The use of physiotherapy in diabetes mellitus: basic methods and correct prescription. Diabetes

Therapy of diabetes mellitus in people of any age requires the use of integrated approach based on the application medicines, non-drug methods interventions and lifestyle changes. At the same time, non-drug methods of treatment, as well as changes in nutrition and in the level physical activity diabetic have great importance to control blood sugar levels.

Physiotherapy for diabetes is aimed at improving metabolic processes in the body, controlling glucose levels and preventing the development diabetic complications especially in elderly patients. Physiotherapy should always be prescribed only by a doctor and carried out in special rooms at medical institutions.

The impact of physiotherapy

Physiotherapy procedures are an important part of the treatment of diseases endocrine system. Wherein modern varieties This therapy allows you to have a complex effect on the body, which has a positive effect on general forecast for the patient.

Physiotherapy has on the human body a large number of various effects, each of which can either speed up the recovery of the patient, or slow it down. In this regard, the procedure is always prescribed only by the attending physician.

Proper use of physiotherapy for type 1 and type 2 diabetes can achieve the following positive effects:

• normalize the main indicators of metabolism;
• return blood glucose levels to normal;
• increase the concentration of insulin.

In addition to direct influence on metabolic processes, physiotherapy improves vascular tone and blood supply internal organs, and also allow to normalize the work of the peripheral and central nervous system. Such effects prevent the appearance of early and late effects diabetes associated with angiopathy, neuropathy, trophic ulcers, etc.

Varieties of physiotherapy

The physiotherapist has at his disposal a large number of various methods physiotherapy. The choice of a specific method is determined by the patient's condition, the severity of diabetes mellitus and the presence of its complications. It is very important to assess comorbidities in the patient, as they significantly affect the possibility of certain types physiotherapy.

Doctors distinguish the following types of physiotherapy procedures:

• with the use of hardware, for example, electrophoresis, magnetotherapy, etc.;
• without the use of devices: hydrotherapy, therapeutic massage;
• physiotherapy.

The choice of a specific method of physiotherapy is determined by the attending physician, who, after examining the patient, reveals his indications and contraindications.

Hardware methods of therapy

Modern physiotherapy equipment for diabetes mellitus makes it possible to provide patients with effective treatment at various options the course of the disease. In physiotherapy, various methods of hardware exposure are used.

It is possible to increase the effectiveness of physiotherapy with the help of a combination of various procedures, which are very often used in the prevention of complications of diabetes.

Application of magnetotherapy

The use of magnetic therapy is based on positive influence weak electromagnetic field on metabolic processes in biological tissues. When carrying out this procedure in diabetics, the main target of exposure is the pancreas. There is a large amount of scientific evidence that magnetotherapy can reduce blood sugar concentration and strengthen the walls vascular bed, stimulating metabolic reactions and regeneration in them. Such effects make it possible to effectively use magnetotherapy for the prevention and treatment of diabetic complications, primarily neuropathy.

Plasmapheresis

The procedure allows you to cleanse the blood of unwanted components, as well as add to it substances that have therapeutic effect. It is important to note that such physiotherapy is not carried out for all patients, but only for those who have severe diabetic kidney tissue damage and symptoms. kidney failure.

Electrophoresis treatment

Electrophoretic treatment is used in therapy a large number diseases. In this case, the main biological effect of the method is associated with two types of exposure. First, in body tissues under the action of electric current there is a galvanic effect that stimulates regeneration and metabolic processes. Secondly, electrophoresis makes it possible to effectively deliver drugs to the body through skin. As a rule, solutions with the following trace elements are used for this procedure: zinc, copper, potassium, magnesium and calcium. Apart from them, wide application finds electrophoresis with nicotinic acid, novocaine and sodium thiosulfate.

Hyperbaric oxygen therapy

Hyperbaric oxygen therapy can be used in patients with any type of diabetes mellitus. This procedure allows you to increase the oxygen content in the blood, which improves its delivery to the peripheral tissues of the body, since in connection with the development of angiopathy, this process is disturbed. Intermittent hyperbaric oxygen therapy is also used to prevent trophic ulcers and other complications associated with inadequate tissue nutrition.

