Diabetes treatment is certain therapeutic procedures and pharmacological agents that are aimed at normalizing the metabolic processes in a patient with diabetes, stabilizing blood glucose levels, insulin sufficiency and minimizing the symptoms of the disease.
Depending on the type of diabetes mellitus, individually selected agents are used to treat the disease. In the case of an insulin-dependent first type of pathology, daily injections with insulin are shown to all patients. To overcome the severity of symptoms in diabetes of the second type, sugar-reducing pharmacological or folk remedies are prescribed, in rare cases of unallocated pathology, stabilization of health can be achieved by adjusting the patient's diet. In any case, the treatment of diabetes is a complex process that requires regularity and constant medical supervision.
Means and methods of official medicine
Official medicine considers the treatment of diabetes mellitus as a complex therapeutic drug technique, which you should definitely supplement with diet therapy and active physical therapy. With careful observance of all medical prescriptions, it is easy to achieve full compensation of the disease, elimination of symptoms and complete comfort in everyday life.
Medications for treatment
Drug treatment for diabetes in each case is determined primarily by the type of pathology, its stage and the presence of complications and associated diseases.
The first type of diabetes is insulin-dependent, its manifestation often occurs at a young age, and the patient will have to use insulin injections for the rest of his life to maintain an adequate level of the hormone that is produced in his own body in limited quantities. Among other drugs in diabetes of the first type, such groups of drugs that interact well with insulin are common.
In the second type of diabetes mellitus, popularly called “adult diabetes,” the body’s own insulin stops working fully. For a certain period of time, it continues to be produced in a normal amount, but the cells cease to perceive it, then its dosage gradually decreases. To maintain a normal level of blood glucose, it is recommended that patients use specially developed hypoglycemic drugs. Their action can be directed both at stimulating the functionality of the pancreas (sulfonylurea preparations, glinides, incretins), and at suppressing insulin resistance in the body (metformin preparations, thiazolinedione).
Below are examples of pharmacological drugs that are most often used in modern medicine to adjust insulin resistance and blood sugar level of diabetics, as well as insulin substitutes used in various types of diabetes.
|Drug name||Pharmaceutical Group||pharmachologic effect||Indications for use|
|Glucophage||Hormones, their analogues and antihormonal drugs.|
Oral antidiabetic drugs
|Oral hypoglycemic drug. The drug contains the active ingredient - metformin, which has a pronounced hypoglycemic effect, which develops only under the condition of hyperglycemia. In patients with hyperglycemia, the drug reduces the initial level of glucose in the blood plasma, as well as the level of glucose after a meal.||The drug is used to treat patients with type II diabetes, in which diet therapy does not give the desired effect.|
The drug is prescribed as monotherapy, as well as in combination with other oral hypoglycemic agents or insulin.
May be prescribed to children over 10 years old as monotherapy or in combination with other oral hypoglycemic agents or insulin.
|Dianormet||Oral hypoglycemic agents, with the exception of insulin. Biguanides||An antidiabetic drug of a group of biguanide derivatives that lowers the concentration of glucose in the blood plasma both on an empty stomach and after a meal. Does not stimulate insulin secretion and does not cause a hypoglycemic effect mediated by this mechanism.||Type II diabetes mellitus in the absence of an effective diet and exercise regimen, especially in patients with high body mass. As monotherapy or as part of combination therapy with other oral hypoglycemic drugs or insulin for the treatment of adults; as monotherapy or part of combination therapy with insulin for children after 10 years. Reduces the complications of diabetes in adults with type II diabetes and obesity who used metformin.|
|Diaformin||Hormones, their analogues and antihormonal drugs.|
Oral antidiabetic drugs
|It has a hypoglycemic effect, without causing hypoglycemia. Its action differs from the action of sulfonylureas in that the drug does not cause stimulation of insulin secretion, and therefore does not cause hypoglycemia in healthy patients.|
Diaformin increases the sensitivity of peripheral receptors to the action of insulin and leads to an increase in the cellular utilization of glucose. Affects the process of gluconeogenesis in the liver cells. The drug reduces the intensity of absorption of carbohydrates in the gastrointestinal tract.
|Insulin-independent (second) type of diabetes in adults in the case of low effectiveness of diet therapy. This is especially true for obese patients.|
It is used in combination with insulin in insulin-dependent (first type) diabetes, especially in cases of marked obesity in a patient, which is characterized by the emergence of secondary insulin resistance.
|Metthogamma||Oral hypoglycemic agents, with the exception of insulin||Oral hypoglycemic drug from the biguanide group. It inhibits gluconeogenesis in the liver, reduces the absorption of glucose from the gastrointestinal tract, increases peripheral glucose utilization, as well as insulin sensitivity of tissues. It does not affect the production of insulin by beta cells in the pancreas.||Type II diabetes mellitus (non-insulin-dependent) in adults with no effective diet (especially in patients with obesity): as monotherapy or part of combination therapy with other hypoglycemic drugs of the oral form or insulin for the treatment of adults and children after 10 years.|
|Siofor||Hormones, their analogues and antihormonal drugs.|
Oral antidiabetic drugs
|Hypoglycemic agent of the biguanide group. The antidiabetic effect is due to inhibition of glucose absorption from the gastrointestinal tract, increase in the sensitivity of peripheral tissues to insulin, inhibition of glucogenesis. It has a positive effect on lipid metabolism (exerting a lipid-lowering effect) and on the coagulation system (exerting a fibrinolytic effect).||Type II diabetes mellitus (non-insulin dependent), especially in combination with obesity.|
|Farmasulin||Hormones, their analogues and antihormonal drugs.|
Drugs based on pancreatic hormones and synthetic hypoglycemic drugs.
