Diaform Plus Official site
Share this

Types of diabetes

Diabetes mellitus and its types

Diabetes mellitus is a disease of the endocrine system, which is accompanied by pathological changes in hormonal levels and metabolic disorders.

To date, the disease cannot be eradicated (completely eliminated).The destructive process in the body can be slowed down by medication and diet therapy, but it is impossible to stop it and start it in the opposite direction.

The main symptom of the disease is a chronic increase in blood sugar levels.The causes and nature of the course of the disease are different, so it is divided into different types.

The types of diabetes mellitus (DM) are defined by the World Health Organization and have no fundamental differences in the medical world.Diabetes mellitus of any kind is not a contagious disease.

Typing of pathology

There are several types of the disease, which are united by one main symptom - an increased concentration of glucose in the blood.The classification of diabetes mellitus depends on the causes of its occurrence.The treatment methods used, the gender and the age of the patient are also taken into account.

Types of diabetes recognized in medicine:

  • the first type is insulin dependent (IDDM 1) or juvenile;
  • the second is non-insulin dependent (NIDDM 2) or insulin resistant;
  • Gestational diabetes mellitus (GDM) during the perinatal period in women;
  • other specific types of diabetes including:
  • Damage to pancreatic β-cells at the genetic level (variants of MODY diabetes);
  • Pathologies of the exocrine function of the pancreas;
  • hereditary and acquired pathologies of the exocrine glands and their functions (endocrinopathies);
  • pharmacologically induced diabetes;
  • diabetes as a result of congenital infections;
  • Diabetes associated with genomic pathologies and hereditary defects;
  • impaired fasting glucose (blood sugar) levels and impaired glucose tolerance.

Prediabetes is a borderline state of the body in which the glycemic value is elevated (impaired glucose tolerance), but the blood sugar level “does not reach” the generally accepted digital values corresponding to true diabetes.According to the World Health Organization (WHO 2014), more than 90% of endocrinology patients suffer from the second type of disease.

According to medical statistics, there is a clear trend towards an increase in the number of cases worldwide.In the last 20 years, the number of type 2 diabetics has doubled.GDM accounts for approximately 5% of pregnancies.Specific forms of diabetes are extremely rare and only account for a small proportion of medical statistics.

Depending on gender, NIDDM 2 occurs more frequently in women in the premenopausal phase and during menopause.This is due to changes in hormonal status and the gain of extra pounds.In men, the most common factor in the development of type 2 diabetes is chronic inflammation of the pancreas caused by the toxic effects of ethanol.

Insulin-dependent diabetes (type 1)

Type 1 diabetes is characterized by the inability of the pancreatic cells to function.The organ does not fulfill its endocrine (intrasecretory) function of producing insulin, the hormone responsible for supplying the body with glucose.Due to the accumulation of glucose in the blood, the organs, including the pancreas itself, do not receive adequate nutrition.

To imitate the natural production of the endocrine hormone, the patient is prescribed lifelong injections of medical insulin with different durations of action (short and long), as well as dietary therapy.The classification of type 1 diabetes mellitus is determined by the different etiologies of the disease.Insulin-dependent disease has two causes: genetic and autoimmune.

Genetic cause

The formation of a pathology is associated with the biological ability of the human body to transmit its characteristic signs and pathological deviations to subsequent generations.As for diabetes, a child inherits a predisposition to the disease from parents or close relatives with diabetes.

Important!The predisposition is inherited, but not the disease itself. There is no 100% guarantee that a child will develop diabetes.

Autoimmune cause

The occurrence of the disease is caused by a functional failure of the immune system, when, under the influence of negative factors, it actively produces autoimmune antibodies that have a destructive effect on the body's cells.Triggers (impetus) for triggering autoimmune processes are:

  • unhealthy eating habits associated with physical inactivity;
  • Failure of metabolic processes (carbohydrates, lipids and proteins);
  • critical deficiency of cholecalciferol and ergocalciferol (vitamin D) in the body;
  • Pathologies of the pancreas of a chronic nature;
  • a history of mumps (mumps), measles, Coxsackie herpes virus, Epstein-Barr virus, cytomegalovirus, viral hepatitis A, B, C;
  • distress (prolonged stay in a state of neuropsychological stress);
  • chronic alcoholism;
  • incorrect treatment with hormone-containing medications.

