Diabetes mellitus is an endocrinological pathology accompanied by hyperglycemia syndrome (high blood sugar) due to lack of insulin.This disease is accompanied by carbohydrate -lack of balance and other metabolism.
Currently, diabetes mellitus is diagnosed in 10-15 % of our planet's population.Cases of this disease have become more common in childhood, usually unreasonable antibiotic treatment, stress and viral infections.The number of patients with diabetes increases by 9-10%.Nowadays, the number of patients with the disease exceeds 200 million people.Diabetes is diagnosed with both men and women.
Causes and mechanism of diabetes
As a result of insulin synthesis and secretion, a reduction in blood insulin levels is reduced as a result of the Beta cells of the Langergans Islands, leading to absolute insulin deficiency over time.There is also a relative insulin deficiency that may result in a decrease in insulin activity with an increased relationship with protein, intense destruction of liver enzymes, non -hormonal and hormonal antagonists (thyroid hormones, adrenal cortex, round and spherical hormone).fat controls.Insulin -dependent tissues for insulin.
Insulin deficiency provokes protein, carbohydrate and fatty metabolism disorders in the body.The permeability of the glucose of cell membranes in muscle and adipose tissue is reduced, gluconeogenesis and glycogenolysis increase, glucosuria, hyperglycemia, accompanied by polydipsia and polyuria.Decomposition increases and the formation of fats in the blood causes an increase in ketone bodies (acetone condensation product is acetouxyic acid, beta-oxima and acetouxus acids).These phenomena cause the displacement of acid-base balance towards acidosis and also affect the increase in magnesium, sodium, potassium potassium and leads to kidney dysfunction.
It may be reduced to 25% in the alkaline reserve of the blood.Decrease in carbon dioxide and blood pH levels to 7.2-7.0.
How does type I diabetes develop
The causes of diabetes have some differences, depending on the type of diabetes.For example, patients with diabetes due to autoimmune aggression and viral infections are expanded by body beta cells, which results in all the consequences of deficiency.
How II.Type of diabetes
Patients with type II diabetes have sufficient amounts of insulin, but body tissues lose the opportunity to detect the signal.With obesity, adipose tissue acts as a kind of barrier that blocks the effect of insulin.In order to eliminate this dam, beta cells include an intense mode of operation, which later leads to their exhaustion and the transition to relative insulin failure.Nevertheless, insulin -dependent diabetes is not transformed into insulin dependent.
Regardless of the etiological factor of the development of diabetes, the same process occurs when the sugar transformation slows down from the outside and in the blood.
Classification of diabetes
Depending on the clinical characteristics, the following type of diabetes can be distinguished:
- Type I diabetes mellitus with many subspecies:
- insulin -dependent diabetes;
- Insulin -dependent diabetes sugar:
- in obese people;
- In people of normal weight.
- diabetes whose development is not sufficient nutrition;
- Other control of type I diabetes related to certain syndromes and siblings:
- endocrine pathologies;
- insulin disorders or receptor;
- pancreatic diseases;
- certain genetic syndromes;
- conditions caused by taking chemicals or medicines;
- state of mixed etiological factors;
- II.The type of diabetes indicates that it violates glucose tolerance and is divided into such forms:
- In patients without overweight;
- in obese people;
- caused by a certain condition or syndrome.
- The III.Type of diabetes may develop during pregnancy.
Separate static risk departments of the disease have been identified (patients with normal glucose tolerance, but a significant risk of diabetes):
- State preceding glucose tolerance;
- Potential glucose tolerance.
A type of basic (primary) diabetes
The basic (primary) type of diabetes mellitus, which has a connection with nutritional failure, is highlighted as a separate pathology.This disease occurs in people under the age of 30 in tropical countries.According to statistics, the proportion of men and women is 2: 1. The number of patients with diabetes is 20 million people.
Most often there are two subtypes of this diabetes.The first is fibrocalcular pancreatic diabetes.
Fibrocalcule pancreas
From a spatial point of view, it is primarily Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by extensive pankreofibrosis and stone formation in the main channel of the pancreas.The clinical picture is represented by sharp weight loss, recurrent abdominal pain and other signs of inadequate nutrition.In this case, insulin therapy allows you to eliminate moderate and high glucosuria and hyperglycemia.One of the typical signs of this pathology is the lack of ketoacidosis, which is due to the reduced production of insulin and the release of glucagon by the pancreas island.Topographic tests (ultrasonic diagnostics, radiography, computer tomography) allow the presence of stones to determine the presence of the pancreas.
