Diabetes was known as early as the first century AD under the Greek name diabetes mellitus, which literally means sweet penetration.

Hindus more than 2000 years ago, determined this disease for the sweet taste of urine.

They tried to treat Egyptians, Jews, Arabs, but mistakenly interpreted its cause, recognizing for kidney disease.

This opinion was shared by physicians in the Renaissance. Knowledge of the disease increased when it was discovered in the pancreas that a cluster of cells of different structures (islets of Langerhans) and associated insulin production.

At present, about 2 million people suffer from diabetes in Russia. people, including 15 thousand school-age children. According to doctors, there are many diabetics, but not everyone knows about the state of their health. Diabetes mellitus does not cause pain and is therefore diagnosed late.

The mechanism of the onset of diabetes.

Diabetes is an incurable, serious metabolic disorder in which the body is struggling with the consequences of a lack or complete absence of the insulin hormone. It allows you to transport glucose to the blood cells. When there is not enough insulin, glucose can not be used and its blood level rises. Type 1 diabetes mellitus - affects mainly children and young people under the age of 30 years. It occurs as a result of the destruction of the beta-cell antibodies of the pancreatic Langerhans islets.

The body, devoid of insulin, is accompanied by increased thirst, urination and dehydration. Unused sugar is excreted through the kidneys and entails loss of water. This leads to an abnormal level of electrolytes (together with the water the kidneys release potassium and sodium). There comes a general weakness, the patient loses weight, his skin becomes dry and itchy, his legs hurt and his eyesight deteriorates.

The only way to survive is to provide the body with insulin. If the beta cells are completely damaged, they need to be injected. Diabetes mellitus type 2 is less severe. Not always the characteristic symptoms (thirst, increased urination), although the amount of insulin produced by the pancreas is not enough to maintain the correct concentration of glucose. This is due to the fact that a patient with this type of diabetes has a reduced sensitivity of the body's tissues to insulin action, the so-called insulin resistance. When insulin resistance becomes, less glucose is taken from the blood, causing an increased concentration of glucose.

Insulin resistance is affected, in particular: abdominal obesity, aging, lack of exercise and stress. Of great importance here is the malnutrition. It contributes to the depletion of insulin stores as a result of consuming an excessive amount of carbohydrates. Diabetes mellitus type 2 is affected mainly by people who are mature and elderly, although in recent years it has been happening more often among young people and even children.

Symptoms of diabetes.

We can suspect diabetes if the blood glucose level measured on an empty stomach (8 hours after the last meal) is more than 126 mg%. Currently, it is believed that under supervision should be people who have bad results repeated twice. At the onset of type 2 diabetes, a physician, as a rule, recommends changing the diet and lifestyle.

The diabetics menu should be organized in accordance with the weight and physical activity of the patient. The food should be high in calories, but low in carbohydrates and fats, and at the same time rich in protein. You must dramatically reduce rapidly digestible carbohydrates such as sugar, honey, candy, jam, sweet fruit and drinks. If such treatment does not help, pharmacology is used. Oral antidiabetic drugs are given to stimulate the pancreas to produce more insulin or to help the use of already released. When the secretion of the hormone completely disappears, the pills replace insulin injections.

For every diabetic, the most important is maintaining optimal blood sugar levels. Therefore, a glucose meter is needed in the patient's home, designed for systematic measurement. Modern electronic glucometers are characterized by: short measurement time (about 5 seconds), a small volume of blood sample being loaded (eg. 2 ml), memory function (for example. 200 results). They can also work with a computer program, so you can more thoroughly analyze the results of measurements. An important indicator of the evaluation of diabetes control is the designation of glycated hemoglobin (HbA1c). Its rate is up to 6.1%. It is that part of the hemoglobin contained in the red blood cells that connects with glucose (in proportion to the level of sugar in the blood).

The huge diagnostic value of this parameter is due to the fact that it reflects the amount of the average daily glucose level in the patient's blood for 100 days,. Also allows to determine the risk of complications of diabetes mellitus. Reduction of HbA1c by 1% is associated with a 16% decrease in the risk of heart attack; stroke - 5%; death due to diabetes - 12%; complications in the kidneys - 37%; circulatory disorders and innervation within the lower extremities leading to the so-called diabetic foot, and often leg amputation - by as much as 43%.

Prevention of diabetes.

Introduced in 1922, insulin therapy for the first time gave patients a chance of life expectancy. It turned out that this drug has some limitations. In physiological conditions in healthy people, this hormone is released directly into the circulatory system in a precisely defined rhythm.

The treatment of diabetes is a subcutaneous injection, and this directly is a disadvantage of therapy. Insulin should be injected 30-40 minutes before meals, as it is absorbed too slowly, the peak peaks reach too late (after 2-3 hours). This contributes to high blood sugar levels after eating (hyperglycemia after eating and hypoglycemia). In order to prevent this, the patient should use light snacks, which will adversely affect people with excess weight.

Therefore, scientists have been working for several decades on the modification of insulin preparations so that their absorption from the subcutaneous tissue allows to imitate the nature. This led to the introduction of insulin analogues. They differ from human insulin with one or more amino acids. The consequence of this is the acceleration of work (analogues of high-speed ones), t. the drug is absorbed into the blood for several minutes. It can be administered immediately before each meal. Depending on the content, you can enter directly after a meal without affecting the leveling level with a low glycemic index.

Significantly reduces the risk of hypoglycemia, and the patient is relieved from snacks. Another important milestone was the introduction of analogues of prolonged action, usually applied once a day. They allow a very uniform concentration of insulin during the night and between meals.

The result of these drugs is the normalization of the sugar level on an empty stomach and the stabilization of compensation for diabetes mellitus. The most modern method of treating diabetes mellitus (especially type 1) is based on fast and long-working analogues. At present, a commodity high-speed analogue of insulin and insulin with an intermediate action time. They are used mainly in type 2 diabetes. Especially suitable for elderly people with a tendency to hypoglycemia, which causes hand trembling, sweating, tingling around the tongue and lips, palpitations, headaches and hunger. People with glycemia feel generally weak, tired, sleepy.

A sharp drop in glucose can lead to irreversible brain damage and even death.

Modern insulin dispensers Insulin is in a so-called pen that looks like a syringe. There is a button for setting the dose of insulin. Pressing the button results in a painless injection of the drug through the needle into the subcutaneous tissues.

Handle is convenient and accurately measures the dose of the drug. The patient remembers how many units of insulin he took, as well as at what time.

Extremely convenient for diabetics is also an insulin pump. It continuously gives a small amount of insulin (the main dose, regardless of food intake) before or during meals (the so-called bolus insulin delivery). It allows patients to stay up late, play sports without restrictions, eat when they want, and limit the occurrence of complications.

medbe. en.