According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases represents around 50% of those officially recorded.According to the WHO, the disease is only diagnosed in most people when complications arise.
Definition
Diabetes mellitus, translated from Greek, means "to pass through" - is an endocrine disease based on an absolute or relative lack of insulin in the body, causing metabolic disorders, primarily carbohydrates.The main manifestation is prolonged hyperglycemia due to impaired glucose metabolism in the body.It causes damage, dysfunction and failure of various organs, including the 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 this 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 sweet taste in the urine of a diabetic, indicating that it contained sugar.This is how diabetes was called “diabetes mellitus”.
Causes of diabetes mellitus
The exact etiology is not known with certainty.Among the provoking factors, we can distinguish those which are controllable and those which are not.
Immutable risk factors:
- aged 45 and over;
- heredity;
- increased blood sugar levels in a woman during pregnancy (gestational diabetes);
- ethnicity at increased risk of developing diabetes (African and Hispanic, European);
- diseases of the pancreas - pancreatitis, oncology, etc.
Factors controlled:
- overweight;
- high blood pressure;
- physical inactivity;
- poor diet.
Factors causing type 1 diabetes:
- Artificial feeding of babies.Replace 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.This 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 resulting from vascular pathologies.Atherosclerosis, vascular spasms, hemorrhages 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 diet in the context of decreased physical activity associated with rapid technological progress and urbanization.This pathology is more common among representatives of the Mongoloid race.
Diabetes classification
There are two main types of diabetes:
- Type 1 diabetes (T1D)- can be considered a hereditary autoimmune pathology, in which the immune system 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 an absolute insulin deficiency.Patients with this diagnosis must receive insulin injections for life.
- Type 2 diabetes (T2DM)— it 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 the “key” that allows glucose to be used as energy in cells.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 typically affects people after age 40 and does not vary by race, age, or gender.
There is also what is called “hidden diabetes”: prediabetes.The condition is intermediate between normal and pathological: the amount of glucose in the blood is higher than normal, but this 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 giving birth, it often disappears.But this leaves a risk of developing T2D after age 45.
Symptoms of the disease
Diabetes of the first type has an acute and sudden onset, and in the second, the symptoms are initially extremely rare, 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 unquenchable 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 necessary.When they are violated, excess sugar begins to be excreted along with tissue fluid.A vicious circle sets in.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 with an acetone smell).This is particularly visible during coma, which is a differential sign.
- Increased heart rate.
- Itching of genitals and skin.
- Loss of body weight is more characteristic of the first type of pathology and leads to exhaustion.
- Vision deterioration - fog in front of the eyes.
- Polyphagia is a craving for food and a lack of feeling full.
- Paresthesias 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 cause trophic ulcers, decreased vision, impaired tissue sensitivity, etc.
The most serious complication is diabetic coma, most often in cases of 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.
- Intermittent nocturnal sleep.
- Numbness and tingling in the legs, cramps in the calf muscles.
- Increased heart rate during attacks, with increased blood pressure, tinnitus, heaviness in the head and lack of air.
Diagnosis of diabetes mellitus
The main clinical manifestation of diabetes is hyperglycemia, therefore its determination forms 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 blood analysis, electrolyte test;
- urinalysis 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
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 adherence to medical prescriptions.
Important!Type 1 diabetes has no cure, 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 sections of it (islets of Langerhans, responsible for insulin).
- Antihyperglycemic drugs- used in type 2 diabetes to accelerate the use of glucose by tissues and increase insulin synthesis.These are primarily drugs based on sulfonylureas.They help reduce blood sugar levels.
- Biguanides- reduce insulin resistance in cells by reducing its absorption from the intestine and improving metabolism in peripheral cells.
Medications are taken continuously at regulated doses.Treatment regimens and doses are always individual.
The main method of treating type 2 diabetes is diet therapy.
Another important condition for the success of treatment is the correction of body weight.A diabetic must be prepared to monitor their blood sugar daily (have a glucometer at home) and to be regularly examined and observed by an endocrinologist or general practitioner in the clinic.
Important!Early diagnosis and treatment will help avoid negative consequences.
Diet is a necessary element 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 protein, fat and calories.
It is important to adhere to the principles of proper nutrition with the exception of "heavy" fats, refined, canned, smoked, gaseous foods, simple sugars, except in cases of hypoglycemic coma.
Prognosis and prevention
Basic preventive measures:
- track weight changes;
- control of indicators of carbohydrate and lipid metabolism;
- regular moderate physical activity;
- drink enough water (at least 2 liters per day);
- provide the body with vitamins and minerals.
Type 1 diabetes is not transmitted genetically, but only a tendency toward it.Therefore, the prevention methods will be as follows:
- breastfeeding - it is advisable not to interrupt it before 1.5 years;
- prevention of viral diseases - flu, sore throat, mumps, rubella, chickenpox;
- eliminate stress;
- good nutrition.
The prognosis, subject to self-control and timely treatment, is favorable.
Don't view 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 the complete abolition of medications.