There is a opinion that one of the factors of fibrocalcoretic diabetes is the incorporation of manioca roots (Kassava, Tapioka) into the diet, which contain cyanogenic glycosides, which is linamarin, from which cyanic acid is released during hydrolysis.The adverse effects of sulfuric acids are eliminated, and protein -containing consumption, which is often found in the population of the above countries, is not sufficient for cyanide accumulation, which is the cause of fibrocalculosis.
Pancreas
The relationship between pancreatic sugar (type II diabetes) is in contact with the body's protein insufficiency, but there are no pancreas fibrosis.This is characterized by moderate resistance to insulin and the development of ketoacidosis.In most cases, patients suffer from fatigue.Patients have reduced the secretion of insulin, but not to the extent as in patients with type I diabetes, which explains the lack of ketoacidosis.
J subtype
According to the WHO data presented above, there is no reference to the third subtype of the pancreas diabetes, which is Jamaican, is not a reference to Jamaican.
Symptoms of diabetes
The first symptoms of diabetes occur due to high blood sugar levels.After the 8.9-10.0 levels are exceeded, the sugar enters the urine.When it continues to increase blood glucose levels, the kidneys also remove water, clinically showing rapid urination (polyuria).Excessive urinary insulation causes constant thirst (polydipsia).In the case of urine, the body loses many calories represented by glucose, so one loses weight and feels constantly hunger.
Diabetes such as drowsiness, decreasing visual acuity, fatigue and nausea are different.In addition, patients with compensated diabetes are prone to infections.Patients with type I diabetes show pronounced insulin deficiency and therefore almost always lose weight before starting treatment.Patients with type II diabetes do not lose the body.
Type I diabetes develops rapid development of clinical manifestations and can soon become diabetic ketoacidosis.Regardless of the high blood in the blood, cells have no possibility of being used without the presence of insulin, so they switch to other energy sources.The destruction of fat cells begins, which provokes the formation of ketone bodies, which "acidify" the blood to toxic chemical compounds.
Diabetic ketoacidosis
The first symptoms of diabetic ketoacidosis occur in the form of excessive urination and excessive thirst, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients have frequent and deep breaths that the body attempts to neutralize the excessive acidity of the blood, and this process is accompanied by the appearance of acetone from the mouth.In the absence of treatment, diabetic ketoacidosis can become complicated with the formation of a coma, in some cases this process occurs within a few hours.
Type I diabetes is accompanied by ketoacidosis, even after the start of insulin therapy, when the patient passes on a planned injection or undergoes severe emotional overvoltage, especially during injury, severe infection or other serious illness.
Patients who suffer for a long time suffer from II.Type of diabetes, they cannot feel this pathology.Such a hidden period of the disease can last for decades.Clinical manifestations are activated as insulin deficiency worsens.
At first, the volume of dedicated urine is only slightly above the norm, thirst can be poorly expressed, but over time these processes progress.The phenomena of ketoacidosis are rare.In the blood, with a significant increase in glucose levels (in some cases, 55 mmol/l), this is usually done with a further burden on the body, such as under the influence of drugs or with severe infectious diseases, the patient may be immersed in the state of confusion, and the most hyper -hyper -hyperemicus is provoked.
How differently diabetes mellitus manifests
Over time, blood in the blood can cause damage to nerves, blood vessels and other structures.Chemical compounds containing glucose are located on the walls of small blood vessels, which result in thickens and damaged the walls of the blood vessels.Reducing blood vessels causes blood flow to deteriorate, especially 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 in diabetes, regardless of gender, suffer 2-6 times more often in atherosclerosis, compared to people who do not have such diagnosis.Violations in blood circulation cause dysfunctions of the heart, kidneys, eyes, lower limbs, brain, skin and nerves and slows down the healing process of wounds.
What is diabetes mellitus seriousness
All of these factors increase the risk of many distant complications.Patients with diabetes increase the risk of stroke and heart attack, damage to the blood vessels, the result of loss of visinopathy (diabetic retinopathy), kidney disorders may cause kidney failure and in some cases dialysis is required.Nerve damage can lead to many consequences.Mononeuropathy (impaired function of a nerve) may be manifested by sudden weakness of the upper or lower limb.Diabetic polyneuropathy (damage to legs, feet or hands nerves) causes sensitivity, pain, burns or tingling, and sensation of weakness of arms and legs.Temperatures and pain sensitivity decrease, resulting in increased trauma.Circulatory disorders can contribute to the appearance of ulcers and to heal the wounds.The ulcers localized on the legs are very deep and heal poorly, leading to infection and in some cases to the amputation of the affected limb.