Physiotherapy

Therapeutic exercise is recommended for all patients with a diagnosis of diabetes mellitus. Exercise stress improves blood circulation in the body, stimulates metabolism, and also prevents weight gain. It is important to note that the attending physician, who has information about the nature of the course of diabetes in a patient, as well as about the limitations of his health, should select exercises for classes. In addition to standard gymnastic complexes, exercise therapy includes the following types loads:

• running or walking for various distances;
• visiting the pool;
• Biking.

The intensity of exercise is always determined by the level of health of the patient, as well as the degree of his physical development. Under no circumstances should you work on your own. power types sports, because overload can accelerate the course of the underlying disease.

Rational use of physiotherapy, together with drug treatment and dietary changes can improve the prognosis for patients with diabetes and improve their quality of life. Medical institutions offer a large number of different methods of physiotherapy, each of which has its own effect on the body, has indications and contraindications. In this regard, only the attending physician, who is able to assess the state of health of a diabetic and analyze the methods of physiotherapy available in the hospital, should select physiotherapeutic effects. In no case should you try to carry out such therapy yourself, as this is fraught with the progression of the disease and the development of complications.

IN complex treatment diabetes mellitus, as well as its complications, one of the effective additional methods considered physiotherapy. Certain physiotherapeutic procedures have an undoubted therapeutic effect in diabetes. The main points are the fact that hardware physiotherapy, contributing to the normalization of disorders of carbohydrate, protein, lipid and mineral species metabolism as a whole, also has a certain effect, due to which the level of sugar in the blood decreases somewhat. According to the concepts of modern medical science, this effect is due, on the one hand, to an increase in certain types physiotherapeutic effect of the level of immunoreactive insulin in the blood serum, and on the other hand, a simultaneous decrease in the effect of both hormonal and non-hormonal insulin antagonists.

The main place in a number of physiotherapeutic procedures that are successfully used in the treatment of diabetes mellitus and a number of its complications is occupied by medicinal electrophoresis and ultrasound therapy.

The effectiveness of ultrasound therapy in the treatment of diabetes is due to its ability to reduce blood sugar levels. Ultrasound for this purpose affects the projection area of ​​the pancreas; procedures are carried out daily, 10 sessions per course of treatment. The impact of ultrasound on the liver area improves most of the indicators carbohydrate metabolism, noted favorable influence on blood circulation in the liver.

Electrophoresis should be discussed in more detail, due to its significant effectiveness, and especially, as will be shown below, in the treatment of complications of diabetes mellitus. First of all, drug electrophoresis occupies a very significant place in the treatment of diabetic retinopathy due to its ability to provide anti-inflammatory, resolving, trophic, hyposensitizing and anti-sclerotic effects. In the presence of hemorrhages, heparin electrophoresis is recommended, in case of vascular sclerosis - electrophoresis of a potassium iodide solution. With angiospasms, degenerative changes retinal electrophoresis applied nicotinic acid, a mixture of aloe (in a dilution of 1: 3) with vitamins PP, C, a mixture of 1% nicotinic acid and potassium iodide.

If diabetes mellitus is associated with ischemic disease hearts, good effect renders electrophoresis vasodilators(eufillin, papaverine), as well as heparin.

In addition, in fact, the following types of this procedure always give excellent results:

• Zinc electrophoresis on the epigastric region is used to improve functional state islets of Langerhans in the pancreas, where the beta cells responsible for insulin production are concentrated.
• Collar zone calcium electrophoresis. To reduce blood sugar levels, it is recommended every other day, 12 sessions per course of treatment.
• Electrophoresis of nicotinic acid on the epigastric region (12 procedures per course). To improve the function of the pancreas, as well as the liver.
• Electrophoresis of magnesium, papaverine solution - on the liver area in case of liver damage in patients with diabetes mellitus, 12-15 such procedures per course of treatment, as a rule, give positive effect with fatty degeneration of the liver.
• Copper electrophoresis for general stimulation of the circulatory system can improve microcirculation and, consequently, metabolic processes in tissues. Appoint by general methodology to improve redox processes and lower blood sugar.
• Potassium electrophoresis is indicated in connection with the increased loss of potassium in diabetes mellitus and some of its complications.
• magnesium electrophoresis. The trace element magnesium takes part in the processes of carbohydrate metabolism, activates a number of enzymes, reduces the level of cholesterol in the blood (for a course of treatment - 10 - 12 procedures).

Medical therapy and physiotherapy. The latter in diabetes is used as ancillary procedures that stimulate the work of the human body.

Physiotherapy refers to additional ways therapy and.

