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type of diabetes

Diabetes and its types

Diabetes is an endocrine system disease associated with pathological changes in hormone levels and metabolic failure.

To date, the disease cannot be eradicated (completely eliminated).The destructive process in the body can be slowed down by medication and dietary therapy, but it is impossible to stop it and start in the opposite direction.

The main symptom of the disease is a chronic increase in blood sugar levels.The course of the disease is divided into several types due to its different etiology and nature.

Types of diabetes mellitus (DM) are defined by the World Health Organization and do not fundamentally differ across the medical community.Diabetes of any type is not a contagious disease.

Pathological classification

There are many types of this disease, but all have one main symptom - elevated levels of glucose in the blood.Diabetes is classified based on the cause of its occurrence.The treatment used, the gender and age of the patient are also taken into consideration.

Medically accepted types of diabetes:

  • The first type is insulin-dependent (IDDM 1), or juvenile type;
  • The second is non-insulin dependent (NIDDM 2), or insulin resistance;
  • peripartum gestational diabetes mellitus (GDM) in women;
  • Other specific types of diabetes, including:
  • Damage to pancreatic beta cells at the genetic level (various types of MODY diabetes);
  • Pathology of exocrine pancreatic function;
  • Hereditary and acquired pathologies of exocrine glands and their functions (endocrine diseases);
  • drug-induced diabetes;
  • Diabetes caused by congenital infection;
  • Diabetes associated with genomic pathology and genetic defects;
  • Impaired fasting glucose (blood sugar) and impaired glucose tolerance.

Prediabetes is a borderline state of the body in which blood sugar levels are elevated (impaired glucose tolerance), but "fall short" of the generally accepted numerical values that correspond to true diabetes.According to data from the World Health Organization (WHO 2014), more than 90% of endocrinology patients suffer from type II diseases.

According to medical statistics, the number of global cases is significantly increasing.The number of people with type 2 diabetes has doubled in the past 20 years.GDM occurs in approximately 5% of pregnancies.Certain types of diabetes are extremely rare and account for only a small percentage of medical statistics.

By sex, NIDDM 2 is more common in women before and during menopause.This is caused by changes in hormonal status and weight gain.In men, the most common factor leading to type 2 diabetes is chronic inflammation of the pancreas caused by the toxic effects of ethanol.

Insulin-dependent diabetes (type 1)

Type 1 diabetes is characterized by a loss of pancreatic cell function.The organ is unable to fulfill its endocrine (intra-secretory) function of producing insulin, the hormone responsible for supplying glucose to the body.As glucose builds up in the blood, the organs, including the pancreas itself, do not receive enough nutrients.

To mimic the natural production of endocrine hormones, patients require lifelong injections of medical insulin with varying durations of action (short and long), as well as dietary treatment.Type 1 diabetes classification is determined by the different causes of the disease.Insulin-dependent disease has two causes: genetics and autoimmunity.

genetic causes

The formation of pathology is related to the biological ability of the human body to transmit its characteristic signs and pathological deviations to future generations.With regard to diabetes, a child inherits susceptibility to the disease from a parent or close relative who has diabetes.

Important!Susceptibility is inherited, but the disease itself is not.There is no 100% guarantee that your child will develop diabetes.

autoimmune causes

The disease occurs due to the failure of the immune system, which actively produces autoimmune antibodies under the influence of negative factors, causing damage to the body's cells.The triggers (driving forces) that initiate the autoimmune process are:

  • Unhealthy eating behaviors coupled with physical inactivity;
  • failure of metabolic processes (carbohydrates, lipids, and proteins);
  • Severe deficiencies in cholecalciferol and ergocalciferol (vitamin D);
  • Chronic pancreatic pathology;
  • History of mumps (mumps), measles, coxsackie herpesvirus, Epstein-Barr virus, cytomegalovirus, viral hepatitis A, B, and C;
  • Distress (prolonged neuropsychological stress);
  • chronic alcoholism;
  • Incorrect treatment with hormone-containing medications.

