WE LEARN TO CHECK DIABETES

Here this book also has come to an end. We hope, travelling on country of knowledge about to itself has appeared for you not so tiresome. Anyway, but if after perusal of the book you with major understanding began to concern to the disease your travails are rewarded by the found useful knowledge.

About what still at last it would be desirable to talk to you, the reader? Perhaps, here about what. Not a secret that some people, having been ill with a sugar diabetes, are lost, reduce the vital rod, say, sink arms.

It is necessary to tell what to reduce the rod is not a stand. It hardly probable not capitulation before illness. Certainly, if to ask a problem: a leah severe disease a sugar diabetes — the answer will be positive. Yes, a sugar diabetes — the serious illness is unconditional. But nevertheless, dear reader, a sugar diabetes — not that illness which one is capable "to clip the person side panels". Look around!

How much people, sick of a sugar diabetes, lead rigorous, interesting, rich events by life. The history is complete of examples when people, despite an available sugar diabetes, attained the highest peaks not only in a science, the politician, art, but even in sport — that orb of human activity where titanic physical efforts are demanded.

That more, dear doubting reader?! These people thanks to the to transactions, persistence, talent have found happiness! True earth happiness! Therefore and to you it is not necessary to be idle and wait for it, it is not necessary to despair. The illness, whatever it was, always it is possible to defeat. It is necessary to live and struggle only for the happiness.

Life of each of us in a major level depends on our aiming to be happy and, certainly, from understanding of great meaning of happiness for the person. At all apparent differential: skin colours, characters, political and religious beliefs — we are united by the main thing: we are people. All of us were born and we live in one dwelling — on our blue planet where the true happiness is born only in interior creation of a spiritual initiation through world around enhancement.

It would be desirable to believe sincerely that sometime all people will find understanding of true happiness and will learn to come to it as simply as today come to each other. And then the world on land and rest in human souls will be established.

That, these thoughts about perpetually are not new. A leah you remember, what about it told the ancient? They spoke so: "If you want to be happy — be it".

So we will be happy!

HOW OFTEN IT IS NECESSARY TO SEE A DOCTOR?

It depends first of all on disease flow. If you are sick of diabetes of the maiden type, feel not bad, at you good assayings you can visit the doctor of 1 times in 3-6 months. And at astable flow of disease, at predilection to hypoglycemias, retention in the anamnesis ketoatsidozov it is necessary to visit in an out-patient department more often: approximately 1-2 times a month. Certainly, there can be any emergency when it is necessary to visit urgently the doctor, without waiting planned reception.

If at you diabetes of the second type also is well compensated, you can meet the doctor even less often: 1-2 times a year. But it under condition of the regular self-supporting control over disease. Otherwise, come more often.

Remember: however many the patient from books has learnt, he will not manage to manage the illness itself. To struggle with a malaise it is necessary hand in hand with the doctor. Here the main thing that between you there was a trust, mutual understanding. If at occurrings you every time bump against an impenetrable wall of alienation and misunderstanding — discover other doctor. Certainly, the similar solution does not need to be accepted after one-two maiden occurrings. Look narrowly, the maiden impression happens often bastard.

Besides, you should be assured of high professionalism of your attending physician.

Chapter 11

SCHOOLS OF SELF-TESTING AND THE BOOK ABOUT DIABETES — THE KEYSTONE TO SUCCESS

In many Russian cities schools of self-testing for sick of a sugar diabetes work. People trained in them gain submission about the disease. However the main task of schools — to convince the patient of necessity of the active involvement for the control over the disease, in passage to the correct conduct of life and waiving of bad habits. Sick of a sugar diabetes should perceive that the success of treatment, protective treatment of complications, adapting to diabetes in an everyday life on 99 % depend only on them.

The competent patient becomes the ally of the doctor in a control with illness. Learning process does not conclude passing of school of self-testing. The more the person knows, the more it would like to dilate the outlook. In its library there are book innovations on the applicable subjects. We hope, as this book will help to give your knowledge of diabetes in clear harmonous system.

