insulin
As is well known, successful and practical method for the treatment of insulin for most people with diabetes who need to use insulin, such as:
- Each with type I diabetes.
- And infected pregnant women with diabetes.
- And a good number of people with diabetes type II may be up to 30% - 40% of them.
They need to take insulin and insulin injections under the skin., But the question is what is the
most appropriate way to use insulin to these people .. Is treatment in the traditional manner or in a way that intensive treatment?
Note: Of course, the use of insulin pump (which is considered the most accurate method to use insulin) is not an option at this time in our region due to the lack of certain technical matters?!.
So what is meant by a traditional way and intensive treatment.?
The traditional way: use an injection of insulin once or twice a day.
Intensive method of treatment: Is the use of an injection of insulin three times a day or four times a day or use insulin pump.
In fact in both ways (with the exception of insulin pump therapy) there must be a basic insulin In case you need more than one injection Often we also need insulin meals in addition to the primary insulin.
So what is the basic insulin (Basal insulin)?
To answer this question we must understand what the pancreas, specifically beta cells in the natural person ..
The fact that insulin is not only important for the introduction of glucose (sugar) into the cells, such as muscle, but that insulin is also important for some other tasks such as the production of (Nitrous oxide) and Article (Endothelin) and control the growth of cells and control in the process of "programmed death cells "(Apoptosis) ... These tasks require the presence of insulin in the blood circulation throughout the twenty-four hours a day ..?! This is what is doing beta cells in the pancreas actually, they secrete insulin in circulation amount regularly throughout the twenty-four hours a day, regardless of eating a meal .. This means that insulin secreted has nothing to do with a meal .. It is shown in yellow actually below the line colored green (Such as rectangle) in the following manner ..
Another important question now is to assume that someone has no beta cells (insulin or need to) what are the specifications that require their presence in the insulin to be injected under the skin in order to carry out the same role of what he is doing basic insulin? The answer to this question is that you need to inject insulin under the skin and is characterized by
two main two capacities:
- Be absorbed under the skin slowly in order to continue the effect as long as possible and better if continued for a period of twenty-four hours to make it easier for us to give it once a day.
- To have effect after absorbed in a balanced way and better not be his top (ie, there is no him Influence peak).
Do we have insulin has these qualities? Yes .. They are:
- PHP insulin (NPH). Which is human insulin.
- Insulin Alclargen known Ballantos (Lantus) an insulin-like.
- Insulin Aldetimir known Ballivimir (Levemir) an insulin-like.
These three types are, however, a diabetes specialist for use Kansolan essential for people with diabetes. In fact insulin PHP (NPH). Not good Kansolan primarily because his top (may cause hypoglycemia and the person is asleep) and also its effect continues to 18 hours maximum.
As for meals insulin, the beta cells .. The reaction to the excess sugar in the blood after eating a meal, they secrete other quantitative (in addition to the amount of insulin Statute), and this amount starts effect after five to ten minutes and have the top (ie peak effect) and continue the effect of this insulin to a 2-6 hours and depending on the type and quantity of food, and this amount of insulin secreted in response to high blood sugar after meals is what is known as meals (Prandial insulin) is shown in yellow located above the Green Line (Kherm) in the following manner.
Suppose that someone has no beta cells (or need insulin) what are the specifications that require their presence in insulin, which will be injected under the skin in order to carry out the same role of what he is doing insulin meals?The answer to this question is that you need to insulin is injected under the skin and is characterized by three main characteristics:
- 1. Be absorbed under the skin quickly to begin effect rapidly to keep pace with the rise of blood sugar as a result of eating a meal. The greater the effect quickly the better for diabetic in terms of not wait to start eating after the injection.
- 2. To have effect after absorbed and have a top (any Influence peak) in order to keep up with the sudden increase of the high sugar in the blood as a result of eating a meal.
- 3. And also expires quickly (within two hours or four hours, this is good) so as not to cause hypoglycemia if eating with diabetes eat a few.
Do we have insulin has these qualities? Yes .. They are:
- Regular insulin, a human insulin.
- Insulin Aspart which is similar to insulin.
- Insulin Glulicine which is similar to insulin.
- Insulin Lispro which is similar to insulin.
These four types are, however, a diabetes specialist used Such as insulin and meals for people with diabetes.
So to go back now to talk about the traditional method and the method of intensive insulin therapy.
Suppose that there are Type I diabetic addresses in three meals a day, what is the best way that can simulate natural pancreas to cover its needs for insulin?
The answer is a single injection insulin fundamental and three insulin injections and meals .. Is not it?
So four injections per day are the best ways to treat Type I diabetes is what is known as intensive therapy.
Scientifically and found (in the study of the DCC T) to three injections per day .. One key insulin or two insulin and meals are also effective as intensive therapy, for the use of insulin. And good control of blood sugar.
In short intensive treatment is the most appropriate way to treat both:
- All people with type I diabetes.
- All pregnant women with diabetes.
The traditional treatment is .. either a single injection of insulin primary or two injections (one insulin essential and other insulin and meals) has Othbt effectiveness for people with diabetes type II and who need to use insulin. So as to control the good blood sugar.
The question now is whether there is evidence that this speech? Is there scientific evidence that intensive treatment using three or four daily injections of insulin for Type I diabetes is better than the traditional method,
using a syringe or two injections only?
Study the DCC T (DCCT) to answer this question clearly at the beginning of the nineties of the last century has been found that for diabetes complications in the group that was less intensive treatment (and enormous statistical ratios) of the conventional therapy group.Not only that .. Here are the researchers for this study and after thirty years .. was thirty years ... At the beginning of the study they analyzed data on people with diabetes for the study and researchers concluded that "his diabetes first type of effort using intensive treatment method will reap good fruits compensates tired"
In the medical journal (Archives of internal medicine) edition of July 27 2009, ie before about a few days published the results of data analysis with diabetes type I (involved in the study of the DCC T) and that after thirty years with the knowledge that The group was on conventional treatment advised to follow the intensive treatment after nine years of the beginning of the study (remember not to forget the increase phenomenon). But with this, the results (comparison between the conventional therapy group with intensive treatment group) were as follows:
- incidence of retinal disorders 50% to conventional therapy and 21% for the intensive treatment.!!.
- incidence of kidney disorder 25% to conventional therapy and 9% for the intensive treatment!!.
- incidence of disorder in blood circulation and heart 14% to conventional therapy and 9% for the intensive treatment.
Note that less than 1% were blindness or kidney failure or amputation of the Parties to the intensive therapy group for the duration of the study, a thirty years.
So while there are other effective ways to use insulin, Type I diabetes and pregnant women should use intensive therapy. And that good control of blood sugar and avoid complications.
As for people with diabetes type II Treatment traditional enough in most cases to get good values to control blood sugar.
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sugary culture