Diabetes is one of the most common diseases today. Let us consider in more detail the signs of diabetes and the causes of its occurrence.
Diabetes mellitus has been known since the time of medicine BC. The ancient Egyptians described this disease as an independent pathology. The ancient Greek scientist Celsus argued that the main cause of diabetes is not the proper functioning of the stomach, and Hippocrates made a diagnosis by tasting the patient's urine. Doctors ancient China came up with their own original method for diagnosing diabetes: the patient's urine was poured into a saucer and put out on the street. If wasps and bees sat on the edge of the saucer, then the doctors knew that sugar was present in the patient's urine.
Diabetes is a disease endocrine system and is characterized by an increase in blood sugar levels as a result of a violation of the production of the hormone insulin by the pancreas. The progression of diabetes mellitus leads to disruption of metabolic processes in the body, damage to nervous system, blood vessels and other organs and systems.
Types and types of diabetes
Depending on the form of the course of the disease, there are:
- Insulin-dependent diabetes mellitus (type 1 diabetes) - most often occurs in children and young people;
- Non-insulin-dependent diabetes (type 2 diabetes) - most often occurs in people over 40 years of age who are overweight. This form of diabetes is observed in 80% of cases;
- Secondary diabetes mellitus - symptomatic;
- Diabetes in pregnant women - blood sugar levels are elevated during pregnancy, and after childbirth everything returns to normal;
- Diabetes resulting from malnutrition and malnutrition.
Diabetes mellitus of the insulin-dependent type is characterized by an absolute deficiency of insulin, which occurs against the background of insufficient production of it by the pancreas.
Diabetes can be caused by lack of insulin
When diagnosing the second type of diabetes mellitus, we are talking about relative insulin deficiency.
Causes of Type 1 Diabetes
Type 1 diabetes begins to manifest itself clinically after the destruction of more than half of the cells of the islets of Langerhans of the pancreas (responsible for the production of insulin). In children and patients adolescence progression of the disease is observed much faster, as a result of which and general state the patient is rapidly deteriorating.
Type 1 diabetes is characterized by inadequate production of insulin by the cells of the pancreas. Insulin is either not produced at all, or its quantity is very small. The main function of this hormone is to ensure the delivery of glucose into cells. Glucose is the main source of energy for all tissues and cells of the body. If glucose, for some reason, does not enter the cell, then it begins to accumulate in the blood in high concentrations, and, accordingly, the cells and tissues of the body experience an energy deficit (that is, hunger). To compensate for the deficiency nutrients and carbohydrates, the body begins to intensively break down fats and proteins. It is this fact that contributes to the sudden and sharp weight loss of the patient.
Glucose molecules have the property of attracting water to themselves. If the level of sugar in the body rises significantly, then glucose with liquid is intensively excreted from the body along with urine. Thus, a diabetic patient experiences intense thirst and noticeable dehydration.
Due to the active breakdown of fats, blood begins to accumulate fatty acid. The liver makes heavy use of these acids to provide the body with energy. As a result, the concentration of ketone bodies in the blood increases sharply. Ketone bodies are products of the breakdown of fats, and their accumulation in the blood leads to the development of ketosis and severe dehydration. If at this stage the patient does not start rehydration (replenishment of fluid deficiency in the body) and insulin therapy, then soon a coma develops and the subsequent shutdown of vital organs.
Predisposing factors provoking the development of this disease are:
- Transferred mumps, rubella virus, chickenpox and hepatitis;
- hereditary predisposition;
- Regular intake of selenium-based supplements.
Causes of Type 2 Diabetes
The main predisposing factors for the development of type 2 diabetes are heredity and overweight.
Obesity
If a person is obese 1 degree, then the risk of developing diseases of the endocrine system is doubled. With obesity of the 2nd degree - 5 times, with obesity of the 3rd degree - more than 10 times!
hereditary factor
If at least one of the parents had and has diabetes, then there is a very high probability that the children will also inherit this disease. Type 2 diabetes mellitus develops gradually with mild clinical symptoms.
Diabetes is hereditary
secondary diabetes mellitus
The secondary form of the disease can develop in humans against the background of such factors:
- Prolonged and uncontrolled intake of certain drugs;
- Changes in cell receptors responsible for delivering insulin to tissues;
- Concomitant diseases of the pancreas (pancreatitis, tumor neoplasms on the gland, partial removal of the pancreas);
- Hormonal diseases (Itsenko-Cushing's disease, acromegaly, thyrotoxicosis, toxic goiter and pheochromocytoma).
How to recognize diabetes? First clinical symptoms
This endocrine disease is characterized by a whole range of clinical symptoms. These include:
- Constant thirst of the patient (a person can drink more than 5 liters of water per day);
- Frequent urination and severe oliguria (up to 10 liters of urine per day);
- Increased appetite, feeling of constant hunger;
- Rapid weight loss, sudden weight loss;
- Rapid fatigue and a feeling of general weakness;
- Sudden deterioration of vision - the appearance of the so-called "white veil" before the eyes;
- Cramps of the calf muscles, disturbing the patient more often at night;
- Dizziness and headaches;
- Decreased libido in women and erectile dysfunction in men;
- Decreased immunity;
- Slow wound healing.
Fatigue is one of the symptoms of diabetes.
In medicine, there have been cases when a constant increase in blood glucose levels was not accompanied in a patient by typical symptoms of diabetes mellitus - thirst and an increase in daily diuresis. Only as the disease progressed, patients noted the presence of dizziness and constant weakness, visual impairment, rapid weight loss and prolonged healing of wounds on the skin. It is these symptoms that often force the patient to consult a doctor.
