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 those officially registered.According to WHO, in most people, the disease is diagnosed only when complications arise.
Definition
Diabetes mellitus, translated from Greek, means "to pass" - is an endocrine disease based on an absolute or relative lack of insulin in the body, causing metabolic disorders, mainly carbohydrates.The main manifestation is long-term 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.BCThis is confirmed by the Ebers papyrus, which describes a condition accompanied by excessive urination.The name "diabetes" was given by Demetrios of Apamania, a Greek doctor who lived in the 2nd century BC.e.Much later, in 1776, the English doctor Dobson found a sweet taste in the urine of a diabetic patient, indicating the presence of sugar.Thus, diabetes was called "diabetes".
Causes of diabetes mellitus
The exact etiology is not known.Among the triggering factors, we can distinguish between those that are controlled and those that are not.
Immutable risk factors:
- age 45 years and older;
- heredity;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnicity with a high risk of developing diabetes (African and Hispanic, European);
- pancreatic diseases - pancreatitis, oncology, etc.
Controlled factors:
- overweight;
- high blood pressure;
- physical inactivity;
- poor nutrition.
Factors that cause type 1 diabetes:
- Artificial feeding of babies.Replacing breast milk with formula or cow's milk.It contains 3 times more protein and 50% more fat than human milk.Protein or casein is a complex component similar in structure 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.For this reason, it is not recommended to give cow's milk to a baby before the age of 3.
- Viral infections.Rubella, chicken pox, parotitis, viral hepatitis, etc.
- Pancreatic tissue hypoxia as a result of vascular pathologies.Atherosclerosis, vascular spasm, bleeding and other diseases cause hypoxia of beta cells and islets of Langerhans and reduce insulin secretion.
- Destruction of pancreatic tissue due to alcohol, intoxication, drugs and oncology.
Type 2 diabetes is triggered by poor nutrition against the backdrop of rapid technological progress and decreased physical activity associated with 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 an inherited autoimmune pathology, where a person's own immune system attacks the pancreas' own beta cells.Destruction of glandular tissue can be complete or partial.The pathology is diagnosed in young people, and therefore it is called juvenile diabetes.This type of disease definitely has insulin deficiency.Patients with this diagnosis must receive insulin injections for life.
- Type 2 diabetes (T2DM)— is based on insulin resistance (immunity of cells to the effect of insulin, with subsequent disruption of glucose flow to cells and tissues).Insulin acts as a "switch" that allows glucose to be used as energy by the cells.In this type of diabetes, insulin deficiency is relative, that is, the gland itself is not damaged, but is forced to work for years "to wear out".Type 2 diabetes usually affects people after age 40 and does not differ by race, age, or gender.
There is also "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 absence of symptoms.
Another form of gestational diabetes develops in some women during pregnancy.It often disappears after birth.But after 45 years, there is a risk of developing T2DM.
Symptoms of the disease
The first type of diabetes begins acutely, suddenly, and the second type has extremely few initial symptoms, develops over several years, and a person does not even suspect the presence of pathology.
Symptoms of all types of diabetes in women and men:
- The classic ones are unrelenting thirst and polyuria.This causes the body to become dehydrated.The mechanism of this phenomenon is related to the accumulation of excess sugar in the blood.It requires intensive work of the kidneys to filter, absorb and remove it from the body.When they break down, excess sugar begins to be removed from the tissues with fluid.A vicious circle is formed.After drinking, thirst continues;the patient drinks up to 4 liters of water per day, which again causes frequent urination.
- Persistent dry mouth associated with dehydration.
- Increased fatigue.
- Yawning, drowsiness - hypoxia and lack of nutrition of brain cells due to the lack of glucose in the cells.
- The weakness comes from dehydration and the 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.
- Itching of genitals and skin.
- Loss of body weight is more typical for the first type of pathology and leads to exhaustion.
- Deterioration of vision - fog in front of the eyes.
- Polyphagia is a thirst for food and a lack of satiety.
- Paresthesia in the limbs.
- Bleeding gums that are swollen and red.
Failure to treat diabetes mellitus leads to complications in the form of angiopathy (vascular dysfunction).They cause trophic ulcers, reduced vision, tissue sensitivity, etc.
The most severe complication is diabetic coma, most often in insulin-dependent diabetes.
Type 2 diabetes has its own characteristic symptoms:
- 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, chills are felt.
- Urinary incontinence.
- Tendency to gain weight.
- Interrupted night sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- In attacks, increased heart rate, increased blood pressure, tinnitus, heaviness in the head and lack of air.
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 a single analysis;will not be objective.
For a complete diagnosis, the following is required:
- glucose tolerance test;
- biochemical blood analysis, test for electrolytes;
- urine analysis for sugar and acetone;
- Reberg tests - determination of creatinine content in urine to evaluate the state of the kidneys;
- fundus examinations;
- vascular studies - Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Treatment of diabetes
The main 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.
Treatment of diabetes mellitus continues for years and requires strict adherence to medical prescriptions.
It is important!Type 1 diabetes is incurable, but it can be managed.
Drug therapy:
- Insulin hormone injections for type 1 diabetes.Another method of treatment is transplantation - transplantation of the entire gland or its individual parts (insulin-responsible islets of Langerhans).
- Antihyperglycemic drugs- In type 2 diabetes, it is used to accelerate the use of glucose by tissues and increase insulin synthesis.These are primarily sulfonylurea-based drugs.They help reduce blood sugar.
- Biguanides- reduces insulin resistance of cells by reducing absorption from the intestine and improving metabolism in peripheral cells.
Medicines are taken in regularly adjusted doses.Treatment regimen and doses are always individual.
The main method of treatment of type 2 diabetes is diet therapy.
Another important condition for the success of the treatment is the correction of body weight.A diabetic patient should be prepared to monitor blood sugar daily (must have a glucometer at home) and be regularly examined and observed by an endocrinologist or general practitioner in the clinic.
It is important!Early diagnosis and treatment will help prevent negative consequences.
Diet is a necessary component, without which it is impossible to normalize hyperglycemia.It compensates carbohydrate metabolism in type 2 diabetes.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.
Except for cases of hypoglycemic coma, it is important to follow the principles of proper nutrition, excluding "heavy" fats, refined, canned, smoked, carbonated foods, and simple sugars.
Prognosis and prevention
Main preventive measures:
- monitor weight changes;
- control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drink enough water (at least 2 liters per day);
- provides the body with vitamins and minerals.
Type 1 diabetes is not genetically transmitted, it is only predisposed to it.So, the methods of prevention are as follows:
- breastfeeding - it is recommended not to stop it until the age of 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chicken pox;
- stress relief;
- proper nutrition.
Subject to self-control and timely treatment, the prognosis is favorable.
Don't treat 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 the complete abolition of drugs.