Terminology"diabetes mellitus"name a whole group of endocrine diseases, united by a common feature: they are based on carbohydrate metabolism disorders. The body experiences a lack of the insulin hormone produced by the pancreas, or the body's cells stop responding adequately to it, which causes the level of glucose in the blood plasma to rise. In this case, cells experience a lack of energy and hunger, even with a sufficient supply 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, people with diabetes account for about 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes have not yet been identified, so the actual percentage may 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 of the occurrence of carbohydrate metabolism disorders and problems with insulin. A special role is played by unfavorable genetics if a close relative suffers from diabetes.
In addition, certain factors and triggers can be provocateurs. this:
- poor nutrition with an excess of light carbohydrates, refined foods, fast foods, saturated and trans fats, and a lack of dietary fiber;
- overweight and obesity (BMI over 30 and fat deposits on the anterior abdominal wall are particularly dangerous);
- chronic water-electrolyte balance disorders;
- endocrine pathology (Cushing's disease, hyperfunction of the thyroid gland);
- long-term, chronic physical and psycho-emotional stress;
- complications of "childhood infections, " especially measles, rubella, and chicken pox;
- abdominal injury affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
A high risk of diabetes may occur in children born to mothers suffering from the gestational form of this disease if the baby is born with a high weight, he has problems with glucose levels in the first days of life.
Disease symptoms
In the early stages, diabetes mellitus has almost no obvious symptoms. Often the first alarm bell is mistaken for overwork, infection, or stress. But it is important to pay attention to the combination of symptoms, which in themselves may be signs of other diseases, but in combination indicate the manifestation of diabetes.
The main symptoms of diabetes are:
- persistent dry mouth, severe thirst with adequate or excessive fluid intake;
- frequent urination, large output of urine (up to 3-5 liters or more);
- dry skin, itching in the legs, elbows, feet;
- rapid weight gain or sudden weight loss;
- persistent hunger despite proper nutrition;
- increased sweating, sweat smell and sweet breath;
- slow healing of scratches and wounds on the skin;
- persistent fatigue, drowsiness, decreased performance.
In addition, there may befainting, unconsciousness, malaise, dizziness. Often, people first learn about their diagnosis when they are hospitalized in a hyperglycemic or ketoacidotic coma.
Type of diabetes
There are two main forms of this disease, which have different causes and mechanisms of development, and in the early stages they differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of the invasion of the immune system against the cells of the pancreas that synthesize insulin. As a result, hormone production 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 at an 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)occurs more often in older people or people who are overweight. It occurs because the sensitivity of cells is affected to insulin, which often occurs as a result of obesity and metabolic disorders. Correction can be done with diet and glucose-lowering drugs.
In addition, there are other specific forms of diabetes:
- pregnant– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injury, severe damage to the pancreas;
- PEPPER-diabetes(abbreviation for latent autoimmune diabetes), has mild symptoms, does not require insulin injections;
- MODY-diabetes- This is a special form of genetic disease.
Any form of diabetes can be present
Complications of the disease
If a patient with diabetes mellitus 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 threaten life. this:
- severe visual impairment, damage to the structures inside the eyeball and its channels;
- the formation of persistent hypertension (increased blood pressure);
- disorders of lipid metabolism, an increase in "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that affect performance;
- sensory disorders in the legs (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. It occurs when the glucose level drops to less than 2. 8 mmol/l. Doctors can help with this by administering glucose doses with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disrupted when it rises in the blood. It breaks down into ketone bodies, which poison the body.
- Lactate comaoccurs when there is a failure in glucose metabolism, where acidic metabolic products accumulate, which leads to respiratory and circulatory disorders, and requires treatment in intensive care.
Diagnostics
Basic laboratory tests that confirm diabetes:
- blood test for glucose level (given in the morning, on an empty stomach);
- exercise 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 HbA1c glycosylated hemoglobin levels;
- general and daily urine analysis with determination of glucose and protein levels;
- determination of endogenous insulin levels.
The doctor also prescribes a number of instrumental tests and consultations - an examination by an ophthalmologist with an evaluation of the fundus of the eye, a consultation with a neurologist with an assessment of the state of the peripheral nerves, blood pressure monitoring, ECG, and 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 mellitus (fasting and postprandial blood sugar, activity). Treatment approaches differ depending on the type of disease.
For type 1 diabetesthe basis of drug treatment isinsulin injection(short type, prolonged and others depending on the severity of the situation and situation).With the second typeThe basis of glucose treatment and control isdiabetes pills. They help in reducing glucose levels along with dietary adjustments. It is important to emphasize that the treatment is carried out throughout life, with dose adjustments and dynamic monitoring of the patient.
In controlling 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 trigger sudden spikes in blood sugar. The doctor helps in correcting the diet, teaching the patient how to choose the right food and its combination with taking medicine or insulin. All products for diabetes are divided into groups - which can be used without fear, which should be reduced, and which should be excluded.
In addition, doctors recommend changes in lifestyle - weight control, physical activity, regular visits to the doctor to prevent pathological complications.
Prevention
To maintain health and reduce the risk of developing this disease, it is necessary to control your body weight, periodically evaluate carbohydrate and lipid metabolism, and undergo medical examinations. Moderate physical activity, drinking enough fluids and a balanced diet with a reduced amount of carbohydrates, saturated fat, fast food and refined food are important.