Diabetes mellitus is an endocrinological pathology accompanied by hyperglycemia syndrome (high blood glucose), which is caused by insulin deficiency.The disease is accompanied by carbohydrate imbalance and other metabolic disorders in the body.
Currently, diabetes mellitus is diagnosed in 10-15 % of our planet population.The cases of the development of the disease in children have become more frequent, as a rule, after unreasonable antibiotic therapy, stress and viral infections.There is an annual increase in the number of diabetes patients of 9-10%.Today, the number of patients with the disease exceeds 200 million people.Diabetes is diagnosed in men and women.
The cause and mechanism of diabetes development
As a result of violations of synthesis and insulin secretion by beta cells of the islands, there is a decrease in blood insulin levels, which over time leads to absolute insulin deficiency.Relative insulin deficiency is also found, which may be the result of a decrease in insulin activity as a result of its increased connection with protein, intensive destruction of the liver enzymes, the prevalence of the effects of non -Hormonal and hormonal antagonists of insulin (thyroid hormones,The adrenal cortex, glucagon, and unstericed fatty acids, growth hormone), changes in insulin insulin tissue resistance -depending on insulin.
Insulin deficiency causes protein disorders, carbohydrates and fat metabolism in the body.The glucose permeability of cell membranes in muscle tissue and adipose is reduced, gluconeogenesis and glycogenolysis are enhanced, glucoseuria, hyperglycemia occurs, accompanied by polydipsy and polyuria.The decomposition is intensified and the formation of fat is reduced, which results in increased levels of ketone body (acetouxic acetone acetic acid, beta-oxyma and assetouxus acid).This phenomenon causes an acid-base balance shift towards acidosis, and also affects the increase in magnesium, sodium, potassium in the urine and causes kidney dysfunction.
There may be a decrease in blood alkaline reserves to 25%.carbon dioxide and decreased blood pH levels to 7.2-7.0.
How my kind diabetes grows
The cause of diabetes development has some differences, depending on the type of diabetes.For example, patients with diabetes, due to autoimmune invasion and viral infections, are expanded by beta cells in the body, resulting in deficiency that develops with all the consequences.
How Type II diabetes grows
Patients with diabetes II have sufficient amounts of insulin, but body tissue loses the opportunity to see the signal.With the development of obesity, adipose tissue acts as a type of obstruction that prevents insulin effects.To eliminate these obstacles, beta cells include intensive operating mode, which later leads to deficiency and transition of insulin deficiency relative to absolute.However, insulin -dependent diabetes does not turn into insulin -depending on the insulin.
Regardless of the etiological factors in the development of diabetes, the same process occurs in the moisture of sugar transformation that comes from the outside and available in the blood.
Diabetes classification
Depending on the clinical features, the following types of diabetes are distinguished:
- I kind of diabetes mellitus, which in turn has several subspecies:
- Insulin -dependent diabetes;
- Insulin -Diabetes depends on:
- in people with obesity;
- In people with normal weight.
- diabetes, the cause of its development is inadequate nutrition;
- Other authentication of type I diabetes associated with certain body syndrome and conditions:
- endocrine pathology;
- insulin anomalies or receptors;
- pancreatic disease;
- Certain genetic syndrome;
- conditions caused by the effects of chemicals or taking drugs;
- the condition of mixed etiological factors;
- II Types 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 particular condition or syndrome.
- Type III diabetes can develop during pregnancy.
Separate static risk classes of the disease have been identified (patients with normal glucose tolerance, but significant diabetes risk):
- conditions prior to violation of glucose tolerance;
- Potential glucose tolerance disorders.
The most important type of diabetes (main)
The most important type of diabetes mellitus (primary), which is related to nutritional failure, is highlighted as a separate pathology.The disease occurs in people under the age of 30 living in tropical countries.According to statistics, the ratio of men and women is 2: 1. The number of patients with diabetes is 20 million people.
There are usually two subtypes of diabetes.The first is a fibrocalcular pancreatic diabetes.
Fibrocalcule of pancreatic diabetes
Region, it covers Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of pancreate and extensive stone formation in the main channel of the pancreas.Clinical pictures are represented by sharp weight loss, recurrent abdominal pain and insufficient signs of nutrition.In this case, insulin therapy makes it possible to eliminate moderate and high glucosuria and hyperglycemia.One of the signs of this pathological feature is the lack of ketoacidosis, which is caused by reduced insulin production and the release of glucagon by pancreatic island apparatus.Topographic studies (ultrasound diagnostics, radiography, computed tomography) allow to determine the presence of stones in the pancreas.
