What insulin in a diabetic patient. Insulin in diabetes mellitus: when prescribed, dose calculation, how to inject? Why do patients refuse insulin therapy?

Type 2 diabetes occurs due to metabolic disorders. This situation is due to the failure of insulin to fulfill its functions, since cell resistance to it develops. It is commonly believed that type 1 diabetes is treated with insulin, but this is not the case. Type 2 diabetes can also become insulin dependent. When insulin is prescribed for type 2 diabetes, we will understand below.

Clinical picture

What doctors say about diabetes

Doctor of Medical Sciences, Professor Aronova S. M.

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Why inject a hormone with type 2 diabetes

The occurrence of diabetes mellitus due to improper interaction of insulin with tissues, when it is sufficient, is classified as the second type. Most often, this disease manifests itself in middle age, usually after 40 years. Initially, the patient gains or loses significant weight. During this period, the body begins to experience a lack of insulin, but all the signs of diabetes do not appear.

The examination reveals that the cells that produce insulin are present in large numbers, but they are gradually depleted. For proper treatment, it is necessary to administer insulin for diabetes, but first, the number of insulin injections and its volumes are calculated.

Insulin in type 2 diabetes is indicated for such conditions:

• uncorrectable glycemia while taking hypoglycemic drugs;
• development acute complications(ketoacidosis, precoma, coma);
• chronic complications (gangrene);
• extreme sugar levels in people with newly diagnosed diabetes;
• individual intolerance to drugs to reduce sugar;
• decompensation;
• diabetes in pregnant and lactating women;
• during surgical interventions.

Insulin in type 2 diabetes is used when patients are already becoming insulin dependent and their own hormone is not enough. You can follow a diet, play sports, but without injections, the sugar level will still be high. Complications may occur and any chronic disease may worsen. The calculation of the dose of insulin should be done by the endocrinologist.

But it is very important that the doctor teaches diabetics how to correctly calculate the dose and switch to insulin painlessly. To say which insulin is better, you can use the selection method. After all, only an extended version will be enough for someone, and for someone a combination of an extended and a short action.

There are the following criteria, the presence of which requires the transfer of a patient with type 2 diabetes to insulin:

be careful

According to the World Health Organization, 2 million people die every year from diabetes and its complications. In the absence of qualified body support, diabetes leads to various complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development cancerous tumors. In almost all cases, a diabetic either dies while struggling with a painful disease, or turns into a real invalid.

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• if diabetes is suspected, a person's glucose level is more than 15 mmol / l;
• glycated hemoglobin rises by more than 7%;
• the maximum dosage of drugs that reduce sugar is not able to maintain fasting glycemia below 8 mmol / l, and after meals below 10 mmol / l;
• Plasma C-peptide does not exceed 0.2 nmol/l after a test with glucagon.

At the same time, it is imperative to constantly and regularly monitor blood sugar levels and count carbohydrates in the diet.

Is it possible to switch back to pills

The reason for the development of type 2 diabetes is the poor sensitivity of body cells to insulin. In many people with this diagnosis, the hormone is produced in the body in large quantities. If it is found that sugar rises slightly after eating, you can try replacing insulin with tablets. For this, Metformin is suitable. This drug is able to restore the cells, and they will be able to perceive the insulin that the body produces.

Many patients resort to this method of treatment in order not to do daily insulin injections. But this transition is possible provided that a sufficient part of beta cells is preserved, which could adequately maintain glycemia against the background of hypoglycemic drugs, which happens with short-term administration of insulin in preparation for surgery, during pregnancy. In the event that when taking pills, the sugar level will still rise, then injections are indispensable.

Reception scheme

Our readers write

Topic: Defeated diabetes

From: Lyudmila S ( [email protected])

To: Administration my-diabet.ru

At 47, I was diagnosed with type 2 diabetes. In a few weeks I gained almost 15 kg. Constant fatigue, drowsiness, feeling of weakness, vision began to sit down. When I turned 66 years old, I was already steadily injecting myself with insulin, everything was very bad ...

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The disease continued to develop, periodic attacks began, the ambulance literally brought me back from the next world. I always thought that this time would be the last...

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When choosing insulin for diabetes, it is necessary to take into account the diet and physical activity that the patient experiences. If a low-carbohydrate diet and small loads are determined, you need to self-monitor your sugar levels during the week, which is best done with a glucometer and keep a diary at the same time. The best option is to switch to insulin therapy in a hospital.

The rules for administering insulin are shown below.

1. It is necessary to find out whether to give hormone injections at night, which can be understood by measuring the level of sugar and at night, for example, at 2-4 am. The amount of insulin taken can be adjusted during treatment.
2. Determine morning injections. In this case, you need to do injections on an empty stomach. Some patients are satisfied with the use of an extended drug, which is administered at the rate of 24-26 units / day once in the morning.
3. It is necessary to find out how to inject before meals. For this, a short-acting drug is used. Its amount is calculated based on the fact that 1 unit covers 8 g of carbohydrates, 57 g of protein also requires 1 unit of the hormone.
4. Doses of ultrashort insulin should be used as an emergency.
5. In obese patients, the level of the administered drug often needs to be increased compared to the average dosage in people with normal weight.
6. Insulin therapy can be combined with hypoglycemic drugs, which should only be determined by a doctor.
7. Measure blood sugar levels and use the selection method to find out how long before a meal you need to inject insulin.

Be sure the patient needs to learn that the intake of carbohydrates must be compensated by the introduction of insulin. If a person uses a combination of hypoglycemic tablets and insulin, then the hormone not only enters the body, but the tissues adequately absorb glucose.

Currently, insulins are distinguished by the time of their action. This refers to how long the drug can lower blood sugar levels. Before prescribing treatment, it is imperative to conduct an individual selection of the dosage of the drug.

Stories from our readers

Defeated diabetes at home. It's been a month since I forgot about sugar spikes and taking insulin. Oh, how I used to suffer, constant fainting, emergency calls ... How many times I went to endocrinologists, but they say only one thing - "Take insulin." And now the 5th week has gone, as the blood sugar level is normal, not a single injection of insulin, and all thanks to this article. Anyone with diabetes should read this!

1. Those who act very quickly are called ultrashort, which begin to perform their function in the first 15 minutes.
2. There is a definition of “short”, meaning that the impact is not so fast. Calculate them before eating. After 30 minutes, their action is manifested, the peak reaches within 1-3 hours, but after 5-8 hours their influence fades.
3. There is the concept of "average" - their impact is about 12 hours.
4. Long-acting insulins that are active during the day are administered 1 time. These insulins create a basal level of physiological secretion.

Currently, insulin is produced, which is developed on a genetically engineered basis. It does not cause allergies, which is very good for people prone to it. The calculation of the dose and the intervals between injections should be determined by a specialist. This can be done in an inpatient or outpatient setting, depending on the general condition patient's health.

At home, it is important to be able to control the amount of sugar in the blood. It is necessary to undergo adaptation to the treatment of type 2 diabetes only under the guidance of a doctor, and it is better to do this in a hospital setting. Gradually, the patient himself can calculate the dose and adjust it.