IDDM develops in children, adolescents and adults under 30 years of age.The childhood variant of diabetes form 1a is associated with complicated viral infections.Form 1b occurs in adolescents and children against the background of autoimmune processes and hereditary predisposition.The disease usually develops rapidly over several weeks or months.

Insulin-resistant diabetes (type 2)

The difference between the second and first types of diabetes is that the pancreas does not stop producing insulin.Glucose is concentrated in the blood and is not released to the cells and tissues of the body due to its lack of insulin sensitivity (insulin resistance).To some extent, treatment includes hypoglycemic (sugar-lowering) medications and dietary therapy.

To correct the imbalance in the body, the pancreas activates the production of the hormone.In emergency mode, the organ wears out over time and loses its intrasecretory function.Type 2 diabetes becomes insulin dependent.A decrease or loss of cell susceptibility to the endogenous hormone is primarily associated with obesity, which disrupts fat and carbohydrate metabolism.

This is especially true of visceral obesity (fat deposits around internal organs).In addition, if you are overweight, blood circulation is impaired by numerous cholesterol plaques in the vessels, which are formed in hypercholesterolemia, which is always accompanied by obesity.This leads to a lack of nutrients and energy resources in the body's cells.Other factors that influence the development of NIDDM include:

  • alcohol abuse;
  • gastronomic addiction to sweet dishes;
  • chronic diseases of the pancreas;
  • pathologies of the heart and vascular system;
  • overeating against the background of a sedentary lifestyle;
  • incorrect hormone therapy;
  • complicated pregnancy;
  • Adverse heredity (diabetes in parents);
  • distress.

The disease most commonly occurs in women and men aged 40 and over.At the same time, type 2 diabetes is latent and may not show pronounced symptoms for several years.Measuring your blood sugar levels early can detect prediabetes.With adequate treatment, the prediabetic condition is reversible.If time is lost, the disease progresses and NIDDM is subsequently diagnosed.

Lada diabetes

In medicine, the term “diabetes 1.5” is used, or the term Lada diabetes.This is an autoimmune disease of hormone production and metabolic failure that occurs in adults (25 years and older).The disease combines the first and second types of diabetes.The development mechanism corresponds to IDDM, the latent course and the symptom expression are similar to NIDDM.

The trigger for the development of pathology are autoimmune diseases in the patient's history:

  • non-infectious inflammation of the intervertebral joints (Bechterew's disease);
  • irreversible disease of the central nervous system – multiple sclerosis;
  • granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
  • chronic inflammation of the thyroid gland (Hashimoto's thyroiditis);
  • juvenile and rheumatoid arthritis;
  • Change in color (loss of pigment) of the skin (vitiligo);
  • inflammatory pathology of the colon mucosa (ulcerative colitis);
  • chronic damage to connective tissue and exocrine glands (Sjögren's syndrome).

In combination with a hereditary predisposition, autoimmune diseases lead to the progression of Lada diabetes.To identify the disease, basic diagnostic methods are used, as well as blood microscopy, which determines the concentration of immunoglobulins of the IgG class to antigens - ELISA (Enzyme-linked Immunosorbent Assay).Therapy is carried out through regular insulin injections and nutritional correction.

