Types of Diabetes, diabetes type 1 – diabetes type 2

Question: How are he and can be considered diabeton MB hormones

Answer: 1. Diabeton – one of the many drugs that affect the endocrine system, hormones, he is not (because it does not contain hormones). 2. XE (bread units) needed to calculate the number of carbohydrates (saharopovyshayuschego component of food) for those people with diabetes who injected insulin and change the dose depending on the number of carbohydrates eaten. There are tables for the calculation of HE, they have the web, but it's better – to get this information to the School of diabetes (because not all so simple, and independent learning is often inefficient). In the treatment of type 2 diabetes pill counting HE does not want (the program of the School of diabetes type 2 diabetes in the tablets is a summary of carbohydrates, but in the everyday lives of their calculation does not benefit).

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Question: I am 32 years old. From 10 years on insulin. Naturally for such period, any comorbidity (diabetich. polyneuropathy, angiopathy, etc.) In recent years often numb fingers on his left hand, even in hot weather. My endocrinologist appoint me dropper berlitiona, milgamma etc. expensive drugs that I can not afford because of the severe financial situation, without offering any counterparts at a lower price. Now I do not pass maintenance therapy in general. But before I did dropper with trentalom, Cavinton, Actovegin. Please answer these drugs are effective, why their popularity has fallen? And advise, what can replace berlition

Answer: numb fingers on your hand is often a consequence of disease of the cervical spine, and not a complication of DM. The prevention of complications: before there were such a practice – periodically in patients with diabetes treatment "cocktails" of vascular and restorative drugs (such as trentala, Actovegin, etc.). Then I realized that the risk or rate of progression of complications such "cocktails" are not reduced, and money spent on them throughout the country very much (and then not enough on the test strips for self-control, which are of significantly greater benefit in the prevention of complications). So in essence, the ability to "nonspecific" Prevention (of all the complications of diabetes) is just the maintenance of sugar as close to normal. With regard to drugs – yes, drugs are known to have an effect on the complications, but they are only effective when administered at certain situations (all of these situations endocrinologists know). For example – a lifelong administration of drugs such as enalapril (and other "-catch") slows down kidney damage in patients with protein in urine, or microalbuminuria. To save the vessel brings the greatest benefits for life administration of drugs that reduce cholesterol (statins). Berlition and milgamma – drugs for the treatment of neuropathic (nerve injury – see answers about her treatment). Cavinton Trentalom or they do not replace. If you do have neuropathy – that can obszhdat its treatment. But do not think that just some "preventative dropper, have a revitalizing effect – again, would be more useful if the money to buy test strips. See also FAQ "treat diabetes in the sanatorium" and other questions about the treatment of complications of DM.

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Question: A little more than six months ago I was diagnosed with type 1 dabet. The diagnosis was made based on the analysis of blood glucose (14.4) and urine (in response to the analysis set "+++") as well as during the preceding 1.5 months smptomov – all classic symptoms of diabetes – dry mouth, frequent urination, rapid fatigue, loss of weight (10kg for 1,5 months). Within three months from the date of diagnosis, I need insulin dose decreased from 20-22 (12 long and 10-12 short) units up to 6 long (Lantus), and even those 6, I sometimes manage to sometimes forget the staple. At this point blood glucose in the morning 5. 2-6. 2, within 2 hours after meals (sometimes just for fun doing 2-3 metering) 6. 0-9. 5, two hours after eating – 5. 3-6. 8. Diet in the last 1.5 months of almost no respect but at the same time try not to overeat. 2-2,5 In the last month lost 1.5 kg of weight (now weigh 67.5 kg during the growth of 170cm.). Sugar Merya 3-5 times a day in two different glyukometramiZa this time made two analysis HBA1c. For the first time I carefully observed the diet, chopped a lot of insulin, and used that caught the slack hypoglycemia, HBA1c was 4,4%. Recently did a second analysis, in a commercial laboratory for a fixed rate, and the result gave me 12%. I think that this is a mistake, or they do not have time to do the analysis and simply wrote "the average figure for the hospital." I'm going to do the analysis again. From their physician (regular doctor conventional local clinic) tried to discuss my current state, but unfortunately nothing intelligible was not told me. I'm going to go for a paid consultation, on the recommendation of friends. Own questions: 1. Can we assume this condition diabetes? 2. Does it make sense at all to poke 6 units Lantus ®? 3. Can we expect a deterioration in the future and how this can happen? 4. What can lose weight, and is it good or bad? 5. What tests makes sense to do before a paid consultation, not to go twice? "Thanks in advance for the answer.