WE LEARN TO HELP THEMSELVES

Successfully to check the diabetes, the following is necessary for you.

At first, to perceive, what processes happen in an organism at this disease.

Secondly, to be able to plan a delivery taking into account characteristic ideal weight, an occupation, exercise stresses and, certainly, to follow this plot.

Thirdly, it is obligatory to be engaged in physical culture and sport, but it is reasonable.

Fourthly, the nobility as insulinic drugs work to remember spikes of their activity, to match up this knowledge to clinic and effects of assayings. That who accepts saharosnizhajushchie tablets, precisely also it is necessary to perceive the gear of their activity.

Fifthly, to have firm conviction in necessity of self-testing of diabetes.

Sixthly, to be assured of regularities of the knowledge and activities.

Only meeting all these requirements, you will manage to help yourselves really.

IT IS POSSIBLE FOR LIE TO MODIFIED TREATMENT OF A SOFTWARE TO EFFECT OF ONE MEASURING?

To modified the circuit of treatment by results of one assaying in nowise it is impossible. Exclusion is constituted by the emergency situations. Remember that the error, at first, is always possible. Secondly, both at healthy, and at sick of diabetes of the person Saccharum level in a blood is subject to various oscillations within days. To gain correct submission about diabetes compensating, effects of assayings throughout days, and not just in the morning are necessary. Though, much to our regret, in out-patient departments practice till now is saved to research a sugar content in a blood only once — in the morning.

Let’s recall a phenomenon of "a morning dawn", consisting that at early morning o’clock the need for insulin is increased. Therefore in 8 o’clock in the morning Saccharum level in a blood can appear above, than in 6. If the patient does not know anything about it, he can solve that its state was degraded, and to spend unjustified correction of treatment.

Or, to the contrary, will be delighted to effect of the blood handed on an empty stomach of 10,0 mmol/l on Saccharum, having solved that leads quite correct conduct of life, at all without suspecting about that, such index is how much high. When the sugar content in a blood matches 10,0 mmol/l after meal is still more or less anything. But when such effect is gained after a sleep, after a night time-out in a delivery — it is possible to introduce only what it was in the evening, after a supper. 13,0 16,0 mmol/l for certain there are less.

Only multiple checkouts (within three days on end on some times a day) will help to tap this or that regularity and to spend proper correction.

HOW OFTEN IT IS NECESSARY TO CHECK SACCHARUM IN THE BLOOD?

If to you make insulin injections, every day and on some times. And it is written in many books about diabetes. But a leah substantially it? A leah always patients fulfil "idealised" references? And a leah it is necessary to follow such references? We will try reasonably porassuzhdat, allowing and judgement of the majority of patients on a case in point.

Maiden with what should clashing the patient at frequent checkouts of level of Saccharum in a blood, is with constant microtraumas of a skin. What will be setpins after numerous nyxes an ordinary spear or a needle? At daily determination of Saccharum three times a day only for one month on your setpins there will be 90 holes.

And if the patient — the child? Add daily psychologic injuries from injections of insulin and constant assayings. Such trial will be withstood not by each adult. The nyxis is let small, but shakeup for all organism, stress. And any stress only degrades diabetes flow. Recall that you have read in the head about influencing of stress on health. Certainly, inektory, entering in a dial-up to gljukometru, minimise skin injuries.

However gljukometry roads and many patient appear it is too expensive. nedeshevy as well test strias. How there was well an instrument which one was recommended by the doctor if the patient does not have money, these references are senseless. The patient will spare all the same strias on an event of impairment of state of health and will be failed from the assaying if feels well. Therefore we also will lead speech about that minimum of assayings without which one the control over diabetes becomes impossible.

Diabetes of the maiden type, unconditionally, demands the strictest and regular control. Therefore, as though you well felt yourselves, research Saccharum level in a blood not less often than an once in a week. Select one day and make three measurings: in the morning — hours in 6, before the main eat period (for example, before a dinner) and before going to bed.

