Diabetes mellitus is an endocrinological pathology accompanied by hyperglycemia syndrome (high blood glucose), which occurred due to insulin deficiency.This disease is associated with carbohydrate imbalance and other metabolic disorders in the body.
At the moment, diabetes mellitus is diagnosed in 10-15 % of the population of our planet.Cases of developing this disease in childhood have become more frequent, as a rule, after unreasonable 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 with both men and women.
Causes and mechanism for the development of diabetes
As a result of a violation of the synthesis and secretion of insulin from the Beta-cells of the islands of Langergag, there is a decrease in the level of insulin in the blood, which over time leads to an absolute lack of insulin.There is also a relative insulin deficiency, which may be the result of a decrease in insulin activity as a result of its increased protein bonding, intense destruction of liver enzymes, prevalence of non -hormonal effects and hormonal antagonists of insulin, insulin insulin, insulin, insulin insulin, insulin insulin,Insulin hormones, insulin hormones.
Insulin deficiency provokes disorders of metabolism of protein, carbohydrates and fat in the body.The spread of glucose of cell membranes in muscle tissue and adipose is reduced, gluconeogenesis and glycogenolysis have improved, glucoseuria occurs, hyperglycemia occurs, which are associated with polydipsia and polyuria.Dismissal is intensified and fat formation has decreased, which causes an increase in the level of ketone bodies in the blood (acetone-product of acethaic acid condensation, beta-oxyma acids and acetouxus).These phenomena cause a displacement of acid-base balance in terms of acidosis, and also affect the increase in secretion of magnesium, sodium, potassium in the urine and leads to kidney dysfunction.
There may be a decrease in alkaline blood reserve to 25% about.Carbon dioxide and a decrease in blood pH level at 7.2-7.0.
How does type I diabetes develop
The causes of diabetes development have some changes, depending on the type of diabetes.For example, patients with diabetes, due to autoimmune aggression and viral infection, are enlarged by beta cells in the body, as a result of which a deficiency develops with all subsequent consequences.
How Type II Diabetes develops
Patients with type II diabetes have a sufficient amount of insulin, but body tissues lose the opportunity to perceive its signal.With the development of overweight, adipose tissue acts as a type of obstacle that blocks the effect of insulin.To eliminate this obstacle, beta cells include the intense mode of functioning, which then leads to their impoverishment and passage of relative insulin insulin into absolute.However, insulin -dependent diabetes is not transformed into insulin dependent.
Regardless of the etiological factor in the development of diabetes, the same process takes place in slowing the transformation of sugar that comes from the outside and available in the blood.
Diabetes classification
Depending on the clinical traits, the following types of diabetes are distinguished:
- I type of diabetes mellitus, which in turn has several species:
- Insulin dependent diabetes;
- Diabetes -dependent insulin dependent:
- in overweight people;
- In people with normal weight.
- Diabetes, the cause of the development of which is insufficient nutrition;
- Other type I diabetes verification associated with certain syndromes and body conditions:
- endocrine pathology;
- insulin abnormalities or its receptor;
- Pancreatic diseases;
- some genetic syndromes;
- conditions caused by the effects of chemicals or medication intake;
- State of mixed etiological factors;
- II type of diabetes indicates a violation of glucose tolerance and is divided into such forms:
- in patients without excess weight;
- in overweight people;
- caused by a particular state or syndrome.
- Type III diabetes can develop during pregnancy.
Special static risk classes of this disease have been identified (patients with normal glucose tolerance, but an important risk of diabetes):
- a state that precedes a violation of glucose tolerance;
- Possible disorders of glucose tolerance.
Essential (primary) type of diabetes
The essential (primary) type of diabetes mellitus, which has a connection to food failure, is emphasized as a particular pathology.This disease occurs in people under the age of 30 living in tropical countries.According to statistics, the ratio of men and women is 2: 1. The total number of patients with this form of diabetes is 20 million people.
Most often there are two subtypes of this diabetes.The first of them is the diabetes of the fibrocalcular pancreas.
Pancreatic diabetes of fibrocalcula
Territory, it mainly covers Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of wide pancreofibrosis and stone formation in the main pancreas canal.Clinical photography is represented by sharp weight loss, repeated abdominal pain and other signs of insufficient nutrition.In this case, insulin therapy makes it possible to eliminate glucosuria and high and high hyperglycemia.One of the characteristic signs of this pathology is the lack of ketoacidosis, which is due to the reduction of insulin production and the release of glucagon from the pancreas island apparatus.Topographic studies (ultrasound diagnostics, radiography, calculated tomography) make it possible to determine the presence of stones in the pancreatic canals.
