According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases is about 50% of the officially registered cases.According to the WHO, the disease is diagnosed in most people only when complications arise.
Definition
Diabetes mellitus, translated from Greek, means "to pass" - is an endocrine disease, which is based on an absolute or relative lack of insulin in the body, which causes metabolic disorders, mainly carbohydrates.The main manifestation is prolonged hyperglycemia due to impaired glucose metabolism in the body.It causes damage, dysfunction and failure of various organs, especially eyes, kidneys, nerves, heart and blood vessels.
The disease has been known since the 17th century.BC e.This is confirmed by the Ebers papyrus, which describes a condition accompanied by excessive urination.The name "diabetes" was given to the pathology by the Greek physician Demetrios of Apamania, who lived in the 2nd century BC.e.Much later, in 1776, the English doctor Dobson discovered a sweet taste in the urine of diabetics, which indicated that it contained sugar.That's how diabetes was called "sugar diabetes".
Causes of diabetes mellitus
The exact etiology is not reliably known.Among the provocative factors, we can distinguish those that can be controlled and those that are not.
Nonmodifiable risk factors:
- age 45 and over;
- heredity;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity with an increased risk of developing diabetes (Africans and Hispanics, Europeans);
- diseases of the pancreas - pancreatitis, oncology, etc.
Controlled factors:
- overweight;
- high blood pressure;
- physical inactivity;
- poor nutrition.
Factors that provoke type 1 diabetes:
- Artificial feeding of babies.Replacing breast milk with formula or cow's milk.It contains 3 times more protein than human milk and 50% more fat.Protein or casein is a complex component in its structure, similar to beta cells.When the child enters the body, the immune system attacks it, but due to the structural similarity, the beta cells of the pancreas also suffer.This is why it is not recommended to give your baby cow's milk before the age of 3.
- Viral infections.Rubella, chicken pox, mumps, viral hepatitis, etc.
- Pancreatic tissue hypoxia as a result of vascular pathologies.Atherosclerosis, vascular spasm, bleeding and other diseases lead to hypoxia of the islets of Langerhans with their beta cells and reduce insulin secretion.
- Destruction of pancreatic tissue due to alcohol, intoxication, drugs and oncology.
Type 2 diabetes is caused by poor nutrition against the backdrop of a decrease in physical activity associated with rapid technological progress and urbanization.This pathology is more common among representatives of the Mongoloid race.
Classification of diabetes
There are two main types of diabetes:
- Type 1 diabetes (T1DM)- can be considered a hereditary autoimmune pathology, where the own immune system attacks the own beta cells of the pancreas.Destruction of gland tissue can be complete or partial.The pathology is diagnosed in young people and is therefore called juvenile diabetes.This type of disease has an absolute lack of insulin.Patients with this diagnosis must receive insulin injections for life.
- Type 2 diabetes (T2DM)— is based on insulin resistance (immunity of cells to the action of insulin, with subsequent disruption of glucose flow to cells and tissues).Insulin serves as the "key" that allows glucose to enter cells to be used as energy.The lack of insulin in this type of diabetes is relative, that is, the gland itself is not damaged, but is forced to work "for wear and tear" for years.Type 2 diabetes usually affects people after the age of 40 and does not differ by race, age or gender.
There is also the so-called "hidden diabetes" - prediabetes.The condition is intermediate between normal and pathological: the amount of glucose in the blood is higher than normal, but not enough to make a diagnosis.This condition usually precedes type 2 diabetes. The main danger is the absence of symptoms.
Another form, gestational diabetes, develops in some women during pregnancy.After childbirth, it often disappears.But it leaves the risk of developing T2DM after 45 years.
Symptoms of the disease
Diabetes of the first type has an acute, sudden onset, while the symptoms of the second type are extremely scarce at the beginning, they develop over several years and the person does not even suspect the existence of the pathology.
Signs of diabetes of any type in women and men:
- Insatiable thirst and polyuria are classic.This leads to dehydration of the body.The mechanism of this phenomenon is due to the fact that excess sugar accumulates in the blood.Filtering, absorption and removal from the body requires intensive work of the kidneys.When they are broken, the excess sugar begins to be excreted with the liquid from the tissue.A vicious circle is created.After drinking, thirst persists;the patient drinks up to 4 liters of water a day, which again leads to frequent urination.