It allows you to simultaneously solve a number of problems: normalize mineral, carbohydrate, protein and lipid metabolism, reduce glycemia and increase blood levels of immunoreactive insulin.

Varieties of physiotherapy for diabetics

Physiotherapy procedures increase efficiency, general condition of the body, improve. Additional effect is to lower blood sugar and strengthen the immune system. Depending on the severity of the disease and the presence of concomitant diseases, various manipulations can be prescribed for therapy.

Balneotherapy

Balneotherapy is indicated for patients with mild form diabetes or moderate illness.

The hydrotherapy procedure is designed to slow down the development of the disease and prevent the occurrence of concomitant ailments:

• fatty infiltration;
• cholecystitis;
• hepatitis;
• enterocolitis;
• gastritis;

The nature of mineral water treatment depends on the type concomitant diseases. Based on this, the type mineral water and the method of its reception.

Balneotherapy has a positive effect on insulin production and carbohydrate metabolism. Hydrocarbonate and sulfate waters are useful in this case.

Magnetotherapy

During complex procedures in the treatment of type 1 and type 2 diabetes along with drug therapy, diet and moderate magnetic therapy is used. Advantage this method lies in the absence side effects and that the sessions are not addictive.

Magnetotherapy

The basis of the technique is the impact of various magnetic fields on the patient's body. The magnetic field has a high bioactivity, stimulates peripheral circulation and hemodynamics. The procedure is carried out using special devices "Pole", "Olympus", "Hummingbird", "Almag" and the like.

The advantages of the technique are:

• reducing development risks - or;
• stimulation ;
• stabilization of digestive functions.

In diabetes mellitus, magnetotherapy is used as aid during complex treatment.

electrophoresis

The procedure allows you to improve the functioning of the islets of Langerhans, which are responsible for the production of insulin. It is carried out according to the Vermel method or transversely on the epigastric region. Electrophoresis is necessary to reduce blood sugar and improve the redox reactions of the body.

Medicinal electrophoresis involves the use of drugs that:

• normalize the work of the adrenal glands, thereby affecting the insular apparatus;
• restore tone;
• improve;
• participate in the oxidation of carbohydrates;
• reduce blood sugar levels;
• improve carbohydrate metabolism.

Electrophoresis is carried out using Novocaine with iodine, Papaverine, No-shpy.

In severe or moderate stages of diabetes, Prozerin or Dibazol is used, as well as a 1% solution of nicotinic acid on the legs.

Oxygen therapy (oxygenation)

This technique involves the supply of oxygen under high pressure. Used in the treatment of type 1 and type 2 diabetes.

Oxygen therapy relieves hypoxia, from which patients often suffer. The duration of the course is 10-12 procedures, each lasting from 40 to 60 minutes.

The onset of positive dynamics is noted in a few days. After a course of treatment, the patient eliminates the consequences of diabetes, including hypoxia. Hearing is greatly aggravated and the work of the pancreas, other organs and the circulatory system improves.

Acupressure, acupuncture and acupuncture

Massage treatments aimed at normalizing general well-being, restoration of blood flow, elimination of the consequences of damage nerve endings. To this end, many diabetics are prescribed acupuncture, acupressure and acupuncture.

Procedures help:

• improvement nerve conduction fabrics;
• reduction of pain;
• foot sensitivity.

During point massage (acupressure), certain points on the patient's body are stimulated. The duration of the course is two weeks. Massage is carried out daily and helps to regulate.

Massage treatments for diabetes are a therapeutic manipulation that relaxes muscles, improves blood circulation and regulates the level of glucose in the body.

Plasmapheresis

If problems with sugar content are accompanied by renal failure and septic, the patient is recommended to undergo a course of plasmapheresis.

During the procedure, the patient's blood plasma is cleaned with special substances.

Plasmapheresis helps to remove various pathological products from the body through blood purification. During the purification process, the patient's plasma is filtered, purified in a special apparatus and returned back.

The blood becomes cleaner due to the removal of toxins and toxins contained in it. Harmful substances contribute to the development of pathologies and inflammatory processes. After the procedure, the blood becomes not so viscous, it passes well through circulatory system and nourishes all organs and tissues.

Ozone treatment (ozone therapy)

After the procedure, the permeability of cell walls for glucose improves. This reduces hyperglycemia. Ozone helps to improve sugar metabolism in red blood cells, giving the body tissues additional oxygen. This eliminates tissue hypoxia.

