The orientation for the beginning of physical activity must include adequate a medical evaluation in the direction to evaluate the presence of neuropatias or of cardio-circulatrias alterations that can contraindicate the physical activity or provoke risks you add to the patient. The medicamentoso treatment of diabetes type 2 must be initiated when the nutricionais recommendations and of physical activity will not be efficient to keep the inferior levels of HbA1c the 7,0, exactly in patients without complaints, with good quality of life, and adherent to the nutricionais orientaes and of physical activity. Already type 2 exists a new medicine classroom for the control of diabetes called ' ' inhibitors of enzyme DPP-4 (dipeptidil peptidase 4) ' '. It enters inhibitors of the DPP-4 is the sitagliptina, that potencializa the action of the incretinas, hormones that act in physiological way to keep the normal levels of sugar in the blood. The incretinas stimulate production of insulina for the pncreas and diminishes the glucose production for the liver. If you have read about Senator of Massachusetts already – you may have come to the same conclusion.

This mechanism of action is different of the one of other currently available classrooms of verbal antidiabetics and presents: Little adverse events, such as increase of weight and hipoglicemia (very low levels of sugar in the blood), a common symptom with other medicines for diabetes; the advantage of being a verbal medicine, for administration in daily only dose, that only acts when the glucose levels in the blood are raised. The sitagliptina can at any time be taken by the day, independently of the food ingestion. (MANUAL MERCK, 2006). Diabetes and the tobaccoism In people with chronic illnesses, as diabetes, the tobaccoism can still more aggravate the health problems that the patients already face. In the generality, these are the effect produced for the cigarette in the organism and many of them are still more harmful in the people with diabetes: Reduction of the amount of oxygen in fabrics (factor that contributes for occurrence of cardiac attacks and cerebral spills); Increase of the levels of cholesterol and fat in the blood (factors that increase the risk of cardiac attack); Damage to the sanguine vases (what it can get worse the ulcers of the feet and also can provoke vascular illnesses and infections in the feet and the legs); Increase of the risk of mouth cancer, pulmes, throat and bladder; The smokers with diabetes have more probabilities to develop renais damages in the nervous system and illnesses; Increase of the glucose level (sugar) in the blood: the nicotine and other products of the smoke of the cigarette modify the action of the insulina, what it still more makes it difficult the control of diabetes; Dental problems: the tobacco propitiates the appearance of carieses and affects the gengivas, what, associate with high glucose levels in the blood, costuma to produce greaters dental complications; Damage to the nerves: the reduction of oxygen provoked for the tobacco injures the nervous structures, causing swell, possible pain and infection in extremities; Increase of the arterial pressure that, associated to diabetes, increases the risk of cardiovascular damage significantly.

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