The term"diabetes mellitus"name a whole group of endocrine diseases, 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 properly to it, causing the level of glucose in the blood plasma to rise. At the same time, cells suffer from 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 represent around 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply have not yet been identified, so the actual percentage may be almost double.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered polyetiological: there are several theories about the occurrence of carbohydrate metabolism disorders and problems with insulin. Unfavorable heredity plays a special role if close relatives suffer from diabetes.
Additionally, certain factors and triggers can become provocateurs. This:
- poor nutrition with excess of light carbohydrates, refined foods, fast food, saturated and trans fats and deficiency of dietary fiber;
- overweight and obesity (a BMI over 30 and fat deposits on the anterior abdominal wall are especially dangerous);
- chronic disorders of hydroelectrolyte balance;
- endocrine pathologies (Cushing's disease, hyperfunction of the thyroid gland);
- chronic and prolonged physical and psycho-emotional stress;
- complications from "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 had the gestational form of the disease; If the baby was born with a high weight, she had problems with glucose levels in the first days of life.
Symptoms of the disease
At the initial stage, diabetes mellitus practically does not have pronounced symptoms. The first warning signs are often confused with overwork, infections or the consequences of stress. But it is important to pay attention to the combination of symptoms, which in themselves 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, itchy feeling in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite adequate nutrition;
- increased sweating, specific sweetish odor of sweat and breath;
- slow healing of scratches and wounds on the skin;
- Constant fatigue, drowsiness, decreased performance.
Furthermore, there may befainting, loss of consciousness, general malaise, dizziness. Often, people first learn of their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development, and at the initial stage they differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a consequence of the immune system's aggression against the pancreatic cells that synthesize insulin. As a result, the production of the hormone gradually decreases, reaching a critical level, while the level of blood glucose (plasma glucose) increases. This form of diabetes occurs most frequently in children and young people; in old age, it is possible against the background of necrosis of the pancreas due to complicated pancreatitis or removal of an organ. The basis of therapy is the use of insulin.
Type 2 or insulin-resistant diabetes (independent)It occurs more frequently 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 with diet and glucose-lowering medications.
In addition, there are other specific forms of diabetes:
- gestational– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, severe damage to the pancreas;
- LADA-diabetes(means 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 haveuncomplicated (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 threaten life. This:
- severe visual impairment, damage to the internal structures of the eyeball and its vessels;
- formation of persistent hypertension (increased blood pressure);
- disorders of lipid metabolism, increased "bad" cholesterol, leading to atherosclerosis;
- severe swelling of the extremities;
- frequent headaches that impair performance;
- sensory disturbances in the extremities (neuropathy), blood flow 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 decrease (with incorrectly selected treatment, concomitant pathologies).
- hypoglycemic comaIt is dangerous because it develops quite quickly and can lead to serious consequences. It occurs when the glucose level decreases to less than 2. 8 mmol/l. Doctors can help with this by administering glucose doses with individually selected insulin levels.
- ketoacidotic comaIt occurs when glucose metabolism is altered when it increases in the blood. It breaks down into ketone bodies, which poison the body.
- eat lactateIt occurs when there are failures in glucose metabolism, in the face of which acidic metabolic products accumulate, leading to respiratory and circulatory disorders, and requiring treatment in intensive care.
Diagnosis
The basis of diagnosis is laboratory tests.which will detect an increase in plasma glucose. It is important to carry out a full cycle of examinations, since a single analysis is not informative: external factors can influence glucose levels.
Basic laboratory tests that confirm diabetes:
- blood test to determine the level of glucose (carried out in the morning, on an empty stomach);
- stress test (determination of glucose tolerance (blood is taken on an empty stomach, then 1 and 2 hours after taking a glucose solution);
- biochemical studies (protein, lipid, electrolyte levels);
- evaluation 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 number 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 state of peripheral nerves, blood pressure monitoring, an ECG and an ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-pharmacological approaches, lifestyle changes with an individual selection of drugs that control glycemic levels in diabetes mellitus (fasting and postprandial glycemia, activity). Treatment approaches differ depending on the type of disease.
For type 1 diabetesthe basis of pharmacological treatment isinsulin injections(short, long and other types depending on the severity of the condition and situation).With the second typeThe basis of glucose treatment and control isdiabetes pills. They help reduce glucose levels along with dietary adjustments. It is important to highlight that the treatment is carried out for life, with dose adjustments and dynamic monitoring of the patient.
To control diabetes, it is important to follow a diet that provides the body with all the necessary nutrients, vitamins and minerals, but does not cause blood sugar spikes. The doctor helps to correct the diet, teaches the patient to select the right foods and combine them with medication or insulin. All diabetes products are divided into groups: those that can be used without fear, those that should be reduced, and those that should be excluded.
Additionally, the doctor recommends lifestyle changes: weight control, physical activity, regular visits to the doctor to prevent complications of the pathology.
Prevention
To maintain health and reduce the risk of developing the disease, it is necessary to monitor weight, periodically evaluate carbohydrate and lipid metabolism, and undergo medical examinations. It is important to carry out moderate physical activity, drink enough fluids and eat a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods.