the term"diabetes mellitus"name a whole group of endocrine diseases, united by a common feature: they are based on disorders of carbohydrate metabolism. The body develops a deficiency of the hormone insulin produced by the pancreas, or the body's cells stop responding adequately to it, which causes the level of glucose in the blood plasma to rise. At the same time, cells suffer from energy deficiency and starve, even with a sufficient supply of carbohydrates from food.
Among all endocrine diseases, diabetes mellitus in women and men is the most common. There are more than 250 million people in the world with different types of this pathology. In our country, diabetics represent around 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes simply have not yet been identified, so the true percentage may be almost double.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered polyetiological - there are several theories about the occurrence of disorders in carbohydrate metabolism and problems with insulin. A special role is played by unfavorable heredity if close relatives suffer from diabetes.
Furthermore, certain factors and triggers can become provocative. That:
- poor nutrition with excess light carbohydrates, refined foods, fast food, saturated and trans fats and dietary fiber deficiency;
- overweight and obesity (a BMI above 30 and fatty deposits on the anterior abdominal wall are especially dangerous);
- chronic disorders of water and electrolyte balance;
- endocrine pathologies (Cushing's disease, thyroid gland hyperfunction);
- chronic and long-term physical and psycho-emotional stress;
- complications from "childhood infections", especially measles, rubella and chickenpox;
- abdominal injuries affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
A high risk of diabetes is possible in children born to mothers who suffered from the gestational form of the disease, if the baby was born with a high weight, had glucose problems in the first days of life;
Symptoms of the disease
At the initial stage, diabetes mellitus has practically no pronounced symptoms. Often, the first alarms are mistaken for overwork, infections or the consequences of stress. But it is important to pay attention to the combination of symptoms, which in themselves may be signs of other diseases, but combined indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, intense thirst with sufficient or excessive fluid intake;
- frequent urination, abundant urine production (up to 3-5 liters or more);
- dry skin, itching sensation in the area of the feet, elbows, legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite adequate nutrition;
- increased sweating, specific sweet odor of sweat and breath;
- slow healing of scratches and wounds on the skin;
- constant fatigue, drowsiness, decreased performance.
Additionally, there may befainting, loss of consciousness, malaise, dizziness. Often, people first learn of their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development, and at the initial stage they differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs as a result of aggression by the immune system against pancreatic cells that synthesize insulin. As a result, the production of the hormone gradually decreases, reaching a critical level, while the level of blood glucose (plasma glucose) increases. This form of diabetes occurs most often in children and young people of advanced age, it is possible against the background of necrosis of the pancreas due to complicated pancreatitis or removal of an organ. The basis of therapy is the use of insulin.
Type 2 or insulin-resistant diabetes (independent)It occurs more frequently in elderly or overweight people. It occurs due to impaired cellular sensitivity to insulin, which often occurs due to obesity and metabolic disorders. Correction is possible with diet and glucose-lowering medications.
Additionally, there are other specific forms of diabetes:
- gestational– occurs during pregnancy and is associated with metabolic disorders;
- pancreatogenic– associated with injuries, serious damage to the pancreas;
- LADA-diabetes(means latent autoimmune diabetes), presents mild symptoms, does not require insulin injections;
- MODY-diabetes- This is a special genetic form of the disease.
Any form of diabetes can haveuncomplicated (controlled)ANDcomplicated course.
Complications of the disease
If a patient with diabetes mellitus ignores the doctor's recommendations, does not follow a diet or refuses to take medications, the disease can be complicated by serious pathologies and changes in the body that threaten disability and even threaten life. That:
- severe visual impairment, damage to the internal structures of the eyeball and its vessels;
- formation of persistent hypertension (increased blood pressure);
- lipid metabolism disorders, increased "bad" cholesterol, which leads to atherosclerosis;
- severe swelling of the limbs;
- frequent headaches that impair performance;
- sensory disorders in the extremities (neuropathy), blood flow disorders (angiopathy).
Against the background of metabolic disorders, potentially fatal conditions may occur -eat. They develop both against the background of an increase in blood sugar and against the background of its sharp decrease (with incorrectly selected treatment, concomitant pathologies).
- Hypoglycemic comaIt is dangerous because it develops very quickly and can lead to serious consequences. It occurs when glucose levels fall below 2. 8 mmol/l. Doctors can help by administering glucose doses with individually selected insulin levels.
- Ketoacidotic comaoccurs when glucose metabolism is disrupted as it rises in the blood. It breaks down into ketone bodies, which poison the body.
- Lactate comaoccurs when there are failures in glucose metabolism, against which acidic metabolic products accumulate, which leads to respiratory and circulatory disorders and requires treatment in intensive care.
Diagnosis
The basis of diagnosis is laboratory tests, which will detect an increase in glucose in the blood plasma. It is important to carry out a full cycle of examinations, as a single analysis is not informative - external factors can influence glucose levels.
Basic laboratory tests that confirm diabetes:
- blood test for glucose level (carried out in the morning, on an empty stomach);
- exercise test (determination of glucose tolerance (blood is taken on an empty stomach, 1 and 2 hours after taking the glucose solution);
- biochemical studies (protein, lipid, electrolyte levels);
- assessment of the level of glycosylated hemoglobin HbA1c;
- general and 24-hour urine analysis with determination of glucose and protein levels;
- determination of endogenous insulin levels.
The doctor also prescribes a series of instrumental examinations and consultations - an examination by an ophthalmologist with an assessment of the fundus of the eye, a consultation with a neurologist with an assessment of the condition of peripheral nerves, monitoring blood pressure, an ECG and an ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-drug approaches, lifestyle changes with individual selection of drugs that control glycemic levels in diabetes (fasting and postprandial blood glucose, activity). Therapeutic approaches vary depending on the type of disease.
For type 1 diabetesThe basis of drug treatment isinsulin injections(short, prolonged and other types depending on the severity of the condition and the situation).With the second typeThe basis of glucose treatment and control isdiabetes pills. They help in reducing glucose levels along with dietary adjustments. It is important to highlight that the treatment is carried out for life, with dose adjustments and dynamic monitoring of the patient.
To control diabetes, it is important to follow a diet that provides the body with all the necessary nutrients, vitamins and minerals, but that does not cause sudden spikes in blood sugar. The doctor helps to correct the diet, teaches the patient to select the right foods and their combination with the use of medications or insulin. All diabetes products are divided into groups - those that can be used without fear, those that need to be reduced and those that should be excluded.
Furthermore, the doctor recommends lifestyle changes – weight control, physical activity, regular visits to the doctor to prevent complications from the pathology.
Prevention
To maintain health and reduce the risk of developing the disease, it is necessary to control weight, regularly assess carbohydrate and lipid metabolism and undergo medical examinations. Moderate physical activity, drinking plenty of fluids and a balanced diet with a reduction in the amount of carbohydrates, saturated fats, fast food and refined foods are important.