What is better, insulin or diabetes pills? Life on insulin: why the pills are better than injections, and the diet is obligatory?
GEIDI STEVENSON (Heidi Stevenson)
People having diabetes must prick insulin - it seems intuitive. Probably it is correct for the diabetics of the first type, when the pancreas ceases to produce insulin. However, modern doctors usually prescribe insulin to people suffering from a second type diabetes simply because it reduces blood sugar levels.
Composition: glucose, fructose, sucrose. In connection with diabetes, the pandemic is often mentioned today. Changing lifestyle, stress, all of this leads to a sharp increase in the number of patients with type 1. Diabetes. However, the number of patients with diabetes type, i.e. Those who need life introduction of insulin is growing.
Recent studies show that not only long-term hyperglycemia, but also significant fluctuations in blood glucose levels contribute to the development of late complications of diabetes. Some of the most serious of them include blindness, kidney defects or legs. That is why many efforts are being taken not only to develop new drugs that reduce blood sugar levels, new insulin delivery methods, but also methods that allow patients to maximize blood sugar levels.
Reality is actually such that the diabetics of the second type, which make insulin injections, die twice as often as patients who are prescribed non-insulin treatment!
Research, "mortality and other significant outcomes related and diabetes when using insulin in comparison with other antihypertensional treatment methods for second type diabetes" (Mortality and other Important Diabetes-Related Outcomes with Insulin VS Other AntiHyperglycemic Therapies In Type 2 Diabetes) covered 84622 primary Patients with diabetes of the second type period from 2000 to 2010, and it compares the results of the following treatments:
Thanks to the sensor, the patient responds on time
The innovation of recent years is a sensor, which is capable of controlling the current glycemia without a break for 6 days. The sensor is a small electrode that is introduced into the subcutaneous tissue and subcutaneously removes the blood sugar level and warns the patient not only about the current level of glucose in the blood, but also about the upcoming fluctuations in blood sugar levels. The advantage of this system is that the patient responds in a timely manner to change blood sugar levels and prevents fluctuations in blood glucose levels, which greatly contributes to the development diabetic complications.
Metforminov monotherapy;
Sulfonylmic monotherapy;
Insulin monotherapy;
Metforminovaya and sulfonylmic combined therapy;
Insulin and metformal combination therapy.
These groups were compared at risks of several heavy outcomes: cardioproble, cancer and mortality. The primary outcome was determined as the occurrence of one of the three events listed above, while each such event was considered once and only if there was the first manifestation of an undesirable result. Any of these events that occurred at any time plus microcapillary complications were considered as a secondary case. The results were dramatic.
Causes of glycemic oscillations in women
In general, women are slightly overloaded. Women, like men, should make a lot of effort to normalize blood sugar levels. They are limited in food consumption, try to carry out regular physical activity, perform a separate test on blood sugar levels, they are often processed by insulin 4-5 times a day or treated with insulin pump.
Various hormonal equipment of women can lead to large oscillations of glycemia that can complicate life with diabetes. The document will present possible situations where other female hormonal equipment can lead to diabetes. As a labile, we are talking about diabetes, where there is a significant fluctuation of glycemia, and this means that there are conditions of severe hypoglycemia, in which the patient can get into the unconscious state and vice versa hyperglycemia. The most common cause of lability of diabetes in women is a hormonal imbalance associated with the use of hormonal contraceptives and vibrations of female sex hormones during menstrual cycle.
Those who received Metforminic therapy had the smallest mortality rates, so this group was used as a control.
In terms of primary outcome, that is, only the first cases of the onset of undesirable events were considered:
With sulfonyl-imaging monotherapy, patients received one of these outcomes with a probability of 1.4 times greater;
Women are also more prone to psychological problemswhich may adversely affect blood glucose levels. Other causes of diabetes lability may be insufficient insulin doses or the presence of heavier forms of diabetic neuropathy. The last two options are not related to sex, but include diabetes lability as a whole.
Sugar diabetes has long been considered as a contraindication to hormonal contraception. It was associated with higher doses of estrogen and gestagen hormones, which can lead to diabetes. Currently, there are so-called low dose preparations, which can also be used by women with diabetes. Hormonal contraceptives should contain as little estrogen and gestagen as possible. For women with diabetes, pure gestagen injections are recommended, which increase blood sugar and cholesterol.
The combination of metformin and insulin gave rise to risk by 1.3 times;
Insulin monotherapy led to risk raising by 1.8 times;
If you consider the offensive of any of these events, regardless of whether the initial event is an event or secondary, the results are even more dramatic.
