According to statistics, more than 9% of the world's population suffers from diabetes (DM).The number of undiagnosed cases is about 50% of officially registered cases.According to the WHO, the disease is diagnosed in most people only in case of complications.
Definition
Diabetes in Greek means "to pass" - an endocrine disease based on the absolute or relative lack of insulin in the body and causes metabolic disorders, mainly carbohydrates.Its main manifestation is prolonged hyperglycemia due to impaired glucose metabolism in the body.It causes damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels.
The disease has been known since the 17th century.BCThis is confirmed by the Ebers Papyrus, which describes a condition involving excessive urination.The name "diabetes" was given to the pathology by the Greek physician Demetrios of Apamania, who lived in the 2nd century BC.e.Much later, in 1776, the English physician Dobson discovered a sweet taste in the urine of a diabetic patient, which indicated that it contained sugar.This is how diabetes was called "diabetes mellitus".
Causes of diabetes mellitus
The exact etiology is not exactly known.Among the provoking factors, we can distinguish between those that can be controlled and those that cannot.
Unchanged risk factors:
- age 45 and older;
- heredity;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity with an increased risk of developing diabetes (African and Hispanic, European);
- diseases of the pancreas - pancreatitis, oncology, etc.
Controlled factors:
- overweight;
- hypertension;
- physical inactivity;
- poor nutrition.
Factors that trigger the development of type 1 diabetes:
- Artificial feeding of infants.Replacing breast milk with formula or cow's milk.It contains three times more protein than human milk and 50% more fat.Protein or casein is a complex component in its structure, similar to beta cells.When the child enters the body, the immune system attacks it, but due to the structural similarity, the beta cells of the pancreas also suffer.For this reason, it is not advisable to give your baby cow's milk before the age of 3.
- Viral infections.Rubella, chicken pox, mumps, viral hepatitis, etc.
- Pancreatic tissue hypoxia as a result of vascular pathologies.Atherosclerosis, vasospasm, bleeding and other diseases lead to hypoxia of the beta cells of the islets of Langerhans and reduce insulin secretion.
- Destruction of pancreatic tissue due to alcohol, poisoning, drugs and oncology.
Type 2 diabetes is caused by poor nutrition, against the background of a decrease in physical activity associated with rapid technological development and urbanization.This pathology is more common among representatives of the mongoloid race.
Classification of diabetes
There are two main types of diabetes:
- Type 1 diabetes (T1DM)- can be considered a hereditary autoimmune pathology, when the own immune system attacks the pancreas' own beta cells.The destruction of glandular tissue can be complete or partial.The pathology is diagnosed in young people, so it is called juvenile diabetes.This type of disease is associated with absolute insulin deficiency.Patients with this diagnosis must receive insulin injections for the rest of their lives.
- Type 2 diabetes (T2DM)— is based on insulin resistance (immunity of cells to the action of insulin, with subsequent disruption of the flow of glucose into cells and tissues).Insulin serves as the “key” that allows glucose to enter the cells to be used for energy.The lack of insulin in this type of diabetes is relative, that is, the gland itself is not damaged, but is forced to "wear out" for years.Type 2 diabetes usually affects people over the age of 40 and does not vary by race, age, or gender.
There is also so-called "hidden diabetes" - prediabetes.The condition is intermediate between normal and pathological: the amount of glucose in the blood is higher than normal, but this is not enough to make a diagnosis.This condition usually precedes type 2 diabetes.The main danger is the absence of symptoms.
Another form, gestational diabetes, develops in some women during pregnancy.It often disappears after childbirth.But there is a risk of developing T2DM after 45 years.
Symptoms of the disease
The first type of diabetes is acute and occurs suddenly, the symptoms of the second type are extremely rare at the beginning, they develop over several years, and the person does not even suspect the existence of the pathology.
Symptoms of any type of diabetes in women and men:
- The classics are unquenchable thirst and polyuria.This leads to dehydration of the body.The mechanism of this phenomenon is due to the fact that excess sugar accumulates in the blood.Its filtering, absorption and removal from the body requires intensive kidney work.If it is damaged, the excess sugar begins to drain from the tissues with liquid.A vicious circle develops.After drinking, thirst persists;the patient drinks up to 4 liters of water per day, which again leads to frequent urination.
- Persistent dry mouth with dehydration.
- Increased fatigue.
