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 insulin hormone produced by the pancreas, or the body's cells stop responding adequately to it, which causes an increase in the level of glucose in the blood plasma. At the same time, the cells suffer from a lack of energy and die of starvation, 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 various types of this pathology. In our country, diabetics account for about 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply haven't been identified yet, so the real percentage could be almost twice as high.
Causes of diabetes
Today there is no consensus on why this disease appears. Today it is considered polyetiological - there are several theories about the occurrence of carbohydrate metabolism disorders and insulin problems. A special role is played by unfavorable inheritance if close relatives suffer from diabetes.
In addition, some factors and triggers can become provocative. This:
- poor nutrition with an excess of light carbohydrates, refined foods, fast foods, saturated and trans fats, and a lack of dietary fiber;
- overweight and obesity (a BMI over 30 and fat deposits on the front 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, stones in the canal.
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 the level of glucose in the first days of life.
Symptoms of the disease
In the initial stage, diabetes mellitus practically has no pronounced symptoms. Often the first alarm bells are confused with overwork, infections or the effects 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 occurrence of diabetes.
The main signs of diabetes are:
- constant dry mouth, strong thirst with sufficient or excessive fluid intake;
- frequent urination, large amount of urine (up to 3-5 liters or more);
- dry skin, itching sensation in the area of the legs, elbows, feet;
- rapid weight gain or sudden weight loss;
- constant hunger despite adequate food;
- increased sweating, specific sweet smell 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, maltreatment, dizziness. Often, people first learn of their diagnosis when they are hospitalized 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 differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of the immune system's aggression 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 adults of 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 or insulin-resistant (self-sustaining) diabetesit appears more often in the elderly or in overweight people. It occurs due to damage to the sensitivity of cells 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(meaning 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 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 structures inside the eye socket and its vessels;
- the formation of persistent hypertension (increased blood pressure);
- disorders of lipid metabolism, increase in "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disturbances in the extremities (neuropathy), blood circulation disorders (angiopathy).
Against the background 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.
- Ketoacidotic comaoccurs when glucose metabolism breaks down when it rises 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 blood circulation disorders and requires treatment in intensive care.
Diagnosing
Basic laboratory tests that confirm 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);
- 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 evaluation of the fundus of the eye, a consultation with a neurologist with an evaluation of the condition of the peripheral nerves, blood pressure monitoring, an EKG and an ultrasound of the organsinternal and blood vessels.
Treatment
The basis of treatment is a combination of drug-free approaches, lifestyle changes with individual selection of drugs that control blood glucose levels in diabetes mellitus (fasting and postprandial blood glucose, activity). Treatment approaches vary depending on the type of disease.
For type 1 diabetesthe basis of drug treatment isinsulin injections(short, extended 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 lower glucose levels along with dietary adjustments. It is important to note that the treatment is carried out throughout 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 a sudden increase in blood sugar. The doctor helps to correct the diet, teaches the patient how to choose 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 should be reduced and those that should be excluded.
In addition, the doctor recommends changes in lifestyle - weight control, physical activity, regular visits to the doctor to prevent complications of the pathology.
Preventing
To maintain health and reduce the risk of disease development, it is necessary to control your weight, regularly assess carbohydrate and lipid metabolism and undergo a medical examination. Moderate physical activity, drinking enough fluids and a balanced diet with a reduction in the amount of carbohydrates, saturated fat, fast food and refined food are important.