Gestational form of the disease

GDM is a specific form of diabetes that occurs in women in the second half of the perinatal period.The disease is most often discovered at the second scheduled screening, during which the expectant mother undergoes a full examination.The main feature of GDM coincides with type 2 diabetes – insulin resistance.The cells of a pregnant woman's body lose their sensitivity (sensitivity) to insulin due to the correlation of three main reasons:

  • Hormonal changes.During pregnancy, the synthesis of progesterone (a steroid sex hormone) increases, blocking insulin production.In addition, the endocrine hormones of the placenta gain strength, which tend to inhibit insulin production.
  • Double the burden on the female body.To ensure adequate nutrition for the unborn child, the body requires an increased amount of glucose.A woman begins to consume more monosaccharides, which causes the pancreas to synthesize more insulin.
  • Increase in body weight due to reduced physical activity.Glucose, entering the body in large quantities, accumulates in the blood because cells refuse to absorb insulin due to obesity and physical inactivity.In such a situation, the expectant mother and the fetus suffer from nutritional deficiencies and lack of energy.

Unlike type 1 and type 2 diabetes, gestational diabetes is a reversible process because insulin molecules and the functionality of the pancreas are preserved.

Correctly selected therapeutic tactics guarantee elimination of pathology after childbirth in 85% of cases.The main method of treating GDM is the “Table No. 9” diet for diabetics.In difficult cases, injections of medical insulin are used.Antihyperglycemic drugs are not used due to their teratogenic effects on the fetus.

Additionally

Certain types of diabetes are genetic (MODY diabetes, some types of endocrinopathies) or caused by other chronic pathologies:

  • Diseases of the pancreas: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical injuries and operations on the gland;
  • Functional failure of the anterior pituitary gland (acromegaly);
  • increased synthesis of thyroid hormones (thyrotoxicosis);
  • hypothalamic-pituitary-adrenal pathology (Itsenko-Cushing syndrome);
  • Tumors of the adrenal cortex (aldosteroma, pheochromocytoma, etc.).

A separate diabetic pathology, diabetes insipidus, is characterized by reduced production of the hypothalamic hormone vasopressin, which regulates fluid balance in the body.

Diagnostic measures

Diagnosis of diabetes mellitus (of any type) is possible only on the basis of the results of laboratory blood microscopy.Diagnostics consists of several consecutive studies:

  • General clinical blood test to detect hidden inflammatory processes in the body.
  • Blood test (capillary or venous) for glucose content.It is only done on an empty stomach.
  • GTT (glucose tolerance test).It is performed to determine the body's ability to absorb glucose.The tolerance test involves taking blood twice: on an empty stomach and two hours after a “glucose load”, an aqueous glucose solution prepared at a ratio of 200 ml of water per 75 g.substances.
  • HbA1C analysis for glycosylated (glycated) hemoglobin content.Based on the results of the study, a retrospective of the blood sugar values of the last three months will be evaluated.
  • Biochemistry of the blood.The liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alpha-amylase, alkaline phosphatase (ALP), bilirubin (bile pigment) and cholesterol levels are assessed.
  • A blood test for the concentration of antibodies to glutamate decarboxylase (GAD antibodies) determines the type of diabetes mellitus.

Blood sugar reference values and disease indicators

analysis For sugar Glucose tolerance test Glycated hemoglobin
standard 3.3 - 5.5 <7.8 ⩽ 6%
Prediabetes 5.6 – 6.9 7.8 – 11.0 from 6 to 6.4%
diabetes >7.1 >11.1 More than 6.5%

In addition to blood microscopy, a general urine test is performed to determine the presence of glucose in the urine (glycosuria).In healthy people there is no sugar in the urine (for diabetics the acceptable value is 0.061 – 0.083 mmol/l).A Rehberg test is also carried out to detect the protein albumin and the protein metabolite creatinine in the urine.Additionally, hardware diagnostics are prescribed, including an ECG (electrocardiogram) and ultrasound of the abdominal cavity (with kidneys).

Results

Modern medicine classifies diabetes into four main types depending on the pathogenesis (origin and development) of the disease: insulin-dependent (IDDM type 1), non-insulin-dependent (NIDDM type 2), pregnancy-related (GDM in pregnant women), specific (DM includes several types of diseases caused by genetic defects or chronic pathologies).Gestational diabetes that develops during the perinatal period is curable.The condition of prediabetes (impaired glucose tolerance) is considered reversible if diagnosed early.