Medicines for diabetes - Causes, Symptoms and Treatment .MF .
Diabetes mellitus is one of the social diseases.This means that the disease is at present a real threat to our society, as well as, for example, with such terrible diseases as cancer, tuberculosis, HIV and hepatitis.Every year different governments spend millions for the treatment of patients with diabetes struggle with its consequences and prevention of this disease.But, nevertheless, the disease continues to spread at record speed.Today, according to some estimates 10 percent of Russian citizens have diabetes in a latent or explicit.
Diabetes mellitus can at first hardly manifest itself.At this stage there is a disruption in the metabolism (in the first place - an increase in the level of sugar (glucose), blood), but the feeling is almost normal.The first symptoms may be dry mouth, thirst, frequent urination abundant, dry and itchy skin, fatigue.Of course, most people on these changes being unresponsive.This leads to the fact that diabetes is detected late enough, when there is a complication of the
To prevent such damage, it is necessary as soon as possible to see a doctor and begin treatment of diabetes.So, if you think you have diabetes, immediately consult a skilled and pass inspection.If necessary, the doctor will pick up the necessary treatment.
In general, for the treatment of diabetes using diet therapy, lifestyle changes, hypoglycemic pills, insulin.Those skilled in dependence on different selected types of diabetes treatment.For the treatment of type 1 diabetes is always used only the insulin pills are absolutely ineffective.For the treatment of type 2 diabetes can be used as tablets and insulin, and the combination of these drugs.Let's take a closer look at the various diabetes medications.
Medicines to lower blood sugar
tablets from diabetes are divided on the point of application actions into three groups.
first - it drugs acting on the pancreas .These drugs stimulate the production of insulin.This group includes drugs sulfonylurea (gliclazide, glibenclamide), glinides (repaglinide, nateglinide).These drugs have relatively high efficiency, compared with other groups.They help to easily achieve normalization of blood glucose, especially in the early years of the disease.But this effect is achieved by increasing the level of own insulin in the blood, which often leads to undesirable consequences.Suffer pancreatic cells.They are forced to produce excessive amounts of insulin, which leads to their gradual exhaustion and death.In addition, elevated blood insulin levels results in an increase in body weight.Even high concentrations of insulin can be too much to reduce the level of blood sugar (this condition is called hypoglycemia), which requires immediate intervention, or coma develops and may come death of the patient.
The next group of drugs for diabetes acts on peripheral tissues (fat, muscle) and liver.These tablets do not increase the insulin concentration in the blood, but improves the sensitivity of tissues to this hormone.Thus, when the same amount of insulin, the blood sugar decreases.Moreover, unnecessary blocks glucose production in the liver.This group includes biguanides (metformin), thiazolidinediones (pioglitazone, rosiglitazone).Most used metformin.In fact, it is recognized as a "drug of choice" that is, a drug that is used primarily in the type 2 diabetes, according to current recommendations for the Russian endocrinologists.Metformin reduces blood sugar level, insulin concentration reduces excessive blood cholesterol levels reduces it helps normalize weight.The most common side effects when taking Metformin are diarrhea, nausea, vomiting.In many drug contraindications to the appointment.So the combination of severe liver disease, kidney, lung, heart and metformin may develop life-threatening condition - lactic acidosis.Therefore, the appointment of an independent this drug is not allowed.Thiazolidinediones are not used so widely.Their reception is not accompanied by digestive disorders, but quite often develop swelling.Therefore, these pills eliminate heart diseases.
third group of medicines used to treat diabetes, acts small intestine.These drugs block the enzymes involved in the digestion of carbohydrates, slowing rise in blood sugar after a meal.This group includes alpha-glucosidase inhibitors (acarbose, miglitol).These preparations are used infrequently, including due to the relatively low efficiency.When treating diabetes these drugs only blood sugar decreases significantly.They are often prescribed in conjunction with other medications.Tablets from this group can cause flatulence, diarrhea.
Now in Russia began to appear and new drugs for the treatment of type 2 diabetes.This agonists and analogues of glucagon-like peptide-1 (GLP-1) and inhibitors of dipeptidyl peptidase-4 (DPP-4) .the point of application, and their actions are the pancreas and liver.In the pancreas, they stimulate insulin secretion, reduce glucagon formation (this hormone increases blood sugar);reduce hepatic glucose formation.In short duration diabetes drugs GLP-1 and DPP-4 have a high efficiency.They are not only lower blood glucose level, with low risk of hypoglycemia, but also contribute to reduction of body weight, a beneficial effect on the heart, reduce cholesterol.Drugs in this group have shown in experiments to recover the unique property of mass and activity of cells in the pancreas that produce insulin.Of the major side effects revealed diarrhea, nausea.Suffice it inconvenient for patients is the fact that a part of these preparations is only available in the form of solutions, rather than tablets, which means need daily injections (injections).