IDDM occurs in children, adolescents, and adults under the age of thirty.Type 1a diabetes in childhood is associated with complicated viral infections.Type 1b occurs in young adults and children in the context of an autoimmune process and a genetic predisposition.The disease usually develops rapidly over weeks or months.

Insulin resistant diabetes (type 2)

The second type of diabetes differs from the first type in that the pancreas does not stop producing insulin.Glucose becomes concentrated in the blood and cannot be delivered to the body's cells and tissues due to a lack of sensitivity to insulin (insulin resistance).Treatment is, in part, with blood sugar-lowering (sugar-lowering) medications and dietary therapy.

To compensate for the imbalance in the body, the pancreas activates hormone production.Operating in emergency mode, the organ wears out over time and loses its internal secretory function.Type 2 diabetes becomes insulin dependent.Reduced or lost cellular sensitivity to endogenous hormones is primarily associated with obesity, which disrupts fat and carbohydrate metabolism.

This is especially true for visceral obesity (fat deposits around internal organs).In addition, when you are overweight, large amounts of cholesterol plaque build up in your blood vessels, blocking blood flow. These cholesterol plaques form during hypercholesterolemia, which always accompanies obesity.As a result, the body's cells become starved of nutrients and energy.Other factors influencing the development of NIDDM include:

  • alcoholism;
  • Addicted to sweet food;
  • Chronic diseases of the pancreas;
  • Pathology of the heart and vascular system;
  • Overeating while living a sedentary lifestyle;
  • Incorrect hormone therapy;
  • complicated pregnancy;
  • Bad genetics (parents with diabetes);
  • distressed.

The disease occurs most often in women and men over the age of 40.Also, type 2 diabetes is latent and may not show obvious symptoms for years.Testing blood sugar levels early can detect prediabetes.With appropriate treatment, prediabetic conditions are reversible.If time is wasted, the disease will progress and NIDDM will subsequently be diagnosed.

lada diabetes

In medicine, the term "diabetes 1.5" is used, or the name "diabetes mellitus".It is an autoimmune disease involving a breakdown in hormone production and metabolism that occurs in adults (over 25 years of age).The disease combines type 1 and type 2 diabetes.Its mechanism of occurrence corresponds to that of IDDM, and its latent process and symptom manifestations are similar to those of NIDDM.

Triggers for the development of pathology are autoimmune diseases in the patient's history:

  • Non-infectious inflammation of the intervertebral joints (ankylosing spondylitis);
  • Irreversible diseases of the central nervous system - multiple sclerosis;
  • Granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
  • Chronic inflammation of the thyroid gland (Hashimoto's thyroiditis);
  • Juvenile arthritis and rheumatoid arthritis;
  • Changes in skin color (loss of pigment) (vitiligo);
  • Inflammatory pathology of the colonic mucosa (ulcerative colitis);
  • Chronic damage to connective tissue and exocrine glands (Sjogren's syndrome).

Autoimmune disease combined with a genetic predisposition can lead to the progression of Lada diabetes.To identify the disease, basic diagnostic methods are used along with blood microscopy to determine the concentration of IgG class immunoglobulins with antigens - ELISA (enzyme-linked immunosorbent assay).Treatment is with regular insulin injections and nutritional correction.

gestational form of disease

GDM is a specific type of diabetes that occurs in women during the second half of the perinatal period.The disease is most often detected during the second periodic screening, when the expectant mother undergoes a comprehensive examination.The main characteristic of GDM coincides with type 2 diabetes - insulin resistance.The cells of a pregnant woman's body lose sensitivity (sensitivity) to insulin due to three main reasons:

  • Hormonal changes.During pregnancy, the synthesis of progesterone, a steroid sex hormone, increases, blocking insulin production.In addition, endocrine hormones from the placenta tend to inhibit insulin production and are increasing.
  • The burden on the female body is doubled.To ensure that your unborn child has adequate nutrition, the body needs increased amounts of glucose.Women begin to consume more simple sugars, which causes the pancreas to synthesize more insulin.
  • Weight gain due to reduced physical activity.Due to obesity and lack of exercise, cells refuse to accept insulin, and large amounts of glucose entering the body accumulate in the blood.In this condition, the expectant mother and fetus experience nutritional deficiencies and energy deprivation.