The onset of the insulin-dependent type of the disease is characterized by the rapid progression of the pathological process and severe dehydration. Such patients should immediately receive medical attention and administer insulin preparations. Without timely medical intervention, the patient rapidly develops ketoacidosis in the blood, and then he falls into a coma.
Complications of diabetes
If people with this disease ignore the doctor's prescriptions and are irresponsible about their state of health, then against the background of the progression of diabetes mellitus, serious complications will soon develop. First of all, the disease affects the cardiovascular system, organs of vision, kidneys and nervous system.
Damage to the heart and blood vessels
With the progression of diabetes in the first place complications affect the cardiovascular system. Approximately 70% of people with diabetes die as a result of a stroke or heart attack. This is due to the fact that diabetes causes severe damage to the large arteries responsible for the blood supply to the heart muscle and great vessels.
In addition, the progression of diabetes and elevated level sugar in the blood leads to diseases of the feet, microcracks of the limbs, as a result of which gangrene develops. With the development of gangrene, surgeons carry out amputation of the affected limb to prevent further necrosis of healthy tissues.
Doctors say that timely diagnosis of the disease and the responsible implementation of all medical recommendations can prevent the development of complications.
The effect of diabetes on the organs of vision
Diabetes mellitus, in the absence of timely treatment, leads to a complete loss of vision of the patient. As the disease progresses, the patient may develop other eye conditions such as increased intraocular pressure, cataracts, and diabetic retinopathy. The latter disease is the most common complication of the visual system in diabetes. A timely visit to the ophthalmologist in 90% of cases prevents the development of blindness in diabetics.
Disorders of the excretory system and kidneys
Endocrine disease of the pancreas is one of the main causes of kidney failure. To prevent the development of this complication, it is necessary to take drugs that promote the outflow of urine and normalize blood pressure (diuretics).
Pathologies of the nervous system
Especially often in diabetes mellitus, the nervous system, or rather, the nerve endings of the limbs, is at risk of developing complications. This pathology leads to a decrease in the sensitivity of the limbs and the appearance of numbness and burning of the hands and feet.
In addition, damage to the central nervous system in diabetes can provoke violations of the digestive function and the functioning of the organs of the reproductive system.
How to prevent the development of complications?
If the complications of this disease were diagnosed in a patient at an early stage of their appearance, then they can be easily eliminated with the help of medications. Thus, the patient's lifestyle changes somewhat: for example, with developing nephropathy (damage to the renal tubules), the patient must take daily drugs that will help prevent further progression of the pathology.
Diagnosis of diabetes
To diagnose diabetes in a patient, it is enough to examine a blood test, which determines the level of glucose. If a fasting blood glucose level of less than 7 mmol / l, but more than 5.6 mmol / l is detected in a patient, a glucose tolerance test is additionally prescribed. The test is as follows: the patient donates blood on an empty stomach, doctors determine the level of glucose in the blood, after which the person is offered a piece of sugar. Another blood test is taken from this patient after 2 hours. If the blood glucose levels increased to 11.1 mmol / l, then diabetes mellitus can be diagnosed with confidence. If the blood glucose is less than 11.1 mmol / l, but more than 7.8 mmol / l, then we are talking about a violation of the body's tolerance to carbohydrates. At low glucose levels, but at the same time above the norm, the study is repeated after 3 months, and the patient is registered with an endocrinologist.
Blood glucose levels are used to make a diagnosis
Treatment of diabetes
The method of treatment for diabetes largely depends on the type of disease. When diagnosing type 1 diabetes mellitus (insulin-dependent), the patient is prescribed insulin preparations to compensate for the deficiency of the hormone in the body.
When non-insulin dependent diabetes (type 2 diabetes) is detected, treatment begins with dietary adjustments and antidiabetic medications.
As diabetes progresses, the patient is prescribed insulin therapy. Most often, the body's need for insulin is fully satisfied by preparations of the human hormone. These drugs include recombinant human insulin.
For treatment, short-acting insulins, intermediate-acting insulins and prolonged-acting (long-acting) drugs are used. Most often, insulin preparations are administered subcutaneously, but it can also be administered intramuscularly and into a vein.
Diabetes in women
Manifestations of diabetes mellitus in women has some distinctive feature. Often the patient is unaware of the development of diabetes, and the reason for going to the doctor is severe itching of the external genital organs. This symptom often appears first in the progression of diabetes in women. Patients often take itching of the external genitalia for a venereal infection and rush to see a venereologist. During the examination, the woman found an increased level of glucose in the blood.
The risk of getting diabetes
Many people are very concerned about the question, is it possible to get diabetes from a patient through contact with him? No, it's just a stupid myth. Diabetes is not the flu or an acute respiratory infection. This disease is caused by severe disorders in the islets of Langerhans of the pancreas, as a result of which insulin stops being produced or is produced in insufficient quantities. Diabetes mellitus is not transmitted through handshakes, the use of personal hygiene items of the patient, or airborne droplets.
Diabetes mellitus is also called the "disease of civilization", as the cause of its occurrence is often the abuse of various fast foods, pastries and carbonated sweet drinks.
Nutrition for diabetes
Naturally, diabetes mellitus makes multiple adjustments to a person's lifestyle, and this primarily concerns the patient's diet. If you ignore the instructions of a specialist regarding certain food restrictions, the disease provokes a sharp deterioration in the patient's health. The first thing that people with diabetes need to give up is sugar.
