Diabetes mellitus 1 means that a person has stopped producing his own insulin. The reason for this is an autoimmune disorder, and injuries, colds, and infections can trigger it. A radical method of treatment has not yet been invented.
Blood sugar control for type 1 diabetes
In the treatment of diabetes is very important to constantly monitor the level of glucose in the blood. This helps to avoid sudden jumps in blood glucose levels, hyper-and hypoglycemia, life-threatening.
In a healthy person, fasting plasma sugar should be no more than 6.1 mmol / l. If it falls in the range of 6.1-7.0 mmol / l, it is a violation of glucose tolerance. And if the sugar is more than 7.0 mmol / l, it means that the person has sugar diabetes.
With the diagnosis already established, the goal of treatment is to bring the blood glucose level to that of a healthy person – only in this case one can expect that a patient with type 1 diabetes will not develop chronic complications.
In addition to glucose, diabetics need to check glycated hemoglobin. This analysis shows how many red blood cells are changed under the influence of high sugar – hemoglobin in them entered into an irreversible reaction with glucose. The amount of glycated hemoglobin shows what was the level of glucose in the last 3 months – this is the average lifespan of red blood cells. In a healthy person, the indicator should not exceed 6%, and in a patient – 7%. If the level of glycated hemoglobin exceeds 8% with the established diagnosis and prescribed therapy, this suggests that the treatment of diabetes does not bring the desired effect and it needs to be adjusted.
Insulin and type 1 diabetes treatment
Medicine offers patients only regular injections of artificial insulin, which should replace its natural production.
What is insulin?
For diabetes treatment different insulins are used:
- Cattle – its minus is that the drug can give a strong allergic reaction due to the difference in the protein composition with the human.
- The drug obtained from the pancreatic pig is more close in composition to human insulin (it differs only in one amino acid), but allergic reactions still occur.
- The analogs of the human hormone are modified “pig” insulin, in which one amino acid is changed.
- Genetically modified insulin is a drug artificially obtained through synthesis with the participation of Escherichia coli.
The best option for today is genetically modified insulin. On the packaging, it is indicated by the labeling NM. The numbers on the label indicate how many units of the hormone are per milliliter of medication.
Short and long insulin
In addition to the production method, insulins differ in the duration of action:
- Ultrashort (Novorapid, Humalog) – are introduced immediately before a meal or immediately after it, begin to act immediately. The maximum effect is observed 1.5 hours after administration.
- Short (Actrapid) – begin to work 30 minutes after the injection, are as effective as possible after 2 hours, cease to work after 6 hours. Short insulin set 10-15 minutes before meals. 2 hours after the injection the patient needs to eat something so that at the peak of the action of short insulin glucose blood did not fall to critical numbers.
- Medium (Protafan) – they begin to act several hours after the introduction and work for 10-12 hours. They are administered twice a day.
- Long insulin mimics background secretion and is administered twice a day. Modern long-acting drugs (Lantus, Levemir) are peakless, that is, they do not have a peak of activity and completely imitate the normal production of the hormone in healthy people.
- Mixed insulin (for example, Novomix) is a drug that combines long and short-acting insulin doses. The proportions in different medicines are different and are chosen by the doctor.
How to put injections?
Treatment of diabetes of the first type is impossible without injections, and therefore you need to learn how to put them correctly. Insulin needs to be injected into the subcutaneous fatty tissue in order to ensure its even flow into blood. Usually, patients put injections in the abdomen (avoiding the area near the navel), buttocks, the front surface of the thigh and the outer part of the shoulder. Faster insulin absorbed from the abdomen or shoulder. The drug is absorbed more slowly if the injection is placed in the buttock or thigh. Therefore, short-acting drugs should be prickled into the shoulder or abdomen, and the long one into the thigh or gluteal region. For non-peak long insulin, the injection site does not matter.
How do injections?
- It is not recommended to put injections all the time at the same point, because over time, fatty seals may appear that prevent the drug from being absorbed. Syringes with medication should be stored at room temperature. If an injection of long insulin is given, the syringe must be turned several times, avoiding shaking.
- Before starting the procedure, you need to wash your hands and wipe the skin with a napkin with alcohol (if a diabetic patient takes a shower every day, it is not necessary to wipe the injection site).
- After removing the cap, you need to insert a disposable needle into the syringe and fix it as indicated in the instructions.
- The dose of insulin is dialed in accordance with the instructions to the syringe (mainly by turning the regulator to the right in a circle to the desired number). If a large air bubble “floats” in the syringe, you can knock on the body, pointing it up with a needle, and release 1-2 units of medication into the air.
- After that, it is necessary to form a skin fold, insert a needle into it at an angle of 45-90º, press down on the piston, count to 20, and then carefully pull out the syringe with the needle.
The number of injections and the dose of insulin in the treatment of diabetes mellitus are selected by an endocrinologist.
Nutrition for type 1 diabetes
How to eat?
What products are allowed if type 1 diabetes is detected? Without fear, you can eat cereals (except white rice and semolina), vegetables that do not contain starch, low-fat dairy products. Of the cheeses, preference is given to Adyghe or Suluguni. Meat should be lean, and if the patient eats sausage or ham, it should also be made from lean meats. It is useful to include in the diet of sea fish, especially red, as it contains vital omega-3-acids.
Alcohol in diet number 9 – banned, as it, in addition to high calorie, causes a sharp increase in blood glucose. In extreme cases, diabetics are allowed a small amount of dry red wine, not containing sugar.
Glycemic index and bread units
One way to evaluate the benefits of foods is to determine their glycemic index. It shows how the body reacts to the consumption of carbohydrates: over 100 accepted reaction to taking pure glucose. The glycemic index of the remaining products is compared with the glucose index: for example, cabbage has a small index of only 15, since it contains almost no carbohydrates. In the diet of a patient with type 1 diabetes mellitus, foods with a low glycemic index should prevail.
For diabetics, it is also important to know the number of bread units of food. This is necessary for the correct calculation of the dose of “short” insulin, which the patient injects after each meal, in order to ensure the absorption of the received glucose. One eaten bread unit leads to an increase in blood sugar, for the normalization of which 1 unit of insulin is needed. If 100 boiled macaroni correspond to 2 bread units, it means that insulin will also need two units.