There is an opinion that one of the factors in the development of fibrocalcoretic diabetes is the entry of manioca roots (sweet potatoes, tapioka) in the diet, which contains cyanogenic glycosides, one of which is linamarin, from which sitera acid is released during hydrolysis.With the participation of acids containing sulfur, its detrimental effects are eliminated, and inadequate consumption of protein foods, often found in the population of the above countries, causing 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 deficiency in the body, but there is no manifestation of pancreatic fibrosis.It is characterized by moderate resistance to insulin and durability of the development of ketoacidosis.In most cases, patients experience fatigue.Patients have reduced the secretion of insulin, but unlike the size of type I diabetes, this explains the deficiency of ketoacidosis.
Subtype j
In the classification of diabetes, according to the WHO data, presented above, there is no reference to the third subtype of pancreatic diabetes, which is found in Jamaica, we talk about Suberipe J.
Symptoms of diabetes
The first symptom of diabetes occurs due to high blood glucose content.After above 8.9-10.0, the sugar enters the urine.When continuing to increase glucose levels in the blood, the kidneys also produce water, this is clinically indicated by rapid urination (polyuria).Excessive urine isolation causes polydipsy.With urine, the body loses a large amount of calories represented by glucose, so someone loses weight and is always hungry.
Other symptoms of diabetes, such as drowsiness, decreased visual acuity, fatigue and nausea are distinguished.In addition, non -compensate diabetes patients are exposed to infection.Type I diabetes patients have the specified insulin deficiency and, because of this, almost always lose weight before the onset of therapy.Patients with diabetes II do not lose weight.
With type I diabetes disease, the rapid development of clinical manifestations occurs and will soon develop into diabetes ketoacidosis.Regardless of the high levels of glucose in the blood, cells have no chance of using it without the presence of insulin, so they turn to other energy sources.The destruction of fat cells begins, which causes the formation of ketone body, which is a toxic chemical compound "isolate" blood.
Diabetic ketoacidosis
The first symptoms of diabetic ketoasidosis are indicated in excessive urination and excessive thirst, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients have frequent and in -depth breathing, which are associated with trial by the body to neutralize excess blood acidity, this process is accompanied by the appearance of acetone odor from the mouth.In the absence of treatment, diabetes ketoacidosis can be complicated by the development of coma, in some cases this process occurs within hours.
Type I diabetes can be accompanied by the development of ketoacidosis even after the onset of insulin therapy if the patient passes through a planned injection or has severe emotional advantages, especially during injury, severe infection or other serious illness.
Patients suffering from type II diabetes for a long time may not feel these pathological signs.The duration of the hidden disease can last for decades.Clinical manifestations are activated as insulin deficiency.
Initially, the amount of dedicated urine was slightly above the norm, weak thirst was expressed, but over time, this process was evolving.The phenomenon of ketoacidosis is rare.With a significant increase in blood glucose levels (in some cases, up to 55 mmol/l), this usually occurs with additional burden on the body, for example, under the influence of drugs or with severe infectious diseases.
How else is diabetes mellitus real
High levels of glucose in the blood over time can cause damage to the nerves, blood vessels and other structures.Chemical compounds containing glucose are located on the walls of small blood vessels, resulting in the walls of the vessel being thickened and damaged.Narrowing of the blood vessels causes a decline in blood flow, especially blood supply to the skin and nerves.Without compensation for diabetes in the blood, an increase in fat levels occurs, which accelerates the development of atherosclerosis.Patients diagnosed with diabetes, regardless of gender, experience atherosclerosis 2-6 times more often than people who do not have this diagnosis.Violation of blood vessels in blood circulation causes dysfunction from the heart, kidneys, eyes, lower legs, brain, skin and nerves, and even slow down the healing process.
What is the seriousness of diabetes mellitus
All of these factors increase the risk of developing many remote complications.In diabetic patients, the risk of stroke and heart attacks increases, due to damage to the blood vessels, loss of visopathy (diabetes retinopathy) can occur, kidney disorders cause kidney failure, so in some cases, dialysis is required.Nerve damage can cause many consequences.Mononeuropathy (impaired function of one nerve) can be manifested with weakness -up or down.Polyneuropathy diabetes (damage to the nerves of the legs, legs, or hands) causes sensitivity, pain, burning or tingling, sensation of weakness in the arms and legs.Temperature and pain sensitivity decreases, leading to increased trauma.Circulation disorders can contribute to the appearance of ulcers and poor wound healing.The ulcer is placed on the foot is very deep and non -healing, leading to infection and, in some cases, for amputation of the affected member.
Clinical studies have shown that it is possible to avoid or end diabetes, if you always maintain normal blood sugar.The course of the disease is not fully studied.There are several unplanned factors that cause its development, which is genetically included.