Ozone therapy prevents the occurrence of a number of dangerous complications:

Types of procedures are prescribed by the doctor based on the patient's condition. The shower can be needle, rising, dust, Scottish and rain.

The impact of water jets on the body has a very beneficial effect on the patient's well-being. Baths can also be different: general and local. During the procedure, the water in the bath must be at a certain temperature and be at a certain level of vibration.

Thermal waters, wiping ( cold water) and a visit to the bathhouse (hot steam).

Complex of physiotherapy exercises

Is integral part treatment complex.

Doable physical exercise stimulate tissue metabolism, promote the utilization of sugar in the body and its deposition in the muscles.

It has been established that physical therapy in some cases can lower the blood sugar to a normal value. Dosed exercise enhances the action of insulin and reduces its dose.

Related videos

About the methods of physiotherapy used for diabetes in the video:

Diabetes refers to serious illnesses, But modern medicine has ways to alleviate the condition of patients and reduce the manifestation of symptoms of the disease. Innovative technologies combined with compliance with all medical advice significantly improve the quality of life of a diabetic patient.

sports loads, proper nutrition and physiotherapy for diabetes mellitus are the main components of treatment in addition to drugs. Physiotherapy procedures allow you to normalize metabolic processes in the body, improve the functioning of the pancreas. In addition, physiotherapy methods normalize the concentration of glucose in the blood.

The effectiveness of physiotherapy procedures

The effect on the body of various physical factors called physical therapy. Physiotherapy can be carried out both with the help of additional equipment and without it. Physiotherapy is additional element complex therapy of diabetes mellitus. In addition, they allow you to reduce the dosage of medications. Physiotherapy for type 1 and type 2 diabetes is aimed at solving several problems:

• normalization of metabolism (metabolism in the body);
• normalizing the concentration of sugar in the blood;
• an increase in insulin levels in the blood.

In addition, the effectiveness of physiotherapy is that they improve blood circulation and vascular tone, have a beneficial effect on nervous system and sleep quality. Thanks to this, physiotherapeutic procedures can prevent or reduce the manifestations of diabetic complications, in particular angiopathy and neuropathy.

Types of physiotherapy for diabetes

There are quite a large number of methods and procedures of physiotherapy. For each patient, the type of treatment is selected individually, depending on the severity of the disease, the presence or absence of complications and concomitant diseases. Physiotherapy treatments include:

• hardware therapy - electrotherapy, blood purification, etc.;
• medical. physical education;
• acupuncture;
• non-apparatus treatment - phytotherapy, hydrotherapy.

Exercise therapy

Running is one of the elements of exercise therapy for patients with high sugar in blood.

Physiotherapy useful for patients with diabetes in that due to sports exercises improves blood circulation, normalizes metabolic processes, reduces excess weight. A set of exercises is selected individually depending on the severity of diabetes, the presence or absence of complications and comorbidities. TO exercise therapy useful for the prevention of development diabetic angiopathy. TO physiotherapy exercises relate:

• walking;
• swimming;
• nordic walking;
• morning work-out.

Self-selection of exercises is prohibited. Complex exercise therapy appointed by the attending physician individually.

Magnetic Therapy

With this type of physiotherapy, the body of a patient with diabetes is affected magnetic field. The main area of ​​influence in a diabetic is the pancreas. Magnetotherapy helps to reduce the concentration of glucose in the blood, strengthens vascular walls, removes pain. This technique is the main component of the prevention and treatment of diabetic neuropathy.

Plasmapheresis treatment

Plasmapheresis refers to physiotherapeutic methods of blood purification. During this procedure, the patient's plasma is cleaned and replaced with special substances. This technique is most effective for diabetic patients with renal vascular angiopathy and renal insufficiency.

Electrophoresis contributes to the normalization of the secretory function of the pancreas.

Electrophoresis is the most widely used physiotherapy prescribed for the treatment of diabetes mellitus. The essence of this technique is that medicinal substance passed into the body through the action of an electromagnetic field. The electrophoresis procedure is more often used in type 1 diabetes mellitus. Most often, in diabetes, they resort to electrophoresis using minerals:

• zinc;
• copper;
• magnesium;
• potassium;
• calcium.

Zinc-based electrophoresis is used to stimulate pancreatic secretion. In addition, in such a situation, electrophoresis using nicotinic acid is effective. In addition, for the prevention and treatment of diabetic angiopathy and neuropathy, this physiotherapy is carried out using novocaine and a 5% solution of sodium thiosulfate.