Insulin monotherapy led to:
Hormones are used as protection against conception in two ways. The goal is to increase the reliability and reduction of the risk of side effects. Despite certain risks of use, hormonal contraceptives are the most reliable type of contraception. The mechanism of action lies in blocking ovulation, that is, the release of eggs from the ovary, which cannot be laid in the uterus. There are more types of hormone contraceptives with different levels of hormones, so almost every woman can use this method of monitoring conception.
The study of myocardial infarction 2.0 times;
Participation of cases of serious lesions of the cardiovascular system 1.7 times;
Stupidity of strokes 1.4 times;
An increase in the number of renal complications by 3.5 times;
Neuropathy 2.1 times;
Eye complications 1.2 times;
Increased cancer cases by 1.4 times;
Mortality 2.2 times.
Medical arrogance
Studies have been focused not only on the new composition, but also on the new forms of its presentation. At the end of the last century there was a slight decrease in the use of hormonal contraceptives. The reason was concerns about possible side effects that were associated with a high level of hormones. Currently, some of the hormonal contraceptives in the Czech Republic use approximately 40% of women of childbearing potential. Hormonal contraception is a reliable method, the risk of failure to use is significantly lower than 1%.
The coupling and the arrogance of modern medicine allow it to make applications that are simply not justified. Based on these unreasonable statements, thousands, and in the case of diabetes - millions of people sit on medicines and regime that never demonstrated a positive effect. As a result, a huge mass of people become experimental pigs for medical experiments - experiments that are not even documented and not analyzed!
Women who cannot take ordinary hormonal contraceptives for various reasons can successfully use the intrauterine system. The first body was introduced in the uterus this year. The intrauterine body is made of copper, which is covered with a hormone, which further increases the contraceptive effect of copper. One of the most modern drugs It is an organism from which the Levonorgestrel hormone is released. The local hormone effects affect the structure of the endometrium, thicken the cervical mucus, which becomes difficult to penetrate not only spermatozoa, but also for microbes that do not affect the activity of the ovaries.
The use of insulin with a second type diabetes is just one of the many similar examples. One of the most striking similar cases is the story with the drug Vioxx (Vioxx)
Reorienting on markers
The method by which such treatment methods are justified, this is a small reorientation aside from what is really significant. It is significant is to improve the quality and life expectancy of patients. But the pharmaceuticals are rarely tested for compliance with these criteria. The usual pretext, which at the same time put forward that such research will take too much time. If it were a true explanation, we would have seen regulatory authorities, carefully follow the results of the use of new drugs during the first few years of their use. But this we simply do not observe. Instead of observation of truly significant outcomes, substitutes are used. They are called markers, these are intermediate results, about which it is believed to indicate an improvement. In the case of insulin, the marker is the level of blood sugar. Insulin is required for transporting glucose (blood sugar) into the cells, thus the latter can produce energy. So, insulin reduces blood sugar levels. If artificial pharmaceutical insulin leads the level of sugar to more "normal" values, the drug is considered effective.
It is shown that this prevents the growth of myoma, some of the mioma even decreased after its introduction. Menstruation with intrauterine system with hormone is less painful. A large number of women will completely disappear. The reasons why the organism prevents egg nesting, more. After hormonal contraception is the most safe Method Prevent conception. The body is introduced outpatient, life expectancy is about 5 years. This is a good choice for women who have already gave birth to a child, do not have impaired uterus, inflammatory diseases, are also suitable for women with all forms of diabetes, provided that they correspond to the above conditions.
Erroneous markers
As the study has demonstrated, markers are simply not able to show the effectiveness of treatment. In the case of diabetes of the second type, the problem is not in the absence of the ability to produce insulin, also in high level blood glucose. The problem in the ability of cells to use insulin to transport glucose from blood into cells.
Low levels of hormones that act only on the site of the uterus mucous membrane do not affect blood sugar levels. Hormonal contraceptives can lead to different complications, most serious include obstruction blood vessels - Thrombosis, are especially vulnerable to women: smokers, women older than 35 years old, women who suffer from high blood pressure, diabetic patients with damage to vessels, women with violations fat Exchange, Women with pronounced varicose veins or other vascular diseases.
The problem is that the cell's ability to use insulin is disturbed. Therefore, how can it be useful to introduce additional insulin when cells are not able to use the one that already exists in the body? In fact, it is counterproductive.
However, this is exactly what doctors do. They introduce insulin to replace insulin while the problem is not at all in the insulin lack! Therefore, it should not be surprised that insulin therapy does not meet the real needs of people treated from diabetes.
Some tablets lead to weight gain. The most modern contraception, which contains the lowest number of hormones, should not be attributed to weight gain. Headache, changing the skin color, chest tenderness, changes in blood lipids, increased frequency of gallbladder attacks, high blood pressure, all these other possible side effects Hormonal contraception.
