NON-INSULIN-DEPENDENT DIABETES

Disease information

NON-INSULIN-DEPENDENT DIABETES

Diabetes noninsulino employee.

Definition.

This type of diabetes insulino - employee (often normal rates of insulinemia) generally does not appear after the 40 years in a subject with ponderal overload. Type II by opposition to the diabetes of type I is described as diabetes that is pronounced in young and thin individuals with rates of very low and sometimes even null insulin.

The diabetes insulino - employee (II) does not represent the three fourth parts of the diabetics. The diagnosis is first of all biological. One leans mainly on the appreciation of three parameters:

• Glucemia.

• Glucosuria.

• Insulinemia.

Often elevated triglicéridos rates of cholesterol are observed and of related to the ponderal overload. Therefore, also a lipídico control is due to anticipate.

In the beginning of the diabetic disease, glucemia, glucosuria and insulinemia are not altered. Only as a result of certain tests (test of tolerance to the glucose) or from certain affections or circumstances (pregnancy, operations, infectious diseases, take from certain medicines. we realize of which the biological values are seen abnormally modified. A latent diabetes is diagnosed then.

The gravity of the diabetic disease must to the complications that can be produced in the long term and that are in relation to one hiperglucemia prolonged:

• In their majority, these complications, is of vascular origin, affecting to the great glasses (HTA, infarcts of myocardium, arteritis of the inferior members, cerebral circulatory insufficiency) and the glasses of very small caliber (ocular, renales and nervous complications)

• Other complications are in relation to the accumulation of sorbitol in the organism; due to the transformation of the glucose in excess, catalyzed by the aldosa enzyme reductasa. Sorbitol is toxic for the crystalline (cataracts) and the nervous weave (neuropatías)

The insulin has the physiological paper to control glucemia and to favor the penetration of the glucose in the cells, by means of insulínicos receivers. The regulation of glucemia is extremely complex. It is possible to be compared to a balance that it has, on the one hand, a hipoglucemiante system: the insulin; and on the other hand a hiperglucemiante system: certain hormones under hipofisario control (hormone somatotropa, catecholamines and glucocorticoids) and glucagón.

The disturbance of this balance in the diabetics insulino - employees is not completely clear. It seems to be plurifactorial.

It is possible to be attributed to an accumulation of dietetic errors during many years, with an important consumption of saturated greasy elements and fast sugars.

Another predisponente factor could be the composition of the cellular membranes that are richer in phospholipids in people with excess of weight, which they would increase the rigidity of the same ones, and this would influence in the effectiveness of the insulínicos receivers. It is known that the membrane receivers need to move by the cellular membrane breaking through in the phospholipids to make contact with enemy with their specific hormone. The insulínicos receivers of the obese person have a smaller mobility, which causes a smaller effectiveness.

On the other hand, the nutritional sugar abuse produces an excessive stimulation of the páncreas that takes to a progressive exhaustion of producing insulin cells b.

The conjugación of these two phenomena (receiving less sensible and modified insulin secretions) cause a slow deterioration of the hipoglucemiante system, that is in the origin of the diabetic disease.

Treatment.

The treatment is based in the first place on a nutritional regime destined to reduce the ponderal overload and to diminish the fat and sugar contributions. The regime is, therefore, hypocaloric, with a daily ration between 1, 000 and 1, 600 calories, and hipoglucémico with an amount of glucose of 100 to 160 grams daily (to see table of regimes calculated for diabetics) The regime of the diabetic must be associated with oral anti - diabetics.

Treatment.

Classically the oral anti - diabetics are member of two great chemical groups: biguanidas and the hipoglucemiantes sulfonilureas.

Biguanidas.

The biguanidas ones are anti - hiperglucemiantes, nonhipoglucemiantes. They allow a better use of the glucose of the organism. Its prescription needs a normal renal function. They can produce lactic acidosis.

Sulfonilureas.

They are hipoglucemiantes that stimulate the pancreática insulin secretion. Its use is contraindicated in cases of renal or hepática insufficiency. They can cause hipoglucemia severe.

Treatment.

Two types of plants can be useful: hipoglucemiantes plants with mucílago (already studied) and plants like Eucalyptus, Ginseng and Fenogreco.

The fitoterapia anti - diabetic can be indicated in association with an appropriate dietetic regime and always with medical knowledge, in the following patients:

• In the latent diabetic, like treatment of balance and prevention of complications.

• In the diabetic itself:

Like treatment of first intention, before advising a treatment by biguanidas or sulfonilureas.

In case that the biguanidas ones are contraindicated and sulfonilureas.

Plants with mucílagos.

The plants with mucílago play an important role in the treatment anti - diabetic, since they have a favorable effect in the excess of weight and excessive secretions of the páncreas.

The hydrophilic properties of mucilaginosas fibers allow, when forming a gel, diminishing the assimilation of the nutrients (mainly sugars and fats) and to restrain the absorption of the glúcidos ones.

For these patients ispágula is used with more frequency (tegumento of the seed) that as already it has been said is rich in hidrosolubles fibers (to see ways of action of the mucílagos in the chapter of the obesity)

Hipoglucemiantes plants.

Numerous medicinal plants traditionally are used by their hipoglucemiantes properties. They are had counted up to 150 species pertaining to fifty different families. Recently, systematic experiences have been made in animals. Only some have been revealed like really effective, with a demonstrated activity. We have selected 3 that presents / displays a true therapeutic interest: Eucalyptus, Ginseng and Fenogreco.

Treatment.

The fitoterapia presents / displays a great interest in the preventive treatment of the complications that in the long term can undergo the diabetic. But it is indicated in the ocular and neurological complications, although also in the related ones to the micro - angiopatías.

Cataracts and neuropatías.

One has demonstrated at the moment that these complications are related to the excessive production of sorbitol in the diabetic. Sorbitol comes from the transformation of the glucose by the aldosa enzyme reductasa.

• At ocular level: The normal crystalline contains sorbitol in small amounts physiologically; the increase of the levels of sorbitol in the diabetic causes a opalescencia of the crystalline. It is the origin of the génesis of the cataract.

• At neurological level: The accumulation of sorbitol in the peripheral nervous completions is responsible for the appearance of diabetic neuropatías.

In Japan they are used traditionally, from the antiquity, two medicinal plants for the treatment of the neurological and ocular complications of the diabetic. These plants are:

• Glycyrrhiza glabra L. root) and white Paeonia (root)

Studies in vitro and alive made in different universities from Japan have demonstrated that these two plants contain polifenólicas molecules able to inhibit the aldosa reductasa. With the obtained experimental results, on the activity of these two plants, it has been confirmed that the traditional use of the same ones well was founded.

We have selected the white Paeonia, in which two components with a specially active inhibiting potential have been identified on the aldosa reductasa: they are the galoil - glucoses (1, 2, 3, 6 - tetra - or - galoil - b - D - glucose and 1. 2. 3. 4, 6 - pentomic - or galoil - b - D - glucose)

Micro - angiopatías.

The micro - angiopatías are responsible for serious complications in diabetics, specially retinitis that finishes, in the long term, in blindness, arteritis glomerulares that causes a renal insufficiency, and neuritis that cause the appearance of peripheral neuropatías. In order to fight the appearance of the angiopatías and to improve the microcirculatory upheavals an important plant sets out: the Ginkgo.

Plants adapted for this disease.

Eucalyptus.

Ginseng of Korea.

Fenogreco (alholva)

White Peonia.

Ginkgo.

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