According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases is approximately 50% of those officially registered.According to the WHO, in most people the disease is diagnosed only when complications arise.
Definition
Diabetes mellitus, translated from Greek, means "to go through" - 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.B.C.And.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 doctor Demetrius of Apamania, who lived in the 2nd century BC.And.Much later, in 1776, the English doctor Dobson discovered a sweetish taste in the urine of a diabetic, which indicated that it contained sugar.This is how diabetes came to be called “sugar diabetes”.
Causes of diabetes mellitus
The exact etiology is not known with certainty.Among the provoking factors we can distinguish those that are controllable and those that are not controllable.
Immutable risk factors:
- age 45 years 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;
- hypertension;
- physical inactivity;
- bad diet.
Factors that cause type 1 diabetes:
- Artificial feeding of children.Replacing breast milk with formula or cow's milk.Contains 3 times more protein than women's milk and 50% more fat.The 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 recommended to give cow's milk to your child before the age of 3.
- Viral infections.Rubella, chickenpox, mumps, viral hepatitis, etc.
- Hypoxia of pancreatic tissue following 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 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 disease, in which your own immune system attacks your own beta cells in the pancreas.Destruction of glandular tissue can be complete or partial.The disease is diagnosed in young people and is therefore called juvenile diabetes.This type of disease has an absolute deficiency of insulin.Patients with this diagnosis must receive insulin injections throughout their lives.
- Type 2 diabetes (T2DM)— is based on insulin resistance (immunity of cells to the action of insulin, resulting in interruption of the flow of glucose into cells and tissues).Insulin acts as a “key” that allows glucose to enter cells and be used as energy.The insulin deficiency in this type of diabetes is relative, that is, the gland itself is not damaged, but is forced to work "through wear and tear" for years.Type 2 diabetes usually affects people after age 40 and does not vary 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 it is 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 giving birth it often disappears.But it leaves you at risk of developing T2DM after 45 years.
Symptoms of the disease
Diabetes of the first type has an acute and sudden onset, while in the second the symptoms are initially very rare, develop over the course of 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 classic ones 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.To filter it, absorb it and eliminate it from the body, intense work of the kidneys is necessary.When they are violated, excess sugar begins to be expelled with fluid from the tissues.A vicious circle is created.After drinking, thirst persists;the patient drinks up to 4 liters of water per day, which again leads to frequent urination.
- Persistent dry mouth associated with dehydration.
- Increased fatigue.
- Yawning, drowsiness - hypoxia and deficiency 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 of nausea and even vomiting.
- Rapid breathing (possibly with acetone odor).This is especially noticeable during coma, which is a differential sign.
- Increased heart rate.
- Itching of the genitals and skin.
- Loss of body weight is more characteristic of the first type of pathology and leads to exhaustion.
- Vision deterioration: fog before the eyes.
- Polyphagia is the thirst for food and lack of feeling of satiety.
- Paraesthesia in the limbs.
- Bleeding gums that become swollen and red.
Lack of treatment for diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They cause trophic ulcers, decreased vision, reduced 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 and even while sleeping.Usually the head and chest sweat, but the hands and feet remain cold, tremble and feel chills.
- Urinary incontinence.
- Tendency to gain weight.
- Intermittent nocturnal 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 the 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 meals.They are not limited to a single analysis;it will not be objective.
For a complete diagnosis you need the following:
- glucose tolerance test;
- biochemical blood analysis, testing it for electrolytes;
- urinalysis for sugar and acetone;
- Reberg test: determination of creatinine content in urine to evaluate the condition of the kidneys;
- fundus exams;
- vascular studies - Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Diabetes treatment
Primary duties 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.
The treatment of diabetes mellitus lasts years and requires strict compliance with medical prescriptions.
Important!Type 1 diabetes is incurable, but it can be controlled.
Drug therapy:
- Insulin hormone injections for type 1 diabetes.Another method of treatment is transplantation: transplantation of the entire gland or individual sections of it (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 primarily drugs based on sulfonylureas.They help lower blood sugar.
- Biguanides- reduce insulin resistance of cells by reducing its absorption at the intestinal level and improving metabolism in peripheral cells.
The drugs are taken continuously with regulated dosages.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 treatment is the correction of body weight.A diabetic should be prepared to monitor blood sugar daily (have a glucometer at home) and be regularly examined and observed by an endocrinologist or general practitioner in a 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.In type 1, a diet is needed to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in terms of proteins, fats and calories.
It is important to adhere to the principles of correct 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:
- monitor weight changes;
- control of indicators of carbohydrate and lipid metabolism;
- regular and moderate physical activity;
- drink enough water (at least 2 liters a day);
- provide the body with vitamins and minerals.
Type 1 diabetes is not genetically transmitted, but only a tendency towards it.Therefore, the prevention methods will be as follows:
- breastfeeding: it is advisable not to interrupt it until 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chickenpox;
- eliminate stress;
- correct nutrition.
The prognosis, subject to self-monitoring and timely treatment, is favorable.
Don't take your diabetes diagnosis as a death sentence.The transition to a healthy lifestyle and proper nutrition with moderate physical activity allows you to enter a stable remission with the complete abolition of drugs.