Diabetes is a hormonal disease accompanied by hyperglycemia (high blood sugar), which occurs due to insulin deficiency.This disease comes with carbohydrate imbalance and other metabolic disorders in the body.
Currently, diabetes are diagnosed at 10-15 % of the planet's population.Cases of developing this disease in childhood have become more frequent, according to regulations, after treatment with antibiotics is unreasonable, stressed and viral infection.There is an annual increase in the number of patients with diabetes to 9-10%.Today, the number of patients with this disease exceeds 200 million.Diabetes is diagnosed in both men and women.
Causes and mechanisms of diabetes development
The results of the aggregate violation and insulin excreted by the beta cells of the small islands of Langerganes, which reduces the level of insulin in the blood, over time leading to absolute insulin deficiency.The relative insulin deficiency is also found, which may be the result of reducing insulin activity due to its increase in protein, destroying liver enzymes, the circulation rate of non -anti -cancer substances of insulin -dependent tissues to insulin.
Insulin deficiency causes protein disorders, carbohydrates and fat metabolism in the body.The permeability of glucose of cell membranes and adipose tissue is reduced, gluconeogenesis and glycogenolysis are enhanced, urinary glucose, hyperglycemia occurs, accompanied by polydipsy and multi -uria.The enhanced decay and the formation of fat are reduced, which causes an increase in the level of ketone bodies in the blood (acetone-condensation product of acetouxic acid, beta-oxyma acid and acetouxus acid).These phenomena cause a change in acid-base balance towards acidosis, and also affects the increase in the secretion of magnesium, sodium, potassium in the urine and leads to kidney dysfunction.
It is possible to reduce the alkaline reserves of blood by 25%.Carbon dioxide and blood pH level decreased to 7.2-7.0.
How to develop type I diabetes
The causes of the development of diabetes are different, depending on the type of diabetes.For example, patients with diabetes, due to autoimmune and viral aggression, are expanded by beta cells in the body, due to the lack of development with all the next consequences.
How to develop type II diabetes
Patients with diabetes II have sufficient insulin, but body tissue loses its signal aware.With the development of obesity, fat tissue acts as a type of barrier that prevents insulin effects.To eliminate this barrier, beta cells include intensive operation mode, then lead to their decline and conversion of relatively luxurious insulin deficiency.However, insulin dependent diabetes must not be converted to insulin dependent.
Regardless of the cause in the development of diabetes, the same process takes place in the slow down of the transformation from outside and available in the blood.
Classification of diabetes
Depending on the clinical characteristics, the following types of diabetes are distinguished:
- I have diabetes, it's my turn to have a number of species:
- Diabetes dependent insulin;
- Diabetes dependent insulin:
- In people who are obese;
- In people with normal weight.
- Diabetes, its development is not enough nutrition;
- Another verification of type I diabetes related to a certain number of syndrome and body condition:
- Endocrine pathology;
- anomalous insulin or its receptor;
- pancreatic disease;
- some genetic syndrome;
- conditions caused by the effect of chemicals or medication;
- The state of the mixed cause;
- II Type of diabetes shows violations of glucose tolerance and is divided into such forms:
- In patients without excessive weight;
- In people who are obese;
- Caused by a certain state or syndrome.
- Type III diabetes can develop during pregnancy.
The specific types of static risks of this disease have been determined (patients with normal glucose tolerance, but there is a significant risk of diabetes):
- A state before violating glucose tolerance;
- Potential glucose intolerance.
Diabetes needed (Nguyen Phat)
The type of diabetes (primary) is essential, related to malnutrition, emphasized as a separate disease.This disease occurs in people under 30 years old living in tropical countries.According to statistics, the rate of men and women is 2: 1. The total number of patients with this diabetes is 20 million.
There are usually two subgroups of this diabetes.First of all of them are pancreatic diabetes.
Fibrocalcule's pancreatic diabetes
On the territory, it mainly includes Indonesia, India, Brazil, Bangladesh, Uganda and Nigeria.This pathology is characterized by the presence of broad pancreas and the formation of rocks in the main duct of the pancreas.The clinical picture is manifested by weight loss, recurrent abdominal pain and other signs of nutrition are not enough.In this case, insulin therapy allows medium and high urinary removal and hyperglycemia.One of the typical signs of this pathology is Ketoacidosis deficiency, due to reduction in insulin production and glucagon release by the pancreatic island movement.Terrain studies (ultrasound diagnosis, X -ray, computerized tomography) allow the determination of the presence of stone in pancreatic ducts.