Medicines group insulin.
Short acting insulins
|A drug with a clear hypoglycemic effect. Contains insulin, which regulates glucose metabolism. In addition, it affects a number of anticatabolic processes in tissues.||Used to treat diabetes, if necessary insulin to maintain normal plasma glucose levels. Effective means of initial therapy in insulin-dependent (type 1) diabetes, as well as in the treatment of women with diabetes during pregnancy.|
Used for the treatment of patients with the first type of pathology, as well as with the second, in the case of insufficient effectiveness of the diet and oral hypoglycemic agents.
|Humalog||Hormones, their analogues and antihormonal drugs.|
Drugs based on pancreatic hormones and synthetic hypoglycemic drugs.
Medicines group insulin.
|It is an analogue of human insulin, differs from it by the reverse sequence of proline and lyin amino acid residues at positions 28 and 29 of insulin B-chain.||Insulin-dependent (type 1) diabetes mellitus: intolerance to other insulin preparations, postprandial hyperglycemia (increased blood sugar levels), which cannot be corrected by other insulin preparations; acute subcutaneous insulin resistance (accelerated local degradation of insulin). Insulin-independent (type 2) diabetes mellitus: in cases of resistance to oral antidiabetic drugs (impaired absorption of other insulin preparations, uncorrected postprandial hyperglycemia); during intercurrent operations (complicating the course of diabetes mellitus) diseases.|
|Lantus||Hormones, their analogues and antihormonal drugs.|
Drugs based on pancreatic hormones and synthetic hypoglycemic drugs.
Medicines group insulin.
Long acting insulins.
|Insulin hypoglycemic drug. Contains insulin glargine - an analogue of human insulin, which has a low solubility in a neutral environment.||It is used to treat adults and children over 6 years of age suffering from insulin-dependent (type 1) diabetes.|
|Maninil||Hormones, their analogues and antihormonal drugs.|
Oral antidiabetic drugs.
|Stimulates insulin secretion by β-cells of the islets of Langerhans of the pancreas. The intensity of the β-cell response is directly proportional to the concentration of glucose in the blood and the environment that surrounds them.||Used in diabetes mellitus type 2 (non-insulin-dependent). Its purpose is shown, if an increase in physical activity, a correction in body weight in the direction of reduction, strict dietary rules, do not have a hypoglycemic effect, stabilizing the blood glucose level within physiological values.|
Innovative in modern medicine is the method of treating diabetes mellitus using autologous stem cells. Autologousness is explained by the origin of cells in the patient’s body The technique is able to overcome the original cause of the pathology, reduce hyperglycemia and eliminate the complications that it provokes. Also, the technique works in the direction of overcoming hypoglycemia, leading to coma or shock, in which case the lack of immediate medical care sometimes even leads to the death of patients.
The stem cell therapy technique involves their introduction through a catheter into the pancreatic artery. If catheterization is not possible, stem cells can be injected intravenously.
At the first stage of treatment with a thin needle, the patient takes bone marrow from the pelvic bone under local anesthesia. The whole process lasts up to half an hour, and then the patient returns to his usual life.
Under laboratory conditions, stem cells begin to be isolated from the patient's bone marrow, test their quality and count the number of suitable ones. Suitable stem cells are able to transform into any kind of cells in the body and restore stocks of those that for some reason are lacking. Thus, stem cells in diabetes can replace non-working pancreatic beta cells.
At the last stage of the procedure, stem cells are transplanted into the pancreatic artery zone using a catheter. A catheter under local anesthesia is inserted into the femoral artery and, using X-ray scanning, is carried forward to the pancreatic artery, where the implantation of stem cells begins.
The whole procedure of implantation usually lasts about one and a half hours. After its termination the patient is left in the clinic for several hours. Doctors check during this period the healing process in the arteries after the catheter was inserted. If the patient can not use a catheter, for example, in renal pathologies, then all of the above is done by intravenous administration. In diabetic peripheral neuropathy, own stem cells are introduced into patients by intramuscular injections into the muscles of the legs.
It is important to understand that adult stem cells cannot act as a panacea for any disease. To assess the therapeutic effect of such manipulation in an adult patient is very difficult. Sometimes improvements come very quickly, sometimes they are almost invisible. Therefore, the method of treating diabetes with stem cells is still considered experimental and requires constant study.
Stem cell therapy is now being carried out in hospitals in America, Israel, Germany, Turkey, the Czech Republic, as well as in Russia and Ukraine.
Laser therapy as a treatment
One of the new methods in the treatment of diabetes mellitus today is laser therapy, which helps to significantly reduce the level of glucose in the blood and eliminate the pronounced clinical signs of pathology. The effectiveness of the technique is confirmed in practice in the treatment of a large number of diabetics with its help.
