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 officially registered cases.According to the WHO, the disease is diagnosed in most people only when complications arise.
The definition
Diabetes mellitus, translated from Greek, means "to pass" - is an endocrine disease, which is based on the absolute or relative lack of insulin in the body, causing 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 the eyes, kidneys, nerves, heart and blood vessels.
The disease has been known since the 17th century.before Christ 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 physician Dobson discovered a sweet taste in the urine of a diabetic, indicating that it contained sugar.This is how diabetes came to be called "diabetes with sugar".
Causes of diabetes mellitus
The exact etiology is not known for sure.Among the provoking factors we distinguish those that are controllable and those that are not.
Unchangeable risk factors:
- age 45 or older;
- inheritance;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity with an increased risk of developing diabetes (African and Hispanic, European);
- diseases of the pancreas - pancreatitis, oncology, etc.
Controlled factors:
- overweight;
- high blood pressure;
- physical inactivity;
- poor nutrition.
Factors that provoke type 1 diabetes:
- Artificial baby food.Replacing breast milk with formula or cow's milk.It contains 3 times more protein than women's milk and 50% more fat.Protein or casein is a complex component in its structure, similar to beta cells.When a 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 advisable to give your child cow's milk before the age of 3.
- Viral infections.Rubella, chickenpox, mumps, viral hepatitis, etc.
- Pancreatic tissue hypoxia as a result of vascular pathologies.Atherosclerosis, vascular spasm, hemorrhage 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 provoked by poor nutrition against the background of a decline 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 one's immune system attacks one's own pancreatic beta cells.The destruction of the gland tissue can be complete or partial.The pathology is diagnosed in young people and therefore it is called juvenile diabetes.This type of disease has an absolute lack of insulin.Patients with this diagnosis must receive insulin injections throughout life.
- Type 2 diabetes (T2DM)- is based on insulin resistance (immunity of cells to the action of insulin, with subsequent interruption of the flow of glucose in cells and tissues).Insulin serves as the "switch" that allows glucose in the 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 consumption" 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 risk is the lack of symptoms.
Another form, gestational diabetes, develops in some women during pregnancy.After the birth of the child, it often disappears.But it leaves a risk of developing T2DM after 45 years.
Symptoms of the disease
The first type of diabetes has an acute, sudden onset, and in the second, the symptoms are initially extremely few, 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:
- The classics are unquenchable thirst and polyuria.This leads to dehydration of the body.The mechanism of this phenomenon is due to the fact that excess sugar accumulates in the blood.In order to filter, absorb and remove it from the body, intensive work of the kidneys is required.When they are violated, excess sugar begins to be excreted with liquid from the tissues.A vicious circle appears.After drinking, thirst continues;the patient drinks up to 4 liters of water a day, which again brings frequent urination.
- Persistent dry mouth accompanied by dehydration.
- Increased fatigue.
- Drowsiness, 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.
- Feeling nauseous and even vomiting.
- Rapid breathing (possibly with the smell of acetone).This is especially noticeable during coma, which is a differential sign.
- Increased heart rate.
- Itching of genitals and skin.
- Loss of body weight 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 are swollen and red.
Lack of treatment for diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They provoke trophic ulcers, decreased vision, damage to tissue sensitivity, etc.
The most serious complication is diabetic coma, more often in insulin-dependent diabetes.
Type 2 diabetes has its own 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 feel shaky.
- Urinary incontinence.
- Tendency to gain weight.
- Interrupted night sleep.
- Numbness and tingling in legs, cramps in 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 a single analysis;it will not be objective.
For a complete diagnosis, the following are required:
- glucose tolerance test;
- biochemical blood analysis, testing it for electrolytes;
- urine analysis for sugar and acetone;
- Reberg tests - determining the content of creatinine in the urine to assess the condition of the kidneys;
- fundus examinations;
- vascular studies - Dopplerography, reovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Treatment of diabetes
The main tasks of doctors:
- 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 lasts for years and requires strict adherence to medical prescriptions.
Important!Type 1 diabetes is incurable but can be controlled.
Drug therapy:
- Insulin hormone injections for type 1 diabetes.Another treatment method is transplantation - transplantation of the entire gland or its individual parts (Islets of Langerhans, responsible for insulin).
- Antihyperglycemic drugs- used in type 2 diabetes to accelerate the use of glucose by tissues and increase insulin synthesis.These are, first of all, sulfonylurea-based drugs.They help lower blood sugar.
- biguanide- reduces cell resistance to insulin by reducing its absorption from the intestines and improving metabolism in peripheral cells.
Medicines are taken continuously in adjusted 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 to monitor blood sugar daily (have a glucometer at home), and be examined and observed regularly by an endocrinologist or general practitioner in a clinic.
Important!Early diagnosis and treatment will help to avoid negative consequences.
Diet is an indispensable component, without which it is impossible to normalize hyperglycemia.In type 2 diabetes, it compensates for carbohydrate metabolism.In type 1, a diet is needed to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in the content of proteins, fats 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;
- drinking enough water (at least 2 liters per day);
- supplying the body with vitamins and minerals.
Type 1 diabetes is not genetically transmitted, only a tendency to it.Therefore, the prevention methods will be as follows:
- breastfeeding - it is recommended not to interrupt up to 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chicken pox;
- elimination of stress;
- proper nutrition.
The prognosis, subject to self-control and timely treatment, is favorable.
Don't take a diabetes diagnosis as a death sentence.Transitioning to a healthy lifestyle and proper nutrition with moderate physical activity allows you to enter lasting remission with complete withdrawal of medication.