Diagnosis of diabetes
Diagnosis of diabetes begins with the accumulation of anamnesis and patient examination.During these steps, the patient has the presence of hereditary factors, obesity, whether the patient belongs to a single twin (if one of them suffers from diabetes mellitus, the second must be examined), women determine the presence of childbirth and whether large fruit is determined.
Here are some laboratory tests, consisting of:
- Blood tests for glucose levels are done twice;
- Glucose tolerance tests;
- Determine the level of glucose in daily urine.
With diagnosis of diabetes mellitus, it is very important to know the presence of complications;For this, all organs and systems are diagnosed.
A complication of diabetes
The complications of diabetes mellitus can be acute and chronic, they also split depending on the form of diabetes.Among the acute complications, the coma is distinguished, in which loss of consciousness is preceded by brain disorders due to very low or very high blood sugar concentration.Such a situation includes:
- Ketoacitosis of diabetes (the most common complications of acute properties) is indicated by polyuria, polydipsy, lack of appetite, weakness, abdominal pain, nausea and vomiting;
- Hypoglycemic coma, is an extreme level of hypoglycemia, occurs with a sharp decrease in blood glucose levels.It is usually the result of the introduction of irregular doses of insulin, and sometimes occurs after consuming certain foods or sulfanilamide.
- Hyperosmolar comics in the state of the state exceed diabetes that, mostly found in the elderly, with type II diabetes.In 30% of cases, the cause of the patient's death became, and with the presence of severe equivalent pathology - in 70%.
Chronic (late) complications are combined into a group of pathologies that develop with prolonged exposure to high blood sugar in the patient's organs and systems.First of all, more sensitive organs to sugar are subject to damage, they are a kind of "target" for diabetes.Among the complications of chronic diabetes, the following is known:
- Diabetes retinopathy is observed in 90% of diabetes patients.Develop with a long course of diabetes and is characterized by damage to the retinal vessels;
- Diabetes nephropathy consists of complex damage to the kidneys (tubules, arteries, glomeruli, arterioles).The prevalence of diabetic patients is 75%;
- Diabetes neuropathy is represented by damage to the peripheral nerves in diabetic patients.Neuropathy is a predisposition factor in the development of diabetes, which can cause amputation of the body;
- Diabetes encephalopathy is a damage to the brain, which is progressive.It is characterized by increased fatigue, decreased performance, affected concentration, emotional failure, headache, anxiety and worsening thinking process;
- Skin diabetes lesions are the deformation of the structure of the epidermis, follicles, sweat glands due to infarction of carbohydrate metabolism and the accumulation of metabolic products.In the case of severe diabetes, the skin becomes weak, rough, with homosoper, cracking, skin is yellowish, hair loss occurs;
- Foot syndrome and diabetes brushes occur in 30-80% of diabetic patients and are complex anatomical disorders and functions that appear in the form of brown spots and ulcers in the lower legs, feet and finger falanx, which in severe cases can cause limb amputation.
Diabetes treatment
The treatment of diabetes depends on the type of disease, but first, the patient needs to normalize the level of glucose in the blood.To do this, you need to radically change your lifestyle and diet.Special diets are recommended for diabetic patients, which are based on the calculation of carbohydrates, proteins and fats, vitamins and trace elements used.This calculation is taught by experts in this field.
The choice of drug therapy tactics depends on the type of diabetes.Patients with diabetes are necessary to perform insulin therapy, with type II it is shown to adhere to a strict diet and use glucose -containing agents, with the effectiveness of tablet drugs, insulin prescribed.
Insulin is taken under the strict control of glucose levels in the blood.Insulin preparations according to the mechanism of action are divided into three types: prolonged, short and intermediate actions.Medicines containing sugar are shown in the case of diabetes mellitus that depend on insulin in combination with diet.Drugs containing sugar include: biguanides, sulfonylmochevina, thiazolidindyons and meglitinides.
With this dangerous disease, it is very important for medical staff to teach patients and their relatives well with the ability to monitor the patient's condition and first aid in the case of pre -stomach and coma.
Forecasts for diabetes mellitus
In the presence of diabetes mellitus, patients are registered with endocrinologists.In adequate therapy conditions, the patient may be in good condition for a long time.To aggravate the prognosis of the health and life expectancy of patients with diabetes mellitus may experience acute and chronic complications.
Diabetes prevention
With 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 in adjusting nutrition and preventing the development of obesity.To prevent the development of complications in diabetes, it is necessary to adhere to the doctor's recommendations properly and systematically and to explain whether this or edible foods.