Unlike type 1 and type 2 diabetes, gestational diabetes is a reversible process because the function of the insulin molecule and pancreas is preserved.

Correctly chosen treatment strategies guarantee elimination of pathology postpartum in 85% of cases.The mainstay of treatment for GDM is the "Form 9" diet for diabetics.In difficult cases, medical insulin can be injected.Hypoglycemic drugs are not used because they have teratogenic effects on the fetus.

in addition

Specific types of diabetes are genetically determined (MODY diabetes, certain types of endocrine diseases) or caused by other chronic pathologies:

  • Pancreatic diseases: pancreatitis, hemochromatosis, neoplasms, cystic fibrosis, mechanical injury and glandular surgery;
  • Failure of the anterior pituitary gland (acromegaly);
  • Increased thyroid hormone synthesis (thyrotoxicosis);
  • Hypothalamic-pituitary-adrenal pathology (Itsenko-Cushing syndrome);
  • Adrenocortical tumors (aldosteroma, pheochromocytoma, etc.).

Diabetes insipidus is a separate diabetic pathology characterized by reduced production of the hypothalamic hormone vasopressin, which regulates fluid balance in the body.

diagnostic measures

The diagnosis of diabetes (any type) can only be based on the results of laboratory blood microscopy.Diagnosis consists of several consecutive studies:

  • General clinical blood tests can identify hidden inflammatory processes in the body.
  • Blood tests (capillary or venous) detect glucose levels.Strictly required to do it on an empty stomach.
  • GTT (glucose tolerance test).It is performed to determine the body's ability to absorb glucose.Tolerance testing involves two blood draws: fasting and two hours after a "glucose load", which is an aqueous solution of glucose prepared at a ratio of 200 ml of water per 75 g.substance.
  • HbA1C analyzes glycosylated (glycated) hemoglobin levels.Based on the study results, blood glucose levels were retrospectively assessed over the past three months.
  • Biochemistry of blood.Liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alpha-amylase, alkaline phosphatase (ALP), bilirubin (bile pigment), and cholesterol levels are evaluated.
  • The type of diabetes can be determined by testing the concentration of glutamic acid decarboxylase antibodies (GAD antibodies) in the blood.

Blood glucose reference values and disease indicators

analyze for sugar glucose tolerance test Glycated hemoglobin
specification 3.3-5.5 < 7.8 ⩽ 6%
prediabetes 5.6 – 6.9 7.8 – 11.0 6% to 6.4%
diabetes >7.1 >11.1 More than 6.5%

In addition to blood microscopy, a general urine test is done to determine whether glucose is present in the urine (glucosuria).The urine of healthy people does not contain sugar (for diabetics, the acceptable standard is 0.061 - 0.083 mmol/l).The Rehberg test is also performed to detect the protein albumin and the protein metabolite creatinine in the urine.In addition, hardware diagnostics are prescribed, including electrocardiogram (ECG) and abdominal (including kidney) ultrasound.

result

Modern medicine divides diabetes into four main types based on the pathogenesis (origin and development) of the disease: insulin-dependent (type 1 IDDM), non-insulin-dependent (type 2 NIDDM), gestational type (GDM in pregnant women), and specific type (DM includes several types of diseases caused by genetic defects or chronic pathology).Gestational diabetes that occurs during the peripartum period is treatable.The condition of prediabetes (impaired glucose tolerance) is considered reversible if diagnosed early.