The term"diabetes mellitus"name a whole group of endocrine diseases, united by one common feature: they are based on disorders of carbohydrate metabolism. The body develops a deficiency of the hormone insulin produced by the pancreas, or the body's cells stop responding adequately to it, which causes an increase in the level of glucose in the blood plasma. At the same time, cells suffer from energy deficiency and starve, even with a sufficient intake of carbohydrates from food.
Among all endocrine diseases, diabetes mellitus in women and men is the most common. There are more than 250 million people in the world with different types of this pathology. In our country, diabetics represent approximately 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply have not yet been identified, so the true rate could be nearly double.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered polyetiological: there are several theories about the occurrence of disorders of carbohydrate metabolism and problems with insulin. A special role is played by unfavorable heredity if close relatives suffer from diabetes.
Additionally, some factors and triggers can become provocative. This:
- poor diet with excess light carbohydrates, refined foods, fast food, saturated and trans fats and lack of dietary fibre;
- overweight and obesity (particularly dangerous are a BMI above 30 and fat deposits in the anterior abdominal wall);
- chronic disorders of the water-electrolyte balance;
- endocrine pathologies (Cushing's disease, thyroid hyperfunction);
- chronic long-term physical and psycho-emotional stress;
- complications of "childhood infections", especially measles, rubella and chickenpox;
- abdominal lesions affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, ductal stones.
A high risk of diabetes is possible in children born to mothers who suffered from the gestational form of the disease, if the child was born with a high weight, had problems with glucose levels in the first days of life;
Symptoms of the disease
In the initial stage, diabetes mellitus has practically no pronounced symptoms. Often the first warning signs are mistaken for overwork, infections or the consequences of stress. But it is important to pay attention to the combination of symptoms, which in themselves can be signs of other diseases, but when combined indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, severe thirst with insufficient or excessive fluid intake;
- frequent urination, copious urine production (up to 3-5 liters or more);
- dry skin, itching sensation in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, specific sweetish odor of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant tiredness, drowsiness, decreased performance.
Besides, there might befainting, loss of consciousness, malaise, dizziness. Often, people first learn of their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development and in the initial stage differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of the immune system's aggression against the pancreatic cells that synthesize insulin. As a result, the production of the hormone gradually decreases, reaching a critical level, while the blood sugar (plasma glucose) level increases. This form of diabetes occurs most often in children and young people; at an advanced age it is possible against the background of necrosis of the pancreas due to complicated pancreatitis or removal of an organ. The basis of therapy is the use of insulin.
Type 2 or insulin-resistant diabetes (independent)occurs more often in older or overweight people. It occurs due to reduced cellular sensitivity to insulin, which often occurs due to obesity and metabolic disorders. Correction is possible with diet and hypoglycemic drugs.
Furthermore, there are other specific forms of diabetes:
- gestational– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, serious damage to the pancreas;
- LADA-diabetes(stands for latent autoimmune diabetes), presents mild symptoms, does not require insulin injections;
- MODY-diabetes- This is a special genetic form of the disease.
You can have any form of diabetessimple (controlled)ANDcomplicated course.
Complications of the disease
If a patient with diabetes mellitus ignores the doctor's recommendations, does not follow a diet or refuses to take medications, the disease can be complicated by serious pathologies and changes in the body that put disability and even life at risk. This:
- severe visual impairment, damage to structures inside the eyeball and its vessels;
- formation of persistent hypertension (increased blood pressure);
- disorders of lipid metabolism, increased "bad" cholesterol, leading to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disorders in the extremities (neuropathy), blood flow disorders (angiopathy).
Against the background of metabolic disorders, life-threatening conditions can occur -coma. They develop both against the background of an increase in blood sugar, and against the background of a sharp decrease in it (with incorrectly selected treatment, concomitant pathologies).
- Hypoglycemic comaIt is dangerous because it develops quite quickly and can lead to serious consequences. It occurs when glucose levels drop to less than 2. 8 mmol/l. Doctors can help with this by administering doses of glucose with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disrupted when it increases in the blood. It breaks down into ketone bodies, which poison the body.
- Coma lactateoccurs when breakdowns in glucose metabolism occur, against which acidic metabolic products accumulate, leading to respiratory and circulatory disorders and requiring treatment in intensive care.
Diagnostics
The basis of the diagnosis is laboratory tests, which will detect an increase in glucose in the blood plasma. It is important to carry out a full course of tests, since a single analysis is not informative: external factors can affect glucose levels.
Basic laboratory tests that confirm diabetes:
- blood test for glucose level (administered in the morning, on an empty stomach);
- exercise test (determination of glucose tolerance (blood is taken on an empty stomach, then 1 and 2 hours after taking a glucose solution);
- biochemical studies (levels of proteins, lipids, electrolytes);
- evaluation of the glycosylated hemoglobin level HbA1c;
- general and daily urinalysis with determination of glucose and protein levels;
- determination of endogenous insulin levels.
The doctor also prescribes a series of instrumental tests and consultations: an examination by an ophthalmologist with an assessment of the fundus of the eye, a consultation with a neurologist with an assessment of the condition of the peripheral nerves, blood pressure monitoring, an ECG and an ultrasound of the internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-pharmacological approaches, lifestyle changes with individual selection of drugs that control glycemic levels in diabetes mellitus (fasting and postprandial blood sugar, activity). Therapeutic approaches differ depending on the type of disease.
For type 1 diabetesthe basis of drug treatment isinsulin injections(short, prolonged and other types depending on the severity of the condition and the situation).With the second typeThe basis of glucose treatment and control isdiabetes pills. They help reduce glucose levels along with dietary adjustments. It is important to underline that the treatment is carried out throughout life, with dose adjustments and dynamic monitoring of the patient.
To control the condition of diabetes, it is important to follow a diet that provides the body with all the necessary nutrients, vitamins and minerals, but does not cause sudden increases in blood sugar. The doctor helps to correct the diet, teaches the patient how to select the right foods and their combination with taking medications or insulin. All diabetes products are divided into groups: those that can be used without fear, those that need to be reduced and those that should be excluded.
In addition, the doctor recommends lifestyle changes: weight control, physical activity, regular visits to the doctor to prevent complications of the disease.
Prevention
To maintain health and reduce the risk of developing the disease, it is necessary to control your weight, regularly evaluate carbohydrate and lipid metabolism and undergo medical examination. Moderate physical activity, drinking enough fluids and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods are important.