The term"diabetes mellitus"name a whole group of endocrine diseases, united by a common feature: they are based on disorders of carbohydrate metabolism. The body develops a deficiency of insulin, a hormone produced by the pancreas, or the body's cells stop responding adequately to it, leading to an increase in blood plasma glucose levels. At the same time, cells suffer from an energy deficit and starve, even with sufficient carbohydrate intake from the diet.
Among all endocrine diseases, diabetes mellitus in women and men is the most common. There are more than 250 million people worldwide suffering from different types of this pathology. In our country, diabetics represent approximately 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply have not yet been identified, so the actual percentage may be almost twice as high.
Causes of diabetes
Today there is no consensus on why this disease appears. Today it is considered polyetiological - there are several theories about the occurrence of carbohydrate metabolism disorders and insulin problems. Unfavorable heredity plays a special role if close relatives suffer from diabetes.
Additionally, certain factors and triggers can become provocateurs. This:
- a poor diet with an excess of light carbohydrates, refined foods, fast food, saturated and trans fats and a deficiency in dietary fiber;
- overweight and obesity (a BMI above 30 and fatty deposits in the anterior abdominal wall are particularly dangerous);
- chronic disorders of water-electrolyte balance;
- endocrine pathologies (Cushing's disease, hyperfunction of the thyroid gland);
- chronic and long-term physical and psycho-emotional stress;
- complications of "childhood infections, " particularly measles, rubella and chickenpox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, ductal stones.
A high risk of diabetes is possible in children born to mothers who suffered from the gestational form of the disease; if the baby was born at a high weight, he had blood sugar problems in the first days of life.
Symptoms of the disease
At the initial stage, diabetes mellitus practically does not have any pronounced symptoms. Often, the first alarm bells are confused with overwork, infections or the consequences of stress. But it is important to pay attention to the combination of symptoms, which in themselves can be signs of other diseases, but in combination indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, intense thirst with adequate or excessive fluid intake;
- frequent urination, copious urine output (up to 3-5 liters or more);
- dry skin, itchy feeling in feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite good nutrition;
- increased sweating, specific sweet smell of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, decreased performance.
Additionally, there may befainting, loss of consciousness, malaise, dizziness. Often, people first learn of their diagnosis when they are admitted to the hospital in a state of hyperglycemic coma or ketoacidosis.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development, and at the initial stage their treatment tactics differ significantly.
Type 1 or insulin-dependent diabetes. It occurs following an attack by the immune system against the pancreatic cells which synthesize insulin. As a result, the production of the hormone gradually decreases, reaching a critical level, while the level of blood sugar (plasma glucose) increases. This form of diabetes occurs more often in children and young people; at a later age, it is possible against the background of necrosis of the pancreas due to complicated pancreatitis or removal of an organ. The basis of treatment is the use of insulin.
Type 2 or insulin-resistant diabetes (independent)Occurs more often in older or overweight people. This is due to impaired cellular sensitivity to insulin, which is often caused by obesity and metabolic disorders. Correction is possible with diet and hypoglycemic drugs.
Furthermore, there are other specific forms of diabetes:
- gestational– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, serious damage to the pancreas;
- LADA-diabetes(means latent autoimmune diabetes), has mild symptoms, does not require insulin injections;
- MODY-diabetes- This is a particular genetic form of the disease.
Any form of diabetes can havesimple (controlled)Andcomplicated course.
Complications of the disease
If a diabetic patient 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 its vessels;
- formation of persistent hypertension (increased blood pressure);
- lipid metabolism disorders, increased "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disorders in the extremities (neuropathy), blood circulation disorders (angiopathy).
Against the background of metabolic disorders, life-threatening conditions can arise -coma. They develop both against the background of an increase in blood sugar levels and against the background of its sharp decrease (with incorrectly chosen treatment, concomitant pathologies).
- Hypoglycemic comaIt is dangerous because it develops quite quickly and can lead to serious consequences. This happens when the glucose level drops below 2. 8 mmol/l. Doctors can help by administering doses of glucose with individually selected insulin levels.
- Ketoacidosis comaoccurs when glucose metabolism is disrupted when it increases in the blood. It breaks down into ketone bodies which poison the body.
- Lactate comaoccurs in cases of dysfunction of glucose metabolism, against which acidic metabolic products accumulate, which leads to respiratory and circulatory disorders and requires intensive care treatment.
Diagnosis
The basis of diagnosis lies in laboratory examinationswhich will detect an increase in blood sugar. It is important to carry out a full series of examinations, because a single analysis is not informative - external factors can influence blood sugar levels.
Basic laboratory tests confirming diabetes:
- blood test for glucose level (to be done in the morning, on an empty stomach);
- stress 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 examinations and instrumental consultations - an examination by an ophthalmologist with assessment of the fundus of the eye, consultation with a neurologist with assessment of the condition of peripheral nerves, monitoring of blood pressure, an ECG and an ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-drug approaches, lifestyle changes with an individual selection of drugs that control glycemic levels in diabetes mellitus (fasting and postprandial blood sugar, activity). Therapeutic approaches differ depending on the type of disease.
For type 1 diabetesthe basis of drug treatment isinsulin injections(short, prolonged and other types depending on the severity of the condition and the situation).With the second typeThe basis of glucose treatment and control isdiabetes pills. They help reduce glucose levels as well as adjust diet. It is important to emphasize that the treatment is carried out for life, with dose adjustments 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 a sudden increase in blood sugar levels. The doctor helps to correct the diet, teaches the patient how to select the right foods and their combination with taking medications or insulin. All diabetes products are divided into groups: those that can be used without fear, those that should be reduced and those that should be excluded.
Additionally, the doctor recommends changes in lifestyle - weight control, physical activity, regular visits to the doctor to prevent complications of pathology.
Prevention
In order to maintain good health and reduce the risk of developing the disease, it is necessary to control weight, regularly assess carbohydrate and lipid metabolism, and undergo a medical examination. Moderate physical activity, sufficient fluid intake and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods are important.