Healthcare sounds alarm in connection with the acceleration of the spread of diabetes around the world.And equally disease overtakes developing and economically developed countries.In addition, diabetes affects not only adults. More and more disease occurs in children and adolescents. Do not forget that diabetes mellitus (DM) is becoming fertile ground for the future development of heart disease and blood vessels.
- 1 than harm elevated blood sugar?
- 2 What is clinical inertia?
- 3 Things to Watch in achieving normoglycemia?
- 4 Explanation of insulin resistance and at the same time the effectiveness of insulin
- 5 Opening insulin
- 6 Indications for insulin therapy in type 2 diabetes
- 7 Administering insulin therapy in the treatment process?
- 8 benefits of early insulin therapy
than harm elevated blood sugar?
believed that elevated blood sugar negatively affects the microvasculature and the reduction of this indicator can be of great assistance
This complexity arises from the uneven functioning pancreatic beta cells.That is why patients with the disease diabetes type 2 not observed positive effects when taking glucose-lowering drugs.
large number of cases of hyperglycemia is not corrected, not carried out adequate hypoglycemic therapy.In this regard, the risk of complications of the disease increases in several times.
What is clinical inertia?
term "clinical inertia" is the lack of purpose and revitalize treatment if clinically indicated.This situation is most vivid in the use of insulin preparations.That is why, in order to improve treatment options and reduce the risk of complications, you need to manage more actively glycemic status.Early use of insulin, thus, can be very reasonable.
on what to look for to achieve normoglycemia?
There are three pathophysiological characteristics, based on which is needed for adequate control of blood glucose:
- Insulin resistance;
- Violation of insulin action.
only insulin can act adequately and eliminate all these three points.
Explanation of insulin resistance and at the same time the effectiveness of insulin
target cells, for example, fat or muscle, are resistant to insulin due to the malfunction of insulin receptors on their surface, or because of damage to the unit postreceptor. Thus, there is an increase in blood sugar, with the pancreatic beta cells (RV) responding to increasing insulin hyperglycemia. However, these actions do not bring any positive results.
Over time, the amount of synthesized insulin is reduced - develops a relative insulin deficiency.In this case, hyperglycemia will only increase.
This indicates that proper and adequate control of blood glucose to avoid many troubles during the development of diabetes.The earlier started insulin therapy, the easier it is possible to control blood glucose levels in patients with the disease second type of diabetes .On the timing of initiating insulin hotly discussions and debates.To come to some kind of ideal solution is not obtained.
discovery of insulin
Insulin was discovered in 1921 in Toronto.This is one of the most important and the most important discoveries in medicine for all time of its existence.
After the discovery of insulin has been cleared, and it became possible to use in humans.The first case was Leonard Thompson, who January 11, 1922 entered the purified insulin Toronto hospital.
After it was launched production of the drug, held a special clean-up.This
animal insulin was possessed short action required 3 to 4 injections per day for normal therapeutic effect.
production of human insulin was established in 1980.However, the insulin still could not give humanity the full independence in the treatment of diabetes, so the analogues of human insulin have been created with different durations of action.
Improved drugs have provided such opportunities:
- short-acting insulin should give the peak of activity, which is combined with the intake of food;
- Insulin is a long-acting basal maintained a constant level.
almost half of the selected insulin accounted for long-acting basal physiological conditions in the body.Other short amount of insulin is provided, which is produced in response to the reception of food.
Indications for insulin therapy in type 2 diabetes
insulin therapy according to European diabetologists should not begin too early and not too late.No wound because secretory failure may be secondary to the insensitivity to insulin, and because of the risk of hypoglycemia.Not too late, because it is necessary to achieve the desired adequate glycemic control.
Administering insulin therapy in the treatment process?
diabetes of the second type disease in every sense of the progressive purpose of insulin is only a matter of time.
Currently traditionally considered the appointment of two antidiabetic drugs.After 10-15 years, the tablets admission pass to the final stage - insulin.Pulling this method of treatment is due to more and because of that it is necessary to do injections, hypoglycaemia may develop and the patient may significantly gain weight.However, many patients find that the result is not stable, low efficiency.Very bad treatment inhibits personal experience, when properly chosen treatment was the cause of frequent hypoglycemic states.
It should be noted that the appointment of a short course of insulin therapy at the beginning of the disease can lead to long-term remission and leveling blood glucose without the need for further use of antidiabetic drugs.
However, many practicing endocrinologists do not approve of this method, and in favor of a step therapy. Of course, there are situations where early onset of insulin is the most appropriate.For example, insulin is appointed by the ineffectiveness of the use of glucose-lowering drugs in the early stages.From this preparation quality of life and patient satisfaction with treatment increased several times.
Numerous studies have shown that hyperinsulinemia is a trigger in the development of atherosclerosis.Moreover, the early use of insulin as the drug can lead to the formation of coronary heart disease (CHD).But to date, accurate and reliable information about this connection is not present.
Before starting insulin therapy is necessary to determine and to consider a number of factors and characteristics that may affect this method.Of these, we distinguish:
- body weight;
- forecast life;
- presence, severity of microvascular changes;
- previous treatment failure.
In order to ensure that the need for insulin therapy, you should definitely determine the level of activity of the beta cells of the pancreas by determining the amount of C-peptide synthesized.
start insulin therapy with type 2 diabetes need to:
- giperglkiemii when expressed at high and maximum doses of antidiabetic drugs;
- sudden weight loss;
- low levels of C-peptide.
as temporary insulin treatment is indicated for the need to reduce glucose toxicity at higher its level in the blood. Studies have shown that insulin significantly reduces the likelihood of developing microvascular complications.
benefits of early insulin therapy
In DM type 2 insulin has the following positive qualities and advantages:
- eliminates the toxicity of blood glucose;
- insulin in the early stages of the disease can provoke the development of remission;
- fasting glucose analysis allows you to control the level of its daily;
- with the progression of diabetes is required to restore the basal and peak insulin levels in the blood;
- individual approach in the treatment of insulin ensures the safety for the patient from the occurrence of hypoglycemia and diabetic com.