Insulin regimens

In order to carry out adequate treatment of type 2 diabetes mellitus and transfer it to insulin, the mode of administration and dosage of the drug should be chosen for the patient. There are 2 such modes.

Standard dose regimen

Under this form of treatment, it is understood that all dosages have already been calculated, the number of meals per day remains unchanged, even the menu and serving size are set by a nutritionist. This is a very strict schedule and is given to people who, for some reason, cannot control their blood sugar levels or calculate insulin dosage based on the amount of carbohydrates in food.

The disadvantage of this mode is that it does not take into account the individual characteristics of the patient's body, possible stress, dietary disturbance, increased physical activity. Most often it is prescribed to elderly patients. You can read more about it in this article.

Intensive insulin therapy

This mode is more physiological, takes into account the peculiarities of nutrition and the loads of each person, but it is very important that the patient sensibly and responsibly treats the calculation of dosages. His health and well-being will depend on this. Intensive insulin therapy can be studied in more detail at the link provided earlier.

Treatment without injections

Many diabetics do not resort to injections because they will not get rid of them later. But such treatment is not always effective and can cause serious complications. Injections allow you to reach normal levels of the hormone when the pills can no longer cope. In type 2 diabetes, there is the possibility that switching back to pills is entirely possible. This happens in cases where injections are prescribed for a short time, for example, in preparation for surgery, when carrying a child or lactation.

Hormone injections are able to remove the load from them and the cells have the opportunity to recover. At the same time, dieting and a healthy lifestyle will only contribute to this. The probability of such an option exists only in case of full compliance with the diet and recommendations of the doctor. Much will depend on the characteristics of the organism.

conclusions

Type 2 diabetes can be treated with diet or other medicines, but there are cases when you can not do without the use of insulin therapy.

Injections may be given:

• if applied maximum doses drugs do not bring the desired effect;
• during the operation;
• during the period of bearing a child, lactation;
• if there are complications.

Be sure to calculate the dose and the time between injections. For this, research is carried out during the week. Each patient is individually selected drug.

Drawing conclusions

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Type 1 diabetes is chronic illness, which requires permanent treatment and control over the health of the patient. It is equally important to adhere to the principles of proper nutrition and generally lead a healthy lifestyle. But it is insulin in type 1 diabetes that is the main medicine, without which it is almost impossible to help the patient.

general information

To date, the only way to treat type 1 diabetes and keep the patient in good condition is insulin injections. All over the world, scientists are constantly conducting research on alternative ways to help such patients. For example, doctors talk about the theoretical possibility of artificially synthesizing healthy pancreatic beta cells. Then they plan to transplant patients to get rid of diabetes. But so far this method has not passed clinical trials, and it is impossible to obtain such a treatment even as part of an experiment.

Trying to treat type 1 diabetes without insulin is pointless and very dangerous. Often such attempts lead to early disability or even death. A person may fall into a coma, have a stroke, and so on. All this can be avoided if the disease is diagnosed in time and treated.

Not all patients psychologically can accept the diagnosis immediately, some of them think that over time, sugar returns to normal without treatment. But, unfortunately, with insulin-requiring diabetes, this cannot happen on its own. Some people start only after the first hospitalization, when the disease has already played out in earnest. It is better not to bring to this, but to start as early as possible proper treatment and slightly adjust the usual way of life.

The discovery of insulin was a revolution in medicine, because previously diabetics lived very short lives, and their quality of life was much worse than that of healthy people. Modern drugs allow patients to lead a normal life and feel good. Young women with this diagnosis, thanks to treatment and diagnosis, in most cases can even become pregnant and give birth to children. Therefore, it is necessary to approach insulin therapy not from the point of view of some restrictions for life, but from the position real opportunity maintain health and well-being for many years.

If you follow the doctor's recommendations regarding insulin treatment, then the risk of side effects of the medication will be minimized. It is important, according to the instructions, to enter the doses prescribed by the doctor and monitor the expiration date. More information about side effect insulin and the rules that will help you avoid it, you can find out.

How to make injections?

From how correct the technique of administering insulin will be, its effectiveness, and hence the well-being of the patient, depends. An example algorithm for administering insulin looks like this:

1. The injection site must be treated with an antiseptic and dried well with gauze wipes so that the alcohol completely evaporates from the skin (with the introduction of some insulins, this step is optional, since they contain special preservative disinfectants).
2. With an insulin syringe, you need to dial the required amount of the hormone. You can initially draw a little more money, then to release air from the syringe to the exact mark.
3. Release the air, making sure that there are no large bubbles in the syringe.
4. With clean hands, you need to form a fold of skin and inject the medicine into it with a quick movement.
5. The needle must be removed, holding the injection site with cotton. It is not necessary to massage the injection site.

One of the main rules for administering insulin is to hit it exactly under the skin, and not into the muscle area. An intramuscular injection can lead to impaired absorption of insulin and to soreness, swelling in this area.

You should never mix different brands of insulin in the same syringe, because this can lead to unpredictable health consequences. It is impossible to predict the interaction of the components, which means that it is impossible to predict their effect on blood sugar levels and the general well-being of patients.

It is advisable to change the area of ​​​​insulin injection: for example, in the morning you can inject insulin into the stomach, at lunchtime - into the thigh, then into the forearm, etc. This must be done so that lipodystrophy does not occur, that is, thinning of the subcutaneous fatty tissue. With lipodystrophy, the mechanism of insulin absorption is disrupted, it may not enter the tissues as quickly as it should. This affects the effectiveness of the medicine and increases the risk of sudden spikes in blood sugar.

Injection therapy for type 2 diabetes

Insulin is rarely used in type 2 diabetes, as this disease is more associated with metabolic disorders at the cellular level than with insufficient insulin production. Normally, this hormone is produced by the beta cells of the pancreas. And, as a rule, in type 2 diabetes, they function relatively normally. The level of glucose in the blood rises due to insulin resistance, that is, a decrease in the sensitivity of tissues to insulin. As a result, sugar cannot enter the blood cells, instead it accumulates in the blood.

If most of the beta cells work normally, then one of the tasks of treating a non-insulin-dependent form of the disease is to keep them in the same active state.

In severe type 2 diabetes and frequent fluctuations in blood sugar levels, these cells can die or weaken their functional activity. In this case, to normalize the condition, the patient will have to either temporarily or permanently inject insulin.

Also, hormone injections may be needed to maintain the body during periods of infectious diseases, which are a real test for the immunity of a diabetic. The pancreas at this moment may produce an insufficient amount of insulin, since it also suffers due to intoxication of the body.

It is important to understand that in most cases, hormone injections for non-insulin-dependent diabetes are temporary. And if the doctor recommends this type of therapy, you should not try to replace it with something.

With mild type 2 diabetes, patients often manage even without hypoglycemic pills. They control the disease only with a special diet and lungs. physical activity, while not forgetting about regular check-ups with a doctor and measuring blood sugar. But during those periods when insulin is prescribed for temporary deterioration, it is better to adhere to the recommendations in order to maintain the ability to keep the disease under control in the future.

Types of insulin

According to the time of action, all insulins can be conditionally divided into the following groups:

• ultra-short action;
• short action;
• medium action;
• prolonged action.

