The term"diabetes mellitus"name a whole group of endocrine diseases, which are united by a 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 the level of glucose in the blood plasma to rise. At the same time, the cells suffer from a lack of energy and starve, even with a sufficient supply 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 make up approximately 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply haven't been detected yet, so the actual rate may be nearly double.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered multi-etiological - there are several theories about the occurrence of disorders of carbohydrate metabolism and problems with insulin. Adverse heredity plays a special role if close relatives suffer from diabetes.
In addition, certain factors and triggers can become provocateurs. This:
- poor diet with excess light carbohydrates, processed foods, fast food, saturated and trans fats and lack of dietary fiber.
- overweight and obesity (BMI over 30 and fat deposits in the anterior abdominal wall are particularly dangerous);
- chronic disorders of water-electrolyte balance.
- endocrine pathologies (Cushing's disease, hyperfunction of the thyroid gland);
- long-term, chronic physical and psycho-emotional stress.
- complications of "childhood infections, " especially measles, rubella, and chickenpox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
A high risk of diabetes is possible in children born to mothers who suffered from the gestational form of the disease, if the baby 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 severe symptoms. Often the first alarm bells are mistaken for overwork, infections or the effects of stress. But it is important to pay attention to the combination of symptoms, which alone can be signs of other diseases, but in combination indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, intense thirst with sufficient or excessive fluid intake.
- frequent urination, abundant urine production (up to 3-5 liters or more);
- dry skin, itching sensation in the area of legs, elbows, feet.
- rapid weight gain or sudden weight loss.
- constant hunger despite proper nutrition.
- increased sweating, specific sweet smell of sweat and breath.
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, reduced performance.
In addition, there may befainting, loss of consciousness, malaise, dizziness. Often, people first learn of their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidal coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of progression, and at the initial stage they differ significantly in terms of therapeutic tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of the immune system attacking the pancreatic cells that synthesize insulin. As a result, the production of the hormone gradually decreases, reaching a critical level, while the level of glycemia (plasma glucose) increases. This form of diabetes occurs more often in children and young adults at an older age, possibly in connection with necrosis of the pancreas due to complicated pancreatitis or organ removal. The basis of treatment is the use of insulin.
Type 2 diabetes or insulin-resistant (independent)it 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 glucose-lowering drugs.
In addition, there are other special forms of diabetes:
- pregnancy– occurs during pregnancy and is associated with metabolic disorders.
- pancreatogenic– associated with injuries, severe damage to the pancreas.
- LADA-diabetes(represents latent autoimmune diabetes), has mild symptoms, does not require insulin injections.
- MODY-diabetes- This is a special, genetic form of the disease.
Any form of diabetes can have
Complications of the disease
If a patient with diabetes mellitus ignores the doctor's recommendations, does not follow a diet or refuses to take medication, the disease can be complicated by serious pathologies and changes in the body that threaten disability and even life. This:
- severe visual impairment, damage to the structures inside the eyeball and its vessels.
- formation of persistent hypertension (increased blood pressure).
- disorders of lipid metabolism, increased "bad" cholesterol, which leads to atherosclerosis.
- severe swelling of the limbs.
- frequent headaches that reduce performance;
- sensory disorders in the extremities (neuropathy), blood flow disorders (vasculopathy).
In the context of metabolic disorders, life-threatening conditions can occur -
- 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 glucose doses with individually selected insulin levels.
- Ketotoxic comaoccurs when the metabolism of glucose is disturbed when it increases in the blood. It breaks down into ketone bodies, which poison the body.
- Lactic comaoccurs when there are failures in glucose metabolism, against which acidic metabolic products accumulate, which leads to respiratory and circulatory disorders and requires treatment in intensive care.
Diagnostics
Basic laboratory tests that confirm diabetes:
- blood test for glucose levels (given 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 (proteins, lipids, electrolyte levels);
- evaluation of the level of glycated hemoglobin HbA1c.
- general and daily urine analysis with determination of glucose and protein levels.
- determination of endogenous insulin levels.
The doctor also prescribes a series of organic tests and consultations - 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, EKG and ultrasound of 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 glucose, activity). Treatment approaches differ depending on the type of disease.
For type 1 diabetesthe basis of drug therapy isinsulin injections(short, prolonged and other types depending on the severity of the situation and the situation).With the second guyThe basis of glucose treatment and control isdiabetes pills. They help lower glucose levels along with dietary adjustments. It is important to emphasize that the treatment is carried out for 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 choose the right foods and their combination with taking drugs or insulin. All products for diabetes are divided into groups - those that can be used without fear, those that should 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 pathology.
Prevention
To maintain your health and reduce the risk of developing the disease, it is necessary to control your weight, regularly evaluate the metabolism of carbohydrates and lipids and undergo a medical examination. Moderate physical activity, drinking plenty of fluids and a balanced diet reducing the amount of carbohydrates, saturated fat, fast food and processed foods are important.