If indexes appear within admissible oscillations, adhere to this circuit and further, under condition of lack of changes in your conduct of life, a delivery and state of health. For a fuller appreciation about a clinical course is not more rare than an once in a month research Saccharum level in a blood the whole day long: in 6 mornings, before a lunch, a dinner and a supper, in 2-2,5 hours after them and before going to bed, about 22 hours. (At suspicion on night hypoglycemias without fail validate level of Saccharum and at night.)

Such diagramme of probes will allow you to gain submission about an effectiveness of each dose of insulin within days and to validate correctness of the circuit of treatment, a diet and exercise stresses. Good effects of assayings will prove the selected treatment.

The patients, suffering affliction diabetes of the second type and gaining insulin, need precisely the same control over sugar content level, as well as patients with diabetes of the maiden type.

The same patient by whom the combined circuit of treatment (insulin + tablets is directed), and also that who accepts only saharosnizhajushchie drugs, it is possible to validate a blood once in two weeks: in the morning — hours in 6, before and after (in 2 hours) any main eat period.

In either case there should be painfull symptoms of diabetes, that is diabetes should be compensated: blanket good state of health, stable weight, lack of the thirst, the peaked sense of hunger, a dermal itch. If you on such satisfactory clinical hum suddenly have Saccharum high level, do not panic and do not make hasty outputs.

Recheck effects next day: standard digits will bear to the measurement error admitted the day before, and high — that not always it is necessary to trust in state of health. Thereby you are once again convinced of necessity of the regular control of diabetes.

But what to make in the event that effects of assayings have appeared really increased? First of all spot Saccharum level in a blood on a standard draught: in 6 o’clock in the morning, before the main eat periods and later 2-2,5 hours after them. Having gained good results, analyze a diet and a diet. Think, a leah exercise stresses are sufficient. A leah is not present at you today problems with a liver, buds or other organs. And only then make outputs.

Let’s admit, in the morning you make injections of insulin of the prolonged and short activity, and accept 2 tablets of Maninilum in the evening. Assayings demonstrate that Saccharum level in a blood at you is always enhanced at night and in the morning. It means that tablets which one you accept in the second half of day, do not check a sugar content in a blood. Hence, there has set in the moment when it is necessary to be failed from tablets generally and completely to transfer to insulin. However concerning the further treatment your doctor should accept final award.

The alternative version is possible: you are sick of diabetes of the second type and check Saccharum level in a blood only saharo-reducing tablets. The made assayings demonstrate a high sugar content in spite of the fact that you keep to a diet, regularly be engaged in physical culture, lead a customary conduct of life for itself. It means that you need to enlarge a dose saharosnizhajushchih tablets. Add at first half-tablets in the morning. If it it will appear a little, add still half-tablets in the evening. Well and if you before treatment correction already gained maximum permissible dose saharosnizhajushchih tablets, be converted to the doctor. Apparently, to treatment it is time to add insulin.

Now we will talk how often should validate Saccharum level in a blood sick of diabetes which one treatment consists only in diet observance. Such patients are recommended to check a sugar content in a blood not less often than an once in a month: in the morning on an empty stomach and in two hours after any main eat period. At obtaining of the bad effects of assayings first of all try to recall, a leah really you strictly adhered to a diet and a diet, a leah exercise stresses were sufficient recently? If yes, has set in it is time to accept saharosnizhajushchie tablets. Do not sidetrack visit to the doctor.

In summary we will give sugar content indexes in a blood to which one the person, sick of a sugar diabetes should be aimed. At ideally countervailed diabetes Saccharum level in a blood to meal should be no more than 6,0 and not less 4,0 mmol/l, in 2 hours after meal — not above 8,0 mmol/l, that is to match to indexes of level of Saccharum at the healthy person.

Saccharum in urine should not be at all. To ideal a clod-G pensatsii it is necessary to be aimed by all. However it is necessary to perceive that each patient can have characteristic limits of admissible oscillations of Saccharum in a blood within days and spot them your attending physician can only, allowing for all your singularities: gravity of diabetes, retention of chronic diseases, your age, an occupation and many other things.