Diabetic patients should take care of their diet
Patients with diabetes mellitus are shown therapeutic diet No. 9. This diet is characterized by a restriction in the diet of a sick person of easily digestible carbohydrates and the prevention of possible disorders of fat metabolism due to the progression of diabetes mellitus.
The patient is recommended to eat 5 times a day in small quantities, preferably at regular intervals. It is absolutely unacceptable for a person with diabetes to skip meals, for whatever reason. This can have a very negative impact on his health.
Diet number 9
The diet of a diabetic patient consists of the following dishes:
First hot meals
Soups and borscht for a diabetic patient are prepared on water, with the addition of boiled lean meat to the plate. Great for eating rabbit meat, turkey breast, chicken fillet and beef. It is very useful to eat soup cooked in vegetable broth for lunch. Thus, the patient not only does not load the pancreas with unnecessary work, but also enriches the body with vitamins.
Main dishes
As a side dish for boiled meat of low-fat varieties, you can cook porridge on the water. Especially useful are buckwheat, barley, oatmeal, wheat and barley. It is very useful as a snack for an afternoon snack to eat wheat bran, pre-filled with warm milk.
Dairy products have a good effect on the digestive system, which is very important for diabetes. Preference should be given to kefir, low-fat cottage cheese, not salty and not spicy hard cheese.
You can also serve the sick porridge with the addition of milk, but always boiled in water. You can add a piece of butter to milk porridge.
Vegetables and fruits
People with diabetes can include vegetables and fruits in their diet: tomatoes, cucumbers, lettuce, zucchini, pumpkin, some eggplant, green apples, dates and figs. Bananas, grapes and strawberries should not be consumed or tasted in very limited quantities, since these fruits and berries are especially rich in fructose and carbohydrates, and their abuse can dramatically worsen the patient's condition.
Drinks for diabetes
Patients with diabetes need to give up black tea, cocoa and coffee. You can drink a coffee drink with the addition of milk. It is allowed to use rosehip broth, green tea, vegetable and fruit juices (from the list of allowed vegetables and fruits), mineral non-carbonated water.
List of products that are strictly prohibited for people with diabetes:
- Chocolate candies;
- Sausages and smoked sausage;
- Fatty fish (such as mackerel and salmon);
- Red caviar;
- mayonnaise, ketchup, margarine;
- Spices, spices, vinegar;
- Canned food;
- Homemade jam.
How to diversify the menu for diabetes?
People who are diagnosed with diabetes complain that their diet is very monotonous, and the food is all insipid and not tasty. This is an unjustified statement. Possessing desire and culinary skills, you can eat fully, tasty and properly. Below is sample menu for patients with diabetes. You can take this menu as a basis, changing and adding products from the allowed list daily.
Breakfast: rice milk porridge boiled in water (add milk directly to the plate), bread with butter and tea.
Second breakfast: biscuit cookies and a glass of low-fat natural yogurt.
Lunch: boiled beetroot salad with vegetable oil, vegetable soup with a piece of boiled chicken meat.
Snack: steamed cheesecakes, apple, rosehip broth.
Dinner: boiled fish, vegetable salad with sour cream
At night: a glass of kefir or milk.
As you can see, the diet is quite varied. Of course, at first the patient will experience certain difficulties with permitted and prohibited foods, but he will soon get used to it.
Controlling blood sugar at home
A patient with diabetes cannot be constantly under the control of doctors, and, as you know, the level of glucose in the blood must be constantly maintained at approximately the same level. It is important to ensure that there are no sudden changes in blood glucose levels - hyperglycemia and hypoglycemia. As a result of such jumps, the patient's blood vessels, organs of vision and nervous system begin to be rapidly affected.
Without insulin, glucose cannot be broken down into necessary for the body substances. The liver begins to intensively produce glucose, believing that the critical state of the body is due precisely to a lack of energy. From an excess of glucose and its accumulation in the body, the accumulation of ketone bodies begins.
If the glucose levels exceed the levels of ketone bodies in the blood, then the patient develops a hyperglycemic coma.
If ketone bodies exceed the amount of glucose in blood, then the patient develops ketoacidotic coma.
It is important to take into account the fact that the development of a coma is not always caused in a patient due to the accumulation of glucose or ketone bodies in the blood. The patient may fall into a coma due to an overdose of insulin. Thus, we are talking about hypoglycemic coma.
Signs of a coma
The first signs of a developing coma include:
- Increased thirst and urination;
- Nervous excitement, subsequently replaced by lethargy;
- Increasing weakness and lethargy;
- Headache;
- Lack of appetite and nausea;
If the patient has such signs within 12-24 hours, it is necessary to urgently seek medical help. Without timely treatment, the patient develops a true coma. Clinical signs of a true diabetic coma are:
- Growing indifference to what is happening around;
- Violation of consciousness (apathy with periods of nervous excitement);
- Lack of response to stimuli.
When examining a patient, the doctor detects severe dryness of the skin, a weakening of the pulse in large arteries, a noticeable smell of acetone from the mouth (with the development of hyperglycemic and ketoacidotic coma), a drop in blood pressure, softening of the eyeballs. The patient's skin is warm to the touch.
With the development of coma due to an overdose of insulin (hypoglycemic), the clinical signs are completely different. When approaching a coma, the patient feels severe hunger, trembling in the limbs and body, increasing weakness, anxiety and sudden sweating.
If, while feeling these signs, the patient is not allowed to drink sweet tea, eat chocolate candy or another “fast” carbohydrate, then the patient experiences loss of consciousness and convulsions. On examination, the doctor notes increased muscle tone, skin moisture and the absence of acetone breath from the mouth.
