Diabetes mellitus is an endocrinological pathology accompanied by a hyperglycemia syndrome (high blood sugar), which occurred due to insulin deficiency.This disease is accompanied by an imbalance in carbohydrates and other metabolic disorders of the body.
Currently, diabetes mellitus is diagnosed in 10 to 15% of the population of our planet.Cases of development of this childhood in childhood have become more frequent, as a rule, after unreasonable antibiotic therapy, stress and viral infections.There is an annual increase in the number of patients with diabetes from 9 to 10%.Today, the number of patients with this disease exceeds 200 million people.Diabetes is diagnosed in men and women.
Causes and mechanism for the development of diabetes
Due to a violation of the synthesis and secretion of insulin by beta cells of the islands of changing, there is a decrease in the level of insulin in the blood, which over time leads to an absolute deficiency in insulin.Insulin deficiency is also noted, which can be the result of a decrease in insulin activity due to its increased connection with proteins, intensive destruction of hepatic enzymes, the prevalence of the effects of non -hormonal and hormonal antagonists (thyroid hormones of tissues dependent on insulin.
Insulin deficiency causes protein, carbohydrate and fat metabolism disorders in the body.The permeability of glucose of cell membranes in muscle and adipose tissue is reduced, gluconeogenesis and glycogenolysis are improved, glucoseuria, hyperglycemia occurs, which are accompanied by polydipsia and polyuria.The decrease is intensified and the formation of fat is reduced, which causes an increase in the level of ketone body in the blood (acetone-the condensation product of acetouxixic acid, beta-oxyma and acetouxus acids).These phenomena cause a gap of acid-base balance in the sense of acidosis, and also affect the increase in the excretion of magnesium, sodium, potassium in urine and leads to renal dysfunction.
There may be a decrease in the alkaline blood reserve at around 25%.Carbon dioxide and decrease in blood pH levels to 7.2-7.0.
How type I diabetes develop
The causes of diabetes development have some differences, depending on the type of diabetes.For example, patients with type of diabetes, due to self-immune aggression and viral infection, are widened by beta cells of the body, as a result of which a deficiency develops with all the consequences that follow.
How type II diabetes develop
Patients with diabetes II have a sufficient amount of insulin, but body tissues lose the opportunity to perceive its signal.With the development of obesity, the adipose tissue acts as a kind of barrier which blocks the effect of insulin.In order to eliminate this barrier, the beta cells include the intensive operating mode, which then leads to their exhaustion and their transition from the relative insulin insulin insulin.Nevertheless, diabetes dependent on insulin is not transformed by depending on insulin.
Whatever the etiological factor in the development of diabetes, the same process takes place in the slowdown in sugar transformation from the outside and available in the blood.
Diabetes classification
Depending on clinical characteristics, the following types of diabetes are distinguished:
- I type diabetes mellitus, which in turn has several subspecies:
- diabetes dependent on insulin;
- Diabetes sugar dependent on insulin:
- in people with obesity;
- In people with normal weight.
- Diabetes, whose cause of development is insufficient nutrition;
- Another verification of type I diabetes associated with certain syndromes and bodily conditions:
- endocrine pathologies;
- Insulin anomalies or its receiver;
- pancreatic diseases;
- certain genetic syndromes;
- the conditions caused by the effects of chemicals or taking medication;
- state of mixed etiological factors;
- II The type of diabetes indicates a violation of glucose tolerance and is divided into such forms:
- in patients without excess weight;
- in people with obesity;
- caused by a certain state or syndrome.
- Type III diabetes can develop during pregnancy.
Distinct static risk classes of this disease have been identified (patients with normal glucose tolerance, but a significant risk of diabetes):
- a state preceding a violation of glucose tolerance;
- Potential glucose tolerance disorders.
Essential type of diabetes (primary)
The essential type (primary) of diabetes mellitus, which has a link with the failure of nutrition, is highlighted as a distinct pathology.This disease occurs in people under the age of 30 living in tropical countries.According to statistics, the report of men and women is 2: 1. The total number of patients with this form of diabetes is 20 million people.
Most often, there are two subtypes of this diabetes.The first of them is fibrocalcalcal pancreatic diabetes.
Fibrocalcule pancreatic diabetes
Territory, it mainly covers Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of an extended pancreofibrosis and the formation of stones in the main channel of the pancreas.The clinical picture is represented by net weight loss, recurring abdominal pain and other insufficient nutrition signs.In this case, insulin therapy eliminates moderate and high glucosuria and hyperglycemia.One of the characteristic signs of this pathology is the absence of ketoacidosis, which is due to the reduction in insulin production and the release of glucagon by the apparatus of the islets of the pancreas.Topographic studies (ultrasound, diagnostics, radiography, computed tomography) make it possible to determine the presence of stones in the conduits of the pancreas.
There is an opinion that one of the factors for the development of fibrocalcoretic diabetes is the inclusion of root roots (Cassava, Tapioka) in the diet, which contain cyanogenic glycosides, whose linamarin, from which cyanistoric acid is released during hydrolysis.With the participation of acids containing sulfur, its harmful effects are eliminated and an insufficient contribution of protein food, often found in the population of the above countries, causes the accumulation of cyanide in the body, which is the cause of the development of fibrocalculosis.
