Diabetes is a disease in which the body either doesn't produce insulin, or it doesn't properly use insulin, or both. Insulin is a hormone produced by the pancreas that metabolizes glucose, which is the source of energy for cells in the body. 

    There are two types of diabetes -- type I and type II.

    Type I affects about 10 percent of all diabetes. I am a type I. My body doesn't produce insulin, so I need to take extra insulin for it to metabolize any carbohydrates that I eat. 

    Insulin cannot be taken orally, so it must taken by injection or by insulin pump, which is a tiny device that connects to the body with plastic tubing and feeds a constant drip of insulin. I use an insulin pump.

    With type II diabetes, which is much more common, the body generally produces some insulin, but it isn't able to process it properly. Type II is often associated with obesity, and part of the difficulty for type II diabetics is that the extra insulin, which is circulating unused in the body, also causes the body to hold on to fat cells. A fine balance must be found between managing insulin sensitivity and losing weight.

    Most type II diabetics are able to take oral drugs that allow their body to properly use the insulin they produce. Obesity is a known risk factor for type II diabetes, and its incidence has increased as obesity rates have climbed.

    The key to good diabetes control is blood sugar, or glucose, management. And the reality is that poor glucose control dramatically increases the risk for health complications related to heart and blood vessel disease: heart attacks, stroke, blindness and peripheral vascular disease, when blood flow to the limbs becomes impaired -- sometimes resulting in amputation.

    All of these problems can develop when a trio of factors -- blood glucose, blood pressure and cholesterol levels -- are not kept within recommended ranges. That's why the concept of "control" is such an important aspect of being diabetic.

    The goal is to mimic what the body would do if it were producing insulin. Normally the body would make smaller, steady amounts of insulin between meals and overnight. This is called the basal rate. And the body would produce larger amounts when you eat in order to burn off the carbohydrates. This is called a bolus.

    Diabetics who inject insulin generally use two types: a slower-acting product that manages the basal rate, and a quicker-acting bolus insulin when they eat food. The bolus and basal rates work to keep blood sugars constantly in control.

    Insulin pumps do much the same thing. These are small devices connected to the body by a small tube. The pump can be used to drip insulin into the body to maintain the basal rate, then give extra boluses with meals.

    糖尿病是由于身體內(nèi)部不再產(chǎn)生胰島素,或者不能夠合理的利用胰島素,或者兩種情況同時(shí)發(fā)生的情況下導(dǎo)致的一種疾病.胰島素,是由促進(jìn)葡萄糖代謝的胰腺產(chǎn)生的,而葡萄糖則是我們身體里細(xì)胞能量的來源.

    糖尿病分為I型和II型兩種類型.

    I型糖尿病患者大約占了總的糖尿病患者的10%.我也是I型糖尿病患者.我的身體沒辦法自動(dòng)產(chǎn)生胰島素,因此只能依靠外部注射的胰島素來促進(jìn)我所吃的各種碳水化合物的新陳代謝.

    胰島素沒辦法通過口服來吸收,必須通過注射或者通過胰島素泵來吸收.胰島素泵是通過塑料管連接身體然后一滴滴,持續(xù)地將胰島素注進(jìn)身體的一種小儀器.我也在用.

    II型的糖尿病是比較常見的,此類型的患者,身體一般都能夠自動(dòng)產(chǎn)生一些胰島素,只是沒有辦法有效利用.II型的糖尿病容易造成肥胖,而在體內(nèi)循環(huán),沒有被使用的那部分多余的胰島素對(duì)II型糖尿病患者造成了一部分的困難,這也造成身體堆積了脂肪細(xì)胞.所以,必須在控制胰島素敏感因子和減肥之間找到一個(gè)好的平衡點(diǎn).

    大部分II型患者都能夠通過口服藥物來使得身體能夠合理利用所分泌的胰島素.肥胖對(duì)于II型患者來說,是常見的一個(gè)危險(xiǎn)的因素,所以,II型糖尿病的影響范圍也隨著肥胖比例的上升而攀升.

    血糖或者葡萄糖的調(diào)節(jié),是控制好糖尿病的關(guān)鍵.現(xiàn)實(shí)中對(duì)葡萄糖缺乏有效的控制,顯著地增加了另外一些跟心血管疾病相關(guān)的并發(fā)癥發(fā)生的風(fēng)險(xiǎn),諸如心臟病,中風(fēng),失明和微血管病,當(dāng)流向四肢的血液不足時(shí),有時(shí)候可能導(dǎo)致截肢情況的發(fā)生.

    當(dāng)血糖,血壓和膽固醇水平這三種因子沒保持在合適的范圍內(nèi),所有的這些問題都有可能發(fā)生.這也是為什么"控制"對(duì)于糖尿病患者來說是一個(gè)這么重要的概念了.

    控制的目標(biāo)是為了模擬身體在分泌胰島素時(shí)的反應(yīng).正常來講,身體本身會(huì)三餐之間和夜間會(huì)分泌小量,持續(xù)穩(wěn)定的胰島素,即基礎(chǔ)量.而當(dāng)你飲食的時(shí)候,身體為了分解碳水化合物,通常會(huì)產(chǎn)生比較大數(shù)量的胰島素,即餐前量.

    糖尿病患者一般注射兩種類型的胰島素:一種是調(diào)節(jié)基礎(chǔ)率的短效胰島素,另一種是進(jìn)餐時(shí)注射的速效胰島素. 餐前量和基礎(chǔ)量的調(diào)節(jié),保證血糖持續(xù)得到控制.

    胰島素泵的用處大同小異. 這些小儀器通過一個(gè)小管連接到身體,持續(xù)將胰島素注射進(jìn)身體,保持基礎(chǔ)率,而在進(jìn)餐的時(shí)候追加劑量