The term"Diabetes mellitus"Name a whole group of endocrine diseases that have one common feature: they are based on disorders of carbohydrate metabolism. The body develops a deficiency in the hormone insulin produced by the pancreas or the body's cells no longer respond adequately to it, which leads to an increase in the level of glucose in the blood plasma. In this case, the cells suffer from a lack of energy and starve, even with an adequate supply of carbohydrates from food.
Among all endocrine diseases, diabetes mellitus is the most common in women and men. There are more than 250 million people worldwide with various forms of this pathology. In our country, diabetics make up about 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes are simply not yet known, so the actual percentage may be almost twice as high.
Causes of diabetes
Today there is no consensus as to 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. Unfavorable heredity plays a special role when close relatives suffer from diabetes.
In addition, certain factors and triggers can become provocateurs. The:
- poor diet with an excess of light carbohydrates, refined foods, fast food, saturated and trans fats, and a lack of fiber;
- Overweight and obesity (a 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, hyperthyroidism);
- long-term, chronic physical and psycho-emotional stress;
- Complications of "childhood infections, " particularly measles, rubella, and chickenpox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
Children born to mothers who have had the gestational form of the disease are at high risk of developing diabetes. If the baby was born with high weight, he had problems with glucose levels in the first days of life.
Symptoms of the disease
In the initial stages, diabetes mellitus has practically no pronounced symptoms. The first alarm bells are often confused with overwork, infections or the consequences of stress. However, it is important to pay attention to the combination of symptoms that, taken by themselves, may 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, copious urine output (up to 3-5 liters or more);
- dry skin, itching in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, specific sweetish smell of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant tiredness, sleepiness, reduced performance.
Furthermore, it can beFainting, unconsciousness, malaise, dizziness. Often people only learn of their diagnosis when they are hospitalized in a state of hyperglycemic or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development and differ significantly in treatment tactics at the initial stage.
Type 1 diabetes or insulin dependent. It occurs as a result of aggression by the immune system against cells in the pancreas that synthesize insulin. As a result, the production of the hormone gradually decreases and reaches a critical level, while blood sugar (plasma glucose) levels increase. This form of diabetes is more common in children and adolescents; in older age it is possible against the background of pancreatic necrosis due to complicated pancreatitis or organ removal. The basis of therapy is the use of insulin.
Type 2 diabetes or insulin resistant (unrelated)occurs more often in older people or people who are overweight. It occurs due to impaired cellular sensitivity to insulin, which often occurs due to obesity and metabolic disorders. Correction is possible through diet and blood sugar-lowering medication.
There are also other specific forms of diabetes:
- pregnancy– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, severe damage to the pancreas;
- LADA diabetes(stands for latent autoimmune diabetes), has mild symptoms, does not require insulin injections;
- MODY diabetes- This is a special, genetically determined form of the disease.
Any form of diabetes can occuruncomplicated (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 threaten disability and even life. The:
- severe visual impairment, damage to structures in the eyeball and its vessels;
- Formation of persistent hypertension (increased blood pressure);
- Disorders of lipid metabolism, increased "bad" cholesterol levels, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that affect performance;
- Sensitivity disorders in the extremities (neuropathy), circulatory 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 its sharp fall (with incorrectly selected treatment, concomitant diseases).
- Hypoglycemic comaIt is dangerous because it develops quite quickly and can have serious consequences. It occurs when glucose levels fall to less than 2. 8 mmol/L. Doctors can help by administering glucose doses with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disturbed, when it rises in the blood. It breaks down into ketone bodies, which poison the body.
- Lactate comaOccurs when there are disorders in glucose metabolism, as a result of which acidic metabolites accumulate, leading to respiratory and circulatory disorders and requiring treatment in intensive care.
diagnosis
The diagnosis is based on laboratory tests, which detects an increase in glucose in blood plasma. It is important to conduct a complete course of examinations, since a single analysis is not informative - external factors can affect glucose levels.
Basic laboratory tests to confirm diabetes:
- Blood test for glucose levels (carried out in the morning on an empty stomach);
- Stress test (determination of glucose tolerance (blood sampling on an empty stomach, then 1 and 2 hours after taking a glucose solution);
- biochemical studies (protein, lipid, electrolyte levels);
- assessment of the level of glycosylated 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 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, etc. , an ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-drug approaches, lifestyle changes with individual selection of drugs that control glycemic levels in diabetes mellitus (fasting and postprandial blood sugar, activity). Depending on the type of disease, treatment approaches differ.
For type 1 diabetesThe basis of drug treatment isInsulin injections(short, longer and other types depending on the severity of the disease and the situation).With the second typeThe basis of glucose treatment and control isDiabetes pills. They help lower glucose levels along with dietary changes. It is important to emphasize that treatment is lifelong, with dose adjustments and dynamic monitoring of the patient.
To keep the condition of diabetes under control, it is important to follow a diet that provides the body with all the necessary nutrients, vitamins and minerals, but does not provoke a sudden increase in blood sugar levels. The doctor helps correct the diet and teaches the patient to choose the right foods and combine them with taking medications or insulin. All products for diabetes 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 pathology.
prevention
To maintain health and reduce the risk of disease, it is necessary to control weight, regularly monitor carbohydrate and fat metabolism, and undergo medical examinations. Moderate physical activity, adequate fluid intake and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods are important.