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 ones.According to WHO, the disease is diagnosed in most people only when complications arise.
Definition
Diabetes mellitus, translated from Greek, means “to pass through” - is an endocrine disease, which is based on an absolute or relative lack of insulin in the body, causing metabolic disorders, mainly carbohydrate.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.BCe.This is confirmed by the Ebers papyrus, which describes a condition accompanied by excessive 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 doctor Dobson discovered a sweetish taste in the urine of a diabetic, which indicated that it contained sugar.This is how diabetes came to be called “sugar diabetes.”
Causes of diabetes mellitus
The exact etiology is not known for certain.Among the provoking factors, we can distinguish those that are controllable and those that are not.
Unchangeable risk factors:
- age 45 years and older;
- 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;
- physical inactivity;
- poor nutrition.
Factors that provoke type 1 diabetes:
- Artificial feeding of babies.Replacing breast milk with formula or cow's milk.It contains 3 times more protein than women's milk and 50% more fat.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 advisable 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, hemorrhage 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 provoked by poor 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.
Diabetes classification
There are two main types of diabetes:
- Type 1 diabetes (T1DM)- can be regarded as a hereditary autoimmune pathology, where one’s own immune system attacks its own beta cells of the pancreas.Destruction of gland tissue can be complete or partial.The pathology is diagnosed in young people and is therefore 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)— it is based on insulin resistance (immunity of cells to the action of insulin, with subsequent disruption of the flow of glucose into cells and tissues).Insulin serves as the “key” that allows glucose into cells to be used as 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 40 years of age and does not vary by race, age or gender.
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 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 second, the symptoms are initially extremely scarce, 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 classic ones 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 remove 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 arises.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 deficiency of nutrition of brain cells due to lack of glucose in the cells.
- Weakness is caused by dehydration and the inability to use sugar as 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 noted 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.
- Deterioration of vision - fog before the eyes.
- Polyphagia is a thirst for food and lack of a feeling of fullness.
- Paresthesia 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 provoke trophic ulcers, decreased vision, impaired tissue sensitivity, etc.
The most severe complication is diabetic coma, most often 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.
- 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 lack of air.
Diagnosis of diabetes mellitus
The main clinical manifestation of diabetes is hyperglycemia, so its determination is the basis of 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, testing it for electrolytes;
- urine analysis 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.
Treatment of diabetes
Primary tasks of doctors:
- Compensation of carbohydrate metabolism.
- Treatment of complications and their prevention.
- Normalization of body weight.
- Patient education - calculating 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 is incurable, but it can be controlled.
Drug therapy:
- Injections of the hormone insulin for type 1 diabetes.Another treatment method 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 utilization of glucose by tissues and increase insulin synthesis.These are, first of all, drugs based on sulfonylureas.They help lower blood sugar.
- Biguanides- reduce insulin resistance of cells by reducing its absorption from the intestine and improving metabolism in peripheral cells.
The drugs are taken continuously with regulated dosages.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 correction of body weight.A diabetic should be prepared to monitor blood sugar daily (have a glucometer at home), and be regularly examined and observed by an endocrinologist or general practitioner 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 adhere to the principles of proper nutrition with the exception of “heavy” fats, refined, canned, smoked, carbonated foods, 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;
- 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, prevention methods will be as follows:
- breastfeeding - it is advisable not to interrupt it until 1.5 years;
- prevention of viral diseases - influenza, sore throat, mumps, rubella, chickenpox;
- eliminating stress;
- proper nutrition.
The prognosis, subject to self-control and timely treatment, is favorable.
Don't take the diagnosis of diabetes 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.