14 November was the world day of struggle against diabetes. Traditionally, doctors dedicate this day to the education of patients who, with regular monitoring of diabetes can stay with him until old age. The correspondent of “Mednovosti” spent the day with doctors and patients of the clinic of endocrinology, First Moscow state medical University them. I. M. Sechenov.
Date of 14 November was chosen in memory of born on this day, canadian scientist Frederick Banting, who in 1922 for the first time in the history of saving the human life by making an injection of insulin. Instead to get a patent on insulin and subsequently fabulously rich, Banting transferred all rights to the University of Toronto, and in less than a year, a new drug appeared on the drug market.
A medal for living with diabetes
Science does not stand still, said, welcoming the patients head. the Department of endocrinology of the University, corresponding member of RAS, Professor Valentin Fadeyev. Today in the Arsenal of physicians 9 classes of antidiabetic drugs, which helps to maintain the glucose levels at a normal level and prevent complications of diabetes mellitus (DM). In may 2013, 90-year-old American Spencer Wallace was awarded the medal “Victory” for 80 years of life with diabetes – was diagnosed in 1931. The medal itself was established in 1948 diabetic centre Elliot Joslin and was originally given to the people who have lived with diabetes for 25 years. In 1970 this bar has risen to 50 years, and in 1996 to 75.
Today, scientists around the world are looking for opportunities to achieve remission of type II diabetes. Such research is done in Sechenovskiy University. In addition, there are working markers at the cellular and molecular level, which can determine pass obesity to diabetes or not.
Photo: Maxim Kolomichenko
Meanwhile, from the beginning, the doctors knew that samoilovna in a person’s life with diabetes is to keep it under control. In his excursion into the history of diabetes assistant Professor, PhD Julia Manuilova quoted Elliot Joslin that “insulin sugar without self-control is a loss of time and money”. Fortunately, today, do not have to taste the urine taste, as it did in the 17th century, nor even use that appears in the middle of the last century heavy refractometers. And almost every patient with DM has an individual meter.
After the seminar patients received treat – glasses with colorful assorted vegetables (diabetologists believe that the plate should be all the colors of the rainbow), as well as educational literature, special creams and toothpastes. “Increased sugar worsens any problems, explained assistant Professor Anastasia Fokina. For example, delaying the moisture, so the usual creams glycerin for our patients no good, need those which have a special, conductive moisture in the skin”.
“Our main tool is prevention”
The theme of the world day against diabetes, 2016 – “Healthy living and diabetes”. Start a healthy lifestyle and prevention of disease complications need today, doctors say. Our doctors help patients choose a diet and exercise regime, trained to achieve the target glucose values to prevent “sugaring” of the body and ensuing complications.
According to endocrinologist,PhD Irina Poluboyarinov, although in the case of SD word of mouth works especially active, it is better to get information from experts. “Our patients have certain limitations, but they are not a million, says Poluboyarinov. For example, nutrition in DM is quite free, you just have to approach it wisely. There is still the problem of excess weight, which often leads to diabetes, on the other hand, the disease itself contributes to weight gain. And this vicious circle must be broken”.
Irina Poluboyarinov. Photo: Maxim Kolomichenko
In this case, simply reduce the level of sugar for a day, it is more difficult to learn to live with its normal rates, said Poluboyarinov. “Our main tool – prevention – says the doctor. – We are talking about many aspects – what you eat, how you move, drink alcohol. All this affects the sugar, and sugar on blood vessels. It is the state of blood vessels depends on how much time you will yourself to serve (after all, after a heart attack people is not the same that to him).” Diabetes is a socially significant disease that causes cardiovascular complications, disability. And it happens that the man literally sacrificed leg, due to the fact that in due time has not taken saharosnijatee medicine, says the doctor.
Diabetic foot is one of the most threatening complications of diabetes. According to Fokina, the endocrinologists to the latest “protecting your patients from surgeons”, fighting for the preservation of the limb. Today doctors have a large Arsenal of tools – from individually selected antibiotics prior to immobilization bandages. But to stop the development of osteomyelitis is not always possible.
Practical workshop on the treatment of wound defects was held by the doctor’s office “Diabetic foot” Alexander Volovik. According to her, decreased sensitivity in the feet require special care. Without feeling pain, people do not notice problems with your feet, and come to doctors with severe wounds, of which is often extracted needles, chips and even small toys.
“Every evening, the patient with diabetes should inspect his feet, if there were any abrasions, scuffs. And as soon as possible to go to the doctors – since the appearance of the sores ulcerative defect develops very quickly,” explained Volovik. In case of damage of the foot is better not to self-medicate and apply antiseptic dressing immediately to the hospital.” Patient during the master class was ligated doctor was saved from amputation, but after two weeks in the hospital, he still has three to six months of outpatient treatment.
Session mythology with its subsequent exposure
Today, doctors in nearly all specialties can’t imagine my work without “schools” for the patients. One of the first training courses for people with diabetes developed endocrinologists. “I love to conduct therapeutic training, – said assistant of the Department, PhD Guzel Runova. The idea of the School is to guide the people and make their lives easier. Particularly interesting are classes on nutrition. We have a kitchen where we, along with patient preparing “proper” food, showing that it can be very tasty. We teach the patients to overcome the mistakes (and unavoidable), and make conclusions from them. And, in any case, nor to be guided by myths.”
Myths about diabetes there is a great variety. At “school” for patients with diabetes of the second type held in the clinic on November 14, also talked about myths. The most common of them: if you go with antidiabetic tablets insulin, the pancreas stops working. “Everything is exactly the opposite, says Runova. – It facilitates the weakened pancreas life, and it begins to secrete insulin in a comfortable mode.” The doctor gave the analogy of a team of horses: how not to whip a horse, it will not be able to budge a heavy burden for her, but if harnessed to help her two other, everything will be easier.
According to doctor insulin is often used in emergency situations, and when after normalization of the issue of hypoglycemic therapy, the person can go on the pill. “The main thing in the choice of therapy – compensation of carbohydrate metabolism – explain Guzel. – Thus, treatment is chosen for lifestyle, not Vice versa.”
The biggest group of myths associated with nutrition. Especially popular: buckwheat lowers blood sugar, no wonder that in Soviet times diabetics received her coupons. “Buckwheat is a good product but does not have it saharosnizhayuschego action, explains to patients Runova. – Like the Jerusalem artichoke. But if you replace on the holiday table, cake, Jerusalem artichoke, I will support you. In the diet of diabetes patient should be low digestible carbohydrates”.
To question patients about what is better to drink tea with sugar or non-caloric sweetener, was considered the best answer is “tea without both”. Necessary for the brain glucose can be obtained from fruit, cereals and even pasta. “There is a good rule: if you really want some food, eat it and 2 hours later check glucose levels in the blood. Helps a lot,” says Runova. And, by the way, for the control of sugar is not enough to measure its level only in the mornings. This should be done at different times of the day but on an empty stomach or two hours after a meal.
And another myth States that Federal medical centers treat only “charge or quota”. And this is absolutely not true, doctors say: in working in system OMS University hospital examined and hospitalityat patients “according to indications”. It is very important that people knew about it, and sought medical assistance as early as possible.