Ultrashort insulin begins to act within 10-15 minutes after the injection. Its effect on the body lasts for 4-5 hours.

Short acting drugs begin to act on average half an hour after the injection. The duration of their influence is 5-6 hours. Ultrashort insulin can be administered both immediately before meals and immediately after it. Short insulin is recommended to be administered only before meals, as it does not begin to act so quickly.

Intermediate acting insulin when ingested, it begins to reduce sugar only after 2 hours, and the time of its total action is up to 16 hours.

Long-acting drugs (extended) begin to affect carbohydrate metabolism after 10–12 hours and are not excreted from the body for 24 hours or more.

All these drugs have different tasks. Some of them are administered immediately before meals to stop postprandial hyperglycemia (increased sugar after eating).

Intermediate and long-acting insulins are administered to maintain the target sugar level constantly throughout the day. Doses and mode of administration are selected individually for each diabetic, based on his age, weight, characteristics of the course of diabetes and the presence of concomitant diseases. There is a state program for the issuance of insulin to patients suffering from diabetes, which provides free provision of this medicine to all those in need.

The role of diet

With diabetes of any type, except for insulin therapy, it is important for the patient to follow a diet. Principles medical nutrition similar for patients with different forms of this disease, but there are still some differences. In patients with insulin-dependent diabetes, the diet may be more extensive, since they receive this hormone from the outside.

With optimally selected therapy and well-compensated diabetes, a person can eat almost everything. Of course, we are talking only about healthy and natural products, since semi-finished products and junk food are excluded for all patients. At the same time, it is important to correctly administer insulin for diabetics and be able to correctly calculate the amount necessary medication depending on the volume and composition of the food.

The basis of the diet of a patient diagnosed with a metabolic disorder should be:

• fresh vegetables and fruits with a low or medium glycemic index;
• low-fat dairy products;
• cereals with slow carbohydrates in the composition;
• dietary meat and fish.

Diabetics who are treated with insulin can sometimes afford bread and some natural sweets (if they do not have complications of the disease). Patients with type 2 diabetes should follow a more strict diet, because in their situation it is nutrition that is the basis of treatment.

Thanks to the correction of the diet, you can get rid of excess weight and reduce the load on all vital organs.

Meat and fish are also very important for a weakened patient's body, because they are a source of protein, which, in fact, is a building material for cells. Dishes from these products are best steamed, baked or boiled, stewed. It is necessary to give preference to low-fat varieties of meat and fish, do not add a lot of salt during the cooking process.

Fatty, fried and smoked foods are not recommended for patients with any type of diabetes, regardless of the type of treatment and the severity of the disease. This is due to the fact that such dishes overload the pancreas and increase the risk of diseases of the cardiovascular system.

A diabetic needs to be able to calculate the number of bread units in food and the right dose of insulin in order to maintain a target blood sugar level. All these subtleties and nuances, as a rule, are explained by the endocrinologist at the consultation. This is also taught in "diabetes schools", which often operate at specialized endocrinological centers and clinics.

What else is important to know about diabetes and insulin?

Probably, all patients who were once diagnosed with this disease are concerned about how long they live with diabetes and how the disease affects the quality of life. There is no single answer to this question, since everything depends on the severity of the disease and the person's attitude to his illness, as well as on the stage at which it was discovered. The sooner a patient with type 1 diabetes begins insulin therapy, the more chances they have to maintain a normal life for many years.

In order for diabetes to be well compensated, it is important to choose the right dose of insulin and not skip injections.

The choice of medicine should be handled by a doctor, any attempts at self-treatment can end in failure. Usually, at first, the patient is selected for extended insulin, which he will inject at night or in the morning (but sometimes it is recommended to inject it twice a day). Then they proceed to the calculation of the amount of short or ultra-short insulin.

It is advisable for the patient to buy a kitchen scale in order to know the exact weight, calorie content and chemical composition meals (the amount of proteins, fats and carbohydrates in it). To choose the right dose of short insulin, the patient needs to measure blood sugar for three days each time before meals, as well as 2.5 hours after it, and record these values ​​in an individual diary. It is important that in these days of selection of the dose of medication the energy value dishes that a person eats for breakfast, lunch and dinner were the same. It can be a variety of food, but it must contain the same amount of fat, protein and carbohydrates.

When choosing a medication, doctors usually recommend starting with lower doses of insulin and gradually increasing them as needed. The endocrinologist assesses the level of sugar rise during the day, before and after meals. Not all patients need to inject short insulin every time before meals - for some of them it is enough to do such injections once or several times a day. There is no standard scheme for administering the drug; it is always developed by the doctor individually for each patient, taking into account the characteristics of the course of the disease and laboratory data.

With diabetes, it is important for a patient to find a competent doctor who can help him choose the optimal treatment and tell him how to easily adapt to a new life. Insulin in type 1 diabetes is the only chance for patients to maintain good health for a long time. By following the recommendations of doctors and keeping sugar under control, a person can live a full life, which is not much different from the life of healthy people.

Last updated: October 7, 2019

Insulin for type 2 diabetes is an indispensable tool so that you can keep your blood glucose levels normal and protect against complications. It is possible to do without injections of a hormone that lowers sugar only in mild cases, but not with a disease of moderate or severe severity. Many diabetics play for time on pills and have high glucose levels. Inject insulin to keep the sugar normal, otherwise the complications of diabetes will develop. They can make you disabled or bring you to an early grave. If blood sugar levels are 8.0 mmol/L or higher, start treatment of type 2 diabetes with insulin immediately, as described below.

Understand that starting insulin treatment is not a tragedy or the end of the world. On the contrary, injections will prolong your life and improve its quality. They will protect against complications in the kidneys, legs and eyesight.

Where to begin?

In any case, practice. You will be amazed at how easy it is. With a syringe pen - the same thing, everything is easy and painless. The skill of injecting insulin will come in handy when you have a cold, food poisoning or other acute condition. During such periods, it may be necessary to temporarily inject insulin. Otherwise, the course of diabetes may worsen for the rest of your life.

Patients with type 2 diabetes who are treated with insulin have difficulties:

• provide themselves with high-quality imported drugs;
• correctly calculate dosages;
• measure sugar frequently, keep a diary daily;
• analyze the results of treatment.

But the pain from injections is not a serious problem, because it is practically non-existent. Later you will laugh at your former fears.

After some time, subcutaneous insulin administration in low doses can be added to these funds according to an individually selected scheme. Your insulin dosages will be 3-8 times lower than what doctors are used to. Accordingly, you do not have to suffer from the side effects of insulin therapy.

The goals and treatments for type 2 diabetes described on this site differ in almost every way from the standard recommendations. However, methods help, and standard therapy does not, as you have already seen. A realistic and achievable goal is to keep the blood sugar stable at 4.0-5.5 mmol/l, as in healthy people. This is guaranteed to protect against complications of diabetes on the kidneys, vision, legs and other body systems.

Why is insulin prescribed for type 2 diabetes?

