Terminology"diabetes"name a group of endocrine diseases, united by a common feature: they are based on disorders of carbohydrate metabolism. The body has a deficiency of the hormone insulin produced by the pancreas or the body cells stop responding adequately to it, causing plasma glucose levels to increase. In this case, the cells are deprived of energy and starve, even when provided with enough carbohydrates from food.
Among all endocrine diseases, diabetes in women and men is the most common. There are more than 250 million people in the world suffering from these diseases. In our country, diabetics account for about 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes have not yet been identified, so the actual incidence may be nearly twice as high.
Causes of diabetes
Today there is no consensus on why this disease occurs. Today it is considered multifactorial - there are several hypotheses about the occurrence of disorders of carbohydrate metabolism and problems with insulin. A special role is played by unfavorable heredity if relatives have diabetes.
In addition, certain factors and agents can become provocateurs. This:
- poor nutrition with an excess of light carbohydrates, refined foods, fast food, saturated and trans fats, lack of fiber;
- overweight and obesity (BMI over 30 and fat accumulation in the anterior abdominal wall are especially dangerous);
- chronic water-electrolyte balance disorders;
- endocrine diseases (Cushing's disease, hyperthyroidism);
- long-term, chronic physical and psychological stress;
- complications of "childhood infections, " especially measles, rubella, and chickenpox;
- abdominal trauma affecting the pancreas;
- chronic inflammatory processes and organ pathologies - cysts, calcifications, pancreatitis, sclerosis, duct stones.
A high risk of diabetes may occur in children born to mothers who had the disease during pregnancy; If a child is born with a high birth weight, he or she will have problems with sugar levels in the first days of life.
Symptoms of the disease
In the early stages, diabetes has practically no noticeable symptoms. Often, the first warning bells are mistaken for overwork, infection or the consequences of stress. But it is important to pay attention to the combination of symptoms, which on their own can be signs of other diseases, but when combined indicate the manifestation of diabetes.
The main signs of diabetes are:
- constant dry mouth, severe thirst when drinking enough or too much liquid;
- frequent urination, large amount of urine (up to 3-5 liters or more);
- dry skin, itchy feeling in the feet, elbows, and legs;
- rapid weight gain or sudden weight loss;
- constant hunger despite proper nutrition;
- increased sweating, characteristic sweet smell of sweat and breath;
- slows down scratches and wounds on the skin;
- constant fatigue, drowsiness, decreased performance.
Additionally, there may befainting, loss of consciousness, discomfort, dizziness. Often, people first learn about their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidotic coma.
Types of diabetes
There are two main forms of the disease, which have different causes and mechanisms of development, and in the early stages they differ significantly in treatment tactics.
Type 1 or insulin-dependent diabetes. It occurs due to an attack by the immune system against pancreatic cells that synthesize insulin. As a result, hormone production gradually decreases, reaching critical levels, while blood sugar (plasma glucose) levels increase. This form of diabetes occurs more often in children and young adults; In the elderly, pancreatic necrosis may occur due to complicated pancreatitis or removal of an organ. The basis of therapy is the use of insulin.
Type 2 diabetes or insulin resistance (independent)occurs more often in older people or people who are overweight. It occurs due to impaired cell sensitivity to insulin, often caused by obesity and metabolic disorders. Can be adjusted with diet and hypoglycemic medications.
In addition, there are other specific forms of diabetes:
- pregnant– occurs during pregnancy and is associated with metabolic disorders;
- cause pancreas– related to trauma, serious damage to the pancreas;
- LADA-diabetes(short for latent autoimmune diabetes), has mild symptoms, does not require insulin injections;
- MODY diabetes- This is a special, hereditary form of the disease.
Any form of diabetes can be presentuncomplicated (controlled)Andcomplex course.
Complications of the disease
If a diabetic patient ignores the doctor's recommendations, does not follow the diet or refuses to take medication, the disease can be complicated by serious pathologies and changes in the body that threaten disability. disability, even life-threatening. This:
- severe visual impairment, damage to the internal structures of the eyeball and its blood vessels;
- formation of persistent hypertension (hypertension);
- lipid metabolism disorders, increased "bad" cholesterol leading to atherosclerosis;
- severe swelling of limbs;
- Frequent headaches reduce performance;
- sensory disturbances in the limbs (neuropathy), blood flow disorders (vascular pathology).
Against the background of metabolic disorders, life-threatening conditions can occur -comatose. They develop both against the background of an increase in blood sugar and against the background of its sharp decrease (with incorrectly selected treatment methods, accompanying pathologies).
- hypoglycemic comaIt is dangerous because it develops quite quickly and can lead to serious consequences. It occurs when glucose levels fall below 2. 8 mmol/l. Doctors can help solve this problem by providing doses of glucose with individually selected insulin levels.
- ketoacidotic comaoccurs when glucose metabolism is disrupted as it increases in the blood. It breaks down into ketone bodies, which are toxic to the body.
- Lactate comaoccurs when there is a disturbance in glucose metabolism, causing acidic metabolic products to accumulate, leading to respiratory and circulatory disorders and requiring treatment in an intensive care unit.
Diagnose
The basis of diagnosis is testing, will detect an increase in plasma glucose. It is important to carry out the entire examination, since a single analysis does not give much information - external factors can affect blood glucose levels.
Basic laboratory tests confirm diabetes:
- blood test to determine blood sugar level (done in the morning, on an empty stomach);
- stress test (determination of glucose tolerance (blood is taken on an empty stomach, then 1 and 2 hours after drinking a glucose solution);
- biochemical studies (protein, lipid, electrolyte concentration);
- assess the level of glycosylation of hemoglobin HbA1c;
- General and daily urinalysis to determine glucose and protein concentrations;
- Determine endogenous insulin concentration.
The doctor also prescribes a number of tests and instrumental consultations - examination by an ophthalmologist to evaluate the fundus of the eye, consultation with a neurologist to evaluate the condition of the peripheral nerves, monitoring of blood pressure, electrocardiogram and ultrasound of internal organs and blood vessels.
Treatment
The basis of treatment is a combination of non-pharmacological methods and lifestyle changes with the selection of each drug to control blood sugar levels in diabetes (fasting and post-meal blood sugar, activity). ). Treatment methods vary depending on the type of disease.
For type 1 diabetesThe basis for drug treatment isInsulin injection(short, long and other types depending on the severity of the disease and condition).With the second typeThe basis of glucose handling and control isdiabetes medicine. They help reduce glucose levels along with dietary adjustments. It is important to emphasize that treatment is carried out for life, with dosage adjustments and active monitoring of the patient.
To control the diabetic condition, it is important to follow a diet that provides the body with all the necessary nutrients, vitamins and minerals but does not cause sudden spikes in sugar levels. in blood. Doctors help adjust the diet, instruct patients on how to choose appropriate foods and combine them with medication or insulin. All diabetes products are divided into groups - those that can be used without fear, those that need to be reduced and those that should be excluded.
In addition, doctors recommend lifestyle changes - weight control, physical activity, regular visits to the doctor to prevent complications of the disease.
prevent
To maintain health and reduce the risk of developing disease, it is necessary to control weight, regularly evaluate carbohydrate and lipid metabolism and have medical examinations. Moderate physical activity, adequate fluid intake and a balanced diet with reduced intake of carbohydrates, saturated fats, fast food and refined foods are important.