Quite admissible today are considered and following measure of compensating of diabetes: a sugar content in a blood on a hungry maw — not above 7,0 mmol/l, in 2 hours after meal — no more than 10,0 mmol/l. A sugar content in urine — no more than 15 grammes for days.

GLJUKOMETRY

As a matter of convenience carryings out of assayings and reaching of higher exactitude of probe have been devised special miniature instruments — gljukometry. Their operation is grounded on a principle of test strias already familiar to you. In a set gljukometra enter still special inektory: the nyxis made them is painless, dermal ranka — microscopical.

Your task consists in seating the gained drip of a blood on a test stria, and the instrument itself will spot effect. If at assaying realisation unaided gljukometra the effect foulness is foregone, as the patient "approximately" compares the bloom gained on a stria to bloom on a standard dial flakonchika at level measurement of Saccharum by means of the instrument the effect will be more exact.

Besides, in gljukometrah there is the unit of electron memory saving effects of the previous probes.

Gljukometr — the instrument compact and light, weighs about 400 grammes, therefore it can be taken with itself on operation, in travelings.

HOUSE LAB OR TEST STRIAS

Everyone sick a sugar diabetes always near at hand should have the characteristic lab, allowing to spend express preliminary treatment. After all necessity for checkout of level of Saccharum can originate and at night, and early in the morning when the out-patient department is still shut. Such "lab" exists for a long time, but, alas, because of dearness is accessible farly not to each patient. These are customary test strias.

For today for sick the flock of the most various test strias intended for a level detection of a sugar content in a blood, urine and for determination of retention of ketone bodies is issued by diabetes. The method essence consists that the stria modifies the bloom depending on an amount of defined substrate in a researched fluid.

On flakonchike there is a colour scale: each colour hue approximately matches to a certain index. Any dial-up of test strias is supplied by the detailed operating instruction.

So any patient can understand, as them to use. If the operating instruction is written on not clear to you a foreign language, closely read routine of determination of a sugar content in a blood, featured more low. You are once again convinced that difficult in it is not present anything.

Carefully wash arms with a soap. Wipe the pin an alcoholic globule. Wait, while alcohol completely will evaporate also a skin becomes dry. Take a spear in a right hand and make a prompt nyxis in a finger-tip side face. Extrude the maiden droplet of a blood and remove its dry web.

The second droplet seat on test stria edge. Having waited for the necessary time (in operating instructions to test strias the time is marked out by digits), blot on it remainders of a blood a napkin or web. Then take a vial with test strias on which one the dial consisting of tones of any one bloom is. Each tone matches to a certain numeral index of defined substrate.

Roaming the edge of the test stria which have decolorized from a droplet placed on it a blood, along a dial, discover such place on it which one painting most matches to bloom of a test stria. The number being near to this scale band also will point an approximate sugar content in your blood.

The same method it is possible to validate on a sugar content and urine. The test strias intended for a level detection of Saccharum in urine for this purpose be required. It is possible to research both diurnal urine, and half-hour portions at any time. A half-hour portion gain as follows: bleed an urinary bladder. Then, without sidetracking, drink a water glassful. Easly in 30 minutes assemble again organised urine is and there will be the half-hour portion intended for probe.

Sink the edge of a stria covered with a reagent, in urine, there and then get, urine excesses shake off or get wet a napkin. Withstand the time pointed in the operating instruction and compare to a colour scale.

There are also test strias for discovery in urine of ketone bodies. They need to use in events of a heightened sugar content in a blood (above 13,0-15,0 mmol/l) or at its major amount in urine. The engineering of discovery of ketone bodies is identical to the previous.

Keep in mind that test strias are light-sensitive and consequently should be stored in package, to get them it is necessary directly ahead of probe.

SMALL CUNNINGS FOR ALL

Keep in mind that the complete submission about Saccharum fluctuations of level in a blood within all days can be gained only at its multiple probe. Therefore listen to following advice:

1. If you do not have capability to check a sugar content in a blood in house requirements, and in an out-patient department conduct only 8-hour morning probe sometimes it is better to have breakfast 1,5-2 hours prior to it. Why it is necessary to tolerate a lunch on earlier time and to hand a blood in 2 hours after meal? Can happen so that every time at Saccharum probe in a blood on a hungry maw you gain good effects whereas your state of health leaves much to be desired.

