- Combination therapy: do when blood glucose control could be better, that way of working is different but the medicine gave a synergy effect.
- Therapy Advanced: especially for patients with type 1 diabetes pancreas transplant can be a small part or whole.
- Therapy accompanying diseases: blood sugar control drugs can be given concurrently with the hypertensive drugs and drug hipokolesterolemia
Monitoring Medications
Monitoring blood sugar levels is an important part of diabetes treatment.
The presence of glucose from the urine of known bias, but examination of urine is not a good way to monitor treatment or adjust the dose of medication. Currently blood sugar levels can be measured easily by patients themselves at home. People with diabetes should record their blood sugar levels and report to the doctor so that dose of insulin or hypoglycemic medications can be adjusted.
Tuesday, July 27, 2010
Sunday, July 25, 2010
Non-Insulin Diabetes Treatment
Treatment of diabetes type 2 diabetes primarily consisted of: control of blood glucose (diet therapy, exercise, medication), treatment of disease (hypertension, obesity, hyperlipidemia), and the detection or treatment complications. Eating arrangements generally have a maximum effect after 2-4 weeks. Similarly, the administration of drugs, generally provide a maximum effect within 1-2 weeks.
There are some things that need attention in the treatment of diabetes using oral hypoglycemic drugs, among others:
- Diabetes type 2 with normal body weight or more
- People with diabetes aged over 40 years
- Diabetes lasted less than five years
- Requires insulin dose less than 40 units a day
1. Sulfonylurea
Sulfonylurea group of drugs that are especially useful in diabetic patients is only about five years or less. Because drugs (glipizide, gluburide) can improve insulin rapidly, this drug can be taken immediately after eating, so there is no hypoglycemia. The following types of more secure the sulfonylurea glimepiride. There are drugs other than sulfonylurea class of repaglinide and nateglinide, which stimulates insulin secretion by working directly on pancreatic beta cells. This last class of drug groups is given before meals, with the aim of reducing hyperglycemia after a meal. These drugs work quick and fast, so the impact of lower hypoglycemia.
This group of drugs should be administered cautiously in renal, liver, pregnant and lactating women and stressful. Can not be given in patients with type 1 diabetes.
2. Alpha-glucosidase inhibitors
Examples of this drug class is acarbose. Acarbose reduce postprandial hyperglycemia by slowing the absorption of glucose in the intestine. Acarbose did not affect the intake of glucose and insulin secretion. This drug is taken before meals. Side effects include flatulence, diarrhea, flatulence.
3. Biguanid
Examples of these drug classes is metformin. Biguanid working mechanism by lowering the production of glucose in the liver and slightly improve the intake of glucose in peripheral tissue. Besides these drugs also lower blood glucose and insulin levels during fasting, improved lipid profile, and help you lose weight. Given metformin in obese diabetic patients. The side effects are diarrhea, nausea, decreased appetite, and bitter tongue. Should not be given to patients with liver disorders, kidney and alcohol drinkers.
4. Thiazolindione
Group of drugs that includes this new type of drug works by lowering insulin resistance and increase insulin sensitivity, increase intake of glucose in peripheral tissue, as well as reduce production of glucose in the liver. This group of drugs including troglitazone, rosiglitazone and pioglitazone. Thiazolindione should not be given to patients with liver disease and severe congestive heart failure. Giving pregnant women is not recommended.
There are some things that need attention in the treatment of diabetes using oral hypoglycemic drugs, among others:
- Diabetes type 2 with normal body weight or more
- People with diabetes aged over 40 years
- Diabetes lasted less than five years
- Requires insulin dose less than 40 units a day
1. Sulfonylurea
Sulfonylurea group of drugs that are especially useful in diabetic patients is only about five years or less. Because drugs (glipizide, gluburide) can improve insulin rapidly, this drug can be taken immediately after eating, so there is no hypoglycemia. The following types of more secure the sulfonylurea glimepiride. There are drugs other than sulfonylurea class of repaglinide and nateglinide, which stimulates insulin secretion by working directly on pancreatic beta cells. This last class of drug groups is given before meals, with the aim of reducing hyperglycemia after a meal. These drugs work quick and fast, so the impact of lower hypoglycemia.
This group of drugs should be administered cautiously in renal, liver, pregnant and lactating women and stressful. Can not be given in patients with type 1 diabetes.
