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 the hormone insulin produced by the pancreas, or the body's cells stop responding adequately to it, leading to an increase in the level of glucose in the blood plasma. At the same time, the cells suffer from an energy deficit and starve, even with a sufficient amount of carbohydrates from food.
Among all endocrine diseases, diabetes mellitus in women and men is the most common. There are more than 250 million people in the world with various types of this pathology. In our country, diabetics are about 6% of the entire population. In some people, carbohydrate metabolism disorders and diabetes simply haven't been identified yet, so the real rate could be almost twice as high.
Causes of diabetes
Today there is no consensus as to why this disease occurs. Today it is considered polyetiological - there are several theories for the occurrence of carbohydrate metabolism disorders and insulin problems. A special role is played by unfavorable heredity if close relatives suffer from diabetes.
In addition, certain factors and triggers can become triggers. this:
- improper nutrition with an excess of light carbohydrates, refined foods, fast food, saturated and trans fats and a deficiency of dietary fiber;
- overweight and obesity (BMI over 30 and fat deposits in the anterior abdominal wall are particularly dangerous);
- chronic disorders of the water-electrolyte balance;
- endocrine pathologies (Cushing's disease, hyperfunction of the thyroid gland);
- long-term, chronic physical and psycho-emotional stress;
- complications from "childhood infections", especially measles, rubella and chicken pox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, stones in the canals.
A high risk of diabetes is possible in children born to mothers suffering from the gestational form of the disease; if the baby was born with a high weight, he had problems with his glucose levels in the first days of his life.
Symptoms of the disease
In the initial stage, diabetes mellitus practically has no pronounced symptoms. Often the first alarm bells are mistaken for overwork, infections or the effects of stress. But it is important to pay attention to the combination of symptoms, which by themselves can be signs of other diseases, but in combination indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, strong thirst with sufficient or excessive fluid intake;
- frequent urination, copious urine output (up to 3-5 liters or more);
- dry skin, a feeling of itching in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, specific sweet smell of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, reduced work capacity.
In addition, 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 or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development, and in the initial stage they differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of aggression of the immune system against the cells of the pancreas 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, in older age it is possible against the background of pancreatic necrosis due to complicated pancreatitis or organ removal. The basis of therapy is the use of insulin.
Type 2 diabetes or insulin resistance (independent)more common in older or overweight people. It occurs due to impaired sensitivity of cells to insulin, which often occurs due to obesity and metabolic disorders. Correction with diet and glucose-lowering drugs is possible.
In addition, there are other specific forms of diabetes:
- gestational– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, severe damage to the pancreas;
- LADA-diabetes(means latent autoimmune diabetes), has mild symptoms, does not require insulin injections;
- MODY-diabetes- This is a special, genetic form of the disease.
Any form of diabetes can have
Complications of the disease
If the patient with diabetes mellitus ignores the doctor's recommendations, does not follow a diet or refuses to take medication, 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 the structures inside the eyeball and its vessels;
- formation of persistent hypertension (high blood pressure);
- disorders of lipid metabolism, increased "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disorders in the limbs (neuropathy), blood flow disorders (angiopathy).
Against the background of metabolic disorders, life-threatening conditions can occur -
- 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 with this by administering glucose doses with individually selected insulin levels.
- Ketoacidotic comaoccurs when the metabolism of glucose is disturbed, when it increases in the blood. It breaks down into ketone bodies that poison the body.
- Lactate comaoccurs when there are failures in glucose metabolism, against which acid metabolic products accumulate, which leads to breathing and circulatory disorders and requires treatment in intensive care.
Diagnosis
Basic laboratory tests confirming diabetes:
- blood glucose level test (given 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 tests (protein levels, lipids, electrolytes);
- evaluation of the level of glycosylated hemoglobin HbA1c;
- general and daily urine analysis with determination of glucose and protein levels;
- determination of endogenous insulin levels.
The doctor also appoints a number of instrumental examinations and consultations - an examination by an ophthalmologist with an assessment of the fundus, a consultation with a neurologist with an assessment of the condition of the peripheral nerves, blood pressure, ECG, etc. ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-drug approaches, lifestyle changes with individual selection of drugs that control glycemic levels in diabetes (fasting and postprandial blood sugar, activity). Treatment approaches differ depending on the type of disease.
For type 1 diabetesis the basis of drug treatmentinsulin injections(short, long and other types depending on the severity of the condition and situation).With the second kindThe basis of glucose treatment and control isdiabetes pills. They help reduce glucose levels along with dietary adjustments. It is important to emphasize that the treatment is carried out throughout life, with dose adjustment and dynamic monitoring of the patient.
To control the condition of diabetes, it is important to eat in such a way as to provide the body with all the necessary nutrients, vitamins and minerals, but not to provoke sudden spikes in blood sugar. The doctor helps to adjust the diet, teaches the patient how to choose the right foods and combine them with taking medication 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.
In addition, the doctor recommends lifestyle changes - weight control, physical activity, regular visits to the doctor to prevent complications of the pathology.
Prevention
In order to maintain health and reduce the risk of developing the disease, it is necessary to control your weight, regularly evaluate carbohydrate and lipid metabolism and undergo a medical examination. Moderate physical activity, the intake of sufficient fluids and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods are important.