First aid for the development of coma
As a rule, people with diabetes are well aware of what happens when insulin is administered incorrectly or the level of glucose and ketone bodies in the blood increases. With increasing signs and symptoms of a coma, such patients know what to do. People who are trying to provide first aid to a patient with increasing symptoms of a coma should ask the patient himself what helps him in this case.
It is strictly forbidden when developing a coma to prevent the patient from administering insulin to himself (some people regard this as inappropriate behavior), as well as to hesitate to call an ambulance, relying on the patient himself knowing what to do in these situations.
Diabetes- is a chronic disease that is characterized by elevated blood glucose levels on an empty stomach and after eating. In addition to hyperglycemia - elevated sugar levels, an integral feature of uncompensated diabetes mellitus is glycosuria - the excretion of glucose in the urine.
Diabetes mellitus translated from Greek means “to pass through”, that is, water does not linger in the body at all, but all comes out.
Diabetes mellitus is not a modern disease, as many believe, but is rooted deep in history.
Diabetes mellitus was first mentioned in ancient Roman documents dating back to the third millennium BC.
And for many hundreds of years, scientists and doctors have been trying to find out the causes of the development of diabetes in order to prevent the development of this disease in future generations and to find a cure to help those who are already sick, but so far all those who have been ill have been doomed.
At the very beginning of the 20th century, scientists Paul Langerhans discovered special pancreatic cells - beta cells responsible for the synthesis of insulin. These cells are arranged in groups that are named after the scientist who discovered them, they were called islets of Langerhans .
After the discovery of these cells, a series of experiments followed, which in 1921 made it possible to isolate a substance from beta cells, which received the name - (the name is derived from the word "island").
Type 1 diabetes is characterized by the fact that the cells of the pancreas stop producing insulin.
At first, insulin can be produced, but in insufficient quantities. Over time, the beta cells die, and insulin stops being produced altogether.
This type requires external insulin.
Type 1 diabetes is also called, although not quite correctly, diabetes of the young, since it most often develops in children, adolescents and people under 30-35 years old. But there are exceptions everywhere, so it can be detected in older people.
This type is not as common as type 2 diabetes.
Neither pills nor any other means will help restore dead beta cells that produce insulin.
But the main thing to remember is that with the right therapy, people with diabetes live a long, full life, without denying themselves anything.
You just have to spend some time and effort to achieve compensation.
More common than type 1 diabetes. Still, it is called obese diabetes, as it develops in people who are overweight, and diabetes in the elderly. Although the latter is not entirely true, although it mainly affects people after 40 years of age and older, it has recently been diagnosed in children and young people.
In type 2 diabetes, insulin is produced in sufficient, and sometimes in excess, amounts. But there is a violation of its structure or the mechanism of its effect on cells. That is, insulin is produced, but it cannot carry glucose into the cells, so glucose molecules accumulate in the blood, which explains the increased blood sugar.
Type 2 diabetes is characterized by gradual development. Often a person learns that he has diabetes only after being tested for a completely different reason.
Type 2 diabetes requires drug treatment (), treatment with insulin therapy is possible (according to test results, if normoglycemia cannot be achieved through diet and sugar-lowering drugs).
In some cases, it is possible to maintain normal sugar levels by following a strict diet and physical activity. Since diet and sports contribute to weight loss, and achieving normal body weight reduces tissue insulin resistance, which leads to normal insulin action on cells and return normal level blood sugar.
It is incorrect to call type 1 diabetes “insulin dependent” and type 2 diabetes “non-insulin dependent”.
Since insulin-dependent can be not only type 1 diabetes, but also type 2; just as type 2 diabetes can be not only non-insulin dependent, but insulin dependent.
Another form of diabetes is gestational diabetes mellitus, or, as it is also called, gestational diabetes.
It occurs in some women at different stages of pregnancy. Its manifestations are the same - elevated blood sugar levels.
Often, in order to achieve normal compensation in gestational diabetes, a diet is required, the exclusion of fast carbohydrates.
But sometimes this is not enough, then insulin therapy is connected during pregnancy. It is possible to use only extended insulin or a combination of short and extended insulin.
This diabetes can completely go away after childbirth and no longer remind of itself. But often after some time (sometimes after several years) it turns into type 2 diabetes, somewhat less often it manifests itself in the form of type 1 diabetes.
Reasons for the development of diabetes
To date, scientists and doctors cannot identify the causes that contribute to the development of diabetes.
There are several theories. One of which says that a person is already born with a predisposition to diabetes, and external conditions only contribute to its development.
The conditions that provoke the development of diabetes mellitus are:
- stressful situations
- severe infections
- taking certain medications
- severe injuries
- surgical interventions
- pregnancy
Diabetes Risk Groups
Although the causes of diabetes are not exactly known, doctors identify several risk groups in which diabetes is most likely to develop.
The risk groups for the development of diabetes include people who may note the following points:
- overweight and obesity (typical for type 2 diabetes);
- the presence of relatives with diabetes;
- transferred severe infections;
- transferred surgical interventions;
- age over 40
Causes
This is what causes a violation of insulin synthesis. This form of diabetes manifests itself if up to eighty percent of the cells that produce it die.
The mechanism of development of diabetes
The disease of the first type begins to develop when the endocrine cells - the islets of Langerhans - of the pancreas cease to produce sufficient insulin.
The hormone promotes the entry of glucose into cells, the synthesis of fat-containing substances. It activates the process of obtaining energy by cells, inhibits the breakdown of fats.
With a lack of a hormone, glucose does not enter the cells, but into the blood. Sorbitol begins to accumulate in the tissues of the body,. These substances contribute to the development, appearance,.