Answer: 1-3. Unfortunately, there is no reason not to consider your state of type 1 diabetes. There is such a state as "Honeymoon diabetes" (apparently, this is it is – you must have heard this term): a significant reduction in insulin requirements (sometimes – to complete its withdrawal) against the background of insulin therapy initiated. This is due to the fact that if detected in time diabetes is still a certain amount is not killed beta cells of the pancreas (secrete insulin). With the high sugar, they work very badly, but the normalization of sugar – on time "come alive". The problem is that at this stage of the process of loss of beta cells, unfortunately, is irreversible, and therefore this state fairly short (a few months, sometimes – up to a year), and then the main source of insulin in the body becomes insulin imposed from the outside. Unfortunately, to date there is no any methods to influence developments in the pancreas, can slow (or, conversely, accelerate) the loss of beta cells. Expressed in varying degrees, "honeymoon" was found in 20-74% of patients with diabetes type 1. 2. Abolish insulin completely in this period should not, but the daily dose should be reduced (as you), if the blood sugar on the background of insulin is too low. 3. It's worth repeating measurement of glycated hemoglobin: if he will once again be above 10% – means that during the day there are episodes of high sugar, but you simply did not commit (eg, after eating). While it may be a problem with the laboratory (or not measured HbA1c, and HbA1 – he has other rules). But possible and error glucometer (for example, if you wipe the finger with alcohol, or due to other causes). 4. Weight can be lost from the high sugar (this will tell glycated hemoglobin), or from what you consume now kaloryi less than before (eg, due to compliance with the "antidiabetic" diet (although the SD type 1 should not be a low-calorie ). 5. Actually it is better to do tests after consulting a doctor – then the doctor will be able to designate what he really needed. In your situation, you can determine the level of antibodies to the pancreas (increased in the first months of illness in 80-90% of patients with type 1 diabetes) . often prescribe the definition of C-peptide (a byproduct in the synthesis of insulin), but in fact, its level is of little use in determining the type of diabetes. Insulin in the blood to determine you do not have – you enter it. But to think about revising the type of diabetes, I would advise if potrebnosit in insulin remains low (ideally with glycated hemoglobin) is more than a year of diagnosis. In this case we can think about other types of LEDs (with a milder course than type 1 diabetes), but there are very rare. Since the end of Honey month "(if it still ends) is to receive training in the School of diabetes" – consult on www. diadom. ru, where it is done.

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Question: Can not compensate well, so the transition to the age of 14 years. I wish summer treat her in a sanatorium, but I predlagpyut vouchers from social bodies in the sanatorium, in which heal anything, but not diabetes. Is there a resort profiles, in which doctors, as in the hospital Morozov, understand what insulin-dependent diabetes and how to compensate

Answer: Unfortunately, "take medical treatment" diabetes in a sanatorium or hospital is impossible. The patient's condition and lack of complications in CD is determined only by the quality control level of blood sugar (now you are managing with her daughter, in 1-2 years it will manage itself). Since it is impossible to conduct his life in honey. institution will have to teach your daughter to manage their sugar. More useful than "podlechivanie, teaching her to" adult "diabetes school a couple of years (the best in Moscow – Department of Diabetes Endocrinology Center School of Medical Sciences (www. endocrincentr. Ru). As a summer holiday – there are summer camps for teenagers with diabetes but this – Recreation (useful in terms of communicating with other teens with diabetes, and social adaptation), rather than a medical event.

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Question: I am 56 years old, diabetes type 2 sick about 7 years. a month ago was transferred to insulin (30 units Kohl in the morning, the evening of 24 units Levomir and 3 times a day 8 units NovoRapid – before the meal (diet respected)), also taken in the morning 8mg Rogl, your meter readings in the morning in the vicinity of 17-19 mmol L, in the evening One unit of more. Advise please, how do I reduce the sugar level in blood. Thank you.

Answer: First, it is necessary together with your doctor to exclude possible causes of the weakening action of insulin: – napravilnaya Technology insulin (see http://www. rusmedserv. com / forums / showthread. php? t = 34287) – delayed or defective insulin-chronic inflammation (urinary infection, teeth, etc.) – a clear failure to comply with the diet (you may not know about the strong saharopovyshayuschem effect of fruit juices, dried fruits, Kiselev, honey, mashed potatoes, semolina and etc.). If these problems are solved – need to increase the dose of insulin. Different algorithms are possible (discuss with doctor), but the most reasonable in your situation to start with a good yield of sugar in the morning: – When the sugar is above 10 at night – add the night short insulin (NovoRapid) without food (usually 4.6 units) just in case, controlling the sugar in 3. 00, to avoid hypoglycemia during the night (in your situation is not very likely). – Probably NovoRapid 8 units needed to cover the carbohydrate food with a good sugar before eating. If it is above 8.10 before the meal – a higher dose (usually up to 14-16 units). If even 14-16 units do not provide a good sugar before the next meal – it is necessary to measure the sugar in 2 h after the meal and bring additional 2.6 units if it is higher than before the meal (of course, referred only to situations with very high sugar before meals). Rather, such an increase in insulin dose – temporary: after the normalization of sugar effect of insulin increases, there comes some sort of "breakthrough" in its action. If you have excess weight – you know also that weight loss increases the effects of insulin (and the more weight, the higher the daily dose of insulin needed to normalize the sugar). Diet aimed at weight reduction (see FAQ in Radel "diet" to maintain the sugar in the long term.