In order to carry out therapy with the help of a laser, it is necessary to use a special quantum apparatus that exerts an intense effect with the help of a laser beam on the biologically active zones of the human body. Quantum therapy improves blood circulation, enhances the functionality of the immune system, accelerates tissue regeneration, relieves soreness and reduces the inflammatory process. A feature of laser therapy is its ability to influence the immediate cause of the disease, and not just to combat its symptoms, like most pharmacological agents for diabetes.
In order to be able to actively influence all affected areas, various light and electromagnetic nozzles are provided in the quantum apparatus:
- for pulsed infrared LED radiation;
- to create a constant magnetic field;
- for pulsed laser radiation;
- for pulsating red light.
Pulsed laser radiation to achieve a therapeutic effect in diabetics can penetrate 13–15 centimeters deep into tissues, having a powerful effect on the cellular structure of various organs, ensuring blood flow and increasing membrane metabolic processes.
The use of laser therapy for diabetes can provide a significant improvement in the clinical picture of the patient.Moreover, before using this method of treatment, it is always necessary to carry out preparatory procedures, including the following types of diagnosis:
- examination and laboratory tests to determine the severity and type of diabetes of the patient, as well as the associated lesions of the internal organs and systems, which helps to form an adequate course of therapy;
- determination of blood glucose levels to select appropriate insulin therapy.
In the absence of symptoms of diabetic ketoacidosis, the patient is assigned an individual treatment program, which includes such activities as:
- magnetic infrared laser therapy for milder forms of pathology;
- magnetic-infrared-laser therapy in combination with therapeutic procedures for getting rid of etiological factors - cytomegalovirus, herpes infection, chlamydia and others - with moderate forms of diabetes;
- magnetic-infrared-laser therapy in combination with the therapy of the complications (pancreatitis, gastroduodenitis, vascular pathologies, etc.) in severe forms of the disease.
When analyzing the effects of laser therapy on the functionality of the pancreas, a noticeable increase in insulin concentration was found, provided that the pancreas functions at least minimally on its own. To obtain the maximum effect, the treatment should be carried out in the early stages of the pathology, when the chronically high blood sugar has not yet managed to cause irreversible changes in the health of the whole organism.
Alternative medicine believes that curing diabetes with fasting is quite possible, unlike endocrinologists who consider this approach pseudo-scientific. Experts on starvation insist that only type 1 diabetes can be considered an absolute contraindication to the use of the technique, and patients with the second type of pathology can in some cases eliminate symptoms by refusing to eat. At the same time, in this aspect only fasting of medium and long periods can play an important role, but short two-three-day fasting will not bring results.
Apply fasting in the case of diabetes should be extremely careful. The main role here will be played by the preparatory period, during which the patient learns to follow a diet and carry out special cleansing procedures. Fasting is best in a specialized medical institution under the supervision of qualified professionals. It is also very important to get out of fasting correctly, following a prescribed diet throughout the entire recovery period.
During the fasting period in the patient's body, the metabolic processes are normalized, the workload of the liver and pancreas decreases. These processes have a positive effect on the course of diabetes. The functionality of other systems in the body, in which pathologies often provoke the manifestation of diabetes, is also normalized.
Therefore, starvation specialists actively recommend the use of this technique in case of early forms of diabetes mellitus type II, in order to improve the patient's well-being and even completely eliminate the cause of the disease.
Hirudotherapy in the treatment
Hirudotherapy or leech therapy has not lost its relevance for centuries. This is due to the complex effect of such treatment on the body of a sick person, including local activation of the immune mechanisms, acceleration of the venous blood flow, the effect on the energy centers of a particular affected organ, the antithrombotic effect of the leech.
All of the above effects are very important in the treatment of diabetes, since any of its complications are associated with impaired vascular processes, atherosclerosis, and problems with blood circulation. Already at the first use of hirudotherapy, diabetics patients often notice improvements in their state of health, and course therapy is characterized by such positive changes in the clinical picture of diabetes, such as:
- normalization of pressure;
- lowering cholesterol;
- cleansing the blood vessels from atherosclerotic manifestations;
- reduction of trophic failures, restoration of tissue nutrition;
- elimination of symptoms characteristic of vascular encephalopathy.
However, it is important to remember that the use of hirudotherapy in diabetes is only possible as an additional technique in complex treatment. In the case of this pathology, leeches are put on several main points on the body:
- in the area of the axis of the spine between the 11 and 12 thoracic vertebrae, between the 12 thoracic and 1 lumbar vertebrae and on the additional points located 3-4 centimeters to the left and to the right of these;
- in the region of the xiphoid process of the chest and 3-4 centimeters below the first point;
- in the region of the liver - on the lower right border of the chest;
- on top of coccyx and upper part of sacrum.
Course treatment of diabetes with hirudotherapy usually lasts 10-15 times with a frequency of 1 procedure in 3 days. At each point in the body requires the use of 3 leeches.
Despite the fact that in modern conditions doctors cannot completely cure diabetes, traditional healers help their followers alleviate the symptoms of this pathology with the help of natural herbal preparations and infusions. However, before being treated for diabetes with popular recipes, it is better to consult with your doctor about this possibility.