2. Alpha-glucosidase inhibitors
Examples of this drug class is acarbose. Acarbose reduce postprandial hyperglycemia by slowing the absorption of glucose in the intestine. Acarbose did not affect the intake of glucose and insulin secretion. This drug is taken before meals. Side effects include flatulence, diarrhea, flatulence.
3. Biguanid
Examples of these drug classes is metformin. Biguanid working mechanism by lowering the production of glucose in the liver and slightly improve the intake of glucose in peripheral tissue. Besides these drugs also lower blood glucose and insulin levels during fasting, improved lipid profile, and help you lose weight. Given metformin in obese diabetic patients. The side effects are diarrhea, nausea, decreased appetite, and bitter tongue. Should not be given to patients with liver disorders, kidney and alcohol drinkers.
4. Thiazolindione
Group of drugs that includes this new type of drug works by lowering insulin resistance and increase insulin sensitivity, increase intake of glucose in peripheral tissue, as well as reduce production of glucose in the liver. This group of drugs including troglitazone, rosiglitazone and pioglitazone. Thiazolindione should not be given to patients with liver disease and severe congestive heart failure. Giving pregnant women is not recommended.
Friday, July 23, 2010
Elementary Forms of Insulin
Insulin has three basic forms, each with a speed and duration of different work.
1. Rapid acting insulin
An example is regular insulin, which works the fastest and most briefly. Insulin was started lower blood glucose within 20 minutes, reaching a peak within 24 hours, and work for 6-8 hours.
Rapid acting insulin is often used by the patients who underwent multiple injections each day and injected 15-20 minutes before eating.
2. Acting insulin was
An example is insulin zinc suspension or suspension of insulin isofan. Begin work within 1-3 hours, reaches a maximum peak within 60-10 hours and work for 18-26 hours. Insulin can be injected in the morning to meet the needs for a day and can be injected at night to meet the needs throughout the night.
3. Acting insulin long
An example is insulin zinc suspension has been developed. The effect emerging after six hours and work for 28-36 hours.
Insulin supplies stable at room temperature for months so that you can take them everywhere.
Selection of insulin to be used depends on:
- The desire to control diabetes sufferers
- The desire to monitor the patients blood sugar and adjust the dose
- Daily Activities patient
- The ability of patients to understand and study the disease
- Kedtabilan blood sugar levels throughout the day
Most are easy to use once-daily injections of insulin are working, but this provides control of blood sugar at a minimum.
Tighter control can be obtained by combining two types of insulin, which is fast acting insulin and the insulin is working. The second injection is given at the dinner table or when going to sleep tonight. The most stringent control is obtained by injecting rapid acting insulin and insulin is working in the morning and evening along with an additional fast acting insulin injections during the day.
Some adult patients require the same dose of insulin every day. Other patients need to adjust the dose of insulin depending on the food, sports and the pattern of blood sugar levels. Insulin needs vary with changes in diet and exercise.
Some sufferers experience for insulin resistance. Insulin is not entirely the same as the insulin produced by the body. Because the body can form antibodies to insulin replacement. These antibodies affect the activity of insulin, so patients with insulin resistance should increase the dose.
Injecting insulin can affect the skin and underlying tissues at the injection site. Sometimes the allergic reaction that causes pain and burning sensation, redness, itching and swelling around the injection site for several hours. Inject often cause damage to precipitate fat or fat.
These complications can be avoided by replacing the injection site and replace the type of insulin. On the use of synthetic human insulin resistance and allergies are rare.
1. Rapid acting insulin
An example is regular insulin, which works the fastest and most briefly. Insulin was started lower blood glucose within 20 minutes, reaching a peak within 24 hours, and work for 6-8 hours.
Rapid acting insulin is often used by the patients who underwent multiple injections each day and injected 15-20 minutes before eating.
2. Acting insulin was
An example is insulin zinc suspension or suspension of insulin isofan. Begin work within 1-3 hours, reaches a maximum peak within 60-10 hours and work for 18-26 hours. Insulin can be injected in the morning to meet the needs for a day and can be injected at night to meet the needs throughout the night.
3. Acting insulin long
An example is insulin zinc suspension has been developed. The effect emerging after six hours and work for 28-36 hours.