insulin in the treatment of diabetes
Now let's discuss overriding injectable drug for the treatment of diabetes - insulin .Insulin has been successfully used in medicine for nearly a century.It is absolutely universal - that is, can be used to treat all types of diabetes, regardless of the reasons, which led to increased levels of blood sugar.Insulin - a biologically active substance that is normally produced by the pancreas.In healthy human blood is always a small concentration of this hormone.After ingestion, especially if it contains carbohydrates (e.g., sugars, fruit, bread) insulin level increases sharply.As a result, sugar, improve postprandial organism cell used and its content in the blood is reduced to the standard values.This occurs normally.In diabetes the formation of insulin or its action violated.
For the treatment of any form of disease can be used the same preparations of insulin.The origin of the insulin may be of animal (bovine, porcine), human (recombinant) or an analogue of human insulin.Bovine and porcine insulins cheapest, they are derived from animal pancreas.Of course, hormones, porcine, bovine and human not completely identical, so the animal insulin does not work very effectively.Furthermore, this frequently causes insulin allergy.Because of this, in recent years, in Russian such preparations are prohibited for use.All our patients receive newer drugs.
most widely used human recombinant insulin.It is produced genetically modified bacteria.The preparation obtained in this way, completely corresponds to insulin, which generates a healthy human pancreatic gland.He called insulin-short duration of action.With subcutaneous insulin begins to exert glucose-lowering effect after 30 minutes after injection, peak action at 2 hours, and the total duration of 6-8 hours.This insulin is administered 20-30 minutes before each meal.
to during the day carried out normal metabolism, a person always need a small, basal insulin concentration in the blood.To ensure that this concentration, using recombinant intermediate-acting insulin.To get it, a "short" added zinc insulin or protein.After that insulin acquires new properties - it is slowly absorbed into the bloodstream and has been operating for 12-16 hours.Therefore, such an insulin is usually administered two times a day at the same time.
So often the patient will require injections of 3 "short" of insulin before meals and 2 injections of the "middle" of insulin (in the morning and at bedtime).
most modern insulin preparations are analogs of human insulin.The structure of these molecules is changed in comparison with a normal human insulin, thereby reducing the number of injections and to improve the control of diabetes.Normally, insulin is administered by the patient on a daily basis on their own in the subcutaneous fatty tissue of the abdomen, thighs.Doses first selects a physician, and then corrects himself sick.The doses depend on the amount of carbohydrates eaten, physical activity, blood sugar levels.To use a simple injection insulin syringe, special individual injectors (pen) or apparatus constant supply of insulin (insulin pump).Accordingly, for insulin injection pens cartridges available in 1.5 ml and 3 ml, and for syringes of 5 ml vials or 10 ml.pump reservoir can be filled from a vial and the cartridge.It is important to keep insulin and never use after the expiry date.
In Russia, insulin and other drugs for the treatment of diabetes are included in the "List of essential medicines".This means that all citizens are insured in the compulsory health insurance scheme are entitled to free obtain these drugs.To take advantage of this opportunity, you must visit the endocrinologist in your district clinic or general practitioner, a prescription for a drug discount and pick it up at the pharmacy attached.Citizens who do not have a disability, are provided from the regional budget.Insulin recently purchased always in full at the same time the tablets are often underfunded.With regard to patients with disability group medications for this category of citizens pay federal budget.Typically, and tablets, and insulin purchased in full, and all patients receive the necessary preparations.Disabled persons who refuse a set of social services in terms of drug provision, the right to free insulin and diabetes pills to lose.In some regions, such patients give insulin at the expense of the local budget.
Medication complications of diabetes
treatment of diabetes complications appointed an endocrinologist and other specialists: cardiologist, nephrologist, neurologist, ophthalmologist, surgeon.For the treatment of heart diseases caused by diabetes prescribed statins, fibrates, beta-blockers, nitrates, calcium channel blockers, diuretics and other drugs.With the defeat of the nervous tissue prescribe vitamin therapy, antioxidants, anticonvulsants and some antidepressants.To apply the correction condition kidney angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, heparin, nicotinic acid.Optometrist may recommend the patient angioprotectors, enzymes and other medicines to reduce diabetic eye disease.In case of complications of these drugs have to be used continuously or courses several times a year.
Diabetes - it's always quite a serious illness.If you are unable to normalize blood glucose levels, the patient is threatened with serious complications.Only attention to their illness, adherence to all the doctor's recommendations about diet, lifestyle, and receive prescription drugs to help maintain health, performance, and prolong life.
endocrinologist Tsvetkova IG