There is an opinion that one of the factors in the development of fibrocialcoretic diabetes is the inclusion of the roots of the manoca (cassava, tapioca) in the diet, which contain cyanogenic glycosides, one of which is linamarin, from which cyanistoric acid is released during hydrolysis.With the participation of sulfur -containing acids, its harmful effects are eliminated, and insufficient intake of protein nutrition, often found in the population of the above countries, provokes the accumulation of cyanide in the body, which is the cause of fibrocalculosis development.
Pancreatic
The development of pancreatic diabetes (type II diabetes) has a relationship with protein insufficiency in the body, but there are no manifestations of pancreatic fibrosis.It is characterized by moderate resistance to insulin and resistance to ketoacidosis development.In most cases, patients suffer from exhaustion.Patients have reduced insulin secretion, but not to such an extent as in patients with type I diabetes, this explains the lack of ketoacidosis.
Subtype j
In the classification of diabetes, according to WHO data, which are presented above, there are no references to the third subtype of pancreatic diabetes, which is in Jamaica, we are talking about the J. subtype J.
Symptoms of diabetes
The first symptoms of diabetes occur due to a high blood glucose content.After exceeding the level of 8.9-10.0, sugar enters the urine.When you continue to increase blood glucose levels, the kidneys also remove water, this is clinically manifested by rapid urination (polyuria).Excessive urinary insulation causes a constant feeling of thirst (polydipsia).With hunger, the body loses a large number of calories represented by glucose, so a person loses weight and constantly feels hunger.
Among other symptoms of diabetes, such as drowsiness, decreased visual sharpness, fatigue and nausea are distinguished.Moreover, patients with uncompensated diabetes are prone to infections.Type I diabetes patients have a significant lack of insulin and, because of this, almost always lose weight before the onset of therapy.Patients with type II diabetes do not lose body weight.
With type I diabetes disease, the rapid development of clinical manifestations occurs and can soon progress to diabetic ketoacidosis.Despite the high level of glucose in the blood, cells are unable to use it without the presence of insulin, so they pass to other energy sources.The destruction of fat cells begins, which provokes the formation of ketone bodies, which are toxic chemical compounds "acidify" blood.
Diabetic ketoacidosis
The first symptoms of diabetic ketoacidosis manifest in the form of excessive urination and excessive thirst, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients have frequent and profound breathing, which is associated with the body's effort to neutralize excessive blood acidity, this process is associated with the appearance of acetone odor from the mouth.In the absence of treatment, diabetic ketoacidosis can be complicated by the development of a coma, in some cases this process occurs within hours.
Type I diabetes may be associated with the development of ketoacidosis even after the onset of insulin therapy if the patient passes a planned injection or undergo severe emotional overload, especially during damage, severe infection or other serious illness.
Patients suffering from type II diabetes for a long time may not feel signs of this pathology.Such a hidden period of the disease can take up to several decades.Clinical manifestations are activated while insulin deficiency exacerbates.
At first, the volume of urine dedicated only slightly exceeds the rate, thirst is poorly expressed, but over time, these processes progress.The phenomena of ketoacidosis are rare.With a significant increase in blood glucose levels (in some cases, at 55 mmol/l), this usually occurs with additional loads on the body, for example, under the influence of medicines or with serious infectious diseases, the patient may be plunged into a conscious state, provoked by severe dehydration, sequestration phenomena, sequestration phenomena, phenomena,seizure phenomena, hidden phenomena of seizure phenomena.Hyperosmolar spouse.
As else is the manifesto of diabetes mellitus
High blood glucose levels over time can lead to damage to nerves, blood vessels and other structures.Chemical compounds containing glucose are located on the walls of small blood vessels, as a result of which the walls of the vessels are thickened and damaged.The narrowing of the vascular gaps causes the blood flow to worsen, especially the blood supply to the skin and nerve endings.Without compensation for blood diabetes, there is an increase in the level of fatty substances, which accelerates the development 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 dysfunctions from the heart, kidneys, eyes, lower extremities, brain, skin and nerves, and also slows the healing process of wounds.
What is the seriousness 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 damage to the blood vessels, loss of visinopathy (diabetic retinopathy) may occur, kidney disorders provoke kidney failure, and therefore, in some cases, dialysis is required.Nerve damage can lead to many consequences.Mononeuropathy (damaged function of a nerve) can manifest with a sudden weakness of the upper or lower limbs.Diabetic polneuropathy (damage to the nerves of the legs, feet or hands) causes disorders of sensitivity, pain, burning or tingling of needles of weakness in the arms and feet.Sensitivity of temperature and pain decreases, which leads to increased trauma.Disordisms of blood circulation can contribute to the emergence of ulcers and poor wound healing.Located foot ulcers are very deep and poorly healing, which leads to infection and, in some cases, to the amputation of the affected limbs.
