DEFINITION:
disorder(confusion) of the bound(connected) hydrocarbon metabolism either in a deficit of insulin, or in an abnormal resistance in this hormone, where from an abnormal accumulation of glucose in tissues
To WHAT IS OF USE The INSULIN? She(it) favors the penetration of the glucose in cells. The insulin is secreted by the pancreas and more exactly by the Langerhans cells of this organ.
Who provokes the secretion of the insulin?
The passage of the acid stomach chyme in the duodenum, provokes the production of the secretin, which by humeral way(pathway), acts on cells béta of Langerhans of the pancreas who secrètent the insulin.
SAFE(SURE) WHAT IS BASED THE REGIME(DIET) OF MONTIGNAC?
(Weight-reducing diet)
On the separation and the estrangement in the time(weather), of the entrance(entry) and of the main course, some dessert. This last one containing essentially carbohydrates, may favor more the secretion of the insulin and consequently the penetration of the nourishing(nutritious) elements in cells.
WHY FOOD AND DIET DRINKS? The sugar which is added to them, is the aspartame, which is a sweetener of synthesis; his(her,its) consumption may not provoke the secretion of insulin.
WHY A BOTTOM Of EYE?
He allows to see the state of the retina and the second nerve, and more exactly the state of arteries and veins, susceptible to be distorted(altered) in the diabetes.
WHY TO MAKE AN ANGIOGRAPHY?
She allows to visualize(display) haircare(capillaries), not seen by the bottom of simple eye; now, haircare(capillary) is the first ones to be affected(touched) in the diabetes.
AGGRAVATING FACTORS OF the DIABETES: essentially the association with a high blood pressure; obviously the smoking(tobacco), the regime(diet), the sedentary lifestyle…
MEDICAL TREATMENT(PROCESSING) It is the oral treatment, essentially substances which improve the secretion of the insulin by the pancreas. A well led(driven) treatment(processing) delays many the appearance of the diabetic retinitis.
TREATMENT(PROCESSING) BY INJECTION of the insulin by needles.
TREATMENT(PROCESSING) Has The TRIAL ( 2004 ) implanting(implantation) of pump with an autonomy of approximately 10 years. The progress of biomaterials and microelectronics, development(clarification) of stable insulins, allows a drip(perfusion) of insulin by peritoneal way(pathway), in a continuous way, prolonged and programmable today. (Pr J. BRINGER Montpelier)
TREATMENT(PROCESSING) OF THE EYE DAMAGE
The damage are essentially retinal, and the result(profit) of an ischemia, a lack of vascularization, which, in the long run, provoke the raid within the retina of new vessels of substitution says neovessels; the hatching of these new vessels destroys in the passage in particular cones and surrounding sticks. So the treatment(processing) consists you he(it), for the moment, to destroy the being born neovessels before they expand. Destruction by the photocoagulation in the laser.
TREATMENT(PROCESSING) OF FUTURE
Recently the discovery of substances which prevent the hatching of neovessels is promising. Substances ” Here stops(arrests) the translation ” called anti-angiogenic. They fight against a substance, called VEGF or Vascular Endothélialgrowth Factor, who favors the birth of neovascularization within ischémiés tissues (missing vascularization). They are on approval by vitreous intra injection.
Trials of intra-vitreous injection of adrenal steroids are in progress, or of intra-vitreous implants relarguant of the adrenal steroids. Trials of antagonist’s muscle intra injections of the growth hormone are in progress. The acetate of anécortave is an angiostatique steroid to periocular administration in experiment.
The PEDF or Pigmental Epithélial Dérived Factor, pigmentary factor derived of the epithelium, a freed(delivered) viralement inhibiting factor, is the first gene therapy which is the object of a clinical trial. The squalamine is another inhibiting factor of the angiogénèse administered by venous intra way(pathway).
We so see that the method of destruction of neovessels is going to be supplanted in the future by a medical treatment(processing) which will stop(arrest) the problems to the source(spring). As well as antituberculostatic antibiotics replaced the amputations(dismembrements) of lungs, we attend the succession(advent) of new molecules which will allow to warn(prevent) diabetic retinites and neovascularizations of the DMLA, without resorting(turning) to the photocoagulation.
RECOMMENDATIONS FOR THE DIABETICS
– Try to have an overtaking glycemia 1gramme 40.
An unstable diabetes balances itself by stages over three months
– In case of high blood pressure, its control is essential.
– a glycosilée hemoglobin not exceeding 7 % HbA1c).
– Normal vision does not want to say healthy retina: threatening retinal damage can evolve while the central vision is still good. A fundus oculi a year is indispensable.
– Young women: try to have your children before the installation of the diabetic retinitis; the pregnancy risks to aggravate this last one.
