Diabetes mellitus is an endocrinological pathology accompanied by hyperglycaemia syndrome (high blood glucose), which occurred due to insulin deficiency.This disease is accompanied by carbohydrate imbalance and other metabolic disorders in the body.
At present, diabetes mellitus is diagnosed in 10-15 % of our planet's population.Cases of developing this disease in childhood have usually become more common, as a rule, after irrational treatment with antibiotics, stress and viral infections.There is an annual increase in the number of patients with diabetes by 9-10%.Today, the number of patients with this disease exceeds 200 million people.Diabetes is diagnosed in both men and women.
Causes and mechanism for the development of diabetes
As a result of violating the synthesis and secretion of insulin by Langerganes islands, there is a decrease in blood insulin levels, which over time leads to absolute insulin deficiency.There is also a relative insulin deficiency, which may be the result of reducing insulin activity as a result of its increased association with protein, intensive destruction of liver enzymes, the prevalence of non -homosexual effects and hormonal competitors,inauguration of fatty acids, growth), changes).Resistance of insulin -dependent insulin insulin.
Insulin deficiency causes protein, carbohydrate and fat disorders in the body.The permeability of the glucose of the cell membranes in muscles and adipose tissue is reduced, glyconeogenesis and glycogenolysis are enhanced, glucose, hyperglycaemia, which are accompanied by polytheism and polyuria.Decutation is exacerbated and reduced the formation of fats, which causes an increase in the level of ketones in the blood (acetone-the acetooxic acid condensation product, beta-oxya and acetox).These phenomena cause an acidic -based acid -based balance in the direction of acidosis and also affect the increase in magnesium excretion, sodium, potassium in urine and leads to renal impairment.
There may be a decrease in alkaline reserve blood to about 25%.Carbon dioxide and the decrease in blood pH level to 7.2-7.0.
How does type I diabetes grow
The causes of diabetes growth have some differences, depending on the type of diabetes.For example, patients with type of diabetes, due to autoimmune aggression and viral infection, extend from beta cells to the body, as a result of which a deficiency develops with all the consequent consequences.
How does type II diabetes grow
Patients with the type of diabetes II have a sufficient amount of insulin, but body tissues lose the opportunity to perceive its signal.With the development of obesity, the fatty tissue acts as a type of barrier that prevents the effect of insulin.In order to eliminate this barrier, beta cells include the intensive mode of operation, which then leads to the exhaustion and transition of the relative insulin deficiency to the absolute.However, diabetes dependent insulin is not converted to insulin dependent.
Regardless of the causative factor in the development of diabetes, the same procedure takes place when slowing the transformation of sugar coming from abroad and is available in the blood.
Sorting Diabetes
Depending on clinical characteristics, the following types of diabetes are distinguished:
- The type of diabetes mellitus, which in turn has many subspecies:
- Insulin -Depending Diabetes.
- Insulin -Depending Diabetes Sugar:
- to people with obesity.
- To people with normal weight.
- Diabetes, the cause of the growth of which is inadequate diet.
- Another verification of type I diabetes associated with certain syndromes and body conditions:
- Endocrine pathologies.
- its insulin or receptor abnormalities.
- Pancreatic diseases.
- Some genetic syndromes.
- the conditions caused by the effects of chemicals or drug taking;
- state of mixed causal factors;
- II Diabetes Type indicates a violation of glucose tolerance and is divided into such forms:
- in patients without excess weight.
- to people with obesity.
- caused by a particular condition or syndrome.
- Type III diabetes can grow during pregnancy.
Separate static risk classes of this disease have been identified (patients with normal glucose tolerance but significant risk of diabetes):
- A state preceding a violation of glucose tolerance.
- Possible glucose tolerance disorders.
Noun (primary) type of diabetes
The basic (primary) type of diabetes mellitus, which is related to nutritional failure, is highlighted as a separate pathology.This disease occurs in people under the age of 30 who live in tropical countries.According to statistics, the ratio of men and women is 2: 1. The total number of patients in this form of diabetes is 20 million people.
Most of the time there are two subtypes of this diabetes.The first of them is the pancreatic diabetes.
Fibrocalcule pancreatic diabetes
Territories, it mainly covers Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of extensive plans and stone formation in the main pancreas conductor.The clinical picture is represented by abrupt weight loss, repeated abdominal pain and other signs of inadequate diet.In this case, insulin therapy makes it possible to eliminate moderate and high glycosuria and hyperglycaemia.One of the characteristic signs of this pathology is the deficiency of ketoxicosis, which is due to reduced insulin production and the release of glucagon from the pancreas islands.Topographic studies (diagnostic ultrasound, radiography, computed tomography) make it possible to determine the presence of stones in the pancreas.