It means that during the day sugar content level, most likely, is increased. Therefore, having validated its amount in a blood in 2 hours after a lunch, you gain submission about that, the dose of insulin or tablets how much effectively works.

If their dose is sufficient, the sugar content in a blood in 2 hours after eat period will not exceed 8-10 mmol/l. To gain a fuller appreciation about diabetes compensating, it is necessary to hand and the urine assaying on Saccharum. For this purpose it is necessary to assemble urine within days: in 6 o’clock in the morning to bleed an urinary bladder in the closet basin, and then till 6.00 following day to assemble urine in any vessel — a pot, a jar. In day of surrender of the assaying you mould about 100 grammes of urine in a jar, beforehand well having intermixed all diurnal urine, and bring on probe in lab.

If Saccharum in a portion of diurnal urine misses, means, within days its level in a blood does not rise above 10, 0 mmol/l. The lunch can consist of a sandwich with cheese or sausage, a glassful of kefir or a fruit juice, fruit, a gruel portion.

2. Never try to trick neither, nor the doctor. Sometimes happens so: the patient, having prepared to validate a sugar content in a blood, the day before or day for two starts to live, adhering to a rigid diet, or generally half-starving. And in day of survey after the maiden assaying at 8 o’clock has not breakfast at all and, being hungry, hands a blood of willows 11, and at 13 o’clock.

All three times it gains rather good effect: 8,0 or 9, 0 mmol/l — and rad-radeshenek. And tomorrow again forgets about a diet, and sugar content level rises at it on an unknown quantity. To whom are such assayings necessary?

3. Learn to tap regularities. Do not make hasty outputs about diabetes compensating only by one effect. Some times iterate measurings at the same time and in miscellaneous days. And only after that, having analyzed events of past week, initiate with treatment correction.

DO NOT FORGET TO VISIT THE OUT-PATIENT DEPARTMENT

All patients with the taped sugar diabetes consist on the dispensary count at the doctor-endokrinologa. Checking disease, someone is converted behind the help in out-patient department lab, and many promptly master engineering of checkout of level of a sugar content in a blood and spot it self-contained.

It is is especially relevant today when the domestic medicine because of the poverty appears not to give in a state to the patient necessary assistance. So, in many out-patient departments of probe of level of Saccharum in a blood are led all once in the morning. Probe insufficient and maloinformativnoe. But if there is nothing, use also it.

Some labs all the same try to select one-two day in a week for sugar content probe in a blood in a various time of days, for example, at 8, 11 and 13 hours. In such days, preparing in an out-patient department to hand a blood on a hungry maw at 8.00, do not forget to take with itself a lunch.

Having made the maiden test, have breakfast and occupy itself with something till 11.00, for example, book reading. At 11 and 13 hours once again hand a blood. By the gained effects your doctor and you can judge performance of antidiabetic therapy.

Some advice about visitation of the doctor. Not a secret that conventional queues in out-patient departments break any desire them to visit. However all the same there are running problems on disease which one are necessary for solving. Also you want you do not want — and to the doctor it is necessary to go. The problem also that in a short space of time reception cannot be told about all and about all to ask.

It is not less difficult also to the doctor, forced to judge your diabetes of all under one assaying of a blood on Saccharum and to the urine assaying. Certainly, it is quite good to be converted to the private doctor who will accept you at once as soon as there will be any doubts. The family or private doctor — current situation escaping, however it is far not everyone in a state to pay its transactions. Having stayed queue in an out-patient department, patients are quite often lost and have not time to tell about everything that them troubles few minutes led out by it.

How to derive from their maximum benefit? At first, without fail take with itself effects of the last assayings of a blood and urine. Secondly, capture the diagramme of a diet and the circuit of antidiabetic therapy. And, thirdly, in advance record all problems which have originated at you. Then everyone, even short, an occurring will be transmuted into constructive lecture, and you from it only will benefit.