Insulin supplies stable at room temperature for months so that you can take them everywhere.
Selection of insulin to be used depends on:
- The desire to control diabetes sufferers
- The desire to monitor the patients blood sugar and adjust the dose
- Daily Activities patient
- The ability of patients to understand and study the disease
- Kedtabilan blood sugar levels throughout the day
Most are easy to use once-daily injections of insulin are working, but this provides control of blood sugar at a minimum.
Tighter control can be obtained by combining two types of insulin, which is fast acting insulin and the insulin is working. The second injection is given at the dinner table or when going to sleep tonight. The most stringent control is obtained by injecting rapid acting insulin and insulin is working in the morning and evening along with an additional fast acting insulin injections during the day.
Some adult patients require the same dose of insulin every day. Other patients need to adjust the dose of insulin depending on the food, sports and the pattern of blood sugar levels. Insulin needs vary with changes in diet and exercise.
Some sufferers experience for insulin resistance. Insulin is not entirely the same as the insulin produced by the body. Because the body can form antibodies to insulin replacement. These antibodies affect the activity of insulin, so patients with insulin resistance should increase the dose.
Injecting insulin can affect the skin and underlying tissues at the injection site. Sometimes the allergic reaction that causes pain and burning sensation, redness, itching and swelling around the injection site for several hours. Inject often cause damage to precipitate fat or fat.
These complications can be avoided by replacing the injection site and replace the type of insulin. On the use of synthetic human insulin resistance and allergies are rare.
Wednesday, July 21, 2010
Diabetes Treatment with Insulin
Initial therapy with insulin is given consideration in patients who are underweight (due to the drastic weight loss), patients with sick hearts, kidneys, and severe pain. Another indication of insulin:
- People with type 1 diabetes
- Diabetes Pregnancy
- Diabetes with ketoacidosis
- In the treatment of hyperglycemia nonketosis hyperosmolar syndrome
- Type 2 diabetes who can not handle blood sugar levels, such as surgery, trauma.
The types of insulin based on the peak effect and duration of works:
- Work quickly (insulin regular): peak 2-4 hours of work, long hours of work 5-8
- Work is (NPH): peak 4-12 hours of work, working long hours 8-24
- Working length (PZI): peak 6-20 hours of work, long hours of work 18-24
- Insulin combination: peak work 2-4 hours, 6-12 hours, and working long hours 8-24
In type 1 diabetes, the pancreas can not produce insulin, so insulin must be given a replacement. Giving insulin can only be done by injection. Insulin is destroyed in the stomach so it can not be taken orally. New forms of insulin (nasal spray) is under study. At this time, this new form of insulin that can not work properly because of different absorption rates cause problems in the determination of the dose. Insulin injected under the skin into the fat layer, usually in the arm, thigh, or abdominal wall. Used needles are very small so as not too painful.
- People with type 1 diabetes
- Diabetes Pregnancy
- Diabetes with ketoacidosis
- In the treatment of hyperglycemia nonketosis hyperosmolar syndrome
- Type 2 diabetes who can not handle blood sugar levels, such as surgery, trauma.
The types of insulin based on the peak effect and duration of works:
- Work quickly (insulin regular): peak 2-4 hours of work, long hours of work 5-8
- Work is (NPH): peak 4-12 hours of work, working long hours 8-24
- Working length (PZI): peak 6-20 hours of work, long hours of work 18-24
- Insulin combination: peak work 2-4 hours, 6-12 hours, and working long hours 8-24
In type 1 diabetes, the pancreas can not produce insulin, so insulin must be given a replacement. Giving insulin can only be done by injection. Insulin is destroyed in the stomach so it can not be taken orally. New forms of insulin (nasal spray) is under study. At this time, this new form of insulin that can not work properly because of different absorption rates cause problems in the determination of the dose. Insulin injected under the skin into the fat layer, usually in the arm, thigh, or abdominal wall. Used needles are very small so as not too painful.
Monday, July 19, 2010
Diabetes Treatment
The main goal of diabetes treatment is to maintain blood sugar levels under normal circumstances. Blood sugar levels normal is really difficult to maintain. But getting closer to normal, the possibility of temporary or long-term complications will decrease.
