According to statistics, more than 9% of the world's population suffers from diabetes mellitus (DM).The number of undiagnosed cases accounts for approximately 50% of the officially registered cases.According to the World Health Organization, most people are diagnosed with the disease only when complications develop.
definition
Diabetes - translated from the Greek word meaning "through" - is an endocrine disease caused by an absolute or relative lack of insulin in the body, causing metabolic disorders, mainly carbohydrate metabolism.The main manifestation is impaired glucose metabolism in the body leading to long-term hyperglycemia.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.This is confirmed by the BC Ebers papyrus, which describes a condition accompanied by excessive urination.The name "diabetes" was given to the pathology by Demetrios of Apamania, a Greek physician who lived in the 2nd century BC.e. Much later, in 1776, the British doctor Dobson discovered a sweet taste in the urine of diabetic patients, indicating that it contained sugar.This is why diabetes is called "sugar diabetes."
causes of diabetes
The exact cause is unknown.Among the predisposing factors, we can distinguish which ones are controllable and which ones are uncontrollable.
Immutable risk factors:
- Age 45 and over;
- genetics;
- Increased blood sugar in a woman during pregnancy (gestational diabetes);
- Ethnic groups with a higher risk of developing diabetes (Africans and Hispanics, Europeans);
- Pancreatic diseases - pancreatitis, tumors, etc.
Control factors:
- overweight;
- hypertension;
- lack of physical activity;
- Malnutrition.
Factors that trigger type 1 diabetes:
- Artificially fed infants.Substitute formula or cow's milk for breast milk.It contains 3 times more protein and 50% more fat than breast milk.Proteins or caseins are structurally complex components, similar to beta cells.When the child enters the body, the immune system attacks it, but because of the similar structure, the beta cells of the pancreas are also affected.This is why it is not recommended to give your baby cow's milk before the age of 3 years.
- Viral infection.Rubella, chickenpox, mumps, viral hepatitis, etc.
- Vascular lesions cause pancreatic tissue to become hypoxic.Diseases such as atherosclerosis, vasospasm, and hemorrhage lead to hypoxia in pancreatic beta cells and reduced insulin secretion.
- Destruction of pancreatic tissue caused by alcohol, intoxication, drugs, and tumors.
Type 2 diabetes is triggered by malnutrition in a context of rapid technological advancement and urbanization leading to reduced physical activity.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 considered a hereditary autoimmune pathology in which the body's own immune system attacks its own pancreatic beta cells.The destruction of glandular tissue can be complete or partial.This pathology is diagnosed in young people, hence the name juvenile diabetes.In this disease there is an absolute deficiency of insulin.Patients with this diagnosis must receive insulin injections throughout their lives.
- Type 2 diabetes (T2DM)— It is based on insulin resistance (immunity of cells to the action of insulin, with subsequent disruption of glucose influx into cells and tissues).Insulin is the "key" that allows glucose to enter cells and be used as energy.The insulin deficiency in this type of diabetes is relative, that is, the gland itself is not damaged, but is forced to work with "wear and tear" for many years.Type 2 diabetes typically affects people after age 40 and does not differ by race, age, or gender.
There is also a so-called "hidden diabetes" - prediabetes.This condition is somewhere between normal and pathological: the level of glucose in the blood is higher than normal, but not high enough to make a diagnosis.This condition often precedes type 2 diabetes.The main danger is the absence of symptoms.
Another form is gestational diabetes, which occurs in some women during pregnancy.It usually goes away after delivery.But there is still a risk of developing T2DM after 45 years.
disease symptoms
The first type of diabetes has an acute, sudden onset, while the second type has extremely rare symptoms at first, appear over several years, and the patient does not even suspect the presence of pathology.
Signs of any type of diabetes in women and men:
- Typical ones are uncontrollable thirst and polyuria.This can cause the body to become dehydrated.The mechanism of this phenomenon is due to the accumulation of excess sugar in the blood.It takes a lot of work from the kidneys to filter it, absorb it, and remove it from the body.When they are violated, excess sugar begins to drain out of the tissues along with fluid.A vicious cycle occurs.Still thirsty after drinking; the patient drinks up to 4 liters of water per day, which in turn causes frequent urination.
- Persistent dry mouth is associated with dehydration.
- Increased fatigue.
- Yawning and drowsiness - brain cells are starved of oxygen and nutrients due to lack of glucose in the cells.
- Weakness is caused by dehydration and the inability to use sugar for energy.
- Wounds and cuts heal slowly and become infected frequently.
