According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases is around 50% of those officially registered.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 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 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 doctor Demetrios de Apamania, who lived in the 2nd century BC.Much later, in 1776, the English doctor Dobson discovered a sweet 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 for sure.Among the provoking factors we can distinguish those that are controllable and those that are not.
Immutable risk factors:
- aged 45 years or over;
- heredity;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity with 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 feeding of babies.Replace breast milk with formula or cow's milk.Contains 3 times more protein than female milk and 50% more fat.Protein or casein is a complex component in 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 cow's milk to your baby before the age of 3.
- Viral infections.Rubella, chickenpox, mumps, viral hepatitis, etc.
- Hypoxia of pancreatic tissue 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 caused by poor nutrition in the context of a decrease in physical activity associated with rapid technological progress and urbanization.This pathology is most common among representatives of the Mongoloid race.
Diabetes classification
There are two main types of diabetes:
- Type 1 diabetes (DM1)- it can be considered a hereditary autoimmune pathology, in which the immune system itself attacks its own beta cells in the pancreas.The destruction of glandular tissue can be complete or partial.The pathology is diagnosed in young people and is therefore called juvenile diabetes.This type of disease presents absolute insulin deficiency.Patients with this diagnosis must receive lifelong insulin injections.
- Type 2 diabetes (DM2)— is based on insulin resistance (immunity of cells to the action of insulin, with subsequent disruption of the flow of glucose in cells and tissues).Insulin serves as the “key” that allows glucose to enter cells to be used for energy.Insulin deficiency in this type of diabetes is relative, that is, the gland itself is not damaged, but is forced to work “with wear and tear” for years.Type 2 diabetes generally affects people after age 40 and does not vary by race, age or sex.
There is also the so-called “hidden diabetes” - pre-diabetes.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 the diagnosis.This condition often 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 the risk of developing DM2 after 45 years.
Symptoms of the disease
Diabetes of the first type has an acute and sudden onset and, in the second, the symptoms are initially extremely scarce, 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:
- The classics are insatiable 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 it, absorb it and remove it from the body, the kidneys require intensive work.When they are violated, excess sugar begins to be excreted with fluid from the tissues.A vicious circle emerges.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 nutritional deficiency of brain cells due to lack of glucose in the cells.
- Weakness is caused by dehydration and the inability to use sugar for energy.
- Slow healing of wounds and cuts, frequent infections.
- Feeling of nausea and even vomiting.
- Rapid breathing (possibly smelling of acetone).This is especially seen during coma, which is a differential sign.
- Increased heart rate.
- Itching in the 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 the lack of a feeling of satiety.
- Paresthesia 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 provoke trophic ulcers, decreased vision, decreased tissue sensitivity, etc.
The most serious complication is diabetic coma, most frequently in insulin-dependent diabetes.
Type 2 diabetes has its own characteristic signs:
- Increased sweating during any physical activity - when eating, moving and even sleeping.Generally the head and chest sweat, but the hands and feet remain cold, trembling and chills are felt.
- Urinary incontinence.
- Tendency to gain weight.
- Intermittent night sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Increased heart rate during crises, 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, therefore 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, the following is required:
- glucose tolerance test;
- biochemical analysis of blood, testing electrolytes;
- urine analysis for sugar and acetone;
- Reberg tests - determination of creatinine content in urine to assess the condition of the kidneys;
- fundus examinations;
- vascular studies - Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Diabetes treatment
Primary 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, self-monitoring diary maintenance.
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 method of treatment is transplantation - transplantation of the entire gland or individual sections of it (islets of Langerhans, responsible for insulin).
- Antihyperglycemic medications- used in type 2 diabetes to accelerate the use of glucose by tissues and increase insulin synthesis.These are, first of all, medicines based on sulfonylureas.They help reduce blood sugar.
- Biguanides- reduce insulin resistance in cells, reducing its absorption in the intestine and improving metabolism in peripheral cells.
Medications 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 successful treatment is correcting body weight.A diabetic should be prepared to monitor their 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, diet is necessary to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in proteins, fats and calories.
It is important to follow 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:
- track weight changes;
- control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drink plenty of water (at least 2 liters per day);
- providing the body with vitamins and minerals.
Type 1 diabetes is not transmitted genetically, just a tendency towards it.Therefore, 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;
- eliminating stress;
- adequate nutrition.
The prognosis, subject to 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 nutrition with moderate physical activity allows you to go into stable remission with the complete abolition of medications.