With the rapid development of medical science, disease, the treatment philosophy are constantly updated. RegardingDiabetesThe older age groups prone diseases, there is always lots to talk about many topics. Articles 2007, No. 10, “Family Doctor” column compiled and distributed a “new concept of diabetes, diet therapy” for diabetes as part of an integrated treatment concept. Issue published his companion – “diabetes medication new ideas” to readers suffering from the disease to provide further medical treatment medication for reference.

 

Full-text includes “Notes from patients,” the form of a successful treatment experience, reading will give you empathy; subsequent “expert consensus” to help you read the theory behind this success relies on; final “extension services” to introduceInsulinPens and insulin pumps, to provide you with a specific close help.

　Do not refuse to type 2 diabetes mellitus Insulin

□ Xu Yu

I am a retired doctors, 74-year-old, four years ago I was diagnosed with type 2 diabetes. Fasting blood glucose was 14.1 mmol / l,Urine+ + + + + Urine protein, creatinine is also much higher, and every morning have a mild facial swelling. There are indications that I have emergedDNComplications, the condition is very serious.

Under the guidance of professional doctors, I am strictly in accordance with the principles of comprehensive treatment of diabetes, adjusting the diet, regular exercise, maintaining optimism, and with the foot massage (the text, see page 61 this issue, “might try” section). In drug treatment, I have no use of any oral hypoglycemic agents, only insulin Novolin 30R, 16 units before breakfast and dinner the first 12 units. Treatment a week later, fasting blood glucose fell to 6.1 mmol / l, urine loss, urine protein, reduced by the + + +. The first two weeks of urine protein was negative, facial swelling disappears. A year later a decrease of insulin dosage, and all indications were normal. Now I use the insulin for nearly four years, the monthly check is generally not more than 7 fasting blood glucose, postprandial blood glucose 2 hours is generally not more than 8, glycosylatedHemoglobinOnly 5.5%, then no new complications, the original general belly,Fatty LiverWas gone too.

I’m glad he has discovered soon after the use of insulin diabetes treatment, not only effectively control blood sugar, but also to curb the development of diabetic nephropathy, thus avoiding the serious consequences of renal failure. Now I not only lived a normal life after retirement has also been active aging, old age, full and happy life.

　Type 2 diabetic patients with insulin-good effect as early as

Affiliated Hospitals vice president, chief physician, Professor Weng Jianping authority in the international medical journal “Lancet” the author says, the traditional treatment of type 2 diabetes is to take from the diet, exercise to a single drug taken orally, to jointly oral ladder -type therapy. However, so far not found any kind of oral hypoglycemic agents in patients with type 2 diabetes can change the islet β-cell function decline process. On the contrary, about half of patients over the long-term drug stimulation as a result of islet β-cell failure, resulting in difficult to control blood sugar. And long-term toxicity of high blood sugar will undoubtedly increase the risk of complications. Research shows that early stage of type 2 diabetic patients intensive insulin therapy, the effect is better than the traditional method of treatment.

　　Metabolic Disease Hospital of Tianjin Medical University,Professor Xie Yun believes that early stage of type 2 diabetes with insulin resistance in the main. As the disease progress, and gradually reduce the number of β cells occurs, until failure. Early application of insulin, allowing β-cell rest, in order to protect its function, so that patients achieve good blood glucose control as soon as possible, eliminating high-sugar toxicity, delayed complications. Therefore, the clinical insulin therapy should not be treated with oral medication as a last resort after the failure.

The United States Lawson Zito (Rosenstock), Professor and the United Kingdom Holmes (Home) Professor of the same view that the current use of oral hypoglycemic agents can hypoglycemic limited. Therefore, a considerable number of patients with type 2 diabetes eventually need insulin therapy. The early use of insulin, will not only help control blood sugar compliance and prevention of complications, but also beneficial to the preservation of β-cell function.

Second Affiliated Hospital, Sun Yat-sen, director of physician Professor Cheng Hua pointed out that in patients with type 2 diabetes with insulin is not a security of tenure.

In fact, in patients with type 2 diabetes with insulin may be short-term, it can be long-term. Part of the blood glucose returned to normal, may switch to less variety and smaller doses of oral hypoglycemic agents. For patients with failure of oral hypoglycemic agents, short-term intensive insulin therapy, some patients may resume oral drug therapy. Only the islet β-cell function in patients with poor only need long-term insulin therapy. Thus, when doctors believed that type 2 diabetes require insulin, the patient should understand and actively cooperate with.

　　To help you understand the insulin pens and insulin pumps

□ Changhai Hospital, Second Military Medical University, Professor Chang

Insulin pen is a pen Xingzhuang Si insulin syringes, pens and refills from the two parts. Cartridge vary according to the type of insulin, may need to purchase, no need for pen after use, you can only refillable. Within the insulin cartridge can be directly injected into the skin, eliminating the need for extraction from the bottle and then injected trouble. Insulin dose by controlling the rear of putting pen to move forward to capture the distance, the dose directly to the unit displayed in the rear of the window. Special thin pen needles, you can meet the basic painless. Needles and a one-time, spent must be promptly replaced.

If the doctor recommends that you use insulin, you can require the use of insulin pens.

Doses of insulin pens is not only accurate, painless, and easy to operate, especially the travel is very convenient to carry.

Insulin pump is a need to keep wearing the body of the artificial islets, there are cigarette box so much. It continues to enter the small amount of insulin the body to eat when the input again to increase the amount of insulin. Onto it from the design concept is in line with the physical, there are many advantages, but in actual application there are many other restrictions.

As the constant input of insulin, the need for fine-needle buried in the skin, the needle should be changed regularly. Due to the time of testing blood sugar, but also need to have pocket-sized glucose detector. In short, this series of equipment, more complicated, difficult to operate there, but also expensive. Therefore, the insulin pump is currently used to type 1 diabetes with insulin in patients with type 2 diabetes limited in China.