Among the popular recipes for diabetes, the following collection of herbs, berries, and seeds has long been known:
- 2 pieces of seed flax;
- 1 part of the leaves of the cuff ordinary;
- 2 pieces of juniper berries;
- 4 pieces of blueberry leaves.
All ingredients are thoroughly mixed, then take 2 tablespoons of the mixture and pour 400 ml of boiling water. The composition put on a small fire and boil for 5 minutes. After removing from heat for another 30 minutes, the infusion is infused, filtered and taken 3 times a day before meals for 15 minutes.
Popular against the manifestations of diabetes and the green triad of Professor Ivanchenko. It effectively treats not only the symptoms, but also stabilizes the processes that cause the disease. It consists of flowers of tansy (1 gram), clove powder (0.5 grams) and grass of wormwood (200-300 milligrams). The components are mixed, a tablespoon of this mixture is poured right in the spoon itself with water at room temperature. This is a one-time mixture, which on the first day of treatment should be drunk half an hour before meals once, on the second day it is already used twice a day, and in 3-7 days the medicine is drunk before meals 3 times a day. After a week of use, the triad must be used once a week for a year. However, after a month of triad therapy, it is important to monitor blood sugar levels and make sure that the treatment is effective. It is also necessary to remember that the clove can increase blood pressure, therefore, its use in hypertension should be coordinated with your doctor.
Also, for the purpose of sugar reduction, the leaves of a young dandelion, added to soup, salad, minced meat, are also used. If the leaves are not young, they are soaked in salted water until bitterness leaves. You can eat dandelion leaves and in its pure form - 150-200 grams per day.
Other folk remedies
Bay leaf is used to lower sugar. At the same time, 2 leaves of laurel will suffice for 2 liters of liquid. Liquid with leaves required to boil, and then insist for 14 days in a dark place, then filter and store in the refrigerator. It is necessary to drink laurel broth warm on an empty stomach in the amount of ½ cup with the level of sugar in the blood up to 10 mmol per liter, or in the amount of the whole cup with the indicators of sugar more than 10 mmol per liter. More than 1 cup of funds in one step can not be used.
The course of treatment with decoction of laurel is 3 months, during which it is necessary to constantly monitor the indicators of glucose and adjust, depending on them, the amount of tincture. In addition to the glucose-lowering function, the decoction also has the ability to excrete salt deposits and harmful substances from the body. Regular use of the drug reduces sweating, improves mood and general well-being of patients with diabetes.
Therapy with the use of baking soda in diabetes mellitus neutralizes a lot of harmful substances in various organs and systems. Soda can be used in a diluted form of water orally or by injecting its drugs intravenously.
Sodium carbonate or soda in the case of diabetes perfectly cleans the intestines, which helps the affected liver function. With indicators of acidity in the body above 7.4 units, soda therapy will be most welcome, since the substance effectively reduces acidity and protects against bacteria. Drinking soda solution is possible for the prevention of the disease, and in the process of its treatment. At the same time baking soda in parallel supports immunity, relieves discomfort in the stomach.
Another popular remedy for diabetes is cinnamon. The reduction in sugar is due to the content of calcium, minerals, manganese, vitamins, choline, iron, pantothenic acid and pyridoxine in this spice. Among the main advantages of cinnamon in the treatment are the following properties:
- It quickly increases the metabolism of carbohydrates, which leads to self-regulation of glucose in the patient’s blood.
- It has an effect that is similar to the effect of insulin in the body, due to the presence in the composition of bioactive substances - natural insulin substitutes.
- Reduces the growth of blood sugar after a meal, so that you can fight diarrhea, and also increases insulin sensitivity.
- It acts as a natural antioxidant, reduces the weight of those who suffer from its set in diabetes, sensitizing insulin.
- It is able to change insulin-signaling activity due to the presence in its composition of biological flavonoids, which leads to a decrease in blood glucose levels in patients with diabetes.
Also, cinnamon infusions have anti-inflammatory, anti-arthritic, firming effects, they normalize the digestive system, treat women, fungal infections and so on. Cinnamon in the blood can liquefy it and stimulate healthy circulation. The sugar-reducing effect of cinnamon will be noticeable when using the product from 2 grams per day. Regular use of spices will provide the patient with a glucose indicator close to the physiological norm.
The use of cinnamon in diabetes is recommended in combination with kefir, which does not harm the cardiovascular system and has many positive effects on the body, reinforcing the effect of this spice.
Diabetes with careful attention to one's own health and health can be recognized at the earliest stages when the blood sugar level approaches 6 mmol per liter. Completeness and sedentary lifestyle of a patient are very frequent provoking factors of pathology. If you take into account such specifics and identify the signs of diabetes in the early stages, it will be much easier to cure the symptoms and even the cause of the disease. However, any treatment of the disease should be strictly under the control of an endocrinologist according to an individual scheme for each patient. The main element of any antidiabetic therapy is always proper nutrition.
Early-stage diabetes treatment is usually accompanied by a carbohydrate-free diet. The amount of carbohydrates in all consumed foods must be carefully counted so as not to exceed the daily rate allowed by specialists. Categorically it is impossible to eat while baking, sugar, eggplant, potatoes, sweet fruits, smoked meats, canned foods, pickles, spicy and alcohol. Cooking with frying is prohibited, as well as smoking.
