The term"diabetes mellitus"name a whole group of endocrine diseases, united by a common feature: they are based on carbohydrate metabolism disorders. The body develops a deficiency of the hormone insulin produced by the pancreas, or the body cells stop responding adequately to it, which causes the level of glucose in the blood plasma to increase. At the same time, the cells suffer from energy deficiency 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 account for about 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes have simply not yet been identified, so the real percentage may be almost twice as high.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered polyetiological - there are several theories of the occurrence of carbohydrate metabolism disorders and problems with insulin. A special role is played by unfavorable heredity if close relatives suffer from diabetes.
In addition, certain factors and triggers can become provocateurs. This:
- poor nutrition with an excess of light carbohydrates, refined foods, fast food, saturated and trans fats, and a deficiency of dietary fiber;
- overweight and obesity (a BMI over 30 and fat deposits in the anterior abdominal wall are especially dangerous);
- chronic water-electrolyte balance disorders;
- 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, he had problems with glucose levels in the first days of life.
Symptoms of the disease
In the initial stage, diabetes mellitus has practically no pronounced symptoms. Often the first alarm bells are mistaken for overwork, infections, or the consequences of stress. But it is important to pay attention to the combination of symptoms, which in themselves may be signs of other diseases, but in combination indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, severe thirst with sufficient or excessive fluid intake;
- frequent urination, copious urine output (up to 3-5 liters or more);
- dry skin, itching sensation in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, specific sweetish odor of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, decreased performance.
In addition, there may befainting, loss of consciousness, malaise, dizziness. Often, people first learn about their diagnosis when they are admitted to the hospital 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 in the initial stage they differ significantly in treatment tactics.
Type 1 diabetes or insulin dependent. It occurs as a result of aggression of the immune system against 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 people; in older 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 diabetes or insulin resistant (independent)occurs more often in older people or people who are overweight. It occurs due to impaired cell 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(stands for 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 structures inside the eyeball and its vessels;
- formation of persistent hypertension (increased blood pressure);
- lipid metabolism disorders, increased "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- 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 glucose levels decrease to less than 2. 8 mmol/l. Doctors can help with this by administering doses of glucose with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disrupted when it increases in the blood. It breaks down into ketone bodies, which poison the body.
- Lactate 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
The basis of diagnosis is laboratory examinations, which will detect an increase in glucose in the blood plasma. It is important to carry out a full course of examinations, since a single analysis is not informative - external factors can influence glucose levels.
Basic laboratory tests confirming diabetes:
- blood test for glucose level (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 (protein, lipid, electrolyte levels);
- assessment of the level of glycosylated hemoglobin HbA1c;
- general and 24-hour 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 condition 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-drug approaches, lifestyle changes with individual selection of drugs that control glycemic levels in diabetes (fasting and postprandial blood glucose, activity). Approaches to therapy differ depending on the type of disease.
For type 1 diabetesThe basis of drug treatment isinsulin injections(short, prolonged 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 in reducing glucose levels along with dietary adjustments. It is important to emphasize that treatment is carried out for life, with dose adjustments and dynamic monitoring of the patient.
In controlling the condition of diabetes, it is important to eat a diet that provides the body with all the necessary nutrients, vitamins, and minerals, but does not provoke sudden surges in blood sugar. The doctor helps in correcting the diet, teaches the patient how to select the right foods and their combination 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.
Additionally, the doctor recommends changes in lifestyle - weight control, physical activity, regular visits to the doctor to prevent complications of the pathology.
Prevention
In order to maintain health and reduce the risk of developing the disease, it is necessary to control your weight, regularly evaluate carbohydrate and lipid metabolism, and undergo medical examination. Moderate physical activity, drinking enough fluids and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food, and refined foods are important.