Diagnostics
For the diagnosis of the disease is prescribed:
- capillary blood test. The study is carried out on an empty stomach;
- . Examine urine for glucose and the presence of ketone bodies. The appearance of sugar in it can be determined using special test strips. Its minimum content is called the renal threshold;
- glycated hemoglobin test. Its level in diabetics is significantly increased.
- blood test for C-peptides and insulin. Indicators for the first type of ailment are reduced, and for the second they are not changed;
- The exercise test measures glucose tolerance. It is carried out first on an empty stomach. Twice with an interval of an hour, the patient drinks glucose dissolved in water, again the measurement is made.
As an additional examination, ultrasound of the kidneys, EEG of the brain, and rheovasography of the extremities are prescribed.
The first signs of diabetes
One of them is increased excretion of urine, frequent urges at night.
Also, the patient is very thirsty, because a lot of fluid leaves with urine. Due to a metabolic disorder, a diabetic experiences.
Despite the appetite, some patients are rapidly losing weight. These primary symptoms, inherent in the disease of the first type, develop rapidly.
Symptoms
For the disease of both forms, clinical manifestations are characteristic:
- skin itching;
- feeling of dryness in the mouth;
- muscle weakness;
- the formation of difficult-to-heal wounds;
For a disease of the first type is characteristic. The substance is formed due to the burning of fat reserves.
Classification
The disease is classified according to different criteria: by etiology, severity of the course of the disease, phases of its development.
By etiology
There are the following types of illness:
- first type. It is called "youthful", but people of all ages can get sick;
- second type. The patient develops insulin resistance;
- . Typical for pregnant women. The symptoms disappear after the baby is born.
According to the severity of the disease
The mild course of the disease is characterized by a slight excess of the norm of glucose in plasma - no more than 8 mmol / l on an empty stomach.
With an average severity of the disease, sugar rises to 14 mmol / l. are found. Some patients have angioedema.
In severe cases of the disease, the glucose level rises above 15 mmol / l. Patients require constant When it is possible to achieve normal values of glucose in plasma in the absence of it in the urine.
With a subcompensated form, the sugar level does not differ much from the norm, there is no acetone in the urine. does not allow to improve carbohydrate metabolism. Acetone is found in urine, the risk of developing hyperglycemic coma increases.
Complications
The disease is dangerous with complications: disturbances in the functioning of the organs of vision (angiopathy,), limbs (). With development, it arises, leading to death.
Treatment of diabetes
Treatment is aimed at eliminating the main symptoms of the disease. It includes:
- compensation of carbohydrate metabolism;
- normalization of the patient's weight;
1 type
Measures for the treatment of insulin-dependent diabetes:
- . It is aimed at reducing the amount of carbohydrates consumed;
- . Necessary to control the weight of the patient;
- . Includes the introduction of long-acting and short-acting hormones;
- gland transplant. Recommended for .
2 types
Methods for the treatment of non-insulin dependent diabetes are divided into groups:
- non-drug therapy. Implies observance, reasonable, refusal from;
- drug therapy. Provides for the use of hypoglycemic agents.
In some patients, insulin is indicated for type 2 disease.
Diet for diabetics
A diet for illness involves eating low-fat foods, reducing the amount of carbohydrate foods. Food should be taken often, in small portions.
In the menu you need to include , . Patients should eat bread with. Honey can be eaten in small quantities.
Medications
Diabetics are prescribed Tolbutamide, Chlorpropamide, Glipizide, Gliquidone, Glimepiride. Medicines increase the secretion of the hormone by the cells of the gland. Repaglinide, Nateglinide are rapidly absorbed, have a short-acting hypoglycemic effect.
Tablets Gliquidone
Biguanides reduce sugar absorption in the intestines and production in the liver. They increase the sensitivity of tissues to insulin.
Rosiglitazone is involved in glucose metabolism. Acarbose inhibits the enzymes that break down carbohydrates into glucose. Insulin replacement therapy is indicated when other measures are ineffective.
Can the disease be cured?
Both types of illness are independent diseases.Secondary diabetes is a consequence of pathological processes in the body.
It can be treated if the factor that caused it is removed. The primary disease of both types is incurable. bean seed infusion. Several pieces are poured into 100 mg of water. The liquid is drained in the morning, the beans are eaten before breakfast.
Birch buds are harvested in spring. Three spoons are poured with two glasses of boiling water, they insist and drink the resulting infusion all day.
Which doctor should I contact?
The first signs of the disease can be detected by the therapist after the patient has given blood for analysis.
He will refer the patient to an endocrinologist.
If there are complications in the work of other organs, a diabetic will need to consult an ophthalmologist, vascular surgeon, cardiologist.
Prevention
Preventive measures are aimed at preventing complications, include dieting, weight control, maintaining water balance, and preventing viral diseases. Diabetics are recommended classes, swimming, walking.
Related videos
All about type 1 and type 2 diabetes in the video:
With a slight production of insulin by the pancreas and resistance to it, glucose in smaller volumes enters the cells, in plasma its content increases. Diabetes develops. The body does not have enough energy, the processes of protein breakdown are activated, which causes muscle weakness.
Oxidation of fats contributes to the formation of ketone bodies, which have a toxic effect on the body. Patients, along with the loss of glucose, which is removed by frequent urination, deplete energy reserves, so many rapidly lose weight. High plasma sugar levels cause nerve endings, eye, kidney, heart.
