Diabetic sugar is an endocrinological pathology, accompanied by hyperglycemia syndrome (high blood glucose), which has occurred due to insulin deficiency.This disease is accompanied by carbohydrate imbalance and other metabolic disorders in the body.
Currently, diabetes mellitus is diagnosed in 10-15 % of the population of our planet.The cases of the development of this disease in childhood have become more common, as a rule, after unjustified antibiotic therapy, stress and viral infections.There is an annual increase in the number of patients with diabetes by 9-10%.Today, the number of patients with this disease exceeds 200 million people.Diabetes is diagnosed in both men and women.
Causes and mechanism for the development of diabetes
As a result of a violation of synthesis and insulin secretion by the beta cells of the islands of Langgana, there is a decrease in the level of insulin in the blood, which over time leads to an absolute deficiency of insulin.The relative insulin deficiency has also been found, which may be the result of a decrease in insulin activity as a result of its increased relationship with proteins, intensive destruction of liver enzymes, the spread of the effects of non -hormonal and hormonal insulin -to -insulin (thyroid hormone, corseli, corseli hormone.
Insulin deficiency causes impaired metabolism of proteins, carbohydrates and fats in the body.The permeability of glucose of the cell membranes in muscle and fat is reduced, gluconeogenesis and glycogenolysis are enhanced, glucoseuria, hyperglycemia, which are accompanied by polydipsy and polyuria.The breakdown is increased and the formation of fat is reduced, which leads to an increase in the level of ketone bodies in the blood (acetone-condensation product of acetic acid, beta oxyme and acetux acids).These phenomena cause the acid balance to shift in the direction 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 reduction in the alkaline blood reserve up to 25% around.Carbon dioxide and a decrease in blood pH to 7.2-7.0.
How do type I diabetes develop
The reasons for the development of diabetes have some differences, depending on the type of diabetes.For example, patients with type of diabetes, due to autoimmune aggression and viral infection, are expanded from beta cells in the body, resulting in the deficiency developing with all subsequent consequences.
How do II diabetes develop
Patients with type II diabetes have a sufficient amount of insulin, but body tissues lose the ability to perceive their signal.With the development of obesity, adipose tissue acts as a type of barrier that blocks the effect of insulin.To eliminate this barrier, beta cells include the intensive mode of operation, which subsequently leads to their depletion and transition of relative insulin failure to absolute.Nevertheless, insulin -dependent diabetes is not transformed into insulin dependent.
Regardless of the etiological factor in the development of diabetes, the same process is carried out when the transformation of sugar coming from the outside is delayed and is available in the blood.
Diabetes
Depending on the clinical characteristics, the following types of diabetes are distinguished:
- I type diabetes mellitus, which in turn has several subspecies:
- Insulin -dependent diabetes;
- Insulin -dependent diabetes sugar:
- in people with obesity;
- In people of normal weight.
- diabetes, the cause of which is insufficient nutrition;
- Another check of type I diabetes associated with certain syndromes and body conditions:
- endocrine pathologies;
- insulin anomalies or its receptor;
- Pancreatic diseases;
- certain genetic syndromes;
- conditions caused by the effects of chemicals or medication;
- state of mixed etiological factors;
- II Type Diabetes shows a violation of glucose tolerance and is divided into such forms:
- in patients without excess weight;
- in people with obesity;
- caused by a particular condition or syndrome.
- Type III diabetes can develop during pregnancy.
Separate static classes at risk of this disease have been identified (patients with normal glucose tolerance, but a significant risk of diabetes):
- a condition preceding glucose tolerance disorder;
- Potential disorders of glucose tolerance.
Essential (primary) type diabetes
The essential (primary) type of diabetes mellitus, which has to do with the failure of nutrition, is emphasized as a separate pathology.This disease occurs in people under 30, living in tropical countries.According to statistics, the ratio 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 these is pancreatic fibrocalcular diabetes.
Fibrocalcal pancreatic diabetes
Territorially, it mainly covers Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of extensive pancreorosis and the formation of stone in the main canal of the pancreas.The clinical picture is represented by a sharp weight loss, recurrent abdominal pain and other signs of insufficient nutrition.In this case, insulin therapy makes it possible to eliminate moderate and high glucosuria and hyperglycemia.One of the characteristic signs of this pathology is the lack of ketoacidosis, which is due to decreased production of insulin and the release of the glucagon from the island apparatus of the pancreas.Topographic tests (ultrasound diagnostics, radiography, computed tomography) allow to determine the presence of stones in the pancreatic ducts.
