advertisement

THE NON INSULIN-DEPENDENT DIABETES

- Definition, A few explanations
- Positive diagnosis
- Evolution
- Treatment

TREATMENT

1 – Aim:

To normalize the glycaemia in order to avoid the complications or to delay their evolution.

2 – Means:

The diet is the same as the one of the insulin dependent diabetes.

Physical exercise and treatment of the cardiovascular risk factors, especially the HBP and the high rate of carbohydrates in blood.

The oral hypoglycaemic medicines: biguanides (Glucophage®, Glucinan®, Stagid® for example) or hypoglycaemic sulfonamides (Daonil®, Diamicron®, Glibenese®, Glucidoral® for example).

	advertisement

Finally, the insulin therapy (administration of insulin) can be used when the oral hypoglycaemic medicines are no longer efficient enough. The mode of prescription will be similar to the one described in the paragraph about the insulin dependent diabetes.

3 – Indications:

- The diet must be low-calorie and bring a loss of weight in the obese.

- In case of failure of the mere diet, one will prefer the biguanides in case of obesity, the sulfonamides in its absence. Very often, it will be necessary to associate the 2 products. The first would encourage the insulin action at the receptors level and are a factor of lactic acidosis. The second stimulate the insulin secretion and their intolerance is represented by the episodes of hypoglycaemia. The posologies must be reduced in the aged subject and the patients with a renal insufficiency.

- The frequent insulin resistance in these patients, notably in the obese, sometimes requires massive doses of insulin if it proves necessary to get a good glycaemia balance. It involves the formation of atheroma plates. In the beginning, it is sometimes preferable to associate oral hypoglycaemic medicines and insulin.

4 – Surveillance:

In the non insulin dependent diabetes, 1 glycaemia/day, 2 or 3 times a week is sufficient to the self-check.