According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases is about 50% of officially registered cases.According to the WHO, most people are not diagnosed with the disease until complications arise.
definition
Diabetes mellitus, translated from Greek, means “to go through” – is an endocrine disease based on an absolute or relative lack of insulin in the body and causes metabolic disorders, mainly carbohydrates.The main manifestation is persistent hyperglycemia due to impaired glucose metabolism in the body.It causes damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels.
The disease has been known since the 17th century.BC e.This is confirmed by the Ebers Papyrus, which describes a condition associated with excessive urination.The name “diabetes” was given to the disease by the Greek physician Demetrios of Apamania, who lived in the 2nd century BC.lived.e.Much later, in 1776, the English physician Dobson discovered a sweetish taste in the urine of a diabetic patient, indicating that it contained sugar.Therefore, diabetes was also called “sugar diabetes”.
Causes of diabetes mellitus
The exact etiology is not known with certainty.Among the provoking factors we can distinguish which are controllable and which are not.
Unchangeable risk factors:
- age 45 years and older;
- heredity;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity at increased risk of developing diabetes (African and Hispanic, European);
- Diseases of the pancreas - pancreatitis, oncology, etc.
Controlled factors:
- obesity;
- high blood pressure;
- physical inactivity;
- poor diet.
Factors provoking type 1 diabetes:
- Artificial feeding of babies.Replace breast milk with formula or cow's milk.It contains three times more protein than human milk and 50% more fat.Protein or casein is a complex component in its structure, similar to beta cells.When a child enters the body, the immune system attacks it, but due to the structural similarity, the beta cells of the pancreas also suffer.For this reason, it is not advisable to give your baby cow's milk before the age of 3.
- Viral infections.Rubella, chickenpox, mumps, viral hepatitis, etc.
- Hypoxia of pancreatic tissue as a result of vascular diseases.Arteriosclerosis, vascular spasms, hemorrhages and other diseases lead to hypoxia of the islets of Langerhans with their beta cells and reduce insulin secretion.
- Destruction of pancreatic tissue caused by alcohol, poisoning, drugs and oncology.
Type 2 diabetes is caused by poor nutrition in the context of a decline in physical activity associated with rapid technological advances and urbanization.This pathology occurs more often in representatives of the Mongolian race.
Diabetes classification
There are two main types of diabetes:
- Type 1 diabetes (T1DM)- can be considered a hereditary autoimmune disease in which one's own immune system attacks the pancreas' own beta cells.The destruction of the glandular tissue can be complete or partial.The pathology is diagnosed in young people and is therefore called juvenile diabetes.In this type of disease there is an absolute insulin deficiency.Patients with this diagnosis must receive insulin injections for life.
- Type 2 diabetes (T2DM)— It is based on insulin resistance (immunity of cells to the action of insulin with subsequent disruption of the flow of glucose in cells and tissues).Insulin serves as a “key” that allows glucose to enter cells and be used as energy.In this type of diabetes, the insulin deficiency is relative, which means that the gland itself is not damaged, but has to work “through wear and tear” for years.Type 2 diabetes typically affects people after age 40 and does not differ based on race, age, or gender.
There is also the so-called “hidden diabetes” – prediabetes.The condition lies between normal and pathological: the amount of glucose in the blood is higher than normal, but is not enough to make a diagnosis.This condition usually precedes type 2 diabetes.The main danger is the absence of symptoms.
Another form, gestational diabetes, develops in some women during pregnancy.It often disappears after birth.However, there is a risk of developing T2DM after 45 years.
Symptoms of the disease
Diabetes of the first type begins acutely and suddenly, with the second, the symptoms are initially extremely rare, develop over several years and the person does not even suspect that the pathology is present.
Signs of diabetes of any type in women and men:
- The classics are unquenchable thirst and polyuria.This leads to dehydration of the body.The mechanism of this phenomenon is due to the fact that excess sugar accumulates in the blood.In order to filter it, absorb it and excrete it from the body, intensive work of the kidneys is required.When they are injured, excess sugar begins to be excreted from the tissues with the fluid.A vicious circle is created.After drinking, thirst remains;The patient drinks up to 4 liters of water per day, which in turn leads to frequent urination.
- Persistent dry mouth associated with dehydration.
- Increased fatigue.