When hormonal contraceptives are not recommended
Some contraceptive pills may disrupt the metabolism of sugars. Although they themselves do not raise diabetes, they can aggravate the existing disease. Due to the low content of hormones in modern contraception, women with diabetes can also take contraception, of course, with proper medical supervision. From the above, it follows that for a specific group of women, hormonal contraceptives are absolutely contraindicated, that is, they cannot accept it. These are the following conditions: Pregnancy, inflammation of the deep vein present or in the past, liver function, severe migraines, hormone-dependent tumors of all other women, including women with diabetes that would like to use contraceptive funds, maybe after consulting a doctor to find Tablet that will be suitable for them.
As this study demonstrated, the introduction of insulin into the body leads to the deterioration of the outcomes. And how many decades this treatment method was in fashion? And all this time, it was justified by the fact that it reduces blood sugar levels. But significant effects are the quality of life and its duration was not taken into account.
The beneficial effect of hormonal contraception
In addition to reliability and contraindications and safety, hormonal contraceptives also have a beneficial effect that is usually mentioned less often than their risks or side effects. In addition to a significant reduction in the number of artificial abortions of pregnancy, ectopic pregnancy, they have a protective effect on the incidence of uterine, ovarian and colorectal tumors. Some high-quality new studies did not find a higher risk of developing breast cancer, as reportedly increased by the number of users of combined hormonal contraceptives.
Here we should learn the following lesson: Health does not gain with the help of pharmaceuticals, even with the help of tested reliable drugs.
Mortality and Oter Important Diabetes-Related Outcomes with Insulin VS Other Antiyperglycemic Therapies in Type 2 Diabetes, Journal of Clinical Endocrinology & Metabolism, Craig J. Currie, Chris D. Poole, Marc Evans, John R. Peters and Christopher LL. Morgan; DOI: 10.1210 / JC.2012-3042
Daily insulin injections are a harsh reality for many diabetics. But now it may change, as the researchers successfully experienced insulin in pills on rats, and declare the possibility of reproducing these results in humans.
The beginning of regular menstrual menstrual bleeding occurs in girls with diabetes about a year later than women without diabetes. Women whose blood glucose levels are significantly increased, more often experience menstrual difficulties, menstrual disorders or even amenorrhea, that is, without menstrual bleeding and, thus, without the possibility of becoming pregnant. But the most common problem of diabetes is to increase glycemia to menstruation, which can lead to a general deterioration in diabetes compensation.
Often women are not aware of this fact and should think about self-control of glycemia. Insulin sensitivity fluctuates during the menstrual cycle. In the period, approximately a week before menstruation, it decreases markedly and increases with the beginning of menstruation. As a result of these changes, the increase in the level of glycemia in premenstrual periods is unusual in women with diabetes, which otherwise does not say. At the beginning of menstruation, glycemia levels are reduced to their initial values. It can cause problems in practical life.
About 350 million people all over the world suffer from diabetes, and forecasts, this number can grow to 500 million by 2030. And although the more common diabetes of the second type does not always require insulin injections, almost a quarter of all diabetics are dependent on this drug. The approximate annual insulin turnover in the form of a pill may range to about $ 17 billion.
Increasing the level of glycemia leads to an increase in the insulin dose in women, and it is often difficult to predict return to the initial dose, so hypoglycemia may occur with increasing insulin. The only way to improve these difficulties is a thorough monitoring of blood sugar levels a week before the expected start of menstruation. However, an increase in insulin doses is always individually. There are women who require 100% more insulin to menstruation, and women who do not change the dose of insulin - women.
Do not forget to return the doses of insulin to the initial values \u200b\u200bimmediately before the start of menstruation. These recommendations apply almost exclusively to women with type 3 diabetes, which are insulin in a dose of 3-5 days. In the treatment schedule, insulin pump treatment is sometimes used, where it is easier to regulate insulin doses to achieve optimal glycemic values \u200b\u200bthan in conventional treatment with 4-5 daily insulin injections. The most common cause of the incidence of diabetes is psychological and social factorsthat affect the patient's life.
The advantage of insulin in tablets is not only in simplicity of medication. The shape of the tablets means that patients can start taking insulin before - which will reduce some of the secondary complications of diabetes, such as blindness or defective treatment, leading to the need for amputation.
On the way of creating insulin in tablets, two major problems were traditionally stood: first, insulin is protein, and in contact with the enzymes of the stomach, it is quickly destroyed; And secondly, even if it is possible to safely connect the stomach, insulin molecule is too large (30 times more aspirin molecule) to be absorbed in the bloodstream.
Now Dr. Sanyat Yang and his colleagues from the Indian National Institute of Pharmaceutical Education and Research found a cheap and reliable method of delivering this medication. They overcame two key obstacles by packing insulin into tiny bags from lipids, and attaching them then to folic acid (Vitamin B9) to help its penetration into the bloodstream.