- Feeling nauseous or even vomiting.
- Shortness of breath (may have an odor of acetone).This is especially noteworthy during coma, which is a differential sign.
- Increased heart rate.
- Itching of the genitals and skin.
- Weight loss is more characteristic of the first pathological type and leads to exhaustion.
- Decreased vision - foggy vision.
- Polyphagia refers to food cravings and a lack of satiety.
- Abnormal sensation in the limbs.
- Bleeding, swollen, and red gums.
Lack of treatment for diabetes can lead to complications in the form of vasculopathy (blood vessel dysfunction).They can cause trophic ulcers, decreased vision, impaired tissue sensitivity, etc.
The most serious complication is diabetic coma, most common in insulin-dependent diabetes.
Type 2 diabetes has unique symptoms:
- Sweating increases during any physical activity (eating, exercising, even sleeping).Usually the head and chest are sweating, but the hands and feet are still cold, trembling, and cold.
- Urinary incontinence.
- Tendency to gain weight.
- Sleep is fitful at night.
- Numbness and tingling in the legs and spasms in the calf muscles.
- Attacks include rapid heart rate, elevated blood pressure, ringing in the ears, heaviness of the head, and lack of air.
Diagnosis of diabetes
The main clinical manifestation of diabetes is hyperglycemia, so its measurement is the basis for diagnosis.
Normal indicators: fasting blood glucose does not exceed 6.1 mmol/L, and blood glucose 2 hours after a meal does not exceed 11 mmol/L.They are not limited to a single analysis; that would not be objective.
For a complete diagnosis, the following conditions need to be met:
- glucose tolerance test;
- Blood biochemical analysis to detect electrolytes;
- Urinalysis for sugar and acetone;
- Rehberg test - measures the amount of creatinine in urine to assess kidney condition;
- fundus examination;
- Vascular studies - Doppler, bleed angiography, capillaroscopy, etc.;
- Organ ultrasound, electrocardiogram.
diabetes treatment
The main tasks of a doctor:
- Compensation of carbohydrate metabolism.
- Treatment of complications and their prevention.
- Weight normalization.
- Patient education - counting bread units, special hygiene, writing a self-monitoring diary.
Treatment of diabetes takes several years and requires strict adherence to medical prescriptions.
Important!Type 1 diabetes cannot be cured, but it can be controlled.
Medication:
- Injections of the hormone insulin treat type 1 diabetes.Another treatment option is transplantation - transplanting the entire gland or its parts (islets of Langerhans, responsible for insulin).
- hypoglycemic drugs- Used in type 2 diabetes to accelerate tissue utilization of glucose and increase insulin synthesis.First, these are sulfonylurea-based drugs.They help lower blood sugar.
- Biguanides- Reduces cellular insulin resistance by reducing intestinal absorption and improving peripheral cell metabolism.
The drug is taken continuously at the prescribed dose.Treatment regimen and dosage are always individualized.
The main method of treating type 2 diabetes is dietary therapy.
Another important condition for successful treatment is weight correction.People with diabetes should be prepared to monitor their blood sugar every day (have a blood glucose meter at home) and be checked and observed regularly by a clinic-based endocrinologist or general practitioner.
Important!Early diagnosis and treatment will help avoid negative consequences.
Diet is an essential component without which it is impossible to normalize hyperglycemia.In type 2 diabetes, it compensates for carbohydrate metabolism.For people with type 1, diet is needed to prevent hypoglycemic or hyperglycemic coma, which can be fatal.Have a balanced diet of protein, fat and calories.
It is important to adhere to the principles of proper nutrition, except for "heavy" fats, refined foods, canned foods, smoked foods, carbonated foods, simple sugars, and in cases of hypoglycemic coma.
prognosis and prevention
Basic precautions:
- Track weight changes;
- Control carbohydrate and lipid metabolism indicators;
- Engage in regular moderate physical activity;
- Drink enough water (at least 2 liters per day);
- Provides vitamins and minerals to the body.
Type 1 diabetes is not hereditary, just a genetic predisposition.Therefore, the prevention method is as follows:
- Breastfeeding - it is recommended not to discontinue before 1.5 years of age;
- Prevent viral diseases - influenza, sore throat, mumps, rubella, chickenpox;
- eliminate stress;
- Proper nutrition.
If you can control yourself and treat it promptly, the prognosis is good.
Don’t think of a diabetes diagnosis as a death sentence.Transitioning to a healthy lifestyle with proper nutrition and moderate physical activity can put you into a stable state of remission and eliminate medications entirely.