There is an idea that one of the factors in the development of fibrous diabetes is the consisting of Manioca roots (cassava, sapioka) in a diet, containing glycoside cyanogen, one of which is linamarin, from which cyanistoric acid is released during hydrolysis.With the participation of sulfur -containing acids, its adverse effects are removed and not enough protein food, often found in the population of the above countries, causing the accumulation of cyanide in the body, which is the cause of the development of fibrosis.
Pancreatic diabetes
The development of pancreatic diabetes (type II diabetes) has a relationship with a decrease in protein in the body, but there is no manifestation of pancreatic fibrosis.It is characterized by moderate insulin resistance and resistance to the development of ketoacidosis.In most cases, the patient is exhausted.Patients have reduced insulin secretion, but not a measure as in patients with type I diabetes, which explains the lack of ketoacidosis.
Group j
In the classification of diabetes, according to WHO data, presented above, there is no reference about the third subgroup of pancreatic diabetes, found on Jamaica, we are talking about J.
Symptoms of diabetes
The first symptoms of diabetes occur due to high blood sugar content.After exceeding 8.9 row 10.0, the road enters the urine.When continuing to increase the level of glucose in the blood, the kidneys also remove water, this is clinically manifested by fast urinating (multi -urinary).Excessive urine isolation causes continuous thirst (polydipsy).With urine, the body loses a large amount of calories expressed in glucose, so a person who lost weight and constantly feels hungry.
Among other symptoms of diabetes, such as drowsiness, vision loss, fatigue and nausea are distinguished.In addition, patients with non -compensated diabetes are prone to infection.Patients with type I diabetes are noticeably deficiency of insulin and because of this, almost always lose weight before starting treatment.Patients with diabetes II do not lose weight of the body.
With type I diabetes, the rapid growth of clinical manifestations occurs and soon it can progress into diabetic ketoacidosis.Regardless of the high level of glucose in the blood, cells do not have the opportunity to use it without the presence of insulin, so they switch to other energy sources.The destruction of fat cells begins, causing the formation of Ketone bodies, which are toxic chemical compounds "acidic" blood.
Ketoacidosis diabetes
The first symptoms of diabetic ketoacidosis are manifested in excessive urination and thirst for too much, nausea, vomiting, fatigue, weight loss and abdominal pain (especially in childhood).Patients with regular and deep breathing, related to the body's efforts to neutralize the excessive acidity of the blood, this process comes with the appearance of acetone odor from the mouth.In case of non -treatment, diabetic ketoacidosis may be complicated due to the development of coma, in some cases, this process occurs within hours.
Type I diabetes may be accompanied by the development of ketoacidosis even after starting treatment with insulin if the patient passes out injected as planned or experienced severe emotions, especially in injury, severe infections or other serious illnesses.
Patients with type II diabetes for a long time may not feel any signs of this disease.Such hidden periods of the disease may last for several decades.Clinical manifestations are activated when insulin deficiency worsen.
At first, the mass of specialized urine exceeded the target, thirst was weak, but over time, these processes progress.Ketoacidosis phenomena are very rare.With a significant increase in blood glucose level (in some cases, up to 55 mmol/l), this often occurs with additional loads on the body, for example, under the effects of the drug or with serious infectious diseases Hyperosmolar Mate.
How other is diabetes manifestation
The high level of glucose in the blood over time can lead to damage to nerves, blood vessels and other structures.The chemical compounds containing glucose are placed on the walls of small blood vessels, so the walls of the ships are thick and damaged.The narrowing of the gap of blood vessels causes a decrease in blood flow, especially the blood supply to the skin and nerves.There is no compensation for blood diabetes, the increase in the level of fats occurs, which increases the growth rate of atherosclerosis.The patient is diagnosed with diabetes, regardless of gender, atherosclerosis is 2-6 times more often than those who do not have this diagnosis.Violating blood vessels during blood circulation causes dysfunction from the heart, kidney, eyes, lower limb, brain, skin and nerve, and also slows wound healing.
What is the severity of diabetes
All of these factors increase the risk of developing many remote complications.In patients with diabetes, the risk of stroke and heart attack increases, caused by damage to the blood vessels of the eye, pathological loss (diabetic retinopathy), renal disorders that cause kidney failure, so in some cases, dialysis.Damage to nerves can lead to many consequences.Mononeuropathy Hospital (the weakened function of a nerve) can be manifested by a sudden weakness of the upper or lower limb.Diabetes diabetes (damage to the nerves of the legs, feet or arms) causes sensitive disorders, pain, burns or tingling, weakness in the arms and legs.Temperature and sensitivity relieve pain, leading to an increase in injury.The circulatory disorder may contribute to the appearance of ulcers and healing poorly.The sores located on the foot are very deep and poorly treated, leading to infections and, in some cases, to remove the affected limb.