There is an opinion that one of the factors in the development of fibrocoretic diabetes is the involvement of cassava roots (cassions, tapioc) in the diet that contain cyanogenic glycosides, one of which is linamarin from which cyanistoric acid is released during hydrolysis.With the participation of acids containing sulfur, its pernicious effects are eliminated and insufficient protein food intake, common in the population of the upper countries, provokes 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) is related to protein failure 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 such a measure as in patients with type I diabetes, this explains the lack of ketoacidosis.
Subtype j
In the classification of diabetes, according to the WHO data, which are presented above, there are no references to the third subtype of diabetes of the pancreas, which is located on Jamaica, we are talking about the subtype J. The subtype J has a lot to do with pancreatic diabetes, which occurs due to protein deficiency.
Symptoms of diabetes
The first symptoms of diabetes appear due to high blood glucose content.After exceeding the level of 8.9-10.0, the sugar enters the urine.When they continue to increase blood glucose levels, the kidneys further eliminate water, this is clinically manifested by rapid urination (polyuria).Excessive urine isolation causes a constant feeling of thirst (polydips).With urine, the body loses a large number of calories represented by glucose, so that one loses weight and constantly experiences hunger.
Among other symptoms of diabetes, such as drowsiness, decreased visual acuity, fatigue and nausea are distinguished.In addition, patients with uncompensated diabetes are prone to infections.Patients with type I diabetes have a pronounced insulin deficiency and therefore almost always weaken before the onset of therapy.Patients with type II diabetes do not weaken the body.
In type I diabetes disease, the rapid development of clinical manifestations occurs and may soon progress to diabetic ketoacidosis.Regardless of the high level of blood glucose, cells are unable to use it without the presence of insulin, therefore they move to other energy sources.The destruction of fat cells begins, which provokes the formation of ketone bodies, which are toxic chemicals that "acidify" blood.
Diabetic ketoacidosis
The first symptoms of diabetic ketoacidosis are manifested 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 breathing, which is associated with attempts by the body to neutralize the excessive acidity of the blood, this process is accompanied by the appearance of the odor of acetone from the mouth.In the absence of treatment, diabetic ketoacidosis can be complicated by the development of coma, in some cases this process takes place within a few hours.
Type I diabetes may be accompanied by the development of ketoacidosis even after the onset of insulin therapy if the patient undergoes a planned injection or suffered severe emotional surge, more special during injury, severe infection or other serious illness.
Patients suffering from type II diabetes for a long enough time may not feel signs of this pathology.Such a hidden period of the disease can last up to several decades.Clinical manifestations are activated as insulin deficiency worsens.
In the beginning, the volume of special urine only slightly exceeds the norm, the thirst is poorly expressed, but over time these processes progress.Ketoacidosis phenomena are rare.With a Significant Increase in the Level of Glucose in the Blood (in Some Cases, To 55 mmol/L), This usual Happens with Additional Loads on the Body, For Example, Under the InflueInfective Diseases, The Patient Can Plunge Inta A State of Confused Consciousness, Provited by Severe Dehydration, The Phenomena of SeiSures, Droms and The Most Sevely Likehalf.
How else is diabetes mellitus manifested
High levels of glucose in the blood over time can lead to damage to the nerves, blood vessels and other structures.The chemicals containing glucose are located on the walls of small blood vessels, resulting in the walls of the vessels are thickened and damaged.The narrowing of the gaps of the blood vessels causes a worsening of blood flow, especially the blood supply to the skin and the nerve endings.Without compensation for diabetes in the blood, there is an increase in the level of fatty substances, which accelerates the development of atherosclerosis.Patients diagnosed with diabetes, regardless of gender, suffer from atherosclerosis 2-6 times more often than people who do not have this diagnosis.Disruption of blood vessels in the bloodstream causes dysfunctions from the heart, kidneys, eyes, lower limbs, brain, skin and nerves, and also slows down the healing process of wounds.
What is the seriousness of diabetes mellitus
All these factors increase the risk of developing very distant complications.In patients with diabetes, the risk of strokes and cardiac attacks increases as a result of damage to the blood vessels of the eyes, the loss of hysinopathy (diabetic retinopathy) may occur, therefore, dialysis is required in some cases.Nerve damage can have many consequences.Mononeuropathy (impaired 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, legs or arms) causes disorders of sensitivity, pain, burning or numbness, a feeling of weakness in the arms and feet.The fever and sensitivity to pain decrease, leading to increased trauma.Circulatory disorders can contribute to the appearance of ulcers and poor wound healing.The ulcers, the localized legs, are very deep and low healing, leading to infection and in some cases to the amputation of the affected limb.
Clinical studies show that it is possible to avoid or leak diabetes if you are constantly maintaining normal blood sugar.The course of this disease is currently not fully studied.There are a number of unexplored factors that cause its development, genetic include the number of these factors.