Treatment of diabetes include weight control, exercise and medication and diet. An obese type 2 diabetes do not need treatment if they lose weight and exercise regularly. However, most patients find it difficult to lose weight and exercise regularly. Because it was given insulin replacement therapy or the oral hypoglycemic drug.
Ordering diet is very important. Patients should not eat too many sweet foods and should eat a regular schedule. People with diabetes tend to have high cholesterol levels, because it is recommended to limit the amount of saturated fat in food. But the best way to lower cholesterol is to control blood sugar levels and body weight.
All patients should understand how diet and exercise to control the disease. Patients must understand how to avoid the occurrence of complications. Patients should also pay special attention to foot infections. It is important to examine the eye so that the bias is known that changes occur in blood vessels in the eye.
Treatment of diabetes include weight control, exercise and medication and diet. An obese type 2 diabetes do not need treatment if they lose weight and exercise regularly. However, most patients find it difficult to lose weight and exercise regularly. Because it was given insulin replacement therapy or the oral hypoglycemic drug.
Ordering diet is very important. Patients should not eat too many sweet foods and should eat a regular schedule. People with diabetes tend to have high cholesterol levels, because it is recommended to limit the amount of saturated fat in food. But the best way to lower cholesterol is to control blood sugar levels and body weight.
All patients should understand how diet and exercise to control the disease. Patients must understand how to avoid the occurrence of complications. Patients should also pay special attention to foot infections. It is important to examine the eye so that the bias is known that changes occur in blood vessels in the eye.
Saturday, July 17, 2010
Diabetes Diagnosis
Diabetes diagnosis based on symptoms such as polidipsi, polifagi, poliuri, and the results of blood tests that showed high blood sugar levels.
To measure blood sugar levels, blood samples are usually taken after the patients fasted for 8 hours or can also be taken after meals. At the age above 65 years old, is best done after fasting examination. Because after eating the increased blood sugar is higher.
Other blood tests can be done is a glucose tolerance test. This test is mainly performed in certain circumstances, such as in pregnant women. Patients fasted and blood samples taken to measure fasting blood sugar levels. Then the patient drinks a special solution containing glucose. 2-3 hours later another blood sample taken for examination. Examination to detect diabetes for normal adults glikosa done by checking blood levels during fasting. Especially for those who have a risk factor as above.
Criteria of diagnosis of diabetes according to American Diabetes Association is based on examination of plasma glucose levels in a state of fasting (without food for eight hours) and after oral glucose tolerance test.
Classification of diabetes on the examination of fasting blood sugar levels as follows:
- <110 mg / dL is normal
- 110-126 mg / dL is fasting hyperglycemia (impaired Fasting Glucose)
-> 126 mg / dL is diabetes
In glucose tolerance tests are checked after two hours were classified as follows:
- <140 mg / dL is normal glucose tolerance
- 140-200 mg / dL is disturbed glucose tolerance
-> 200 mg / dL is diabetes
Diagnosis of diabetes can also be based on if a person shows symptoms of diabetes with a fasting blood sugar levels without amounting to> 200 mg / dL. Examination of urine can also be used to detect diabetes, although less convincing. Hyperglycemia which occurs only after oral glucose tolerance test is a condition in a state between normal and diabetes.
Diagnosis of diabetes by ADA in 1998, are:
- There are symptoms of diabetes with blood glucose> 200 mg / dL
- Fasting blood glucose> 126 mg / dL and the glucose tolerance test after 2 hours of fasting is> 200 mg / dL.
To measure blood sugar levels, blood samples are usually taken after the patients fasted for 8 hours or can also be taken after meals. At the age above 65 years old, is best done after fasting examination. Because after eating the increased blood sugar is higher.
Other blood tests can be done is a glucose tolerance test. This test is mainly performed in certain circumstances, such as in pregnant women. Patients fasted and blood samples taken to measure fasting blood sugar levels. Then the patient drinks a special solution containing glucose. 2-3 hours later another blood sample taken for examination. Examination to detect diabetes for normal adults glikosa done by checking blood levels during fasting. Especially for those who have a risk factor as above.
Criteria of diagnosis of diabetes according to American Diabetes Association is based on examination of plasma glucose levels in a state of fasting (without food for eight hours) and after oral glucose tolerance test.
