Monday, January 31, 2011

Saya nak tanya,apa itu diabetic nephropathy?

Diabetic nephropathy adalah komplikasi diabetes pada buah pinggang. Tanda awal adalah air kencing mengandungi albumin ( kotor) atau microalbumin pada peringkat yang lebih awal. Berlaku kebocoran pada kilang penapis dalam buah pinggang disebabkan oleh diabetes dan terdapat tekanan yang tinggi dalam salur darah pada kilang penapis ini. akhirnya kilang penapis ini rosak dan jadi serabut (fibrosis).Akhirnya tahap racun dalam darah tinggi dan akhirnya hampir semua fungsi buah pinggang rosak dan kita terpaksa dirawat secara dialisis

Ask me anything

INSULIN TREATMENT

Insulin treatment is indicated once we are :
1. Not achieved target HbA1c 6.5% despite of two maximum oral diabetic agents ( ie Daonil 7.5mg twice perday and Metformin 1gm bd) or three drugs.
2. At time of we detected to be diabetes, our fasting blood sugar >13mmol/l or HbA1c >10%. This will rest the pancrease and will improved its function.
3.  In illnesses like infection, heart attack, operation.

wide variety of insulin regimes that we can follow:
1. Combination of oral agent with one injection at night using intermediate acting insulin ie Insulatard or Humalin N. We inject this at 10pm or before we go to bed. But not too early otherwise we will developed hypoglycemia early in the morning. we dont need to take super if we donot wish to have it.
Advice 1: How much to start? three ways either 10unit or 0.2u perkg BW or equal to blood sugar before breakfast if 12mmol/l then we take 12 unit of insulin.
Advice 2: how to adjust on night insulin dose? Depend on morning blood sugar reading before breakfast.( prebreakfast). If still not control three or more reading so we can increase 2 unit of insulin. can we increase insulin our self. YES you can but only two unit each time and after 3 abnormal reading. i hope you still can remember our target blood sugar in morning( <4.4 - 6.1 or just remember <6mmol/l)
Advice 3: Please recognised this type of insulin, donot mix with Actrapid or Humalin R which were clear.

Next regime are for the next post