Diagnosis
The diagnosis of diabetes begins with the collection of anamnesis and the patient's examination.During these measures, the patient has the presence of hereditary factors, obesity, whether the patient belongs to the number of disposable twins (if any of them suffers from diabetes mellitus, the second should be examined), women specify the presence of birth and whether a large fetus is indicated.
Following is a number of laboratory tests that consist of:
- Blood tests for glucose levels are performed twice;
- Glucose tolerance test;
- Determination of glucose levels in daily urine.
Diagnosis of diabetes mellitus is very important to understand the presence of complications;All organs and systems are diagnosed for this.
Complications of diabetes
Diabetes mellitus complications can be acute and chronic, they are also divided depending on the shape of diabetes.Acute complications distinguish coma conditions 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 ketoocytosis (the most frequent complication of acute nature) is manifested through polyuria, polydipsia, lack of appetite, weakness, abdominal pain, nausea and vomiting;
- Hypoglycaemic coma is an exceptional degree of hypoglycaemia, occurs with a sharp decrease in blood glucose levels.This is often the result of the introduction of an incorrect dose of insulin and sometimes occurs after taking certain foods or sulfanylamide.
- The hyperosmolar comic book in the gravity of the state exceeds diabetes, which is found mainly in the elderly with type II diabetes.In 30% of cases, the cause of the patient's death is also the presence of severe concomitant pathologies - in 70%.
Chronic (late) complications are combined in a group of pathologies that develop with prolonged exposure to high blood sugar to the organs and systems of the patient.First, the organs, more sensitive to sugar, are subject to damage, they are a type of "goal" for diabetes.Among the chronic complications of diabetes are the following:
- Diabetic retinopathy is observed in 90% of patients with diabetes.It develops with a long course of diabetes and is manifested by damage to the vessels of the eye retina;
- Diabetic nephropathy consists in complex kidney damage (tubules, arteries, glomeruli, arterioles).The spread among patients with diabetes is 75%;
- Diabetic neuropathy is represented by damage to the peripheral nerves in patients with diabetes.Neuropathy is a predisposing factor for the development of a diabetic leg, which can lead to limb amputation;
- Diabetic encephalopathy is a brain damage, which is progressive.It is manifested by increased fatigue, reduction of productivity, impaired concentration of attention, emotional lability, squeezing headaches, anxiety and worsening of the thought process;
- Diabetic skin lesions are structural deformities of the epidermis, follicles, sweat glands due to impaired carbohydrate metabolism and the accumulation of metabolism.In the case of severe diabetes, the skin becomes flaky, rough, with areas of homosoppers, cracks, the skin acquires a yellowish shade, hair loss occurs;
- Diabetic leg and brush syndrome occurs in 30-80% of patients with diabetes and is a complex of anatomical and functional disorders that occur in the form of brown spots and ulcerations of the lower legs, legs and phalanges of the toes, which in severe cases can lead to limb amputation.
Diabetes
The treatment of diabetes depends on the type of disease, but first of all, the patient should normalize blood glucose levels.To do this, you need to radically change your lifestyle and diet.A special diet for patients with diabetes, based on the calculation of used carbohydrates, proteins and fats, vitamins and trace elements, is recommended.This calculation is taught by specialists in this field.
The choice of tactics of drug therapy depends on the type of diabetes.Patients with type of diabetes are needed to perform insulin therapy, with type II showed to adhere to the most striking diet and uses remedies containing glucose
Insulin is taken under strict control of blood glucose levels.Insulin preparations according to the mechanism of action are divided into three types: prolonged, short and intermediate action.Sugar -containing drugs are indicated in the case of insulin -dependent diabetes mellitus in combination with a diet.Sugar -containing medicines include: Biguanides, Sulfonylmochevina, Thiazolidins and Melitinides.
With this insidious discomfort, it is very important for medical staff to teach the patient and his relatives of the patient's condition monitoring skills and first aid in the case of pre -domestic and coma.
Diabetes mellitus prediction
In the presence of diabetes mellitus, the patient is registered with the endocrinologist.In conditions of adequate therapy, the patient may be satisfactory for a long time.In order to worsen the prognosis with regard to the health and life expectancy of a patient with diabetes mellitus, it can develop acute and chronic complications.
Diabetes
In type I diabetes, preventive measures are to increase the body's resistance to various infections and to eliminate the toxic effects of antibodies on the pancreas.For patients with II, the type of diabetes is very important for correcting nutrition and preventing obesity.In order to prevent the development of complications in diabetes, it is necessary to properly and systematically comply with the doctor's recommendations and to clarify whether this or that food can be consumed.