Classification of diabetes on the examination of fasting blood sugar levels as follows:
- <110 mg / dL is normal
- 110-126 mg / dL is fasting hyperglycemia (impaired Fasting Glucose)
-> 126 mg / dL is diabetes
In glucose tolerance tests are checked after two hours were classified as follows:
- <140 mg / dL is normal glucose tolerance
- 140-200 mg / dL is disturbed glucose tolerance
-> 200 mg / dL is diabetes
Diagnosis of diabetes can also be based on if a person shows symptoms of diabetes with a fasting blood sugar levels without amounting to> 200 mg / dL. Examination of urine can also be used to detect diabetes, although less convincing. Hyperglycemia which occurs only after oral glucose tolerance test is a condition in a state between normal and diabetes.
Diagnosis of diabetes by ADA in 1998, are:
- There are symptoms of diabetes with blood glucose> 200 mg / dL
- Fasting blood glucose> 126 mg / dL and the glucose tolerance test after 2 hours of fasting is> 200 mg / dL.
Thursday, July 15, 2010
Severe Diabetes Symptoms
Other symptoms are blurred vision, dizziness, nausea and decreased endurance during exercise, often feel tired, feel itchy and inflamed skin. Patients with poorly controlled diabetes are more susceptible to infection.
Severe diabetes symptoms:
- The occurrence of weight loss
- Occur itching or pain in your feet
- Occur at the foot of the difficult wounds healed
- Loss of consciousness or coma
Because of severe insulin deficiency, before treatment, patients with type 1 diabetes almost always lose weight. Most type 2 diabetics do not experience weight loss. In type 1 diabetes, symptoms occur suddenly and can quickly develop into a state of diabetic ketoacidosis. In blood sugar levels high, but since most cells can not use glucose without insulin, these cells take energy from other sources. Fat cells is broken down fields produce ketones, which is a toxic chemical that can cause blood to become acidic (ketoacidosis).
The early symptoms of diabetic ketoacidosis is thirst and excessive urination, nausea, vomiting, fatigue and abdominal pain. Breathing becomes faster because the body attempts to improve levels of blood acid. Patient breath smell like acetone.
Without treatment, diabetic ketoacidosis bias developed into a coma, sometimes within just a few hours. Even after starting insulin therapy, patients with type 1 diabetes may develop ketoacidosis if they do not to injections of insulin or experiencing stress from infections, accidents or serious ill.
Patients with type 2 diabetes may not show symptoms for several years. If the more severe insulin deficiency, frequent urination symptoms emerge and often thirsty. Ketoacidosis is rare. If blood sugar is very high (more than 1000 mg / dL), usually occur because of stress, infection or drugs, then the patient will experience severe dehydration, which can cause mental disorders, dizziness, seizures, and a condition called coma hiperglikemik -non-ketotik hiperosmolar.
Severe diabetes symptoms:
- The occurrence of weight loss
- Occur itching or pain in your feet
- Occur at the foot of the difficult wounds healed
- Loss of consciousness or coma
Because of severe insulin deficiency, before treatment, patients with type 1 diabetes almost always lose weight. Most type 2 diabetics do not experience weight loss. In type 1 diabetes, symptoms occur suddenly and can quickly develop into a state of diabetic ketoacidosis. In blood sugar levels high, but since most cells can not use glucose without insulin, these cells take energy from other sources. Fat cells is broken down fields produce ketones, which is a toxic chemical that can cause blood to become acidic (ketoacidosis).
The early symptoms of diabetic ketoacidosis is thirst and excessive urination, nausea, vomiting, fatigue and abdominal pain. Breathing becomes faster because the body attempts to improve levels of blood acid. Patient breath smell like acetone.
Without treatment, diabetic ketoacidosis bias developed into a coma, sometimes within just a few hours. Even after starting insulin therapy, patients with type 1 diabetes may develop ketoacidosis if they do not to injections of insulin or experiencing stress from infections, accidents or serious ill.
Patients with type 2 diabetes may not show symptoms for several years. If the more severe insulin deficiency, frequent urination symptoms emerge and often thirsty. Ketoacidosis is rare. If blood sugar is very high (more than 1000 mg / dL), usually occur because of stress, infection or drugs, then the patient will experience severe dehydration, which can cause mental disorders, dizziness, seizures, and a condition called coma hiperglikemik -non-ketotik hiperosmolar.
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