At first glance, there is no need to inject insulin for type 2 diabetes at all. Because the level of this hormone in the blood of patients is usually normal, and even elevated. However, not all so simple. The fact is that in patients with type 2 diabetes, the immune system attacks the pancreatic beta cells that produce insulin. Unfortunately, such attacks happen not only in type 1 diabetes, but also in type 2 diabetes. Because of them, a significant part of the beta cells can die.

Type 2 diabetes is caused by obesity, unhealthy diets, and a sedentary lifestyle. Many people in middle and old age are very overweight. However, not all of them develop type 2 diabetes. What determines whether obesity turns into diabetes? From genetic predisposition to autoimmune attacks. Sometimes these attacks are so severe that only insulin injections can compensate for them.

At what sugar levels should I switch from tablets to insulin?

Glucose levels are also measured 2-3 hours after eating. It may be regularly elevated after breakfast, lunch or dinner. In this case, you need to inject fast (short or ultra-short) insulin before these meals. Or you can try giving extended insulin in the morning, in addition to the shot you take at night.

Do not agree to live with sugar 6.0-7.0 mmol / l, and even more so, higher! Because with such indicators, chronic complications of diabetes develop, albeit slowly. With the help of injections, bring your figures to 3.9-5.5 mmol / l.

In severe cases, it is impossible to do without the introduction of short insulin before meals, in addition to injections of long-term insulin at night and in the morning. If your glucose metabolism is severely impaired, use two types of insulin at the same time, do not be lazy. You can try jogging and strength training exercise. This makes it possible to significantly reduce insulin doses, and even cancel injections. Read more below.

How many times a day do you need to inject insulin?

The answer to this question is strictly individual for each patient. Many diabetics need to inject extended insulin at night to bring their blood sugar back to normal in the morning on an empty stomach. However, some do not need it. If you have severe diabetes, you may need to inject rapid insulin before every meal. In mild cases, the pancreas without injections does a good job of digesting food.

It is necessary to measure blood sugar with a glucometer at least 5 times a day for a week:

• in the morning on an empty stomach;
• 2 or 3 hours after breakfast, lunch and dinner;
• at night before bed.

You can also additionally measure immediately before meals.

By collecting this information, you will understand:

1. How many insulin shots do you need per day.
2. What should be the dosage.
3. What types of insulin do you need - extended, fast, or both at the same time.

Can a type 2 diabetic be treated with insulin and pills at the same time?

As a rule, this is how it should be done. Preparations containing increase the body's sensitivity to insulin, help reduce the dose and number of injections. Keep in mind that physical activity works several times better than metformin. And the main treatment for impaired glucose metabolism is a low-carbohydrate diet. Without it, insulin and pills do not work well.

What should be the diet after type 2 diabetes is treated with insulin?

After type 2 diabetes began to be treated with insulin, you must continue to comply. This is the only way to control the disease well. Diabetics who allow themselves to use are forced to inject huge doses of the hormone. This causes spikes in blood sugar and constantly feeling unwell. The higher the dosage, the greater the risk of hypoglycemia. Insulin also causes weight gain, vasospasm, fluid retention in the body. All this increases blood pressure.

Watch a video about how the proteins, fats, and carbohydrates you eat affect blood sugar.

Limit carbohydrates in your diet to reduce dosages and avoid the side effects listed above.

Read about products for diabetics:

What foods should I eat after I started injecting insulin for type 2 diabetes?

Learn and completely stop using them. Eat. They are not only healthy, but also tasty and satisfying. Try not to overeat. However, there is no need to limit the calorie content of the diet too much and experience a chronic feeling of hunger. Moreover, it is harmful.

Official medicine says that you can eat forbidden foods overloaded with carbohydrates, covering them with injections of high doses of insulin. This is bad advice and should not be followed. Because such nutrition leads to jumps in blood sugar, the development of acute and chronic complications of diabetes.

It is necessary to 100% abandon the use of prohibited foods, without making exceptions for holidays, weekends, business trips, and visits. For diabetic patients, cyclic low-carb diets are not suitable, in particular, the Dukan diet and Tim Ferris.

If you want, you can try intermittent fasting for 1-3 days or even longer. However, this is not required. It is possible to control type 2 diabetes, keep sugar stable in the norm without fasting. Before you fast, figure out how to adjust your insulin doses during your fast.

Many people with type 2 diabetes are interested in the LCHF ketogenic diet. Switching to this diet helps to reduce insulin doses, and even refuse daily injections. Watch a detailed video about ketogenic nutrition. Find out what its advantages and disadvantages are. In the video clip, Sergey Kushchenko explains how this diet differs from the low-carb diet according to the method of Dr. Bernstein. Find out how realistic it is to lose weight by changing your diet. Learn about using the keto diet to prevent and treat cancer.

Read also the article "". Learn in detail about Elena Malysheva's diet, vegetarianism, LCHF, ketogenic diet. Many diabetics fear that switching to a low-carbohydrate diet will make their gout worse. Read about it in the article, as well as about other possible side effects.

How long do type 2 diabetics live when they switch from pills to insulin?

It depends on the motivation of the diabetic. If a person really wants to live, then medicine is powerless :). Patients who correctly inject themselves with insulin live happily ever after. The injections protect them from complications in the kidneys, vision and legs, as well as from early heart attacks and strokes.

Switching to insulin is not a sign of the near end, but on the contrary, a chance to restore health, prolong life. Read also. It details how to determine life expectancy.

Which is less harmful: insulin injections or taking pills?

Both insulin and tablets, when used wisely, do not harm, but rather help diabetics. These therapeutic agents protect patients from the complications of impaired glucose metabolism and prolong life. Their usefulness has been proven by extensive scientific research as well as daily practice.

However, the use of insulin and tablets must be literate. Patients with diabetes who are motivated to live long need to carefully understand their treatment. In particular, study and stop taking them immediately. Switch from taking pills to insulin injections if you have an indication for this.

What happens if a diabetic who is on insulin takes a metformin pill?

This medicine, which increases insulin sensitivity, reduces the required dosages. The lower the required dosages of insulin, the more stable the injections are and the more likely you are to lose weight. Thus, taking metformin brings significant benefits.

For people with type 2 diabetes who are treated with insulin, it usually makes sense to take metformin in addition to injections. However, it is unlikely that you will notice any effect from one tablet you drink. Theoretically, just one metformin tablet taken can increase insulin sensitivity so much that it occurs. However, in practice this is very unlikely.

Is it possible to replace insulin with tablets Diabeton MV, Maninil or Amaryl?

Diabeton MV, Maninil and Amaryl, as well as their numerous analogues, are harmful pills. They temporarily lower blood sugar. However, unlike insulin shots, they do not prolong the life of type 2 diabetics, but rather shorten it.

Patients who want to live long should stay away from these drugs. Getting your type 2 diabetic enemies to take bad pills and eat a balanced, low-calorie diet is top notch. Articles from medical journals can help with this.

What to do if neither pills nor insulin help?

Pills stop helping when the pancreas is completely depleted in a type 2 diabetic. In such cases, the disease actually progresses to type 1 diabetes. It is urgent to start injecting insulin, until disturbances of consciousness develop.

Insulin always lowers blood sugar, except when it's tainted. Unfortunately, this is a very fragile drug. It collapses at the slightest outflow of the storage temperature beyond the permissible limits, both up and down. Also, direct sunlight is harmful for insulin in syringe pens or cartridges.

