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 the officially registered cases.According to the WHO, the disease is diagnosed in most people only when complications arise.
Definition
Diabetes mellitus translated from Greek means "passing" - is an endocrine disease that is based on an absolute or relative lack of insulin in the body, which leads to 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.BCThis is confirmed by the Ebers papyrus, which describes a condition accompanied by profuse 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 sweetish taste in the urine of a diabetic, indicating that it contained sugar.That is why diabetes is called "diabetes mellitus".
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.
Unmodifiable risk factors:
- age 45 and over;
- heredity;
- 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;
- lack of physical activity;
- poor nutrition.
Factors provoking type 1 diabetes:
- Artificial feeding of babies.Replacing breast milk with formula or cow's milk.Contains 3 times more protein than human milk and 50% more fat.Protein or casein is a complex component in its structure similar to beta cells.When the 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 your baby cow's milk before the age of 3.
- Viral infections.Rubella, chicken pox, mumps, viral hepatitis, etc.
- Hypoxia of pancreatic tissue as a result of vascular pathologies.Atherosclerosis, vascular spasm, hemorrhages and other diseases lead to hypoxia of the islets of Langerhans with their beta cells and reduce insulin secretion.
- Destruction of pancreatic tissues due to alcohol, intoxication, drugs and oncology.
Type 2 diabetes is provoked by improper 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 seen as a hereditary autoimmune pathology in which the own immune system attacks its own pancreatic beta cells.The destruction of the tissue of the gland can be complete or partial.The pathology 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 for life.
- Type 2 diabetes (T2DM)— is based on insulin resistance (immunity of cells against the action of insulin, with subsequent disruption of the flow of glucose in cells and tissues).Insulin serves as a "key" that allows glucose in 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 "for wear and tear" for years.Type 2 diabetes usually affects people after age 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 danger is the lack of symptoms.
Another form, gestational diabetes, develops in some women during pregnancy.After birth, it often disappears.But it leaves a risk of developing T2DM after 45 years.
Symptoms of the disease
Diabetes of the first type has an acute, sudden onset, and in the case of the second, the symptoms are initially extremely scarce, develop over several years, and one does not even suspect the presence of pathology.
Signs of diabetes of any type in women and men:
- The classic ones 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, absorb and remove it from the body, intensive work of the kidneys is required.When they are broken, excess sugar begins to be released with liquid from the tissues.A vicious cycle ensues.After drinking, thirst continues;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 lack of nutrition of brain cells due to lack of glucose in the cells.
- The weakness is caused by dehydration and an inability to use sugar as energy.
- Slow healing of wounds and cuts, frequent infections.
- A feeling of nausea and even vomiting.
- Rapid breathing (probably with the smell of acetone).This is especially noted during coma, which is a differential sign.
- Increased heart rate.
- Genital and skin itching.
- 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 a craving for food and a lack of satiety.
- Paresthesia in the limbs.
- Bleeding gums that become swollen and red.
The lack of treatment of diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They provoke trophic ulcers, reduced vision, impaired tissue sensitivity, etc.
The most severe complication is diabetic coma, most common 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 chills are felt.
- Urinary incontinence.
- Tendency to gain weight.
- A broken night's sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Rapid pulse in paroxysms, 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 a meal.They are not limited to one analysis;it will not be objective.
For a complete diagnosis, the following is required:
- glucose tolerance test;
- biochemical analysis of blood, study for electrolytes;
- urine analysis for sugar and acetone;
- Reberg's tests - determination of creatinine content in urine to assess the state of the kidneys;
- fundus examinations;
- vascular studies - dopplerography, rheovasography, 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 diary for self-control.
Treatment of diabetes mellitus lasts for years and requires strict adherence to medical prescriptions.
important!Type 1 diabetes is incurable, but it can be controlled.
Drug therapy:
- Injections of the hormone insulin for type 1 diabetes.Another method of treatment is transplantation - transplantation of the entire gland or individual parts of it (Islets of Langerhans, responsible for insulin).
- Antihyperglycemic drugs- used in type 2 diabetes to accelerate glucose uptake by tissues and increase insulin synthesis.These are primarily drugs based on sulfonylureas.They help lower blood sugar.
- Biguanides- reduces insulin resistance of cells by reducing its absorption from the intestines and improving metabolism in peripheral cells.
Medicines are taken continuously in regulated doses.Treatment regimens and doses are always individual.
The main method of treating type 2 diabetes is diet.
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 regularly examined and monitored by an endocrinologist or general practitioner in a clinic.
important!Early diagnosis and treatment will help to 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 necessary to prevent hypo- or hyperglycemic coma, which can be fatal.The diet is balanced in terms of protein, fat and calories.
It is important to adhere to the principles of proper nutrition, excluding "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;
- 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 it until 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chicken pox;
- eliminate stress;
- proper nutrition.
The prognosis with 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 enter a stable remission with complete removal of drugs.