There is one view that one of the factors in the development of tuberculosis diabetes is the inclusion of the Roots of Manioca (Cassava, Tapioka) on the diet, which contains cyanogenic glycosides, one of which is Linamarin, from which cyanic acid is released during hydrolysis.With the involvement of sulfur acids, its harmful effects are eliminated and inadequate intake of protein foods, often found in the population of the above countries, causes the accumulation of cyanide in the body, which is the cause of the development of fibblock.
Pancreatic diabetes
The development of pancreatic diabetes (type II diabetes) is related to protein deficiency in the body, but there are no manifestations of pancreatic fibrosis.It is characterized by moderate insulin resistance and resistance to the development of ketoacidosis.In most cases, patients suffer from exhaustion.Patients have a reduced secretion of insulin, but not in such a measure as in patients with type I diabetes, this explains the lack of ketgower.
Subtype
In the classification of diabetes, according to its data, which are presented above, there are no references to the third subtype of pancreatic diabetes, which is located in Jamaica, we are talking about the subtype J. The subtype J has much in common with the pancreatic diabetes that occurs due to the deficiency of the protein.
Symptoms of diabetes
The first symptoms of diabetes occur due to high blood glucose content.After the level of 8.9-10.0, sugar enters the urine.When it continues to increase blood glucose levels, the kidneys further remove water, this is clinically manifested with rapid urination (polyuria).Excessive isolation of urine causes a constant sense of thirst (Polydam).With urine, the body loses a large number of calories represented by glucose, so a person loses weight and feels hungry.
Among other symptoms of diabetes, such as drowsiness, reduced visual acidity, fatigue and nausea.In addition, patients with non -compensated diabetes are prone to infections.Patients of type I diabetes have severe insulin deficiency and, because of this, they almost always lose weight before initiating treatment.Patients with II Diabetes type do not lose body weight.
With type I diabetes, the rapid development of clinical manifestations occurs and can soon proceed with diabetic ketoacidosis.Regardless of the high level of blood glucose, cells do not have the opportunity to use it without the presence of insulin, so they go to other sources of energy.The destruction of fat cells begins, which causes the formation of ketones, which are toxic chemical compounds we "acute" blood.
Diabetic ketoacidosis
The first symptoms of diabetic ketoacidosis are manifested in the form of excessive urination and excessive thirst, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients have frequent and deep breathing, which is associated with the body's efforts to eliminate excessive blood acidity, this process is accompanied by the appearance of the smell of acetone orally.In the absence of treatment, diabetic ketoacidosis can complicate the development of coma, in some cases this process occurs within several hours.
Type I diabetes may be accompanied by the development of ketoacidosis even after the onset of insulin treatment if the patient passes a planned injection or severe emotional excessive exaggeration, especially during injury, severe infection or other serious illness.
Patients suffering from type II diabetes for sufficient time may not feel any sign of this pathology.Such a hidden period of the disease can last for several decades.Clinical manifestations are activated as insulin deficiency is exacerbated.
Initially, the volume of dedicated urine slightly exceeds the rule, thirst is weakly expressed, but over time, these processes are progressing.The phenomena of ketoacidosis are rare.With a significant increase in blood glucose level (in some cases, at 55 mmol/l), this is usually the case with additional loads on the body, for example, under the influence of drugs or severe infectious diseases, the patient may be immersed in a state of confusion, caused by severe infectious, severely infectious, severely infectiousimmersed in a state of confusion, caused by severe dehydration.
How else is diabetes mellitus
High level of blood glucose over time can lead to damage to nerves, blood vessels and other structures.The chemicals containing glucose are found on the walls of the small blood vessels, as a result of which the walls of the vessels are thick and damaged.Stenosis of blood vessel gaps causes the blood flow to deteriorate, especially blood blood supply and nerve endings.Without compensation for blood diabetes, there is an increase in the level of fatty substances, which accelerates the growth of atherosclerosis.Patients diagnosed with diabetes, regardless of gender, suffer from atherosclerosis 2-6 times more often than people who do not have this diagnosis.Violation of blood vessels in the bloodstream causes malfunctions from the heart, kidneys, eyes, lower extremities, brain, skin and nerves and also slows the wound healing process.
What is the severity of diabetes mellitus
All of these factors increase the risk of developing many distant complications.In patients with diabetes, the risk of strokes and heart attacks increases as a result of the damage to blood vessels of the eyes, loss of bishopric (passage retinopathy) may occur, renal disorders cause renal disorders.Nerves damage can lead to many consequences.Monopoly (reduced function of a nerve) can be manifested with a sudden weakness of the upper or lower extremity.Diabetic polyneuropathy (damage to the nerves of the feet, feet or hands) causes sensitivity disorders, pain, burning or tingling, a sense of weakness in the hands and legs.The sensitivity of temperature and pain decreases, which leads to increased trauma.Circulatory disorders can contribute to the appearance of ulcers and poor wound healing.The ulcers found on the legs are very deep and bad healing, which leads to infection and, in some cases, to amputation of the affected limb.