In the CIS countries, the deterioration of insulin has become catastrophic. It occurs not only in pharmacies, but also in wholesale warehouses, as well as during transportation and customs clearance. Patients have a very high chance of buying or getting tainted insulin that doesn't work for free. Study the article "" and do what it says.

Why does blood sugar rise even after switching from pills to insulin?

Probably the diabetic continues to use. Or the doses of insulin he receives are insufficient. Keep in mind that obese people with type 2 diabetes are less sensitive to insulin. They require relatively high doses of this hormone to get any real benefit from the shots.

What happens if you stop injecting insulin?

Due to the lack of insulin in severe cases, the glucose level can reach 14-30 mmol / l. These diabetics require urgent medical care and often die. The loss of consciousness caused by high blood sugar in type 2 diabetics is called hyperglycemic coma. It is deadly. Often occurs in older people who are negligent in controlling their disease.

For most readers of this page, hyperglycemic coma is not a real threat. Their problem may be chronic complications of diabetes. Keep in mind that they develop at any blood glucose level above 6.0 mmol/L. This corresponds to a glycated hemoglobin level of 5.8-6.0%. Of course, the higher the sugar, the faster complications develop. But even with indicators of 6.0-7.0, negative processes are already underway.

They often lead to death due to early heart attack or stroke. These causes of death are usually not associated with diabetes, so as not to worsen the official statistics. But in fact they are connected. In some diabetics, the cardiovascular system is so resilient that an early heart attack or stroke does not occur. Such patients have enough time to get acquainted with complications in the kidneys, legs and vision.

Do not believe doctors who say that blood sugar 6.0-8.0 is safe. Yes, healthy people have such glucose levels after eating. But they last no longer than 15-20 minutes, not several hours in a row.

Can a type 2 diabetic switch to insulin temporarily?

Patients with type 2 diabetes should start injecting insulin if compliance and medication do not help enough. Target blood sugar - 3.9-5.5 mmol / l stable 24 hours a day. It is necessary to start injections of insulin with low doses, gradually increasing them until the glucose level is kept within the specified limits.

A significant increase in physical activity can help stop insulin shots. Jogging helps a lot in achieving this goal, as well as strength training in the gym or at home. Ask what is chi-running. Unfortunately, not all diabetics are helped by exercise to jump off insulin. It depends on the severity of your glucose metabolism disorders.

Can I switch back from insulin to pills? How to do it?

Try physical activity to increase your body's sensitivity to insulin. If you succeed, then your own hormone, which the pancreas produces, will be enough to keep the sugar stable in the norm. Under the norm, we mean indicators of 3.9-5.5 mmol / l 24 hours a day.

Glucose level should be normal:

• in the morning on an empty stomach;
• at night before going to bed;
• before eating;
• 2-3 hours after each meal.

It is recommended to combine cardio training with strength exercises. Jogging is the best way to strengthen the cardiovascular system. It is more accessible than swimming, biking and cross-country skiing. You can effectively engage in strength exercises at home and on outdoor areas, without the need to go to the gym. If you enjoy lifting iron at the gym, this will work too.

Regular physical activity not only increases the body's sensitivity to insulin, but also brings many other benefits. In particular, it protects against joint problems and other typical age-related diseases.

Let's say you managed to increase the body's sensitivity to insulin. It became possible to do without injections on ordinary days. However, you should not throw away the insulin pen, put it in the far corner. Because it may be necessary to temporarily resume injections during a cold or other infectious diseases.

Infections increase a diabetic's need for insulin by 30-80%. Because the body's inflammatory response reduces sensitivity to this hormone. Until a patient with type 2 diabetes has recovered and the inflammation has not gone away, you need to especially take care of the pancreas. If necessary, support it with the introduction of insulin. Focus on your blood sugar levels. Determine from them whether it is necessary to temporarily resume injections. If you ignore this advice, after a short cold, the course of diabetes can worsen for the rest of your life.

Will therapeutic fasting help jump off insulin shots?

Type 2 diabetes is caused by your body's intolerance to dietary carbohydrates, especially refined carbohydrates. To bring the disease under control, you need to establish a system of complete abstinence from use. After you do this, there will be no need to starve. - healthy, yet satisfying and tasty. The site emphasizes all the time that people with type 2 diabetes can maintain stable normal blood sugar without resorting to fasting.

Some patients are too lazy to think and build a system, but want to achieve instant results through fasting. Once out of fasting, they reappear uncontrollable cravings for harmful carbohydrates. Alternating periods of starvation and gluttony of carbohydrates is a guaranteed way for diabetics to quickly bring themselves to the grave. In severe cases, psychotherapy may be needed to break the cycle.

Learn and do what it says. Switch to a low-carb diet. Add to it metformin, insulin and physical activity. After your new regimen has stabilized, you can try another fast. Although this is not really necessary. The benefits of fasting are questionable. You will spend a lot of effort to develop a habit of it. It is better to form a habit of regular exercise instead.

If you think about it, at first it’s not clear why diabetics should inject hormonal injections. The amount of such a hormone in the body of a sick person basically corresponds to the norm, and often it is significantly exceeded.

But the matter is more complicated - when a person has a “sweet” disease, then the immune system affects the beta cells of the human body, the pancreas, which is responsible for insulin production, suffers. Such complications occur not only in type 2 diabetics, but also in type 1.

As a result, a large number of beta cells die, which significantly weakens the human body.

If we talk about the causes of pathology, obesity is often to blame, when a person does not eat well, does not move much and his lifestyle can hardly be called healthy. It is known that a large number of elderly and middle-aged people suffer from excess weight, but the "sweet" disease does not affect everyone.

So why is it that sometimes a person is affected by pathology, and sometimes not? It is largely a matter of genetic predisposition, autoimmune attacks can be so severe that only insulin injections can help.

Types of insulin by time of action

The vast majority of insulin in the world is produced at pharmaceutical plants using genetic engineering technologies. Compared to obsolete animal products, modern facilities are characterized by high purification, minimum side effects, stable, well predictable action. Now, 2 types of the hormone are used to treat diabetes: human and insulin analogues.

The human insulin molecule completely repeats the hormone molecule produced in the body. These are short-acting products, the duration of their work does not exceed 6 hours. This group also includes NPH-insulins of medium duration. They have a longer action time, about 12 hours, due to the addition of protamine protein to the preparation.

Insulin analogs are structurally different from human insulin. Due to the peculiarities of the molecule, these drugs can more effectively compensate for diabetes mellitus. These include ultra-short-acting agents that begin to reduce sugar 10 minutes after injection, long-term and extra-long-acting agents that work from a day to 42 hours.

Insulin therapy in diabetes mellitus, pregnancy and children: complications, indications, regimens

• Indications for the use of insulin
• How to design an insulin therapy regimen for type 1 and type 2 diabetes?
• Injection rules
• Traditional and basal-bolus insulin therapy
• Pump therapy
• Insulin therapy in children
• Insulin treatment during pregnancy
• Possible Complications and their prevention

One of the leading treatments for diabetes is insulin therapy. It can significantly improve the health of a diabetic (including a child), and eliminate the development of complications. In order for such treatment to be correct, you need to learn everything about the indications for use, the nuances of drawing up a treatment regimen, the rules for injecting, and much more.