The diet of diabetics should be low-fat meats, dried fruits, unsweetened fruits and citrus fruits, brown rice, oatmeal, buckwheat, millet, barley, black and red currants, cranberries, raspberries, blueberries, gooseberries. As a drink for this disease, dietary water, kefir, unsweetened compote, black or green tea, berry juice, ryazhenka, chicory, mineral water are included in the diet. The use of cottage cheese, egg whites, olive and flaxseed oil, natural yogurt is permissible.
Food with a high glycemic index, which indicates the rate at which the carbohydrates from the product will be absorbed in the body, is completely excluded from the patient’s diet. Forbidden foods that have a high glycemic index include dates, beer, white bread and toast from it, turnips, carrots, chocolate, semolina.
For effective diabetic therapy in the early stages it is important not to neglect feasible physical exertion. Due to physical activity, muscle tissue will intensively absorb sugar, reducing its blood levels, the patient's psycho-emotional background normalizes, the heart muscle strengthens, weight and blood pressure stabilizes, metabolic processes return to normal, and cellular sensitivity to insulin increases. Exercise should be selected by the doctor in each specific case, however, there are also universal types of loads designed to be performed in medium and light intensity. None of the diabetics are not contraindicated swimming, walking, biking. The regularity of training should be constant - the patient is obliged to practice at least 3 times a week. When starting classes, it is better not to overload the body and be limited to 15 minutes of any activity, gradually increasing the time.
With regular exercise, people taking insulin should keep track of its level, since physical activity often reduces the dosage of the hormone used.
Some experts believe that the early stages of type 2 diabetes with a proper diet and necessary physical activity can be completely cured. This is a controversial opinion, but the improvement will definitely come, and in the future it is recommended that the patient constantly monitor the level of glucose with a portable blood glucose meter.
Diabetic foot syndrome is a neurotrophic and microcirculatory disorders of the distal parts of the lower limbs, which provoke necrotic processes of soft tissues and skin, as well as bone and joint damage. Damage to the legs due to diabetic foot occurs in diabetics 15-20 years after the onset of the disease. Usually, about 10% of patients are exposed to it, and another 40% are at risk of developing such a pathology. In 90% of cases, diabetic foot occurs in patients with the second type of pathology.
The main approaches to the treatment of diabetic lesions of the lower extremities include adjusting blood pressure and carbohydrate metabolism in the body, reducing the load on the affected leg, local wound treatment, systemic treatment with pharmacological drugs, and with the ineffectiveness of all of the above, surgery. To optimize glycemia in the patient's body with the first type of pathology, the used dose of insulin is adjusted. In the case of the second type of diabetes, it is recommended to replace the treatment with drugs by insulin therapy.Normalization of pressure can be achieved with the use of beta-blockers, ACE inhibitors, diuretics and calcium antagonists.
When purulent-necrotic lesions of a diabetic foot, it is required to unload the limb, limiting its movements and using crutches, orthopedic appliances, special shoes or insoles. In case of ulcerative defects, it is systematically required to treat the wound, resecting necrotic tissue, apply antibacterial or antiseptic dressings, remove corns, corns and areas with hyperkeratosis around the wound to reduce loading on the affected area.
Antibiotic therapy for diabetic foot syndrome is carried out with preparations of a wide antimicrobial spectrum of action. In parallel with them are used and antispasmodics, infusion of solutions, hemodialysis of serum calves, alipoic acid. In the absence of effectiveness of conservative treatment in very severe cases of diabetic foot surgery is used. In the ischemic form of pathology, endovascular dilation, thromboembolectomy, stenting of the peripheral arteries, arterialization of the veins of the foot, foot-knee and other techniques are used. For plastic closure of large defects, autodermoplasty is performed. Sometimes it may be necessary to have a deep abscess and cellulitis drainage. In the case of gangrene or osteomyelitis, an amputation of the foot or fingers or an exarticulation may be necessary.
Retinopathy for diabetes
By diabetic retinopathy is meant a lesion of the retina due to the progression of the disease. This reduces visual acuity up to complete blindness. The progression of the complications is very slow, gradually the blood vessels in the eyes become fragile, which leads to hemorrhages in the area of the retina.
Retinopathy therapy depends entirely on the stage. All patients with diabetes without symptoms of retinopathy must periodically be examined by retinologists, monitor blood glucose levels, glycated hemoglobin, and pressure.
In order to preserve visual acuity in the case of retinopathy, one should resort to such methods of treatment as laser coagulation, drug treatment and surgical intervention. It is important to understand that fully retinopathy is not amenable to treatment, but laser coagulation in the early stages of the complication will help prevent the patient's blindness. Vitrectomy is often used to improve vision, which is removal of the vitreous body of the eye. However, with the progression of the disease, repeated surgery is no exception.
In severe and moderate degrees of nonproliferative diabetic retinopathy, laser coagulation of the retina is used. This is a painless operation in which the patient feels only the discomfort associated with the illumination of the eyes. The goal of such treatment is to stop the progression of retinopathy, prevent the proliferation of connective tissue and newly formed vessels in the retina and vitreous body.