Clinical studies have shown that it is possible to avoid or expand diabetes if you keep a normal blood sugar.The course of this disease is not fully studied fully.There are several unexplored factors that cause its development, genetics include the number of these factors.
Diagnosis of diabetes
Diagnosis of diabetes begins with the patient's upgrade and examination.During these measures, the patient has the presence of hereditary factors, obesity, if the patient belongs to the number of single twins (if one of them suffers from diabetes, the latter must be examined), women determine the presence of childbirth and if determined.
The following are a series of laboratory tests, which consist of:
- Blood tests for glucose levels are performed twice.
- Glucose tolerance test.
- Determination of glucose level in daily urine.
With the diagnosis of diabetes mellitus, it is very important to determine the presence of complications.Therefore, all organs and systems are diagnosed.
Complications of diabetes
The complications of diabetes mellitus can be acute and chronic, they are also separated according to the form of diabetes.Among acute complications, coma situations are distinguished, during which loss of consciousness is preceded by brain disorders due to very low or very high blood sugar concentration.Such conditions include:
- Diabetic kettling (the most common complication of an acute nature) is manifested by polyuria, polyuria, lack of appetite, weakness, abdominal pain, nausea and vomiting.
- A hypoglycaemic coma, is an extreme degree of hypoglycaemia, occurs with a sharp decrease in blood glucose levels.It is often the result of the introduction of an irregular dose of insulin and sometimes occurs after taking certain foods or sulfanlamide.
- The hyperactive comic in the severity of the state compensates for the diabetic mainly in the elderly, with type II diabetes.In 30% of cases, the cause of the patient's death is also present in the presence of serious consecutive pathologies - at 70%.
Chronic (delayed) complications are combined in a group of pathologies developed with prolonged exposure to high blood sugar in the patient's organs and systems.First of all, sugar -sensitive organs are subject to damage, they are a kind of "target" for diabetes.Among the chronic complications of diabetes, the following are known:
- Diabetic retinopathy is observed in 90% of patients with diabetes.It develops with a long course of diabetes and manifests itself with damage to the vessels of the eye retinal.
- Diabetic kidney disease consists of complex kidney damage (tubes, arteries, coils, arteries).The prevalence between patients with diabetes is 75%.
- Diabetic neuropathy is represented by peripheral nerves damage to patients with diabetes.Neuropathy is a predisposition to the development of a diabetic foot, which can lead to an end of an end.
- Diabetic encephalopathy is a brain damage, which is progressive.It is manifested by increased fatigue, reducing performance, impaired concentration of attention, emotional instability, headache compression, anxiety and deterioration of the process of thinking.
- Diabetic lesions of the skin are structural deformities of the skin, follicles, sweat glands due to a violation of carbohydrate metabolism and the accumulation of metabolism products.In the case of a severe form of diabetes, the skin becomes thin, rough, with areas of homosexual, cracking, the skin acquires a yellowish hue, hair loss.
- Diabetic foot and brush syndrome occurs in 30-80% of patients with diabetes and is a complex of anatomical and functional disorders that occur in the form of brown spots and ulcers in the lower leg, foot and phalanx of fingers, which can in severe cases.
Treatment of diabetes
The treatment of diabetes depends on the type of disease, but first of all, the patient must normalize the blood glucose level.To do this, you need to radically change your lifestyle and diet.A special diet is recommended for patients with diabetes, which is based on the calculation of used carbohydrates, proteins and fats, vitamins and trace elements.This calculation is taught by experts in this area.
The choice of regular medicinal therapy depends on the type of diabetes.Patients with type of diabetes are essential for insulin treatment, with type II appear to adhere to the stricter diet and use glucose -containing agents, with the ineffectiveness of the tablets of drugs, insulin is prescribed.
Insulin is taken under the strict control of blood glucose level.Insulin preparations according to the action mechanism are divided into three types: prolonged, short and intermediate action.Sugar -containing medicines are indicated in the case of insulin -dependent diabetes in combination with diet.Sugar -containing medicines include: Biguanides, sulfonylomoevina, thiazolidinos and glitters.
With this insidious illness, it is very important for medical staff to properly teach the patient and his relatives the patient's and first aid monitoring skills in the event of a pre -empty and coma.
Provision for diabetes mellitus
In the presence of diabetes mellitus, the patient is registered with the endocrinologist.In adequate treatment, the patient may be in a satisfactory condition for a long time.To worsen the prognosis of the state of the health and life of a patient with diabetes mellitus can develop acute and chronic complications.
Prevention of diabetes
With type I diabetes, preventive measures are to increase body resistance to various infections and to eliminate the toxic effects of antibodies to the pancreas.For patients with II, the type of diabetes is very important for adapting nutrition and preventing obesity growth.In order to avoid developing complications in diabetes, it is necessary to comply properly and systematically with the doctor's recommendations and to clarify whether this food can be consumed.