Indications for the use of insulin

• pregnancy and future childbirth, accompanied by diabetes;
• significant decompensation of type 2 diabetes mellitus;
• the minimum degree of effectiveness in the treatment of the disease by other means;
• a significant decrease in body weight.

How to design an insulin therapy regimen for type 1 and type 2 diabetes?

Drawing up an insulin therapy regimen should take into account many nuances.

It is necessary to skillfully combine insulin therapy regimens, it is important to correctly calculate the dose, based on the age of the diabetic, the absence or presence of complications, the "stage" of the disease.

If we talk about a step-by-step procedure, then it should look like this: it is necessary to determine whether injections of prolonged insulin at night are required, if they are necessary, it makes sense to calculate the initial amount, which will subsequently be adjusted.

In order for insulin therapy in type 2 diabetes to be effective, it is necessary to adjust the dosage of prolonged insulin over the next week until the optimal ratio is reached.

Further, after consulting with an endocrinologist, it is important to determine the need for the use of a hormonal component before eating sessions and the exact dosage. Insulin therapy for type 1 diabetes also includes:

• calculation of the initial amount of short or ultra-short insulin before eating and subsequent adjustment of the ratio;
• experimental determination of how many minutes before eating food, the introduction of a hormonal component will be required;
• correct calculation of short or ultra-short insulin in cases where it is important to normalize elevated blood sugar over a long period of time.

Injection rules

The specific rules for introducing a hormonal component depend on whether a pump is used or, for example, the procedure is carried out manually. The principles of insulin therapy are extremely simple: a predetermined amount of the component is administered at a fixed time of day.

If this is not insulin pump therapy, then we are talking about the fact that the hormone is injected under the skin into fatty tissue. Otherwise medicine will not have the desired effect.

The introduction can be carried out in the shoulder region or in the peritoneum, the upper front of the thigh or the outer crease of the buttocks.

The injection area is changed daily, otherwise numerous consequences can be observed: a change in the quality of hormone absorption, changes in blood sugar levels. In addition, the rules exclude injections into modified areas, for example, with scars, scars, hematomas.

For direct administration of the drug, a conventional syringe or syringe pen is used. The rules of insulin therapy are as follows:

1. the injection site is treated with two swabs soaked in alcohol. One of them treats a larger surface, the second provides disinfection of the injection area;
2. it is necessary to wait about 30 seconds until the alcohol evaporates;
3. with one hand, a subcutaneous fat fold is formed, with the other hand, a needle is inserted into the base of the fold at an angle of 45 degrees;
4. without releasing the folds, you will need to press the piston all the way and introduce the hormonal component. Only after that, the syringe is pulled out and the skin fold is released.

For type 2 and type 1 diabetics, mixing or diluting different types of insulin can be vital. In this case, for a 10-fold dilution, one part of the drug and nine parts of the “solvent” must be used. For dilution by 20 times, one part of the hormone and 19 parts of the "solvent" are used.

Insulin can be diluted with either saline or distilled water. The use of other fluids is strongly discouraged. It is permissible to dilute the presented liquids directly in the syringe or in a separate vessel before administration.

Traditional and basal-bolus insulin therapy

Traditional and basal-bolus therapy with a hormonal component is envisaged. In the first case, we are talking about the fact that long-acting insulin is administered twice a day (in the morning and at night), and the short-acting component is either before breakfast and dinner, or before the main meals.

However, the dosage of the latter should be fixed, that is, the diabetic cannot change the ratio of insulin and the amount of XE on his own. The advantage of this technique is that there is no need to determine glycemia before eating.

Indications for insulin therapy for type 2 diabetes

Each endocrinologist, from the moment of diagnosis of type 2 diabetes, should inform his patients that insulin therapy is one of the highly effective methods of treatment today. Moreover, in some cases, insulin therapy may be the only possible, adequate method for achieving normoglycemia, that is, compensating for the disease.

The main role in deciding on the appointment of insulin therapy should be played by information about the reserve capacity of the beta-cells of the gland. Gradually, as type 2 diabetes mellitus progresses, depletion of beta cells develops, requiring an immediate transition to hormonal therapy. Often, insulin therapy alone can achieve and maintain required level glycemia.

In addition, insulin therapy in type 2 diabetes may be required temporarily in some pathological and physiological conditions. The following are situations where insulin therapy for type 2 diabetes is required.

1. Pregnancy;
2. Acute macrovascular complications such as myocardial infarction and stroke;
3. A clear lack of insulin, manifested as progressive weight loss with normal appetite, the development of ketoacidosis;
4. Surgical interventions;
5. Various infectious diseases and, first of all, purulent-septic nature;
6. Unsatisfactory performance of various diagnostic research methods, for example:

• fixation of a low level of C-peptide and / or insulin in the blood on an empty stomach.
• repeatedly determined fasting hyperglycemia in cases where the patient takes oral hypoglycemic drugs, observes the regime of physical activity and diet.
• glycosylated hemoglobin more than 9.0%.

Items 1, 2, 4 and 5 require a temporary switch to insulin. After stabilization of the condition or delivery, insulin can be canceled.

In the case of glycosylated hemoglobin, its control should be repeated after 6 months. If during this period of time its level decreases by more than 1.5%, you can return the patient to taking hypoglycemic tablets and refuse insulin.

If there is no noticeable decrease in the indicator, insulin therapy will have to be continued.

Therapy strategy for the progression of type 2 diabetes With the natural development of type 2 diabetes mellitus (DM), progressive insufficiency of pancreatic beta cells develops, so insulin remains the only treatment that can control blood glucose in this situation.

About 30-40% of patients with type 2 diabetes need long-term insulin therapy for constant glycemic control, but it is often not prescribed due to certain concerns of both patients and doctors.

Early insulin administration, when indicated, is very important in reducing the incidence of microvascular complications of diabetes, including retinopathy, neuropathy, and nephropathy. Neuropathy is the main cause of non-traumatic amputations in adult patients, retinopathy is the leading cause of blindness, nephropathy is the main factor leading to terminal kidney failure.

The UK Diabetes Prospective Study (UKPDS) and the Kumamoto study showed a positive effect of insulin therapy in reducing microvascular complications, as well as a clear trend towards improved prognosis in terms of macrovascular complications.

The DECODE study evaluated the relationship between overall mortality and glycemia, especially postprandial. The Control of Diabetes and its Complications Study (DCCT) in type 1 diabetes defined stringent standards for glycemic control.

The American Association of Clinical Endocrinology (AACE) and the American College of Endocrinology (ACE) set HbA1c targets of 6.5% or less, and fasting glucose targets of 5.5 and 7.8 mmol/L for postprandial glycemia (via 2 hours after eating).

Quite often, these goals are difficult to achieve with oral monotherapy, so insulin therapy becomes necessary. Consider prescribing insulin as initial therapy for all patients with type 2 diabetes.

It is well known that glucose toxicity can be a factor in the difficulty of achieving adequate glycemic control. Insulin therapy almost always controls glucose toxicity.

