View source for Pharmacotherapy of complications of diabetes

== Diabetic ketoacidosis and hyperosmolar coma ==
* '''[[ insulin ]]''' i . v. infusion
* payment deficit fluids and minerals
** first '''[[ physiological solution ]]'''
** Mon decline blood glucose below 15 mmol /l '''5% solution glucose '''
** replacement potassium KCl solution _ _

== Hypoglycemia ==
* ''' lighter form''': glucose po
* ''' harder form''': glucose after or glucagon sc or and _ m.

== Chronic complication diabetes ==
The key is prevention complications by maintaining [[ Glycemia|normoglycemia ]].

=== Diabetic nephropathy <ref name=":0">SUCHOPÁR, Josef, VALENTOVÁ, Štěpánka , ed. '' Remedia compendium''. 4th ed . Prague: Panax , 2009. < nowiki >ISBN 978-80-902806-4-9</ nowiki >.</ref> ===
'' More details in the article '' [[ Complications diabetes mellitus#Diabetic.C3.A1 nephropathy|Complications diabetes mellitu ]]

In the period when she is present only microalbuminuria whose proteinuria without signs reduced function kidneys , it is necessary effectively heal hypertension ( mainly '''[[ACE inhibitors]]'''), strive for ''' good compensation diabetes ''' and ''' treat and asymptomatic infection urinary roads '''.

In stage chronic insufficiency kidney is necessary reduce income proteins in diet , according to needs edit income sodium , potassium and fluids . Calcium and active salts should be given metabolites of [[Vitamin D|vitamin D]]. In case needs must be corrected _ disorders blood formation and metabolic acidosis '''. At high levels acid urinary is appropriate administer '''[[ Antiuratics|allopurinol ]]''' and according '''[[ hypolipidemic ]]''' needs . Sick in the terminal stages insufficiency kidneys they are included in [[ Hemodialysis|hemodialysis ]] transplant program .

=== Diabetic retinopathy <ref>KALVODOVÁ, Bohdana and Pavlína SKALICKÁ. Diabetic retinopathy - options pharmacotherapy and advances in treatment . '' Remedia '' [online]. 2014, (1) [cit. 2018-08-01]. Available from: <nowiki>http://www.remedia.cz/Okruhy-temat/Diabetologie/Diabeticka-retinopatie-moznosti-pharmakoterapie-a-pokroky-v-lecbe/8-V-1C8.magarticle.aspx</nowiki ></ref> ===
'' More details in the article '' [[ Complications diabetes mellitus#Diabetic.C3.A1 retinopathy|Complications diabetes mellitu ]]

Anti-VEGF therapy intravitreal ( ranibizumab , aflibercept ) prevents proliferation vessel .

=== Diabetic polyneuropathy <ref name=":0" /> ===
'' More details in the article '' [[ Complications diabetes mellitus#Diabetic.C3.A1 polyneuropathy|Complications diabetes mellitu ]]

Therapy is mostly symptomatic .

For paresthesia and sensorimotor pain _ neuropathy ''' are used [[ Non-opioid analgesics|analgesics ]] (aspirin, paracetamol), [[ tricyclic antidepressants ]], [[ Antiepileptics|carbamazepine ]] or acid thiocto . ''' Acid thiocto '' is a similar substance vitamins with function coenzyme . It improves endoneural perfusion , increases level physiological antioxidant glutathione and itself as an antioxidant reduces amount free oxygen radicals in the nerve disabled diabetic polyneuropathy . Clinical experiences have proven favorably effects on symptoms such as burning , paresthesia , numbness and pain .<ref>THIOGAMMA 600 ORAL Coated SPC tablet . '' Mediatels database of Medicines '' [online]. [feeling. 2018-08-01]. Available from: <nowiki>https://mediately.co/cz/drugs/NRbOhVL5i0b4S3POU6kmXDcFm8o/thiogamma-600-oral-potahovana-tableta</nowiki></ref>

'''U autonomous neuropathy ''' affecting digestive device it happens the biggest a problem diarrhea , for which it is suitable administration [[ Antidiarrheic|antidiarrheic ]]. Vomiting and more speeches diabetic gastroparesis they can favorably affect [[ prokinetics ]]. In neuropathic orthostatic hypotension is necessary revise existing antihypertensive therapy and exclude medicines that can _ _ on trouble participate with their own unwanted effects . Patients with neurogenic urinary bladder you are at micturition they can help repeated pressure on buckle stydkou , in the austere cases themselves _ they coil . Pharmacologically you can try administer [[ cholinergic ]] or α-1-[[ sympatholytic ]].

=== Diabetic leg ===
Antibacterial therapy guided on basis results cultivation examination and local therapy , focused on systematic cleaning wounds , support granulation and epithelization ( see [[ Therapy ulcers and wounds]]).

In therapy angiopathic diabetic foot is the principle improvement vascular supply ([[ Percutaneous transluminal angioplasty|PTA ]]) that is indicated on basis angiographic examination . In patients with peripheral diffuse disabilities , in which can't to perform revascularization is possible serve drugs for '''' prophylaxis emergence thrombotic closures ''' and to ''' improvement flow Properties blood ''' - haemoreologica ( pentoxifylline ), vasoactive substances , prostanoids ( alprostadil , iloprost ), also [[ anti- aggregation ]] or oral [[ anticoagulants ]], though effect pharmacotherapy is questionable .<ref name=":0" />
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[[ Category : Pharmacology ]]