Clinical trials have shown that it can be avoided or expired by diabetes if you continuously maintain normal blood sugar levels.The course of this disease is currently not fully examined.There are many unovered factors that cause its development, and the genetic factors contain the number of these factors.
Diagnosis of diabetes
Diagnosis of diabetes begins with the collection of anamnesis and the patient's examination.In these measures, the patient has hereditary factors, obesity, whether the patient belongs to the number of twins (if one of them suffers from diabetes, the second must be examined), women determine the presence of childbirth and that a large fruit is determined.
Below is a number of laboratory tests consisting of:
- Glucose blood tests are performed twice;
- Glucose tolerance -Test;
- Determination of glucose levels in daily urine.
Diagnosis of diabetes mellitus is very important to know the presence of complications;For this, all organs and systems are diagnosed.
Complications of diabetes
Diabetes complications can be acute and chronic and are divided depending on the form of diabetes.Acute complications can be distinguished by the condition of the coma, during which the loss of awareness is preceded by the abnormalities of the brain because the blood sugar level has very low or very high concentrations.Such conditions include:
- Diabetic ketoacitosis (the most common complication of acute nature) is polyuria, polyidips, lack of appetite, weakness, abdominal pain, nausea and vomiting;
- Hypoglycaemia in the hypoglycemic coma occurs with a sudden decrease in glucose levels in the blood.It is often the result of the introduction of an irregular insulin dose and sometimes occurs after taking certain foods or sulfanylalamide.
- The hyperosmolar comic book in the severity of the state exceeds diabetes, who is primarily in the elderly, II.Type of diabetes.In 30% of cases, the patient's death will be caused and in the presence of severe simultaneous pathologies -70%.
Chronic (late) complications are combined into a group of pathologies that develop a longer exposure to the patient's organs and systems with a longer exposure to high blood sugar levels.Above all, more sugar sensitive organs are exposed to damage, which is a kind of "target" for diabetes.The following are known among the chronic complications of diabetes:
- 90% of diabetes has diabetic retinopathy.It develops with long diabetes and manifests itself with damage to the pots of the eyeretina;
- Diabetic nephropathy consists of complex damage to the kidneys (tubules, arteries, glomerulles, arterioles).The prevalence of patients with diabetes is 75%;
- Damage to the peripheral nerves of patients with diabetes represents diabetic neuropathy.Neuropathy is a prone to the formation of a diabetic leg that can lead to the amputation of the limb;
- Diabetic encephalopathy is the brain damage that is progressive.Increased fatigue, loss of performance, detrimental concentration of attention, emotional labil, headache, anxiety and deterioration of the thinking process;
- Diabetic lesions of the skin are the structural deformities of the epidermis, the follicles, the sweat glands due to the damage to carbohydrate metabolism and the accumulation of metabolism products.For severe diabetes, the skin is fluffy, coarse, homosopers, cracks, the skin is yellowish, and hair loss occurs;
- Diabetic foot and brush syndrome occur in 30-80% of diabetes patients and a complex of anatomical and functional disorders that appear in the form of brown spots and ulcers in the form of the lower, leg and phalanx, which can lead to severe limb amputation.
Treatment of diabetes
Treatment of diabetes depends on the type of disease, but above 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 based on calculating carbohydrates, proteins and fats, vitamins and trace elements used.This calculation is taught in this field by professionals.
Choosing a tactic of medication depends on the type of diabetes.Patients with diabetes are required to perform insulin therapy.In the case, it is proven to adhere to the strictest diet and use glucose -containing agents, with the effectiveness of the tablet forms of the drugs.
Insulin in the blood is taken under strict control of glucose levels.Insulin preparations are divided into three types according to the mechanism of action: longer, short and intermediate effects.Medicines containing sugar are indicated in the case of insulin -dependent diabetes in combination with the diet.Sugar -containing drugs are: Biguanides, sulfonyl -mochevina, thiazolidindiles and graitinides.
With this misleading disease, it is very important for medical staff to properly teach the patient and relatives the abilities of the patient's condition and first aid control in pre -Domation and coma.
The prediction of diabetes mellitus
In the presence of diabetes mellitus, the patient is registered with the endocrinologist.In the case of proper therapy, the patient may be in satisfactory condition for a long time.You can develop acute and chronic complications to exacerbate the health and life of patients with diabetes mellitus.
To prevent diabetes
In type I diabetes, the purpose of preventive measures is to increase the body's resistance to various infections and to eliminate the toxic effects of antibodies on the pancreas.In patients II, the type of diabetes is very important for the nutrition setting and preventing obesity.In order to prevent the development of complications, the doctor's recommendations should be correctly and systematically observed in the case of diabetes and clarified whether this or food can be consumed.