Diaform Plus Official site
Share this

Types of diabetes

diabetes mellitus and its types

Diabetes mellitus is a disease of the endocrine system, which is associated with abnormal changes in hormone levels and metabolic failures.

To this day, the disease cannot be eradicated (completely eliminated).The destructive process taking place in the body can be slowed down with medicines and dietary therapy, but it cannot be stopped and started in the opposite direction.

The main symptom of the disease is a chronic increase in blood sugar.The causes and nature of the course of the disease differ, so it is divided into several types.

The types of diabetes mellitus (DM) are defined by the World Health Organization and there are no fundamental differences in the medical world.Any type of diabetes mellitus is not an infectious disease.

The type of pathology

There are several types of the disease, which are united by one main symptom - an increase in the concentration of glucose in the blood.The classification of diabetes mellitus is determined by the causes of its occurrence.The treatment methods used, the patient's gender and age are also taken into account.

Types of diabetes accepted in medicine:

  • the first type is insulin-dependent (IDDM 1), or juvenile;
  • the second is non-insulin-dependent (NIDDM 2) or insulin-resistant;
  • gestational diabetes mellitus (GDM) in the perinatal period in women;
  • other types of diabetes, including:
  • damage to pancreatic β-cells at the genetic level (types of MODY diabetes);
  • pathologies of the exocrine function of the pancreas;
  • hereditary and acquired pathologies of the exocrine glands and their functions (endocrinopathies);
  • pharmacologically induced diabetes;
  • diabetes resulting from congenital infections;
  • Diabetes related to genomic pathologies and hereditary defects;
  • reduced fasting glucose (blood sugar) and reduced glucose tolerance.

Prediabetes is the body's borderline state, when the glycemic level has increased (reduced glucose tolerance), but the blood sugar level "does not reach" the generally accepted digital values corresponding to true diabetes.According to the World Health Organization (WHO 2014), more than 90% of endocrinology patients suffer from the second type of the disease.

According to medical statistics, there is a clear trend towards an increase in the number of diseases all over the world.In the last 20 years, the number of people with type 2 diabetes has doubled.GDM accounts for about 5% of pregnancies.Specific types of diabetes are extremely rare and occupy a small percentage in medical statistics.

According to gender, NIDDM 2 is more common in premenopausal and menopausal women.The reason for this is the change in hormonal status and the growth of extra kilos.In men, the most common cause of type 2 diabetes is chronic pancreatitis caused by the toxic effects of ethanol.

Insulin-dependent diabetes (type 1)

Type 1 diabetes is characterized by the inability of pancreatic cells.The organ does not fulfill its endocrine (intrasecretory) function, i.e. insulin, the hormone responsible for the body's glucose supply.As a result of the accumulation of glucose in the blood, the organs do not receive adequate nutrition, including the pancreas itself.

In order to mimic the natural production of the endocrine hormone, the patient is prescribed medical insulin injections of different durations (short and long) and dietary therapy throughout life.The classification of type 1 diabetes mellitus is determined by the various etiologies of the disease.Insulin-dependent disease has two causes: genetic and autoimmune.

Genetic cause

The development of pathology is related to the biological ability of the human body to pass on its characteristic signs and pathological deviations to the next generations.When it comes to diabetes, the child inherits the tendency to the disease from their parents or close relatives who have diabetes.

Important!The tendency is inherited, but not the disease itself.There is no 100% guarantee that a child will develop diabetes.

Autoimmune cause

The occurrence of the disease is caused by a functional failure of the immune system, when it actively produces autoimmune antibodies under the influence of negative factors, which have a destructive effect on the body's cells.Factors (impulses) that trigger the initiation of autoimmune processes are the following:

  • unhealthy eating behavior combined with physical inactivity;
  • failure of metabolic processes (carbohydrate, lipid and protein);
  • critical lack of cholecalciferol and ergocalciferol (vitamin D) in the body;
  • chronic pathologies of the pancreas;
  • in the medical history of mumps (mumps), measles, Coxsackie herpes virus, Epstein-Barr virus, cytomegalovirus, viral hepatitis A, B, C;
  • distress (prolonged stay in a state of neuropsychological stress);
  • chronic alcoholism;
  • incorrect treatment with hormonal drugs.