Oxygenation procedure

Hyperbaric oxygenation is a physiotherapy technique based on the treatment of diabetes mellitus with oxygen at increased atmospheric pressure. This type of treatment is suitable for diabetics of any type. This physiotherapy helps prevent the development of oxygen deficiency in tissues and organs, normalizes the transport of oxygen in the body. Thanks to this method of physiotherapy, diabetic patients can reduce the dosage of insulin or antidiabetic drugs. In addition, oxygenation also includes the use of oxygen cocktails. They contribute to weight loss, improve tissue oxygenation. Oxygen foam is recommended to be consumed three times a day, an hour before meals: thus, there is a feeling of satiety and the diabetic patient eats less food, due to which the excess weight disappears.

These are the views non-drug treatment aimed at improving the functions of the insular apparatus and enhancing the hypoglycemic effect of insulin, sulfonamides, biguanides, and mainly for the treatment of complications of diabetes mellitus.

Hyperbaric oxygen therapy (HBO)

In diabetes mellitus, the oxygen transport function of the blood decreases, which leads to oxygen deficiency fabrics. The elimination of these phenomena improves the absorption of glucose by tissues. HBO also contributes to the restoration of normal gas composition blood, normalization acid-base balance, increasing the sensitivity of insulin receptors, activating glycolysis, etc. It is recommended to carry out 10-15 HBO sessions per course of treatment with a session duration of 40-60 minutes. Sessions are held daily. HBO is especially good to prescribe for decompensation of diabetes mellitus, with diabetic angiopathy lower extremities even with the phenomena of gangrene, as well as with diabetic polyneuropathy.

The use of oxygen foam inside also contributes to the improvement of metabolism. This procedure also contributes to the reduction of body weight with its excess, reduces dyspepsia, since the foam stretches the stomach and gives a feeling of satiety, which reduces the amount of food taken, and oxygen has a positive effect on redox processes.

For the preparation of oxygen foam, infusions and decoctions from medicinal plants, for example, a rosehip infusion or a decoction of oats. Whipped protein is added to them chicken egg(for 2 liters take the protein of 1 egg). The finished mixture is foamed by passing oxygen through it using the Health apparatus.

Patients take oxygen foam 2-3 times a day 1 hour before meals in a volume that causes a feeling of fullness. The course of treatment is 3-6 months under medical and laboratory supervision.

The use of oxygen foam is contraindicated in acute gastrointestinal bleeding, attacks of pancreatitis, adhesive disease, frequent seizures angina.

Use and impact on the area of ​​projection of the pancreas microwave therapy decimeter range. The duration of the procedure is 10 minutes, the course of treatment is 10 procedures. Microwave therapy improves metabolic processes in the gland tissue, improves blood flow in it, and stimulates insulin production.

Ultrasound stimulation of the pancreas

is performed daily for 5 minutes, for a course of 10 procedures.

This method of exposure stimulates the production of insulin.

Exposure to an alternating magnetic field improves microcirculation and is used for neuropathy.

Acupuncture, or acupuncture, is used for neuropathy and consists in the introduction of special needles into biologically active points. Assign 2-3 courses of treatment for 10 sessions each. As a result, there is an improvement general condition patients, reducing pain and improving the sensitivity of the lower extremities, the glucose content in the blood and urine temporarily decreases, which may require an adjustment in the dose of insulin.

They also use electric and laser acupuncture, acupressure, exposure to a constant magnetic field, microwaves with the frequency of the human biofield.

Laser acupuncture can be used as prescribed by the attending physician.

In diabetes mellitus, treatment methods such as hemosorption, enterosorption, and plasmapheresis can be used.

Hemosorption is often used in diabetes mellitus complicated by diabetic nephropathy. The duration of the session is 60-90 minutes. At the same time, carbohydrate metabolism improves.

Enterosorption is the intake of sorbents inside. In 50% of patients, it is possible to reduce the dose of insulin and other hypoglycemic agents, improve lipid metabolism, and reduce the manifestations of polyneuropathy.

Plasmapheresis is the removal of the patient's plasma and its replacement with plasma substitutes. The method is applied when septic complications and in renal failure.

ultraviolet irradiation blood is a method used in complex therapy for a combination of purulent-inflammatory and allergic diseases.