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Question: Zravstvuyte Oleg vViktorovich! My wife age 68, May 30, had to send her to the hospital, before she refused treatment to the doctors. In the intensive care unit, she got almost unconscious. It turned out that her blood sugar is about 40. Week she spent in intensive care and 10 days in endocrinology. Discharged her with sugar about 10 and said that this level is normal for her, but below dangerously low. Recently, it is much thinner and the end of lost my appetite, so worn out and returning from the hospital could not stand on their feet, they did not hold. Now she can stand for some time without support. After discharge from the hospital three days it took to extract the recipe and the acquisition of blood glucose meters. The first measurement showed the level of 24. Now approaching the recommended, ie, to 10. So really 10, is the level below which a dangerously low? Thank you

Answer: Under 10 should not be lower in the first week after a long period of high glucose. In the future, should support the sugar as close to the recommended safe level for today (up to 6-6. 5 before eating, not higher than 8.9 in 2 hours after meals). This may be accompanied by the appearance of hypoglycemia (episodes of low sugar – less than 3). Often (though not all) elderly patients hypoglycemia contraindicated, discuss with their physician whether they should be avoided by your spouse (at least the next month should strive to ensure that the sugar does not fall below 3-4). Instructions how to quickly eliminate hypoglycemia, is acc. section. Now it is important to measure the sugar frequently (before each meal and at night), to learn how to adjust the sugar with insulin (presumably, your spouse is receiving insulin; how to introduce insulin is set out here: http://www. Rusmedserv. Com / forums / showthread. php? t = 34287). May also require treatment of opportunistic diseases (hypertension, urinary infection? Disorders of cerebral circulation? When you last did an X-ray light (must annually)?).

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Question: Doctor a good day. I am 56 years old. Diabetes type 2nd second year. It is well compensated. Agree Glemaz to 1 / 4 in the morning and evening, for Siofor850 tablet morning and evening periods of 3-4 weeks, one Siofor. Morning sugar consistently higher evening to 0. 1-1. 0 mmol. Before the diagnosis the number of daily urine 5. 5 liters. After kmpensatsii now in its second year of below 3x liters. Night prhoditsya vsavat 2-3 times in a toilet. What can it be

Answer: 1. It is pointless to make any pause in receiving hypoglycemic agents. Usually a combination of selected works, and it is used continuously, if it works. 2. If no kidney disease (protein in urine, elevated levels of creatinine in the blood), increased amounts of urine when the SD is associated with a sugar level above the so-called. renal threshold. The renal threshold for glucose – that was the blood-sugar level, above which the sugar starts to move into the urine (and urine volume will be increased). The renal threshold for an individual and usually different people from 9 to 12 mM. Measure blood sugar during those hours when a lot of urine. Most likely, it will be high and will need to adjust treatment. It should also check the accuracy of your meter – perhaps, in fact there is no compensation. . .

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Question: I have 3% of urine sugar in the blood of 7do12POChEMU? And what to do. DIABETES 2tipa 4 years. drink novonor

Answer: Sugar in the urine passes from the blood in the hours when its level in the blood exceeds a certain threshold (typically about 10 mM). When the sugar in the urine of 7, he does not pass, at 12 – goes active. 3% in the urine, consistent with rises of up to 15-16 mM, and most likely a sugar, you have the 1-2 hours after meals (check) – TK 7-12 – is apparently before eating? Perhaps Your question is: what to do if you drink novonorm, and sugar is not reduced. . . Yes, your treatment does not provide the desired level of sugar and requires correction. Discuss with your doctor options: increasing the dose novonorma, adding to it a second drug with a different mechanism of action – usually metformin (= siofor, glyukofazh), modified food so as to reduce weight (if excess).

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Question: I have often noticed that to compensate for 1he need 1.5 units of insulin, if not all, 2 (after breakfast, is used when pricked at the rate of 1:1) in a dinner tested – is 1:1 . In the evening, at dinner happened and 0,5 INS. units. 1 ha. How can this be explained? If other factors are excluded.

Answer: This is just natural (usually included in the program "Diabetes School"). Factor in insulin requirements (ie how many units. Insulin needed to cover 1 XE, with normal sugar, without regard to physical activity and other factors), usually in the morning than in lunch, and dinner is higher than at dinner. These factors are very individual, rasschtiyvayutsya for each patient according to his diary is not very complicated procedure, but usually can be (breakfast-lunch-dinner) 2 – 1. 5 – 1 or 1. 5 – 1 – 0. 5 (or 1 – 1 – 0. 5), etc.

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Question: Doctors discovered I had diabetes at an early stage. whether drugs or herbs that reduce blood sugar, which can be taken without the services of doctors, guaranteed harmless to the body

Answer: to a doctor to resort still stands. The most innocuous – it is diet, rest (drugs) must be used under medical supervision – are appointed with little effect diet. Grasses and popular recipes "You will be a million, but the effect they produce, incidentally, also cause many side effects – so it's better to not spend time and effort:)

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