Laser coagulation of the retina in the proliferative stage of retinopathy, when the vessels and membranes of the connective tissue in the eye grow, ceases to be effective. In this case, vitrectomy is used, during which the vitreous body is surgically removed from the eye. This leads to the elimination of the substrate for the proliferation of connective tissue membranes, blood vessels.
Arthropathy as a complication
Arthropathy in diabetes mellitus occurs in the patient's body with very severe forms of the underlying pathology, very often the manifestation of complications occurs at a young age of 25-30 years. In the absence of a systematic treatment of diabetes, diabetic arthropathy can develop in the patient's body only 5-8 years after the manifestation of the underlying pathology.
With disturbed carbohydrate metabolism, which is a companion of diabetes, begins the dysfunction of many systems in the body, including bone and neuromuscular. Bone pathology begins to develop on the basis of acidosis and the process of enhancing the production of calcium salts from the human body.
Given the fact that arthropathy occurs as a complication of very severe forms of diabetes, all treatment of the complication should be strictly controlled by an endocrinologist. Therapeutic procedures necessarily include both insulin therapy and the use of anti-inflammatory drugs.
Treatment by type of disease
Methods and means of therapy for type I pathology
With a lack of insulin in the body in patients with the first type of diabetes, it is required for life to be used in the form of intramuscular injections. However, despite the replenishment of the reserves of this hormone, the cell metabolism still remains disturbed, so the lifestyle of the patient with this pathology must change for the rest of his life.
In today's high tech world, caring for patients with diabetes is becoming easier. For example, since 2016, a lens with sensors from Google helps patients to measure the level of glucose in the tear fluid. At the same time, in the case of the maximum permissible level in such a lens, special LED bulbs glow, notifying the patient of the time for the next injection of insulin. Or, with the aim of automatically injecting the missing insulin into the blood, Swiss scientists invented a pump, the functionality of which greatly simplifies the life of diabetics.
The main method of treating type 1 diabetes is insulin replacement therapy. The best are the treatment regimens that compensate for carbohydrate metabolism and in parallel improve the quality of life of the patient. The main goal of insulin therapy in type 1 pathology is to approach the effects of endogenous human insulin. The best treatment regimens are those that completely mimic the physiological secretion regimens of this hormone in the human body by pancreas beta cells. In order to achieve a similar effect, human genetically engineered insulin preparations are used in the form of a combination of prolonged drugs and short-term exposure agents.
Intensive insulin therapy in conjunction with modern innovative methods of administering the drug allows patients throughout the day to clearly know when the body requires the introduction of an insulin replacement agent and in what form (short-acting or prolonged). Usually in the morning requires the introduction of prolonged insulin into the body, and after each meal, by analogy with the physiological processes, the dose of the hormone is supported by drugs.
Features of the treatment of type II pathology
The most important factors in the treatment of type 2 diabetes are diet and exercise. However, the duration of the effect of overcoming hyperglycemia is due solely to the combination of these factors and drugs. The initial stages of diabetes of the second type involve the use of metformin drugs, approved in almost all countries of the world for the treatment of diabetes. Further, as the disease progresses, doctors often prescribe sulfonylurea drugs to their patients, the key mechanism of action of which is the activation of insulin secretion. Sulfonylurea drugs can bind to receptors located on the surface of the beta cells of the pancreas. Treatment with such drugs begins with small doses and gradually increases them once a week with therapeutic need. In patients with pronounced glucose toxicity, such agents are immediately prescribed by them at the maximum dosage, and when the disease is compensated, the dose is gradually reduced.
The next group of medications that are necessarily prescribed to patients during the progression of type 2 diabetes mellitus are glitazones or thiazolidinediones, which can reduce insulin resistance by increasing the amount of glucose transporters and increasing the ability of tissues to utilize glucose, as well as reducing the amount of fatty acids, triglycerides in the blood, suppressing liver function by reproduction of glucose. Thiazolidinediones have a beneficial effect on the general condition of patients with type 2 diabetes.
Also, in addition to the above groups of drugs, in the treatment of this disease, experts use such groups of drugs as:
- alpha glucosidase inhibitors;
- incretin mimetics;
- dipeptidyl peptidase-IV inhibitors.
Hypoglycemic agents do not always help to solve the problem of keeping the glycemic level in the right frames. Best of all, the combined method of treating type 2 diabetes has proven itself, in which oral hypoglycemic drugs in combination with insulin replacement agents, when used in the first 6 years of the disease, prevent the formation of severe complications. The highest control of hypoglycemia can be observed in the case of switching to insulin therapy with the stabilization of beta cells.
According to medical observations, with the ineffectiveness of hypoglycemic agents in the second type of diabetes, you should immediately begin to use insulin therapy. Thus, it is possible to neutralize most of the side effects provoked by high doses of glucose-lowering drugs, and to reduce the level of glucose in the blood.
Due to the decrease in the activity of beta cells in the monotherapy of diabetes of the second type, sooner or later all patients suffering from the disease, switch to a combination treatment. Combination treatment regimens that use metformin and sulfonylurea or exenatide and sulfonylurea are considered to be the most effective. However, the combination of metformin and insulin is today considered the best combination. In this case, the minimum dose of funds prevents the occurrence of side effects, which is also a plus of the combination treatment.