- Yawning, drowsiness - hypoxia and lack of nutrition of brain cells due to lack of glucose in the cells.
- Weakness is caused by dehydration and the inability to use sugar as energy.
- Slow healing of wounds and cuts, frequent infections.
- A feeling of nausea or even vomiting.
- Rapid breathing (possibly with the smell of acetone).This is especially noticeable during coma, which is a distinctive sign.
- Increased heart rate.
- Itching of the genitals and skin.
- Weight loss is more characteristic of the first type of pathology and leads to exhaustion.
- Deterioration of vision - fog in front of the eyes.
- Polyphagia is thirst after eating and the lack of a feeling of fullness.
- Paresthesia in the limbs.
- Bleeding gums that become swollen and red.
Failure to treat diabetes mellitus leads to complications in the form of angiopathy (vascular system dysfunction).Trophic ulcers, reduced vision, impaired tissue sensitivity, etc.
The most serious complication is diabetic coma, most often in insulin-dependent diabetes.
Type 2 diabetes has its own characteristic symptoms:
- Increased sweating during any physical activity - eating, moving, sleeping.Usually the head and chest sweat, but the hands and feet remain cold, trembling, and chills are felt.
- Urinary incontinence.
- Tendency to gain weight.
- Intermittent night sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Increased heart rate with seizures, increased blood pressure, tinnitus, heaviness in the head and shortness of breath.
Diagnosis of diabetes mellitus
The main clinical manifestation of diabetes is hyperglycemia, so its determination is the basis of the diagnosis.
Normal indicators: blood sugar level of no more than 6.1 mmol/l on an empty stomach, no more than 11 mmol/l 2 hours after a meal.They are not limited to a single analysis;it will not be objective.
A complete diagnosis requires the following:
- glucose tolerance test;
- biochemical blood analysis, electrolyte test;
- sugar and acetone urine analysis;
- Reberg tests - determination of urine creatinine content to assess the state of the kidneys;
- fundus examinations;
- vascular examinations - Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, EKG.
Treatment of diabetes
The main tasks of doctors:
- Compensation of carbohydrate metabolism.
- Treatment and prevention of complications.
- Normalization of body weight.
- Patient education - calculation of bread units, special hygiene, keeping a self-check diary.
Treatment of diabetes mellitus takes years and requires strict adherence to medical regulations.
Important!Type 1 diabetes is incurable, but it can be controlled.
Drug therapy:
- Insulin hormone injections in type 1 diabetes.Another treatment method is transplantation - the transplantation of the entire gland or its individual sections (the islets of Langerhans responsible for insulin).
- Antihyperglycemic agents- It is used in type 2 diabetes to accelerate the use of glucose by tissues and to increase insulin synthesis.These are primarily drugs based on sulfonylureas.They help lower blood sugar levels.
- Biguanides- reduces insulin resistance of cells by reducing its absorption from the intestine and improving metabolism in peripheral cells.
Medicines are taken continuously, in regulated doses.The regimen and doses are always unique.
The main method of treating type 2 diabetes is diet.
Another important condition for the success of the treatment is weight correction.Diabetic patients should be prepared to check their blood sugar levels daily (have a glucometer at home) and be regularly examined and monitored by an endocrinologist or general practitioner at the clinic.
Important!Early diagnosis and treatment help to avoid negative consequences.
Diet is a necessary component without which it is impossible to normalize hyperglycemia.It compensates for carbohydrate metabolism in type 2 diabetes.In type 1, diet is necessary to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced with protein, fat and calorie content.
It is important to follow the principles of proper nutrition, with the exception of "heavy" fats, refined, canned, smoked, carbonated foods, and simple sugars, except in cases of hypoglycemic coma.
Prognosis and prevention
Basic preventive measures:
- tracking weight changes;
- control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drinking enough water (at least 2 liters per day);
- supplying the body with vitamins and minerals.
Type 1 diabetes is not inherited genetically, only a predisposition.Therefore, the prevention methods are as follows:
- breastfeeding - it is advisable not to stop until the age of 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chicken pox;
- eliminating stress;
- proper nutrition.
The prognosis is favorable with self-control and timely treatment.
Don't treat a diabetes diagnosis as a death sentence.Transitioning to a healthy lifestyle and proper nutrition with moderate physical activity makes it possible to achieve a stable remission with the complete abolition of drugs.