The prognosis for type 1 diabetes is very favorable if the diet and medical recommendations are followed. It is almost impossible to cure the disease of the second type, but the prevention of complications and insulin therapy will allow people to lead a normal life.
Diabetes mellitus is a pathology caused by dysfunction of the endocrine system. The course of the disease is accompanied by an increase in the concentration of sugar in the blood and chronic insulin deficiency. There are many reasons why diabetes occurs. At the same time, the influence of a certain factor does not always lead to the development of the disease.
Types and features of diabetes
Insulin is a special hormone responsible for delivering sugar to the cells of the body. Proteins of the pancreas are responsible for its production. The development of diabetes mellitus is due to a violation of carbohydrate metabolism, in connection with which the concentration of glucose in the body decreases.
There are two types of disease. Type 1 diabetes occurs when the body produces antibodies that attack pancreatic cells. To stop the consequences and suspend the pathological process, the patient needs. More often, the disease of the first type occurs in men under 40 years old with an asthenic physique.
The second form of diabetes mellitus is characterized by a decrease in the sensitivity of cells to. The occurrence of pathology is due to an increase in the concentration of nutrients. The risk group for developing the disease includes people over 40 years of age.
Causes of diabetes
There are two groups of factors that cause diabetes:
- autoimmune;
- idiopathic.
The first group includes factors that affect the functioning of the immune system.
The weakening of the protective mechanisms in the body leads to the appearance of antibodies that attack the pancreas. Autoimmune processes develop due to exposure to:
- toxins;
- pesticides;
- nitrosamines and other factors.
Idiopathic causes combine many factors that occur in both a teenager and an adult.
Provoking factors
Among the probable causes of diabetes, hereditary predisposition is distinguished. The risk group for the development of pathology includes persons who have been diagnosed with this disease among their closest relatives.
The following factors can also provoke the appearance of diabetes:
- overweight;
- malnutrition;
- severe stress;
- course of atherosclerosis;
- long-term medication;
- the course of autoimmune and some other pathologies;
- pregnancy;
- bad habits.
The risk of developing diabetes increases when several factors combine.
Heredity
Heredity is one of the main factors provoking type 1 or type 2 diabetes. If one of the parents is diagnosed with a disease, the pathology develops in 30% of children.
The probability of a child inheriting diabetes mellitus increases by 2 times when a lack of insulin is detected simultaneously in the body of the mother and father.
Overweight
Being overweight, according to medical statistics, is the second most likely cause of diabetes (mainly type 2). In this case, the pathological process provokes a high content of body fat in the body. This circumstance leads to the fact that the cells stop responding to the effects of insulin.
Improper nutrition
Persons with a genetic predisposition to diabetes mellitus and prone to overweight should avoid stressful situations in order to prevent the disease. If necessary, it is recommended to take herbal sedatives.
Systemic diseases
Possible causes of diabetes include:
- atherosclerosis;
- arterial hypertension;
- coronary artery disease.
These pathologies negatively affect the work of internal mechanisms and cause dysfunction of various organs. As a result, the sensitivity of cells to insulin decreases, which leads to diabetes mellitus.
Also, these pathologies reduce the nutrition of the pancreas, which produces insulin.
In addition, there is a relationship between the development of diabetes mellitus and endocrine pathologies:
- Itsenko-Cushing's syndrome (usually occurs in women);
- diffuse toxic goiter;
- acromegaly;
- chronic insufficiency of the adrenal cortex;
- autoimmune thyroiditis;
- pheochromocytoma.
The risk of developing such pathologies is extremely high in individuals who have been exposed to radiation.
Medications
In some cases, diabetes mellitus develops as a complication of long-term medication or an abnormal response of the body to the effects of medications.
The following medications are capable of provoking pathology:
- antitumor;
- glucocorticoids;
- hypotensive;
- diuretics (mainly thiazide diuretics).
It is not excluded the likelihood of diabetes with regular intake of dietary supplements containing selenium.
Infectious pathologies
Can provoke the appearance of diabetes mellitus:
- pig;
- chickenpox;
- hepatitis;
- rubella.
Infection, penetrating the body, can affect the pancreas, which negatively affects the functioning of the organ. As a result, insulin concentrations decrease.
Some viruses have cells similar in structure to pancreatic tissue. Therefore, after infection, the immune system begins to attack this organ.
Pregnancy
In pregnant women, the concentration of sugar in the blood often rises, which is explained by the hypersynthesis of certain hormones. This leads to an increase in the load experienced by the pancreas.
During pregnancy, so-called gestational diabetes develops. However, the disease usually resolves after childbirth. But in some cases, gestational diabetes develops into diabetes. This is facilitated by a large fetus (weight more than 4 kg), “frozen” pregnancy, excessive body weight in a woman.
Lifestyle
With frequent alcohol consumption, the beta cells responsible for insulin synthesis die. In addition, people who adhere to a sedentary lifestyle are at risk for developing diabetes. Due to insufficient physical activity, tissues begin to consume less glucose. Also sedentary image life contributes to obesity.
Age
According to medical statistics, more often diabetes develops in people over 60 years of age. As a person grows older, the concentration of insulin and incretins in the body decreases, which provokes pathology.
Effects
In the absence of adequate and constant therapy, diabetes mellitus provokes:
- Hypoglycemia (a sharp decrease in the concentration of sugar in the blood). This condition often causes a diabetic coma, dysfunction of internal organs, and a decrease in blood pressure.
- Myopia, blindness. Problems with the organs of vision occur if the disease has been occurring for more than 20 years.
- Cardiac pathologies. Due to diabetes, the plasticity of blood vessels decreases, which can cause a heart attack or stroke.
