The expression"diabetes mellitus"name the entire group of endocrine diseases that are united by one common feature: they are based on carbohydrate metabolism disorders. In the body, there is a lack of the insulin hormone produced by the pancreas, or the body cells do not react properly, 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 starve, even if the carbohydrates from the diet are sufficient.
Among all endocrine diseases, diabetes is the most common among women and men. More than 250 million people in the world live with different types of this pathology. In our country, diabetics 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 double.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered polyetiological - there are many theories about the occurrence of carbohydrate metabolism disorders and insulin problems. Unfavorable heredity plays a special role if close relatives suffer from diabetes.
In addition, certain factors and triggers can become provocateurs. 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 (BMI above 30 and fat deposits in the anterior abdominal wall are particularly dangerous);
- chronic water-electrolyte imbalances;
- endocrine pathologies (Cushing's disease, hyperthyroidism);
- 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.
There is a high risk of diabetes in children who suffered from the gestational form of the disease, if the baby was born with a high weight and there were problems with glucose levels in the first days of life.
Symptoms of the disease
In the initial stage, diabetes mellitus practically has no pronounced symptoms. The first alarm is often mistaken for overload, infection or the effects of stress. But it is important to pay attention to the combination of symptoms, which in themselves may be signs of other diseases, but together indicate the manifestation of diabetes.
The main symptoms of diabetes are:
- constant dry mouth, strong thirst, with sufficient or excessive fluid intake;
- frequent urination, copious urination (up to 3-5 liters or more);
- dry skin, itching sensation in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite adequate nutrition;
- increased sweating, specific sweet smell of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, reduced performance.
It may also occurfainting, loss of consciousness, malaise, dizziness. People often first learn of their diagnosis when they are admitted 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 at the initial stage, they differ significantly in treatment tactics.
Type 1 diabetes or insulin dependent. It occurs as a result of the immune system's aggression against the 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 people, at an older age against the background of necrosis of the pancreas due to complicated pancreatitis or the removal of an organ. The basis of the therapy is the use of insulin.
Type 2 diabetes or insulin resistance (independent)more common in older or overweight people. This occurs due to damage to the insulin sensitivity of the cell, which often 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 a metabolic disorder;
- pancreatogenic– related to injuries, serious damage to the pancreas;
- LADA diabetes(abbreviation for latent autoimmune diabetes), has mild symptoms, does not require 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 patient with diabetes 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 life. This:
- severe visual impairment, damage to structures inside the eyeball and blood vessels;
- development of persistent hypertension (increased blood pressure);
- lipid metabolism disorders, increased "bad" cholesterol level, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disorders in the limbs (neuropathy), blood flow disorders (angiopathy).
Metabolic disorders can lead to life-threatening conditions -
- Hypoglycemic comaIt is dangerous because it develops quite quickly and can have serious consequences. It occurs when the glucose level drops below 2. 8 mmol/l. Doctors can help with this by administering individually selected insulin levels of glucose doses.
- Ketoacidotic comait occurs when the metabolism of glucose is interrupted when it rises in the blood. It breaks down into ketone bodies, which poison the body.
- Lactate comait occurs when glucose metabolism fails, against which acid metabolic products accumulate, which leads to respiratory and circulatory disorders and requires intensive treatment.
Diagnostics
Basic laboratory tests to confirm diabetes:
- blood sugar level test (in the morning, on an empty stomach);
- stress test (determination of glucose tolerance (blood is taken on an empty stomach and 1 and 2 hours after taking the glucose solution);
- biochemical tests (protein, lipid, electrolyte levels);
- assessment of glycosylated hemoglobin HbA1c level;
- general and daily urinalysis with determination of glucose and protein levels;
- determination of the endogenous insulin level.
The doctor also prescribes a number of instrumental examinations and consultations - an ophthalmological examination with an assessment of the fundus, a neurologist's consultation with an assessment of the condition of the peripheral nerves, blood pressure monitoring, EKG, orultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-pharmacological approaches, lifestyle changes in diabetes mellitus with individual selection of drugs that control glycemic levels (fasting and postprandial blood sugar levels, activity). Treatment methods differ depending on the type of disease.
For type 1 diabetesit is the basis of drug treatmentinsulin injections(short, prolonged and other types depending on the condition and severity of the situation).With the second typeIt is the basis of glucose treatment and controldiabetes pills. They help lower glucose levels along with dietary adjustments. It is important to emphasize that the treatment must be 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 cause a sudden rise in blood sugar. The doctor helps to correct the diet, teaches the patient how to choose the right foods, and how to combine them with medications or insulin. All diabetes-related products are divided into groups - those that can be used without fear, those that should be reduced and those that should be eliminated.
In addition, the doctor recommends lifestyle changes - weight control, physical activity, regular medical visits to prevent complications of the pathology.
Prevention
In order to maintain health and reduce the risk of developing disease, it is necessary to check body weight, regularly evaluate carbohydrate and lipid metabolism, and undergo a medical examination. Moderate physical activity, adequate fluid consumption and a balanced diet with a reduction in the amount of carbohydrates, saturated fat, fast food and refined food are important.