As soon as the toxic effect of glucose levels out, the patient can either continue motor therapy with insulin, or switch to combination therapy with insulin in combination with oral antidiabetic drugs, or to oral monotherapy.

Failure to strictly control diabetes mellitus leads to an increased risk of complications in the future, in addition, there are suggestions and evidence that timely and early control ensures the effectiveness of therapy in the future in terms of achieving better control.

There are two modes of insulin therapy: traditional and intensive. The first involves constant doses of insulin calculated by the doctor. The second includes 1-2 injections of a pre-selected amount of a long hormone and several of a short one, which is calculated each time before meals. The choice of regimen depends on the severity of the disease and the patient's readiness for self control blood sugar.

Traditional mode

The calculated daily dose of the hormone is divided into 2 parts: morning (2/3 of the total) and evening (1/3). Short insulin is 30-40%. You can use ready-made mixtures in which short and basal insulin are related as 30:70.

The advantages of the traditional regimen are the absence of the need to use daily dose calculation algorithms, rare glucose measurements, once every 1-2 days. It can be used for patients who are unable or unwilling to constantly control their sugar.

The main drawback of the traditional regimen is that the volume and time of insulin intake in injections absolutely does not correspond to the synthesis of insulin in a healthy person. If the natural hormone is secreted for the intake of sugar, then everything happens the other way around: in order to achieve normal glycemia, you have to adjust your diet to the amount of insulin injected.

As a result, patients are faced with a rigid diet, each deviation from which can result in hypoglycemic or hyperglycemic coma.

Intensive mode

Intensive insulin therapy is generally recognized worldwide as the most advanced mode of insulin administration. It is also called basal bolus, as it is able to imitate both constant, basal, secretion of the hormone, and bolus insulin, released in response to an increase in blood glucose.

The undoubted advantage of this regime is the absence of a diet. If a patient with diabetes has mastered the principles of correct dosage calculation and correction of glycemia, he can eat like any healthy person.

In this case, there is no specific daily dose of insulin, it changes daily depending on the diet, level of physical activity or exacerbation of concomitant diseases. Upper border there is no amount of insulin, the main criterion for the correct use of the drug is glycemia numbers.

Patients with diabetes mellitus using an intensive regimen should use the glucometer many times a day (about 7) and, based on the measurement data, change the subsequent dose of insulin.

Numerous studies have shown that normoglycemia in diabetes mellitus can only be achieved with intensive use of insulin. In patients, glycated hemoglobin decreases (7% versus 9% on the traditional regimen), the likelihood of retinopathy and neuropathy decreases by 60%, and nephropathy and heart problems are approximately 40% less common.

Is it permissible to replace pills with injections

There are several options for insulin injections, each of which has a number of nuances.

Table number 1. Types of means for insulin injections

Before answering this question, you need to know which pills are not suitable for diabetics and which carry an immediate danger. If they are dangerous, then they cannot be taken and the sugar level is not taken into account.

It is necessary to use injections, if everything is done correctly, then a person’s life can be significantly extended. When consuming harmful pills, a person's condition worsens, although the glucose level decreases for a short time.

Some patients first go on a rigid diet, with a low carbohydrate intake. And many consume the drug metamorphine.

With hormonal injections, it happens that the sugar level sometimes exceeds the permissible value, although the person does not violate a strict diet and does not violate the doses of insulin administered. This means that it is difficult for the pancreas to cope with such heavy load, then you need to carefully increase insulin doses so that diabetic complications do not develop.

Such negative indicators of sugar content are often observed in the morning, on an empty stomach. To normalize the condition, you need to have dinner early, no later than 19.

00, and before going to bed, inject a small amount of the substance. After each meal, after a couple of hours, it is necessary to change the glucose level.

If at this time it is slightly elevated, then this is not critical. Ultrashort injections between meals will help.

Once again, it should be said about the order - first of all, a sick person sits on a strict diet with a low amount of carbohydrates, then moderate consumption of metamorphine begins. If sugar indicators go up, you should not hesitate, but use hormonal injections.

If a person has started injections, the diet should also be strictly observed, and special attention should be paid to the glucose level, it should be the same as in healthy people.

Insulin under the influence of gastrointestinal juice in the body is destroyed, hydrochloric acid and digestive enzymes are to blame. Despite the high level of development of modern pharmacology, there are no pills that have the most positive effect today. And even active scientific research in this area by pharmaceutical companies is not conducted.

The pharmaceutical market offers the use of an inhalation type aerosol, but its consumption is associated with certain difficulties - the dosage is difficult to calculate, so its use is not recommended.

If a diabetic consumes a large amount of carbohydrates, then he needs a large amount of insulin, which also entails danger, so once again it must be said about the obligatory observance of a low-carbohydrate diet.

Insulin therapy is one of the most advanced treatments for type 1 diabetes. It combines measures aimed at compensating for carbohydrate metabolism disorders in diabetes with the introduction of insulin preparations.

Insulin therapy for diabetes mellitus and some mental illness shows excellent clinical results.

let's define where the technique is applied

1. Treatment of patients with a diagnosis of insulin-dependent diabetes.
2. Interim measures in the treatment of type 2 diabetes. It is usually prescribed when the patient is to undergo a surgical operation as a result of the development of SARS and other diseases.
3. Treatment of patients with type 2 diabetes if hypoglycemic drugs are not effective.
4. Diabetic ketoacidosis (a complication of diabetes mellitus) is common in diabetics.
5. Treatment of schizophrenia.

In addition, first aid may be required for diabetic coma.

Schemes for insulin therapy can be studied in the book "Virtuoso Insulin Therapy" by Jorge Canales. The publication has absorbed all the data on the disease known today, the principles of diagnosis and a lot of other useful information.

Types of insulin therapy

If the patient does not have problems with being overweight and does not experience excessive emotional overload, insulin is prescribed ½ - 1 unit 1 time per day in terms of 1 kg of body weight. At the same time, intensive insulin therapy acts as an imitator of the natural secretion of the hormone.

The rules for insulin therapy require the fulfillment of these conditions:

• the drug in the patient's body should be supplied in an amount that will be sufficient for the utilization of glucose;
• externally administered insulins should become a complete imitation of basal secretion, that is, that produced by the pancreas (including the highest point of release after a meal).

The requirements listed above explain the regimens of insulin therapy, in which the daily dosage of the drug is divided into prolonged or short-acting insulins.

Long insulins are most often administered in the mornings and evenings and absolutely imitate the physiological product of the functioning of the pancreas.

Taking short insulins is advisable after eating a meal rich in carbohydrates. The dosage of this type of insulin is determined on an individual basis and is determined by the number of XE (bread units) at a given meal.

Traditional insulin therapy

The combined method of insulin therapy involves the combination of all insulins in one injection and is called traditional insulin therapy. The main advantage of this method is to reduce the number of injections to a minimum (1-3 per day).

The disadvantage of traditional insulin therapy is the lack of the possibility of absolute imitation of the natural activity of the pancreas. This flaw does not allow to fully compensate for the carbohydrate metabolism of a patient with type 1 diabetes, insulin therapy does not help in this case.