- Renal failure. The appearance of nephropathy is explained by a decrease in capillary plasticity.
- Polyneuropathy (damage to the peripheral nervous system). Pathology is accompanied by a decrease in sensitivity and numbness of the extremities.
To avoid these and other complications, you must:
- to refuse from bad habits;
- timely treat infectious diseases;
- adhere to proper nutrition;
- monitor weight;
- abandon strict diets.
Diabetes is a dangerous disease that develops under the influence of many factors. In some cases, it is almost impossible to prevent pathology.
Diabetes due to relative or absolute insufficiency of insulin in the human body. With this disease, the metabolism of carbohydrates is disturbed, and the amount of glucose in the blood and urine increases. Diabetes mellitus also causes other metabolic disorders in the body.
Cause Diabetes mellitus is a deficiency of insulin, a pancreatic hormone that controls the processing of glucose at the level of tissues and cells of the body.
Risk factors for developing diabetes
Risk factors for the development of diabetes, that is, conditions or diseases that predispose to its occurrence, are:hereditary predisposition;
overweight - obesity;
arterial hypertension;
elevated level .
If a person has several facts at the same time, the risk of developing diabetes for him increases up to 30 times.
Causes of diabetes
Destruction of insulin-producing cells in the pancreas as a result of viral infections. A number of viral infections are often complicated by diabetes, as they have a high affinity for pancreatic cells. The greatest risk of developing diabetes is caused by mumps (viral mumps), rubella, viral hepatitis, chicken pox, etc. So, for example, in people who have had rubella, diabetes mellitus develops in 20 % cases. But especially often viral infection complicated by diabetes in those who also have a hereditary predisposition to this disease. This is especially true for children and adolescents.hereditary factor. Relatives of people with diabetes tend to have diabetes several times more often. If both parents have diabetes, the disease manifests itself in children in 100 % cases, if only one of the parents is sick - in 50 % cases, in case of diabetes mellitus in a sister or brother - at 25%.
But when it comes to diabetes 1
type, the disease may not appear, even with hereditary predisposition.
In this type of diabetes, the likelihood that a parent will pass on to a child defective gene, is about 4 %.
Science also knows cases when only one of the twins fell ill with diabetes. The risk that type 1 diabetes will still develop increases if, in addition to the hereditary factor, there is also a predisposition resulting from a viral infection.
Autoimmune diseases, in other words, those diseases when the body's immune system "attacks" its own tissues. These diseases include autoimmune thyroiditis, glomerulonephritis, lupus, hepatitis, etc. In these diseases, diabetes develops due to the fact that cells of the immune system destroy pancreatic tissue,
responsible for insulin production.
Overeating, or increased appetite leading to obesity. In people with normal body weight, diabetes mellitus occurs in 7,8 %
cases, when the normal body weight is exceeded by 20 %
the incidence of diabetes is 25 %,
with an excess of mass 50 % -
diabetes appears in 60 %
cases. Obesity leads to the development of diabetes 2
type.
You can even reduce the risk of this disease reduced through diet and exercise total body weight 10 %.
Classification of diabetes
The World Health Organization (WHO) classifies diabetes mellitus into 2 type:insulin-dependent - type 1;
insulin-independent - type 2.
non-insulin dependent diabetes also divided into two varieties: 1) diabetes in persons with normal body weight; 2) diabetes in obese individuals.
In the studies of some scientists, a condition called prediabetes (hidden diabetes). With it, the level of sugar in the blood is already above the norm, but not yet high enough to make a diagnosis of diabetes. For example, the glucose level between 101 mg/dl to 126 mg/dL (slightly higher 5 mmol/l). When there is no right treatment Prediabetes turns into diabetes itself. However, if prediabetes is detected on time and measures are taken to correct this condition, the risk of developing diabetes is reduced.
A form of diabetes mellitus has also been described gestational diabetes. It develops in women during pregnancy, and may disappear after childbirth.
Diabetes mellitus type 1. In insulin-dependent diabetes mellitus ( 1 type) are destroyed more 90 % insulin-secreting pancreatic cells. The reasons for this process can be different: autoimmune or viral diseases, etc.
In patients with diabetes 1 type, the pancreas secretes less insulin than necessary, or does not secrete this hormone at all. Of those people who suffer from diabetes, diabetes 1 type suffer only in 10 % sick. Usually diabetes 1 type manifests itself in people before 30 years. Experts believe that the start to the development of diabetes 1 type gives a viral infection.
The destructive role of an infectious disease is also expressed in the fact that it not only destroys the pancreas, but also causes the immune system of a sick person to destroy the pancreas' own insulin-producing cells. So, in the blood of people suffering from insulin-dependent diabetes mellitus, contains antibodies against insulin-producing b-cells.
Normal absorption of glucose without insulin is impossible, that is, the normal functioning of the organism is also impossible. Those with diabetes 1 type, are constantly dependent on insulin, which they need to receive from the outside, since their own body of these people does not produce it.
Diabetes mellitus type 2. In non-insulin dependent diabetes mellitus ( 2 type) the pancreas secretes insulin in some cases even in larger quantities than necessary. However, the cells of the patient's body as a result of the action of any factors become resistant - their sensitivity to insulin decreases. Because of this, even with a large amount of insulin in the blood, glucose does not enter the cell in the right amount.
diabetes mellitus 2 kind of get sick too 30 years. The risk factors for its occurrence are obesity and heredity. Diabetes 2 type can also result from the misuse of certain drugs, in particular, corticosteroids for Cushing's syndrome, acromegaly, etc.
