Diabetes treatment

Overview of diabetes

 

 

 

Diabetes mellitus is an endocrine disease caused by dystrophic metabolism of human body. Its basic biochemical characteristics are continuous hyperglycemia. Because insulin can not play a normal physiological role in target cells, and insulin supply is insufficient, the transformation of protein, fat and monosaccharide is maladjusted, resulting in metabolic disorder of water and electrolyte and systemic diseases. According to the pathological characteristics, the disease can be divided into two categories: insulin-dependent (IDDM, type 1) and non insulin-dependent (NIDDM, type 2) diabetes. Diabetes has become the fourth leading cause of death in the world, and is considered to be a non infectious disease next to cardiovascular and cerebrovascular diseases and malignant tumors. In 2005, the global diabetes population has expanded to 220 million people. Many people are at risk of impaired glucose tolerance. In developing countries, adult prevalence is high, and middle-aged people have become a high-risk group of this disease. Because of the ferocity of this kind of disease, which has caused great harm to human health, the World Health Organization has attached great importance to it.

 

 

 

In the process of China's development to a well-off society, people's intake of fat and sugar has not been reasonably controlled. Under the influence of aging and multi-faceted stress factors, the incidence of diabetes has increased year by year. Compared with the mid-1990s, many areas in China have increased by one thousandth of a year on average, and the prevalence of diabetes in Beijing has increased from 4.6% to 6 4%. Diabetes is a high incidence disease that seriously affects human health and life. There are two types of diabetes. Type 1 diabetes is insulin-dependent, and about 5-10% of the diabetic patients are type 1 diabetes. About 30% of patients with type 2 diabetes will develop into insulin-dependent type in the middle and late stage. Insulin injection (including the use of insulin pump) is an effective means to control the blood glucose of diabetic patients, but exogenous insulin can not achieve the purpose of physiological regulation of blood glucose, so it can not stop the occurrence and development of diabetic complications, such as kidney disease, nervous system disease, retinopathy and cardiovascular disease, so as to greatly reduce the quality of life of patients, and ultimately lead to death Death. There are more than 200 million diabetics in the world, and it is expected to reach 350 million in 2020. Diabetes is the third most common disease and the fourth leading cause of death in the United States. There are more than 15 million people with diabetes, and the annual cost of medical care for diabetes has exceeded 120 billion US dollars. Diabetes has become the most common disease in China since 2004. The number of patients exceeds 50 million. About 20% of diabetes patients inevitably die of diabetes and its complications. The annual treatment cost is up to 250 billion RMB. According to the joint survey conducted by the chronic disease center of China CDC and other institutions in 2010, the prevalence rate of diabetes among the residents aged 18 and over is 9.7%, and that of the elderly aged 60 and over is 19.6%. There are about 97 million adults with diabetes in China. That is to say, in addition to the number of children and adolescents with diabetes and undiagnosed diabetes, there are nearly 100 million diabetes patients in China, becoming the world's largest diabetes country. At present, the prevalence of diabetes is rising rapidly in all countries in the world, which has become an urgent public health issue in the world.

 

 

 

 

 

At present, the commonly used diabetes treatment methods include oral hypoglycemic drugs, insulin injection, insulin inhalation, insulin pump, pancreas transplantation, islet transplantation (including homotransplantation and xenotransplantation). Both the whole pancreas transplantation and the islet transplantation can obtain the insulin secretion in the near physiological state. Compared with total pancreas transplantation, islet transplantation has the advantages of simple procedure, safety and less failure caused by immune rejection.

 

 

 

 

 

 

 

insulin pump

 

 

 

 

 

 

 

Insulin pump, also known as artificial islet of Langerhans, is the first machine imitation of human endocrine gland, which is divided into closed-loop and open-loop (usually carried or implanted by diabetics are open-loop). At present, no matter which insulin preparation or treatment plan is used, the basic value and fluctuation of blood glucose in diabetic patients can not be restored to normal level within 24 hours, and the occurrence and development of chronic complications of diabetes can not be effectively controlled. In order to simulate the physiological state of insulin release as much as possible and make blood glucose fluctuate like normal people, a continuous insulin infusion device, called artificial insulin device or insulin pump, was designed.

 

Although insulin pump can simulate the physiological release of insulin, it still has obvious deficiencies compared with islet transplantation

 

1. Insulin pump is still non physiological secretion of insulin, so it can not completely prevent the occurrence of diabetic complications.

 

2. We need to test blood glucose by ourselves or use it in combination with the dynamic blood glucose monitoring system (expensive). We need to preset the basic amount of insulin and the large dose before meals, and we need to adjust the dose of insulin pump in time, which can not achieve complete physiology (both hypoglycemia and hyperglycemia can occur). It is recommended to use the pump in hospital, and at least provide outpatient guidance at any time.

 

3. The patients with insulin pump need close cooperation. They should fix the type of diet, the amount of diet and the amount of exercise, monitor the blood sugar regularly, and master the performance and usage of the pump skillfully. This is very difficult for young children, even with the cooperation of parents. For example, teenagers and children like to eat snacks and often have extra meals, so it is necessary to adjust the large dose of insulin pump supplement and carry out timely blood glucose monitoring

 

4. The insulin pump should be checked regularly for failure. If the pump is abnormal, the drug input will be interrupted. In addition, take off the pump for bathing and swimming; discharge the gas when changing the needle and tube.

 

5. Teenagers and children like sports. Blood sugar should be monitored before and after sports to determine whether it can be adjusted