Diabetes mellitus(DM): Treatments
The treatment of DM depends on the type of DM. In the case of DM type I, insulin deficiency arising from the destruction of B cells due to autoimmunity is a direct problem. On the other hand, DM type II does not regulate blood glucose by insulin resistance. Therefore, treatment should be different according to etiology.
Treatment of DM type I is aimed at lowering blood glucose by injecting insufficient insulin from the outside. Insulin is an injectable drug, and it is the most definitive hypoglycemic agent. However, there are problems such as hypoglycemia and weight gain. Human insulin and insulin analogue are present as insulin types. Regular insulin, which has a short duration in human insulin, can be expected to lower the blood sugar level for one meal because it takes about 1-2 hours. The human insulin intermediate type NPH insulin is available and has a working time of 12 hours. Insulin analogues include insulin lipro, insulin aspart, insulin glulisine, insulin detemir, and sustained insulin glargine with a 24-hour action time. Methods of administration vary widely, but in general, the administration of a sustained or moderate insulin sets the basal insulin concentration, and the fasting or hypersensitivity insulin is administered according to the diet to control the blood sugar change due to the meal.
Treatment of DM type II is different from type I treatment. Type II management should be accompanied by hyperglycemia control, concomitant disease management, and complication management. Treatment can be combined with exercise, diet, and medication. Eating at 30-35 kcal / kg / day for normal-weight men and 25-30 kcal / kg / day for women and 200-500 kcal for low-fat and overweight / obese subjects were reduced by 500-1000 kcal do. Exercise reduces weight and blood sugar and increases insulin sensitivity. The exercise is performed with the target pulse set as follows: Pulse = (220 - patient's age) x 60-75%. The oral hypoglycemic agents include sulfonylurea, meglitinide / metformin, thiazolidinediones / a-glucosidase inhibitor / glucosidase inhibitor / glucagon secretion inhibitor GLP-1 agonist and dipeptidyl peptidase IV inhibitor, which are insulin secretion enhancers. Among these, metformin is considered as the first line treatment. However, these drugs can not be used in the presence of kidney, heart, or liver disease. Depending on the nature of the patient and the current disease state, dosing agents can be administered and controlled.
Regardless of the type of DM, when uncontrolled blood sugar occurs, treatment is needed considering admission. In general, to control blood sugar, a large amount of insulin is administered intravenously immediately after admission and multiple split insulin injection (MSII) is performed. It is also necessary to control the amount of insulin needed per day by insulin titration.
Treatment of DM type I is aimed at lowering blood glucose by injecting insufficient insulin from the outside. Insulin is an injectable drug, and it is the most definitive hypoglycemic agent. However, there are problems such as hypoglycemia and weight gain. Human insulin and insulin analogue are present as insulin types. Regular insulin, which has a short duration in human insulin, can be expected to lower the blood sugar level for one meal because it takes about 1-2 hours. The human insulin intermediate type NPH insulin is available and has a working time of 12 hours. Insulin analogues include insulin lipro, insulin aspart, insulin glulisine, insulin detemir, and sustained insulin glargine with a 24-hour action time. Methods of administration vary widely, but in general, the administration of a sustained or moderate insulin sets the basal insulin concentration, and the fasting or hypersensitivity insulin is administered according to the diet to control the blood sugar change due to the meal.
Treatment of DM type II is different from type I treatment. Type II management should be accompanied by hyperglycemia control, concomitant disease management, and complication management. Treatment can be combined with exercise, diet, and medication. Eating at 30-35 kcal / kg / day for normal-weight men and 25-30 kcal / kg / day for women and 200-500 kcal for low-fat and overweight / obese subjects were reduced by 500-1000 kcal do. Exercise reduces weight and blood sugar and increases insulin sensitivity. The exercise is performed with the target pulse set as follows: Pulse = (220 - patient's age) x 60-75%. The oral hypoglycemic agents include sulfonylurea, meglitinide / metformin, thiazolidinediones / a-glucosidase inhibitor / glucosidase inhibitor / glucagon secretion inhibitor GLP-1 agonist and dipeptidyl peptidase IV inhibitor, which are insulin secretion enhancers. Among these, metformin is considered as the first line treatment. However, these drugs can not be used in the presence of kidney, heart, or liver disease. Depending on the nature of the patient and the current disease state, dosing agents can be administered and controlled.
Regardless of the type of DM, when uncontrolled blood sugar occurs, treatment is needed considering admission. In general, to control blood sugar, a large amount of insulin is administered intravenously immediately after admission and multiple split insulin injection (MSII) is performed. It is also necessary to control the amount of insulin needed per day by insulin titration.
