Term"diabetes mellitus"name all the group of endocrine diseases united by a common feature: they are based on the violation of carbohydrate metabolism. The lack of insulin hormone produced by the pancreas develops in the body, or the body cells stop responding adequately to it, which leads to an increase in the level of glucose in the blood plasma. At the same time, the cells suffer from a lack of energy and starve even with a sufficient supply of carbohydrates from food.
Among all endocrine diseases, diabetes is the most common in women and men. There are more than 250 million people in the world with various types of this pathology. In our country, diabetes patients make up 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 occurs. Today it is considered polyetiological - there are several theories of the occurrence of carbohydrate metabolism disorders and problems with insulin. If close relatives suffer from diabetes, unfavorable heredity plays a special role.
In addition, certain factors and triggers can become provocative. This:
- poor nutrition with very light carbohydrates, refined foods, fast food, saturated and trans fats and lack of dietary fiber;
- overweight and obesity (BMI above 30 and fat deposits on the front abdominal wall are especially 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 chicken pox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
Children born to mothers suffering from the gestational form of the disease have a high risk of diabetes, if the baby was born with a high weight, there were problems with glucose levels in the first days of life;
Symptoms of the disease
In the initial stage, diabetes mellitus has practically no obvious symptoms. Often the first alarm calls are mistaken for the consequences of overwork, infections or stress. But it is important to pay attention to the combination of symptoms, which in itself can be a sign of other diseases, but together indicate the manifestation of diabetes.
The main symptoms of diabetes are:
- constant dry mouth, severe thirst with sufficient or excessive fluid intake;
- frequent urination, excessive urination (up to 3-5 liters or more);
- dry skin, itching in the area of the legs, elbows, feet;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, sweat and special sweet smell of breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, decreased performance.
In addition, it can beFainting, Fainting, Fainting, Dizziness. People often learn the diagnosis for the first time when they go 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 they differ significantly in treatment tactics at the initial stage.
Type 1 diabetes or insulin-dependent. It occurs as a result of the attack of the immune system against the pancreatic cells that synthesize insulin. As a result, the production of the hormone gradually decreases, reaches a critical level, and the level of glycemia (plasma glucose) rises. This form of diabetes occurs more often in children and young people, it is possible against the background of necrosis of the pancreas due to complicated pancreatitis or removal of the organ; The basis of therapy is the use of insulin.
Type 2 diabetes or insulin resistance (independent)it is more common in older people or people who are overweight. This often occurs due to a violation of cellular sensitivity to insulin, which occurs due to obesity and metabolic disorders. Correction is possible with diet and glucose-lowering drugs.
In addition, there are other specific forms of diabetes:
- pregnancy– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic- due to injuries, serious damage to the pancreas;
- LADA - diabetes mellitus(means latent autoimmune diabetes), has mild symptoms, no need for insulin injections;
- MODY-diabetes- This is a special, genetic form of the disease.
It can be any form of diabetes
Complications of the disease
If a diabetic patient ignores the doctor's recommendations, does not follow a diet or refuses to take medication, the disease can be complicated by serious pathologies and changes in the body that threaten disability and even threaten life. This:
- serious visual impairment, damage to the structures inside the eyeball and its vessels;
- the formation of persistent hypertension (increased blood pressure);
- disturbance of lipid metabolism, increase of "bad" cholesterol, which causes atherosclerosis;
- severe swelling of the extremities;
- frequent headaches that impair performance;
- sensitive disorders in the extremities (neuropathy), blood flow disorders (angiopathy).
Against the background of metabolic disorders, life-threatening situations may arise -
- Hypoglycemic comaIt is dangerous because it develops quite quickly and can cause serious consequences. It occurs when the glucose level drops below 2. 8 mmol/l. Doctors can help with this by managing glucose doses with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disturbed 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 the accumulation of acid metabolic products leads to respiratory and circulatory disorders and requires treatment in intensive care.
Diagnostics
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);
- assessment of glycosylated hemoglobin HbA1c level;
- 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 ophthalmologist's examination with an evaluation of the fundus of the eye, a neurologist's consultation with an assessment of the condition of the peripheral nerves, blood pressure monitoring, ECG and ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-drug approaches, individual selection of drugs that control glycemic levels in diabetes mellitus, and lifestyle changes (fasting and postprandial blood glucose, activity). Treatment methods differ depending on the type of disease.
For type 1 diabetesis the basis of drug treatmentinsulin injections(short, long and other types depending on the situation and the severity of the situation).With the second typeIt is the basis of glucose treatment and controldiabetes pills. Together with dietary adjustments, they help reduce glucose levels. It is important to emphasize that the treatment is lifelong, with dose adjustment and dynamic monitoring of the patient.
To control 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 cause sudden increases in blood sugar. The doctor helps to adjust the diet, teaches the patient to choose the right foods and combine them with medication 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 lifestyle changes - 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 disease development, it is necessary to control 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 carbohydrates, saturated fat, fast food and refined foods are important.