insulin, a heart attack occurs in a more severe form and often leads to death.

Features of therapy for non-insulin-dependent diabetes mellitus

Drug treatment

Diabetes mellitus resistance is eliminated with medication. The patient is prescribed, which are taken orally. Such agents are suitable for patients with mild to moderate non-insulin dependent diabetes mellitus. Medicines can be taken with meals. The exception is "Glipizid", which is taken half an hour before meals. Medicines for non-insulin dependent diabetes mellitus are divided into 2 types: first and second generation. The table lists the main medications and reception features.

The complex treatment includes insulin, which is prescribed in an individual dosage. It should be taken by those patients who are constantly under stress. Associated with intercurrent illness or surgery.

Mode correction

Patients with non-insulin dependent diabetes should be under constant outpatient supervision of doctors. This does not apply to patients with emergencies who are in the ward. intensive care... Such patients need to adjust their lifestyle, add more physical activity. A simple set of physical exercises should be performed daily, which can increase glucose tolerance and reduce the need to use hypoglycemic drugs. Patients with non-insulin dependent diabetes should follow table No. 9. It is extremely important to reduce body weight if there is severe obesity. It is necessary to adhere to the following recommendations:

• eat complex carbohydrates;
• reduce the amount of fat in the daily diet;
• reduce the amount of salt intake;
• exclude alcoholic beverages.