IDDM develops in children, adolescents and adults under the age of thirty.The childhood version of diabetes type 1a is associated with complicated viral infections.Form 1b occurs in young people and children against the background of autoimmune processes and hereditary predisposition.The disease usually develops quickly, over several weeks or months.

Insulin-resistant diabetes (type 2)

The difference between type 2 diabetes and type 1 is that the pancreas does not stop producing insulin.Glucose is concentrated in the blood and does not reach the body's cells and tissues because they are not sensitive to insulin - insulin resistance.Up to a certain point, treatment is carried out with hypoglycemic (sugar-lowering) drugs and dietary therapy.

To compensate for the imbalance in the body, the pancreas activates hormone production.Working in an emergency, the organ wears out over time and loses its intrasecretory function.Type 2 diabetes becomes insulin dependent.A decrease or loss of the sensitivity of cells to endogenous hormones is primarily associated with obesity, which disrupts fat and carbohydrate metabolism.

This is especially true for visceral obesity (fat deposits around the internal organs).In addition, the blood flow is obstructed due to excess weight due to the numerous cholesterol plaques in the blood vessels, which are formed during the hypercholesterolemia that always accompanies obesity.The cells of the body thus experience a lack of nutrients and energy sources.Other factors that affect the development of NIDDM include:

  • alcohol abuse;
  • gastronomic addiction to sweet foods;
  • chronic diseases of the pancreas;
  • pathologies of the heart and vascular system;
  • excessive eating against the background of a sedentary lifestyle;
  • incorrect hormone therapy;
  • complicated pregnancy;
  • Unfavorable inheritance (diabetes in parents);
  • anxiety.

The disease most often develops in women and men over 40 years of age.However, type 2 diabetes is latent and may not show obvious symptoms for several years.Early testing of blood sugar levels can reveal the development of prediabetes.With proper treatment, prediabetes can be reversed.If time is lost, it progresses and NIDDM is subsequently diagnosed.

Lada diabetes

In medicine, the term "Diabetes 1.5" is used, or the name Lada diabetes.It is an autoimmune disorder of hormone production and metabolic failure that occurs in adults (over 25 years of age).The disease combines the first and second types of diabetes.The development mechanism corresponds to IDDM, the latent course and manifestation of symptoms are similar to NIDDM.

Factors triggering the development of pathology are autoimmune diseases in the patient's anamnesis:

  • non-infectious inflammation of the intervertebral joints (spondylitis ankylopoetica);
  • irreversible disease of the central nervous system - multiple sclerosis;
  • granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
  • chronic inflammation of the thyroid gland (Hashimoto's thyroiditis);
  • juvenile and rheumatoid arthritis;
  • change in skin color (loss of pigment) (vitiligo);
  • inflammatory pathology of the mucous membrane of the colon (ulcerative colitis);
  • chronic damage to connective tissue and exocrine glands (Sjögren's syndrome).

Autoimmune disorders combined with a hereditary predisposition lead to the progression of Lada diabetes.To identify the disease, basic diagnostic methods are used, as well as a blood microscopic examination, which determines the concentration of immunoglobulins of the IgG class to antigens - ELISA (enzyme-linked immunosorbent assay).The therapy is carried out with regular insulin injections and nutritional correction.