Features of therapy during pregnancy
Every day in the world there are more and more pregnant patients with gestational diabetes. Gestational diabetes mellitus is a pathological state of glucose intolerance, due to which the level of sugar in the blood rises, which first appears in a woman during the period of carrying a child. Usually, this condition goes away by itself after delivery. For treatment during the period of manifestation of symptoms, it is recommended to change lifestyle, stick to a diet and devote more time to the necessary physical activities. Oral administration of antidiabetic agents is prescribed to some pregnant women, in particular, glibenclamide and metformin, which are an alternative and approved for use during pregnancy along with insulin to control glucose levels.
During pregnancy during diabetes, it is necessary to learn to independently control blood glucose in order to correct it in time. In most cases, the diet is enough. The principles of diet therapy in this case imply splitting the daily diet into foods containing 35-40% carbohydrates, 35-40% fats and 20-25% proteins. In the presence of excess weight, the calorie content of food should not exceed the limit of 25 kilocalories per 1 kilogram of body weight, and with normal weight it should be within 30-35 kilocalories per kilogram. At the same time, calorie reduction should occur smoothly, without sharp jerks.
In the menu of a pregnant woman with gestational diabetes, sweets (digestible carbohydrates) are not allowed, the fats consumed are reduced, and the amount of fiber and protein increases to one and a half grams per kilogram of body weight.
In the absence of positive dynamics in the level of glycemia during diet therapy, patients are prescribed insulin therapy to the extent that the attending physician constantly recounts and corrects.
How to reduce sugar at home
There are a few rules for lowering blood glucose levels at home. It is imperative to purchase an imported blood glucose meter, check it for accuracy and constantly measure sugar to determine how it behaves throughout the day. From what time of day the glucose level in the patient's blood is the highest, depends on the treatment, diet and physical activity.
It is important to remember that the lower the level of carbohydrates in the food consumed, the more effective the diet will regulate the level of sugar. Therefore, even if the doctor prescribes a balanced diet, you can reduce the amount of carbohydrates, even in it. This will not worsen the flow of diabetes and will quickly help to return the proper level of glucose. The goal of home blood sugar control is to achieve a constant level of this indicator within 4.0-5.5 mmol per liter. In the absence of effectiveness in this issue of the diet connects metformin in the form of Glucophage or Siofor for overweight patients. When thinness such drugs will not act, they can not use.
It is important to adjust the insulin produced in the body to increase physical activity. In diabetes, jogging, walking, and swimming are most effective. Strength training can benefit health in general, but they will have no effect on the course of diabetes.
Insulin shots are a lifesaver for those patients with diabetes who have already tried all means, but they did not bring the proper effect. With a diet, competent physical activity and the use of metformin insulin dosage, as a rule, we need the most minimal.
Is it possible to fully recover?
Any diabetic is always wondering whether it is possible to completely get rid of the pathology that has arisen. However, doctors are relentless - diabetes mellitus type 2 is a chronic pathology that remains in the body throughout life and can either worsen or go into a remission stage. To constantly maintain the compensation of the disease, you should follow all the recommendations of the doctor and take the necessary medicines. If only to stop using medications, pathology can begin to progress at a rapid pace, causing many complications in parallel. Therefore, it is worth being careful if an alternative medicine clinic offers a complete cure for diabetes with the following methods:
- purification from the body toxins;
- vibrations of unthinkable instruments;
- herbal medicine without the use of pharmacological agents and insulin injections;
- energy impact on the subconscious;
- wearing medallions and special clothes.
It is important to understand that the early stages of the pathology of the second type are really easily compensated with the help of a competent diet and physical exertion, but this does not mean that the patient is completely cured. In the later stages of the disease, it is simply deadly to stop taking the drugs, because both the disease itself and many dangerous complications can progress. Therefore, phytotherapy and sports can actually become easier, but only if they are used as a supplement to insulin therapy and the main treatment.
Primary diabetes mellitus type 1 or 2 cannot be cured, but using various methods it is possible to save the patient from the symptoms of the disease, maintain the metabolism in his body for a long time, prevent the occurrence of complications and improve the patient's quality of life. In this case, self-treatment in this case is strictly prohibited.If we start to be examined and treated in a timely manner, the question of getting rid of diabetes will no longer worry the patient, since his life with this disease will not be difficult in any sense.
Consequences of not treating
If you do not treat diabetes, you can expect severe pathologies in your own health, despite the fact that diabetes mellitus itself does not pose a direct threat to human life. Untreated pathology causes a lot of serious complications that can affect absolutely any systems and organs in the body. Ignoring therapeutic techniques can lead to disability, and even death. That is why diabetes is popularly called “silent killer” - the disease can hardly manifest itself and does not bother the person, but can provoke a progression of complications that are not compatible with life.
In 2007, scientists conducted a study that showed how diabetes affects the life and health of people in accordance with gender. It turned out that for women this pathology is much more dangerous. The reduction of life expectancy for men with diabetes, on average, is 7 years, while for women it is more than 8 years. The development of cardiovascular pathologies due to diabetes in men occurs 2-3 times more often, and in women 6 times more often. In this case, it is cardiovascular diseases that cause the death of many diabetics.