The combined scheme of insulin therapy in this case looks something like this: the patient receives 1-2 injections per day, at the same time he is given insulin preparations (this includes both short and prolonged insulins).

Intermediate-acting insulins account for about 2/3 of the total volume of drugs, short-acting insulins account for 1/3.

It is also necessary to say about the insulin pump. An insulin pump is a type of electronic device that provides round-the-clock, subcutaneous insulin delivery in mini-doses with an ultra-short or short duration of action.

This technique is called insulin pump therapy. works in different modes of drug administration.

Insulin regimens:

1. Continuous delivery of pancreatic hormone in microdoses that mimics the physiological rate.
2. Bolus rate - the patient himself can program the dosage and frequency of insulin administration.

When the first regimen is used, background insulin secretion is simulated, which makes it possible, in principle, to replace the use of prolonged preparations. The use of the second mode is advisable immediately before a meal or at those moments when the glycemic index rises.

When you turn on the bolus mode of administration, insulin pump therapy provides the ability to change insulins different kind actions.

Important! With a combination of these modes, the most approximate imitation of the physiological secretion of insulin by a healthy pancreas is achieved. The catheter should be changed at least once every 3 days.

Application of insulin therapy methods in type 1 diabetes

The treatment regimen for patients with type 1 diabetes involves the introduction of a basal preparation 1-2 times a day, and immediately before meals - a bolus. In type 1 diabetes, insulin therapy should completely replace the physiological production of a hormone that is produced by the pancreas of a healthy person.

The combination of both regimens is called "basic bolus therapy", or regime with multiple injections. One of the types of this therapy is intensive insulin therapy.

The scheme and dosage, taking into account the individual characteristics of the body and complications, the patient should choose his attending physician. Basal preparation usually takes 30-50% of the total daily dose. The calculation of the required bolus amount of insulin is more individual.

Insulin treatment for type 2 diabetes

Treatment of type 2 diabetics requires a specific scheme. The essence of this therapy is that the patient begins to gradually add small doses of basal insulin to sugar-lowering drugs.

When first exposed to a basal preparation that is presented as a peak-free, long-acting insulin analog (eg, insulin glargine), patients should stop at 10 IU per day. Preferably, injections are given at the same time of day.

If diabetes mellitus continues to progress and the combination of sugar-reducing drugs (tablet form) with injections of basal insulin does not lead to the desired results, in this case the doctor decides to completely transfer the patient to the injection regimen.

At the same time, the use of all kinds of means is encouraged. traditional medicine, but any of them must be approved by the attending physician.

Children are a special group of patients, so treatment with insulin in case of childhood diabetes always requires individual approach. Most often, for the treatment of babies, schemes of 2-3 times the introduction of insulin are used. To reduce the number of injections for young patients, a combination of drugs with short and medium exposure times is practiced.

It is very important to achieve the most simple scheme, which will achieve good compensation. The number of insulin injections does not affect the improvement in blood sugar levels. Children over 12 years of age are prescribed intensive insulin therapy.

The sensitivity of children to insulin is higher than in adult patients, so the dose adjustment of the drug should be done in stages. The range of changes in the dosage of the hormone must be laid in 1-2 units at a time. The maximum allowable one-time limit is 4 units.

Note! It will take several days to understand and feel the results of the change. But doctors categorically do not recommend simultaneously changing the morning and evening dose of the drug.

Insulin treatment during pregnancy

Treatment of diabetes during pregnancy is aimed at maintaining the concentration of sugar in the blood, which should be:

• In the morning on an empty stomach - 3.3-5.6 mmol / l.
• After eating - 5.6-7.2 mmol / l.

Determination of blood sugar for 1-2 months allows you to evaluate the effectiveness of the treatment. The metabolism in the body of a pregnant woman is extremely shaky. This fact requires frequent correction of the regimen (scheme) of insulin therapy.

Pregnant women with type 1 diabetes are prescribed insulin therapy according to the following scheme: in order to prevent morning and postprandial hyperglycemia, the patient needs at least 2 injections per day.

Short or medium insulins are administered before the first breakfast and before the last meal. Combined doses may also be used. total daily dose it is necessary to distribute correctly: 2/3 of the total volume is intended for the morning, and 1/3 part before dinner.

To prevent nocturnal and dawn hyperglycemia, the dose "before dinner" is changed to an injection made just before bedtime.

Insulin in the treatment of mental disorders

Most often, insulin in psychiatry is used to treat schizophrenics. In the morning on an empty stomach, the patient is given the first injection. The initial dose is 4 units. Every day it is increased from 4 to 8 units. This scheme has a feature: on weekends (Saturday, Sunday) injections are not made.

At the first stage, therapy is based on keeping the patient in a state of hypoglycemia for about 3 hours. To normalize the level of glucose, the patient is given sweet warm tea, which contains at least 150 grams of sugar. In addition, the patient is offered a carbohydrate-rich breakfast. The level of glucose in the blood gradually returns to normal and the patient returns to normal.

At the second stage of treatment, the dose of the administered drug increases, which is associated with an increase in the degree of the patient's unconsciousness. Gradually, the stupor develops into a stupor (oppressed consciousness). Elimination of hypoglycemia begins approximately 20 minutes after the onset of sopor development.

The patient is brought back to normal with a dropper. He is injected intravenously with 20 ml of a 40% glucose solution. When the patient regains consciousness, he is given sugar syrup (150-200 grams of product per glass of warm water), sweet tea and a hearty breakfast.

The third stage of treatment is to continue the daily increase in the dose of insulin, which leads to the development of a condition bordering on stupor and coma. This condition cannot last more than 30 minutes, after which an attack of hypoglycemia should be stopped. The derivation scheme is similar to the previous one, that is, the one used in the second stage.

The course of this therapy covers 20-30 sessions, in which a sopor-coma state is achieved. After the required number of such critical conditions is reached, the daily dose of the hormone begins to be gradually reduced, until it is completely canceled.

How is insulin treatment done?

Insulin treatment is carried out according to the following plan:

1. Before making a subcutaneous injection, the injection site is slightly kneaded.
2. Eating after the injection should not move more than half an hour.
3. The maximum dose of administration cannot exceed 30 IU.

In each individual case, the exact regimen of insulin therapy should be made by a doctor. Recently, insulin syringe pens have been used for therapy, you can use the usual insulin syringes with a very thin needle.

The use of syringe pens is more rational for several reasons:

• Thanks to a special needle, the pain from the injection is minimized.
• The convenience of the device allows you to inject anywhere and at any time.
• Some pens are equipped with vials of insulin, which provides for the possibility of combining drugs and the use of different schemes.

The components of the insulin regimen for type 1 and type 2 diabetes are as follows:

1. Before breakfast, the patient should enter the drug of short or prolonged action.
2. The insulin injection before dinner should consist of a hormone with a short exposure period.
3. The shot that precedes dinner includes short insulin.
4. Before going to bed, the patient should inject a prolonged drug.

There are several areas of administration on the human body. The absorption rate of the drug in each zone is different. The stomach is more susceptible to this indicator.

If the area for injection is not chosen correctly, insulin therapy may not give positive results.