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 and means "pass", is an endocrine disease that 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 the eyes, kidneys, nerves, heart and blood vessels.
The disease has been known since the 17th century.BC my.This is confirmed by the Ebers papyrus, which describes a condition accompanied by excessive urination.The name “diabetes” was given to this pathology by the Greek doctor Demetrius of Apamania, who lived in the 2nd century BC.my.Much later, in 1776, the English doctor Dobson discovered a sweetish taste in the urine of a diabetic, indicating 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.
Immutable risk factors:
- 45 years and older;
- inheritance;
- increased blood sugar in a woman during pregnancy (gestational diabetes);
- ethnic group with increased risk of developing diabetes (Africans and Hispanics, Europeans);
- diseases of the pancreas: pancreatitis, oncology, etc.
Controlled factors:
- overweight;
- hypertension;
- 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 than female 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.That is why it is not recommended 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 consequence of vascular pathologies.Atherosclerosis, vascular spasms, hemorrhages and other diseases cause hypoxia of the islets of Langerhans with their beta cells and reduce insulin secretion.
- Destruction of pancreatic tissue due to alcohol, poisoning, drugs and oncology.
Type 2 diabetes is caused by poor nutrition against the background 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)- can be considered a hereditary autoimmune pathology, in which the immune system itself attacks its own beta cells of the pancreas.The destruction of glandular tissue can be complete or partial.The pathology is diagnosed in young people and that is why it is called juvenile diabetes.This type of disease has absolute 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 action of insulin, with the consequent interruption of the flow of glucose into cells and tissues).Insulin serves as the "key" that allows glucose entering cells to be used for 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 over 40 years of age and does not vary by race, age or sex.
There is also 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 childbirth it usually disappears.But it leaves a 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 few, 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.To filter it, absorb it and eliminate it from the body, intensive work of the kidneys is required.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 a day, which in turn causes frequent urination.
- Persistent dry mouth associated with dehydration.
- Greater fatigue.
- Yawning, drowsiness - hypoxia and nutrition 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 with the smell of acetone).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 impairment: fog before the eyes.
- Polyphagia is thirst for food and lack of feeling of satiety.
- Paresthesia in the extremities.
- Bleeding gums that become swollen and red.
Lack of treatment for diabetes mellitus causes complications in the form of angiopathy (vascular dysfunction).They cause trophic ulcers, decreased vision, altered tissue sensitivity, etc.
The most serious complication is diabetic coma, more common in insulin-dependent diabetes.
Type 2 diabetes has its own characteristic signs:
- Increased sweating during any physical activity: when eating, moving and even sleeping.Typically, the head and chest sweat, but the hands and feet remain cold, tremble, and feel chills.
- Urinary incontinence.
- Tendency to gain weight.
- Intermittent night 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;will not be objective.
For a complete diagnosis the following is required:
- glucose tolerance test;
- biochemical blood test, electrolyte test;
- urine analysis for sugar and acetone;
- Reberg tests - determination of the content of creatinine in the urine to assess the condition of the kidneys;
- fundus examinations;
- vascular studies: Dopplerography, rheovasography, capillaroscopy, etc.;
- Ultrasound of organs, ECG.
Diabetes treatment
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 self-monitoring diary.
Treatment of diabetes mellitus lasts for 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 treatment method is transplantation: transplantation of the entire gland or its individual sections (islets of Langerhans, responsible for insulin).
- Antihyperglycemic medications- used in type 2 diabetes to accelerate the utilization of glucose by tissues and increase insulin synthesis.These are, first of all, drugs based on sulfonylureas.They help reduce blood sugar.
- biguanides- reduce insulin resistance of cells by reducing its absorption in the intestine and improving metabolism in peripheral cells.
Medications are taken continuously in regulated doses.Treatment regimens and doses are always individual.
The main method to treat 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 level daily (have a glucometer at home) and be examined and observed periodically by an endocrinologist or family doctor 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 protein, fat and calorie content.
It is important to respect the principles of proper nutrition, with the exception of "heavy" fats, refined, canned, smoked, carbonated foods and simple sugars, except in cases of hypoglycemic coma.
Prognosis and prevention
Basic preventive measures:
- tracking weight changes;
- control of carbohydrate and lipid metabolism indicators;
- regular moderate physical activity;
- drink enough water (at least 2 liters per day);
- providing the body with vitamins and minerals.
Type 1 diabetes is not transmitted genetically, only a tendency to suffer from it.Therefore, the prevention methods will be the following:
- breastfeeding: it is advisable not to interrupt it until one and a half years old;
- prevention of viral diseases: influenza, sore throat, mumps, rubella, chickenpox;
- eliminate stress;
- proper nutrition.
The prognosis, subject to self-monitoring 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 stable remission with complete abolition of medications.