Pancreatic diabetes
The development of pancreatic diabetes (type II diabetes) has a relationship with the insufficiency of proteins in the body, but there are no manifestations of pancreatic fibrosis.It is characterized by moderate resistance to insulin and resistance to the development of ketoacidosis.In most cases, patients suffer from exhaustion.Patients have reduced insulin secretion, but not to measure as in patients with type I diabetes, this explains the absence of ketoacidosis.
J SUBTYPE
In the classification of diabetes, according to the WHO data, which is presented above, there are no references to the third subtype of pancreatic diabetes, which we find on the Jamaica, we are talking about the J. subtype J has a lot in common with the pancreatic diabetes which occurs due to the protein deficiency.
Diabetes symptoms
The first symptoms of diabetes occur due to a high content of blood sugar.After exceeding the level of 8.9 to 10.0, the sugar enters the urine.When you continue to increase the level of glucose in the blood, the kidneys also eliminate water, this manifests clinically by rapid (polyuria) urination.Excessive urine isolation causes a constant feeling of thirst (polydipsia).With urine, the body loses a large number of calories represented by glucose, so a person loses weight and constantly feels hunger.
Among other symptoms of diabetes, such as drowsiness, a decrease in visual acuity, fatigue and nausea are distinguished.In addition, patients with uncompensated diabetes are subject to infections.Type I diabetes patients have pronounced insulin deficiency and, because of this, almost always lose weight before the start of treatment.Diabetes II patients do not lose body weight.
With type I diabetes disease, the rapid development of clinical manifestations occurs and soon it can progress towards diabetic ketoacidosis.Whatever the high level of glucose in the blood, the cells do not have the possibility of using it without the presence of insulin, they therefore go to other sources of energy.The destruction of fat cells begins, which causes the formation of ketone bodies, which are toxic chemical compounds "acidifying" blood.
Diabetic ketoacidosis
The first symptoms of diabetic ketoacidosis manifest themselves in the form of excessive and excessive thirst, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients have a frequent and deep breathing, which is associated with the body's attempts to neutralize excessive acidity of the blood, this process is accompanied by the appearance of the smell of acetone of the mouth.In the absence of treatment, diabetic ketoacidosis can be complicated by the development of a coma, in some cases, this process occurs in a few hours.
Type I diabetes can be accompanied by the development of ketoacidosis even after the start of insulin therapy if the patient passes a planned injection or undergoes a severe emotional occurrence, especially during injuries, serious infection or other serious illnesses.
Patients with type II diabetes for a long time long may not feel any sign of this pathology.Such a hidden period of the disease can last up to several decades.Clinical manifestations are activated as insulin deficiency aggravates.
At the beginning, the volume of dedicated urine only slightly exceeds the norm, the thirst is weakly expressed, but over time, these processes are progressing.The phenomena of ketoacidosis are rare.With a significant increase in the level of glucose in the blood (in some cases, at 55 mmol / L), this generally occurs with additional loads on the body, for example, under the influence of drugs or with severe infectious diseases, the patient can dive into a confused state of consciousness, the most serious are probably hypergylemylemylemylemylemous.
Otherwise, is diabetes sweetened manifest
The high level of glucose in the blood over time can cause damage to nerves, blood vessels and other structures.The chemical compounds containing glucose are located on the walls of the small blood vessels, as a result of which the walls of the vessels are thickened and damaged.The narrowing of the gaps of the blood vessels causes the deterioration of the blood flow, in particular the blood supply to the endings of the skin and the nerve.Without compensation for diabetes in the blood, an increase in the level of fatty substances occurs, which accelerates the development of atherosclerosis.Patients diagnosed with diabetes, whatever the sex, suffer from atherosclerosis 2 to 6 times more often compared to people who do not have this diagnosis.The violation of blood vessels in the blood circulation causes dysfunctions of the heart, kidneys, eyes, lower limbs, brain, skin and nerves, and also slows down the healing process.
What is the severity of diabetes mellitus
All these factors increase the risk of developing many remote complications.In patients with diabetes, the risk of cerebral vascular accidents and heart attacks increases, due to damage to the blood vessels, the loss of screwopathy (diabetic retinopathy) may occur, kidney disorders cause renal failure, therefore, in some cases, dialysis is necessary.Damage to nerves can have many consequences.Mononeuropathy (altered function of a nerve) can manifest itself by sudden weakness of the upper or lower limb.Diabetic polyneuropathy (damage to the nerves of the legs, feet or hands) causes sensitivity problems, pain, burns or tingling, a feeling of weakness in the arms and legs.The temperature and sensitivity to pain decreases, which leads to an increase in trauma.Circulatory disorders can contribute to the appearance of ulcers and a bad healing of wounds.The ulcers located on the feet are very deep and poorly healed, which leads to infection and, in some cases, to the amputation of the affected limb.