Gestational form of the disease

GDM is a specific type of diabetes that develops in women in the second half of the perinatal period.The disease is most often detected during the second planned screening, when the expectant mother undergoes a full examination.The main feature of GDM coincides with type 2 diabetes - insulin resistance.The cells of a pregnant woman's body lose their sensitivity (sensitivity) to insulin due to a combination of three main reasons:

  • Hormonal changes.During pregnancy, the synthesis of progesterone (a steroid sex hormone) increases, which inhibits insulin production.In addition, the endocrine hormones of the placenta, which tend to inhibit the production of insulin, become stronger.
  • Double load on the female body.In order to ensure proper nutrition of the unborn child, the body needs an increased amount of glucose.A woman begins to consume more monosaccharides, as a result of which the pancreas synthesizes more insulin.
  • Weight gain due to reduced physical activity.Glucose, which enters the body in abundance, accumulates in the blood because the cells refuse to accept insulin due to obesity and physical inactivity.In such a situation, the expectant mother and the fetus experience nutrient deficiency and energy starvation.

Unlike type 1 and type 2 diabetes, gestational diabetes is a reversible process, as insulin molecules and pancreatic functions are preserved.

Correctly selected therapeutic tactics guarantee the elimination of the pathology after childbirth in 85% of cases.The main method of treating GDM is the "Table No. 9" diabetic diet.In severe cases, medical insulin injections are used.Antihyperglycemic drugs are not used because of their teratogenic effect on the fetus.

Furthermore

Certain types of diabetes are genetically determined (MODY diabetes, certain types of endocrinopathy) or are provoked by other chronic pathologies:

  • diseases of the pancreas: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical injuries and operations on the gland;
  • functional insufficiency of the anterior pituitary gland (acromegaly);
  • increased synthesis of thyroid hormones (thyrotoxicosis);
  • hypothalamic-pituitary-adrenal pathology (Itsenko-Cushing syndrome);
  • tumors of the adrenal cortex (aldosteroma, pheochromocytoma, etc.).

A separate diabetic pathology, diabetes insipidus, is characterized by a decrease in the production of the hypothalamic hormone vasopressin, which regulates the body's fluid balance.

Diagnostic measures

The diagnosis of diabetes mellitus (of any type) is only possible based on the results of a laboratory blood microscopic examination.Diagnostics consists of several consecutive tests:

  • General clinical blood test to identify hidden inflammatory processes in the body.
  • Blood test (capillary or venous) to determine the glucose content.It is done strictly on an empty stomach.
  • GTT (glucose tolerance test).This is done to determine the body's ability to absorb glucose.The tolerance test is a two-time blood draw: on an empty stomach and two hours after a "glucose load", which is an aqueous solution of 200 ml of water/75 g of glucose.materials.
  • HbA1C analysis for the level of glycosylated (glycated) hemoglobin.Based on the results of the test, the blood sugar level of the last three months is evaluated retrospectively.
  • Biochemistry of blood.Liver enzymes: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alpha-amylase, alkaline phosphatase (ALP), bilirubin (bile pigment) and cholesterol are evaluated.
  • A blood test for the concentration of antibodies against glutamate decarboxylase (GAD antibodies) determines the type of diabetes mellitus.

Blood glucose reference values and disease indicators

Analysis For the sugar Glucose tolerance test Glycated hemoglobin
norm 3.3 - 5.5 < 7.8 ⩽ 6%
prediabetes 5.6 - 6.9 7.8 - 11.0 6-6.4%
diabetes >7.1 >11.1 More than 6.5%

In addition to the blood microscopic examination, a general urinalysis is also performed to determine the presence of glucose in the urine (glycosuria).In healthy people, there is no sugar in the urine (for diabetics, the acceptable norm is 0.061-0.083 mmol/l).A Rehberg test is also performed to detect the protein albumin and creatinine, a product of protein metabolism, in the urine.In addition, hardware diagnostics are prescribed, including ECG (electrocardiogram) and ultrasound of the abdominal cavity (with kidneys).

Results

Modern medicine classifies diabetes into four main types depending on the pathogenesis (origin and development) of the disease: insulin-dependent (type 1 IDDM), non-insulin-dependent (type 2 NIDDM), gestational (GDM in pregnant women), specific (DM includes several diseases caused by genetic defects or chronic pathologies).Gestational diabetes that develops in the perinatal period can be cured.The condition of prediabetes (reduced glucose tolerance) is considered reversible if diagnosed early.