- Yawning, drowsiness – hypoxia and malnutrition of brain cells due to lack of glucose in the cells.
- Weakness comes from dehydration and the inability to use sugar for energy.
- Slow healing of wounds and cuts, frequent infections.
- Feeling of nausea and even vomiting.
- Rapid breathing (possibly with a smell of acetone).This is especially noticeable in coma, which is a differential sign.
- Increased heart rate.
- Itching of the genitals and skin.
- Loss of body weight is more characteristic of the first type of pathology and leads to exhaustion.
- Deterioration of vision – fog in front of the eyes.
- Polyphagia refers to the thirst for food and a lack of satiety.
- Paresthesias in the limbs.
- Bleeding gums that become swollen and red.
Failure to treat diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They provoke trophic ulcers, reduced vision, impaired tissue sensitivity, etc.
The most serious complication is diabetic coma, most common in insulin-dependent diabetes.
Type 2 diabetes has its own characteristic symptoms:
- Increased sweating during any physical activity – eating, moving, even sleeping.Normally the head and chest sweat, but the hands and feet remain cold, trembling and one feels chills.
- Urinary incontinence.
- Tendency to gain weight.
- Intermittent night sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Increased heart rate during attacks, with increased blood pressure, tinnitus, feeling of heaviness in the head and lack of air.
Diagnosis of diabetes mellitus
The main clinical manifestation of diabetes is hyperglycemia, therefore its determination is the basis for diagnosis.
Normal indicators: blood sugar up to 6.1 mmol/l on an empty stomach and no more than 11 mmol/l 2 hours after meals.You are not limited to a single analysis;it will not be objective.
For a complete diagnosis it is necessary:
- glucose tolerance test;
- biochemical blood analysis, examination for electrolytes;
- urine analysis for sugar and acetone;
- Reberg tests – determination of creatinine levels in urine to assess kidney condition;
- fundus examinations;
- Vascular studies – Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Treatment of diabetes
Main tasks of doctors:
- Compensation of carbohydrate metabolism.
- Treatment of complications and their prevention.
- Normalization of body weight.
- Patient education – calculation of bread units, special hygiene, keeping a self-control diary.
The treatment of diabetes mellitus takes years and requires strict adherence to medical prescriptions.
Important!Type 1 diabetes is incurable but manageable.
Drug therapy:
- Injections of the hormone insulin for type 1 diabetes.Another method of treatment is transplantation - the transplantation of the entire gland or individual sections of it (islets of Langerhans, responsible for insulin).
- Antihyperglycemic medications- Used in type 2 diabetes to accelerate tissue utilization of glucose and increase insulin synthesis.These are primarily drugs based on sulfonylureas.They help lower blood sugar.
- Biguanides- Reduce cellular insulin resistance by reducing absorption from the intestine and improving metabolism in peripheral cells.
The medication is taken continuously and in regulated doses.Treatment regimens and dosages are always individual.
The main method of treating type 2 diabetes is diet therapy.
Another important prerequisite for the success of the treatment is the correction of body weight.A diabetic patient should be prepared to monitor blood sugar daily (have a blood glucose meter at home) and be regularly examined and observed by an endocrinologist or general practitioner in a clinic.
Important!Early diagnosis and treatment can help prevent negative consequences.
Nutrition is a necessary component, without which normalization of hyperglycemia is impossible.In type 2 diabetes, it balances carbohydrate metabolism.In type 1, diet is required to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in terms of protein, fat and calorie content.
It is important to adhere to the principles of proper nutrition, excluding “heavy” fats, refined, preserved, smoked, carbonated foods and simple sugars, except in hypoglycemic coma.
Prognosis and prevention
Basic preventive measures:
- tracking weight changes;
- Control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drink enough water (at least 2 liters per day);
- Supplying the body with vitamins and minerals.
Type 1 diabetes is not genetically transmitted, there is just a tendency to be.Therefore, the prevention methods are as follows:
- Breastfeeding – it is advisable to stop it only after 1.5 years;
- Prevention of viral diseases – flu, sore throat, mumps, rubella, chickenpox;
- reduce stress;
- proper nutrition.
The prognosis is favorable with self-control and timely treatment.
Don't view a diagnosis of diabetes as a death sentence.Transitioning to a healthy lifestyle and proper nutrition with moderate physical activity allows you to achieve stable remission with complete abandonment of medications.