Clinical studies have shown that it is possible to avoid or expire diabetes, if you constantly maintain normal blood sugar.The course of this disease is currently not entirely studied.There are a number of unexplored factors that cause its development, genetics include the number of these factors.
Diabetes diagnosis
The diagnosis of diabetes begins with the collection of an anamnesis and the patient's examination.During these measures, the patient has the presence of hereditary factors, obesity, if the patient belongs to the number of single twins (if one of them suffers from diabetes mellitus, the second must be examined), women specify the presence of childbirth and if a large fruit has been specified.
The following is a number of laboratory tests, which consists of:
- Blood tests for glucose levels are carried out twice;
- glucose tolerance test;
- Determine the level of glucose in daily urine.
With the diagnosis of meal diabetes, it is very important to discover the presence of complications;For this, all organs and systems are diagnosed.
Diabetes complications
Complications of diabetes mellitus can be acute and chronic, they are also divided according to the shape of diabetes.Among the acute complications, coma states are distinguished, during which the loss of consciousness is preceded by brain disorders due to a very low or very high concentration of blood sugar.Such conditions include:
- Diabetic ketoacitosis (the most common complication of an acute nature) manifests itself by polyuria, polydipsia, lack of appetite, weakness, abdominal pain, nausea and vomiting;
- A hypoglycemic coma is an extreme degree of hypoglycemia, occurs with a sharp decrease in the level of glucose in the blood.Often, it is the result of the introduction of an irregular dose of insulin, and sometimes occurs after taking certain foods or sulfanilamide.
- Hyperosmolary comics in the gravity of the state prevails over diabetics which is mainly found in the elderly, with type II diabetes.In 30% of cases, the cause of the death of the patient becomes and in the presence of serious concomitant pathologies - in 70%.
Chronic (late) complications are combined in a group of pathologies that develop with prolonged exposure to high blood sugar on the patient's organs and systems.First of all, the organs more sensitive to sugar are subject to damage, they are a kind of "target" for diabetes.Among the chronic complications of diabetes, the following elements are known:
- Diabetic retinopathy is observed in 90% of diabetic patients.Develops with a long diabetes course and manifests itself by damage to the ships of the ocular retina;
- Diabetic nephropathy consists of complex kidney damage (tubules, arteries, glomerules, arterioles).The prevalence in patients with diabetes is 75%;
- Diabetic neuropathy is represented by peripheral nerves damage in diabetic patients.Neuropathy is a predisposing factor in the development of a diabetic foot, which can lead to an amputation of a member;
- Diabetic encephalopathy is a damage to the brain, which is progressive.It manifests itself by an increase in fatigue, a decrease in performance, a concentration of altered attention, emotional lability, headache, anxiety and worsening of the thought process;
- Diabetic lesions of the skin are structural deformations of the epidermis, follicles, sweat glands due to a violation of the metabolism of carbohydrates and the accumulation of metabolism products.In the case of a serious form of diabetes, the skin becomes scattered, rough, with homosopers areas, cracks, the skin acquires a yellowish shade, hair loss occurs;
- Diabetic foot and brush syndrome occur in 30 to 80% of patients with diabetes and constitutes a complex of anatomical and functional disorders which appear in the form of brown spots and ulcers on the bottom of the leg, the foot and the phalanx of the fingers, which, in serious cases, can cause an amputation of the limb.
Diabetes treatment
The treatment of diabetes depends on the type of disease, but first of all, the patient must normalize the level of glucose in the blood.To do this, you must radically change your lifestyle and your diet.A special diet is recommended for patients with diabetes, which is based on the calculation of carbohydrates, proteins and fats used, vitamins and trace elements.This calculation is taught by specialists in this area.
The choice of drug tactics depends on the type of diabetes.Patients with diabetes type are necessary to perform insulin therapy, with type II, it is shown to adhere to the strictest diet and use agents containing glucose, with the ineffectiveness of forms of drug tablets, insulin is prescribed.
Insulin is taken under strict control of the level of glucose in the blood.Insulin preparations according to the action mechanism are divided into three types: prolonged, short and intermediate action.Drugs containing sugar are indicated in the case of diabetes mellitus depending on insulin in combination with food.Drugs containing sugar include: Biguanids, sulfonylmochevina, thiazolidindyons and meglitinides.
With this insidious disease, it is very important for medical personnel to properly teach the patient and his relatives to monitor the surveillance of the patient's state and first aid in the case of pre-documents and coma.
Prediction for diabetes mellitus
In the presence of diabetes mellitus, the patient is recorded with the endocrinologist.Under adequate therapy conditions, the patient can be in satisfactory condition for a long time.Worse the prognosis concerning the state of health and life expectancy of a patient diabetes mellitus can develop acute and chronic complications.
Diabetes prevention
With type I diabetes, preventive measures aim to increase body resistance to various infections and eliminate the toxic effects of antibodies on the pancreas.For patients with II, the type of diabetes is very important for adjusting nutrition and preventing obesity development.To avoid the development of complications in diabetes conditions, it is necessary to comply correctly and systematically to the doctor's recommendations and to clarify if this food or this food can be consumed.