Symptoms and signs of diabetes
The symptoms of both types of diabetes are very similar. As a rule, the first symptoms of diabetes are caused by high blood glucose levels. When its concentration reaches 160-180 mg/dl (above 6 mmol/l), glucose enters the urine. Over time, when the disease begins to progress, the concentration of glucose in the urine becomes very high. At this point, the first symptom of diabetes appears, which is called polyuria- allocate more 1,5-2 l of urine per day.Frequent urination leads to polydipsia - constant feeling of thirst to satisfy which you need to use daily a large number of liquids.
Calories are also excreted with glucose through the urine, therefore the patient begins to lose weight. Patients with diabetes have an increased appetite.
So there is a classic triad of symptoms characteristic of diabetes mellitus:
polyuria - allocation of more 1,5-2
l of urine per day;
polydipsia - constant feeling of thirst;
polyphagy - increased appetite.
Each type of diabetes has its own characteristics. The first symptoms of diabetes 1 types usually come on suddenly or develop over a very short period of time. Even diabetic ketoacidosis this type of diabetes can develop in a short time.
In patients with diabetes mellitus 2 type, the course of the disease is asymptomatic for a long time. If certain complaints appear, then the manifestation of symptoms is still not pronounced. Blood glucose levels at the onset of diabetes 2 type can even be downgraded. This condition is called "hypoglycemia".
In the body of such patients, a certain amount of insulin is secreted, therefore, in the early stages of diabetes mellitus 2 type of ketoacidosis, as a rule, does not occur.
There are also less characteristic non-specific signs of diabetes mellitus [b]2 type:
frequent occurrence of colds;
weakness and fatigue;
abscesses on the skin, furunculosis, hard-healing ulcers;
severe itching in the groin area.
Patients suffering from diabetes 2 type, often find out that they are sick, by chance, sometimes after several years from the moment the disease appeared. In such cases, the diagnosis is established on the basis of a detected increase in blood glucose levels or when diabetes is already causing complications.
Diagnosis of type 1 diabetes
Diagnosis of diabetes mellitus 1 type is put by the doctor on the basis of an analysis of the symptoms identified in the patient and the analysis data. To diagnose diabetes, you need to perform the following laboratory tests:a blood test for glucose to detect its elevated content (see table below);
urinalysis for glucose;
glucose tolerance test;
determination of the content of glycosylated hemoglobin in the blood;
determination of C-peptide and insulin in the blood.
Treatment of type 1 diabetes
For the treatment of diabetes 1 type, the following methods are used: drugs, diet, physical exercise.The insulin treatment regimen for each diabetic patient is individually compiled by the attending physician. In this case, the doctor takes into account the patient's condition, and his age, and weight, and the characteristics of the course of his illness, and the body's sensitivity to insulin, as well as other factors. For this reason, there is no single treatment regimen for insulin-dependent diabetes. Self-medication for diabetes 1 type (both insulin preparations and any folk remedies) strictly prohibited and extremely dangerous to life!
Diagnosis of type 2 diabetes
If there is a suspicion that the patient has diabetes mellitus 2 Type, you need to determine the level of sugar in the blood and urine.Usually diabetes 2 type, unfortunately, is detected at a time when the patient has already developed complications of the disease, usually this happens through 5-7 years since the onset of the disease.
Type 2 Diabetes Treatment
For the treatment of diabetes 2 type, you need to follow a diet, exercise, take drugs prescribed by a doctor that reduce blood glucose levels.For those suffering from diabetes 2 type, oral antidiabetic drugs are usually prescribed. Most often they need to be taken once a day. However, in some cases, more frequent medication is required. To increase the effectiveness of therapy helps to combine medicines.
In a significant number of cases of diabetes mellitus 2 type drugs gradually lose their effectiveness in the process of application. These patients are treated with insulin. Besides, in certain periods For example, if a patient with diabetes 2 such as seriously ill with another disease, most often it is required to temporarily change the treatment with tablets to treatment with insulin.
Only the attending physician can determine when taking pills should be replaced with insulin. Purpose of insulin therapy in the treatment of diabetes mellitus 2
type - compensation of the level of glucose in the blood, and consequently, the prevention of complications of the disease. It is worth considering the use of insulin in diabetes mellitus 2
type if:
the patient quickly loses weight;
symptoms of complications of diabetes are revealed;
other methods of treatment do not provide the necessary compensation for the level of glucose in the patient's blood.
1) products for which there are no restrictions in use for diabetes: cucumbers, tomatoes, cabbage, radishes, radishes, green beans, green peas (no more than three tablespoons), fresh or pickled mushrooms, zucchini, eggplant, carrots, herbs, spinach, sorrel; allowed drinks: mineral water, tea and coffee without sugar and cream (you can add a sugar substitute), drinks with a sweetener;
2) foods that can only be consumed in limited quantities: low-fat chicken and beef meat, eggs, low-fat boiled sausage, low-fat fish, fruits (except those included in the third category, see below), berries, pasta, potatoes, cereals, cottage cheese with a fat content of not more than 4 % (preferably without additives), kefir and milk with a fat content of not more than 2 %, low-fat cheese (less 30 % fat), beans, peas, lentils, bread.
3) Foods to be excluded from the diet: fatty meat (even poultry), fish, lard, sausages, smoked meats, mayonnaise, margarine, cream; fatty varieties of cottage cheese and cheese; canned food in oil, seeds, nuts, sugar, honey, all confectionery, chocolate, jam, ice cream, grapes, bananas, persimmons, dates. It is strictly forbidden to drink sugary drinks, juices, alcoholic drinks.