- Persistent dry mouth associated with dehydration.
- Increased fatigue.
- Yawning, drowsiness - hypoxia and lack of nutrition of brain cells due to lack of glucose in the cells.
- The weakness is caused by dehydration and the inability to use sugar as energy.
- Slow healing of wounds and cuts, frequent infections.
- A feeling of nausea and even vomiting.
- Rapid breathing (possibly with the smell of acetone).This is especially pronounced during coma, which is a differential sign.
- Increased heart rate.
- Genital and skin itching.
- Weight loss is more characteristic of the first type of pathology and leads to exhaustion.
- Deterioration of vision - fog before the eyes.
- Polyphagia is the thirst for food and lack of satiety.
- Paresthesia in the limbs.
- Bleeding gums that become swollen and red.
Lack of treatment of diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They provoke trophic ulcers, reduced vision, impaired tissue sensitivity, etc.
The most serious complication is diabetic coma, most often in insulin-dependent diabetes.
Type 2 diabetes has its characteristic signs:
- Increased sweating during any physical activity - while eating, moving, even while sleeping.Usually the head and chest sweat, but the hands and feet remain cold, trembling and chills.
- Urinary incontinence.
- Tendency to gain weight.
- A broken night's sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Increased heart rate in attacks, with increased blood pressure, tinnitus, heaviness in the head and shortness of breath.
Diagnosis of diabetes mellitus
The main clinical manifestation of diabetes is hyperglycemia, so its determination is the basis of diagnosis.
Normal indicators: blood sugar up to 6.1 mmol/l on an empty stomach and no more than 11 mmol/l 2 hours after eating.They are not limited to one analysis;it will not be objective.
A complete diagnosis requires the following:
- glucose tolerance test;
- biochemical blood analysis, electrolyte testing;
- urine analysis for sugar and acetone;
- Reberg tests - determination of creatinine content in urine to assess kidney condition;
- fund reviews;
- vascular studies - dopplerography, reovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Treatment of diabetes
Primary tasks of the doctor:
- Compensation of carbohydrate metabolism.
- Treatment of complications and their prevention.
- Normalization of body weight.
- Patient education - calculation of bread units, special hygiene, keeping a self-monitoring diary.
Treatment of diabetes mellitus takes years and requires strict adherence to medical prescriptions.
Important!Type 1 diabetes is incurable, but it can be controlled.
Drug therapy:
- Injections of the hormone insulin for type 1 diabetes.Another method of treatment is transplantation - transplantation of the entire gland or some of its parts (Islets of Langerhans, responsible for insulin).
- Antihyperglycemic drugs- used in type 2 diabetes to accelerate glucose utilization in tissues and increase insulin synthesis.These are primarily drugs based on sulfonylurea.They help lower blood sugar.
- Biguanides- reduce insulin resistance of cells by reducing its absorption from the intestine and improving metabolism in peripheral cells.
Medicines are taken continuously in regulated doses.Treatment regimens and doses are always individual.
The main method of treating type 2 diabetes is diet therapy.
Another important condition for the success of the treatment is the correction of body weight.A diabetic should be prepared for daily monitoring of blood sugar (have a glucometer at home), and be regularly examined and monitored by an endocrinologist or general practitioner in the clinic.
Important!Early diagnosis and treatment will help avoid negative consequences.
Diet is a necessary component, without which it is impossible to normalize hyperglycemia.In type 2 diabetes, it compensates for carbohydrate metabolism.Type 1 requires a diet to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in terms of protein, fat and calories.
It is important to adhere to the principles of proper nutrition with the exception of "heavy" fats, refined, canned, smoked, carbonated foods, simple sugars, except in cases of hypoglycemic coma.
Prognosis and prevention
Basic preventive measures:
- tracking weight changes;
- control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drink enough water (at least 2 liters per day);
- supplying the body with vitamins and minerals.
Type 1 diabetes is not transmitted genetically, only a tendency to it.Therefore, prevention methods will be as follows:
- breastfeeding - it is recommended not to interrupt it until 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chicken pox;
- eliminating stress;
- proper nutrition.
The prognosis, with self-control and timely treatment, is favorable.
Don't take a diabetes diagnosis as a death sentence.The transition to a healthy lifestyle and proper diet with moderate physical activity allows you to enter a stable remission with complete discontinuation of medication.