Sugar sickness and depressive syndrome are closely related to each other at a young age. These two conditions in the complex often push young people to take hasty actions, therefore, when detecting early pathology, it will be very good to get a psychologist's consultation regularly.
In general, in the absence of the necessary treatment for diabetes, the disease can easily be aggravated, cause complications, provoke disability and even death.
To diagnose diabetes in a patient or to suggest the presence of this pathology may be a general practitioner or a family doctor (general practitioner). At the slightest sign of illness, the patient is assigned appropriate tests, and according to their results, the patient is referred for consultation to an endocrinologist. If diabetes is confirmed, the patient in endocrinology put on a permanent account.
It is the endocrinologist who is able to find the optimal solution for a particular patient in the selection and adjustment of the level of hormones and sugar in the blood. The specialist conducts research that reveals the existence of problems in the functionality of the endocrine system, diagnoses pathologies, selects treatment, and eliminates negative symptoms. The most common means are selected to correct the hormonal balance in the body, restore metabolism, eliminate the endocrine factor that causes infertility, and others. According to the research results, an accurate diagnosis is made, a diet and specific medical preparations are selected.
Sanatoria for diabetics
Today, patients with diabetes are effectively treated and rehabilitated in specialized specialized institutions, which are designed to combat the problems of the digestive system. However, diabetics often need sanatorium-resort treatment and other pathologies associated with diabetes. Therefore, on the basis of the majority of Russian sanatoriums, there is a special “Diabetes Management School” that trains patients of any specialized health care facility to independently monitor their condition at the time of their stay at a health center, to choose their own dietary meals and physical activity, taking into account diabetes in history.
The most popular for diabetics are the Russian resorts of the Altai, Krasnodar Territory, Yessentuki, Pyatigorsk, Goryachiy Klyuch, Zheleznovodsk, Kislovodsk and others.
The main therapeutic factors of the resort Belokurikha in the Altai Territory are medicinal mud, mineral waters and salubrious climate. Here, patients are offered therapy with nitric siliceous low-mineralized bicarbonate-sulfate sodium weakly radon thermal waters with silicic acid in the composition. As a drinking treatment, patients here are invited to use low-mineralized sulfate-chloride magnesium-calcium-sodium treatment-table water from the Berezovsky field, which the Altai Territory is rich with.
At the best balneological resort of Russia in Anapa (Krasnodar Territory) found many useful mineral waters, which are used for both internal and external use. Throughout the Kuban there are not so many outdoor mineral water deposits. But the most valuable are the waters of internal use, the deposit of which is located directly in the city of Anapa. Here, patients can receive treatment with the help of two types of water - low-saline mineralized (3.2-4.9 grams per liter) bicarbonate-chloride-sulphate and sulphate-bicarbonate-sodium chloride, neutral in alkaline composition. Also, mineral waters of Semigorsk sources of high gas content are delivered daily to the resorts of Anapa. This is nitrogen-carbon dioxide-methane water, sodium chloride-hydrocarbonate iodine with a weak alkaline pH of 7.6 and a mineralization level of 10-11 grams per liter.
Goryachy Klyuch is the only resort in Russia where you can find a combination of mineral waters from Essentuki and hydrosulphuric baths, for which the hydrogen sulfide chloride-hydrocarbonate calcium-sodium thermal mineral water of hot springs with a temperature of up to 60 degrees is present. Lower temperatures of such waters are used for drinking treatment of various pathologies of the gastrointestinal tract.
In the resort, Zheleznovodsk therapy is carried out by the unparalleled "Slavyanovskaya" and "Smirnovskaya" waters in the world, which are very useful for the digestive system as a whole, for pathologies of the kidneys, urinary tract, and for andrological diseases. Here, patients are treated with diabetics suffering from concomitant diseases of the gastrointestinal tract, musculoskeletal tissue, ENT organs, gynecological diseases.
The basis of the resources of the resort Essentuki are mineral waters of salt-alkaline nature - known to all Essentuki number 17 and Yessentuki number 4. On the basis of the Kalinin sanatorium, where diabetes mellitus has been successfully treated for 10 years, the Center for the Rehabilitation of Patients with Diabetes with Natural Factors today functions. Here, patients are led and observed by professors of the endocrinological profile, doctor of science in the field of endocrinology. It treats diabetes in almost all functioning sanatoriums.
Kislovodsk is a famous resort of Narzans.
They all have similarities and are used for balneotherapy. The most effective in diabetes are Dolomite Narzan, which improves metabolic processes, increases urination and excretion of waste slags, and Sulfate Narzan, which increases gastric secretion, improves digestion and choleretic hepatic function, reduces flatulence and improves bowel function. Diabetes patients with concomitant pathologies of the musculoskeletal system, organs, blood circulation and digestion are treated at the Kislovodsk resort.
More than 40 names of the Pyatigorsk sources unite practically all known types of mineral waters of the world. Here it is indicated to be treated in patients with diabetes, whose history is complicated by hepatic, gastric, intestinal pathologies, diseases of the peripheral nervous system, vascular pathologies of the lower extremities, musculoskeletal diseases, skin pathologies, endocrine systems, occupational diseases and others.