Clinical studies have shown that it is possible to avoid or expire diabetes if you constantly maintain normal blood sugar.The course of this disease is not currently fully studied.There are a number of unexplained factors that cause its development, genetic ones include the number of these factors.
Diagnosis of diabetes
Diagnosis of diabetes begins with collecting an anamnesis and patient examination.During these measures, the patient has the presence of inherited factors, overweight, if the patient belongs to the number of single twins (if one of them suffers from diabetes mellitus, the second should be examined), women specify the presence of childbirth and if a large fruit was specified.
Below is a number of laboratory tests, which consists of:
- Blood tests for glucose level are performed twice;
- Glucose tolerance test;
- Determining the level of glucose in daily urine.
With the diagnosis of diabetes mellitus, it is very important to discover the presence of complications;For this, all organs and systems are diagnosed.
Complications of diabetes
Complications of diabetes mellitus can be acute and chronic, they are also divided depending on the form of diabetes.Among the acute complications, coma states are distinguished, during which loss of consciousness is preceded by brain disorders due to a very low or very high blood sugar concentration.Such conditions include:
- Diabetic ketoacitosis (the most common complication of an acute nature) is manifested by polyuria, polydipsia, lack of appetite, weakness, abdominal pain, nausea and vomiting;
- A hypoglycemic coma, is an extreme degree of hypoglycemia, occurs with a sharp decrease in blood glucose levels.It is often the result of introducing an irregular dose of insulin, and sometimes occurs after you have received certain food or sulfanilamide.
- The hyperosmolar comic in the severity of the state exceeds the diabetic that is mainly found in older people, with type II diabetes.In 30% of cases, it becomes the cause of the patient's death, and in the presence of severe accompanying pathologies - at 70%.
Chronic (late) complications combine into a group of pathologies that develop with prolonged exposure to high blood sugar in the patient's organs and systems.First of all, sugar -sensitive organs undergo damage, they are a kind of "target" for diabetes.Among the chronic complications of diabetes, are known below:
- 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 retinal eye vessels;
- Diabetic nephropathy consists of complex kidney damage (tubules, arteries, glomeruli, arterioles).The prevalence among patients with diabetes is 75%;
- Diabetic neuropathy is represented by peripheral nerve damage in patients with diabetes.Neuropathy is a predisposing factor in the development of a diabetic leg, which can lead to a amputation of a limb;
- Diabetic encephalopathy is a brain damage, which is progressive.It is manifested by increased fatigue, a decrease in performance, impaired concentration of attention, emotional endurance, squeezing headaches, anxiety and deterioration of the process of thought;
- Diabetic skin lesions are structural deformities of the epidermis, glands, sweat glands due to violation of carbohydrate metabolism and the accumulation of metabolism products.In the case of a severe form of diabetes, the skin becomes glowing, harsh, with areas of homosopers, cracks, the skin acquires a yellow tinge, hair loss occurs;
- Diabetic foot syndrome and brush occur in 30-80% of patients with diabetes and is a complex of anatomical and functional disorders that appear in the form of brown spots and ulcers in the lower leg, foot and phalaranx of the fingers, which in severe cases can lead to amputation of the limbs.
Treatment of diabetes
Treatment of diabetes depends on the type of disease, but first of all, the patient should normalize blood glucose levels.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 specialists in this field.
The choice of drug therapy tactics depends on the type of diabetes.Patients with diabetes are essential to perform insulin therapy, with type II indicating that it adheres to the stricter diet and use glucose -containing agents, with the ineffectiveness of the forms of medication tablets, is prescribed insulin.
Insulin is taken under strict control of blood glucose levels.Insulin preparations according to the mechanism of action are divided into three types: prolonged, short and intermediate action.Medications containing sugar are indicated in the case of insulin -dependent diabetes mellitus in combination with diet.Sugar -containing drugs include: biguanides, sulfonylmochevina, thiazolidindyons and meglitinides.
With this insidious disease, it is very important for the medical personnel to properly learn the patient and his relatives the abilities to monitor the patient's condition and first aid in the first case -Domestic and coma.
Forecasting for diabetes mellitus
In the presence of diabetes mellitus, the patient is recorded with the endocrinologist.In conditions of adequate therapy, the patient may be in a long -term satisfactory condition.To exacerbate the prognosis regarding the state of health and the longevity of a patient with diabetes mellitus can develop acute and chronic complications.
Preventing diabetes
With type I diabetes, preventive measures are increased body resistance to various infections and eliminate toxic effects of antibodies on the pancreas.For patients with II, the type of diabetes is very important to regulate food and prevent the development of overweight.In order to prevent the development of complications in diabetes conditions, it is necessary to respect the doctor's recommendations correctly and systematically and to clarify whether this or that food can be consumed.