Clinical studies have shown that it is possible to avoid or expire, if you continuously maintain normal blood sugar.The process of this disease is not fully studied.There are a number of not discovered factors that cause its development, genetic factors including the number of these factors.
Diagnosis of diabetes
Diagnosis of diabetes begins with collecting anamnesis disease and testing patients.In these measures, the patient has the presence of genetic and obesity factors, even if the patient belongs to the number of single twins (if one of them has diabetes, the second must be tested), women specify the presence of childbirth and whether the fruit is large or not.
Here are some laboratory tests, including:
- Blood test for glucose concentration is done twice;
- Glucose tolerance test;
- Determine the degree of glucose in the urine daily.
With diagnosis of diabetes, it is very important to find the presence of complications;For this, all organs and systems are diagnosed.
Complications of diabetes
The complications of diabetes may be acute and chronic, they are also divided depending on the form of diabetes.Among the acute complications, the states of coma are distinguished, in which the loss of consciousness is ahead by brain disorders due to blood sugar levels very low or very high.Such conditions include:
- Ketoacitosis diabetes (the most common complication of acute nature) is manifested by polyur, polydipsy, lack of appetite, weak, abdominal pain, nausea and vomiting;
- A coma hypoglycemia, is a degree of extreme hypoglycemia, which occurs with a sharp decrease in the level of glucose in the blood.Often it is the result of the introduction of an irregular insulin dose, and sometimes it occurs after using some foods or sulfanilamide.
- Hyperosmolar comics about the severity of the state far beyond diabetes patients, mainly found in the elderly, with type II diabetes.In 30% of cases, the cause of the patient's death becomes, and with the presence of serious diseases - in 70%.
Chronic (late) complications are combined into a group of developed diseases with prolonged contact with high blood sugar on organs and systems of the patient.First of all, organs are more sensitive to damaged sugar, they are a kind of Muslim target for diabetes.Among the chronic complications of diabetes, the following is known:
- Diabetes retinopathy is observed in 90% of patients with diabetes.Developed with a long process of diabetes and is manifested by damage to the vessels of the retina;
- Kidney diabetes includes complex lesions to the kidneys (tubes, arteries, glomerular, artery urine).The incidence of diabetics is 75%;
- Diabetic neuropathy is manifested by damage to peripheral nerves in patients with diabetes.Neuropathy is a factor in the development of a diabetes foot, which can lead to amputation;
- Diabetes is a brain damage, progressing.It is shown by increasing fatigue, reducing performance, impairing attention, emotional ability, headache, anxiety and worsening the thought process;
- Diabetes lesions of the skin are the structural deformation of the epidermis, follicles, sweat glands due to violations of carbohydrate metabolism and accumulate metabolic products.In the case of a serious type of diabetes, the skin becomes peeling and rough, with areas of homosexuals, cracks, skin gain yellow, hair loss occurs;
- Diabetes feet and brush syndrome occurs at 30-80% of patients with diabetes and is a complex of anatomical disorders and functions that appear in the form of brown spots and ulcers on the lower legs, legs and phalanx of the finger, in serious cases that can lead to removal.
Treatment of diabetes
Treatment of diabetes depends on the type of disease, but first of all, patients need to normalize blood glucose levels.To do this, you need to completely change your lifestyle and diet.A special diet is recommended for patients with diabetes, based on the calculation of carbohydrates, proteins and fats, vitamins and trace elements.This calculation is taught by experts in this field.
The tactical selection of drug therapy depends on the type of diabetes.Patients with diabetes are needed to conduct insulin treatment, with type II, it has been shown to comply with the most stringent diet and use of glucose -containing agents, with the inefficient properties of drug forms, insulin is prescribed.
Insulin is used under strict control of blood glucose levels.Insulin preparations according to the operating mechanism are divided into three types: long, short and intermediate actions.The drug is likely to be indicated in the case of diabetes dependent insulin in combination with diet.The drug is likely to be: Biguanides, sulfonylmochevina, thiazolidindindyons and meglitinides.
With this implicit disease, it is very important for health workers to teach patients and his relatives skills to monitor patient status and first aid in the previous and coma.
Predicting diabetes
With the presence of diabetes, the patient is registered with the endocrinologist.In adequate treatment conditions, patients may be in a satisfactory condition for a long time.To aggravate the prognosis related to the health and longevity of a patient with diabetes can develop acute and chronic complications.
Prevention of diabetes
With type I diabetes, preventive measures are to increase the body's resistance to various infections and eliminate the toxic effects of antibodies on the pancreas.For patients with II, diabetes is important to adjust nutrition and prevent the growth of obesity.In order to prevent the development of complications under the conditions of diabetes, it is necessary to comply with the exact and systematically with the doctor's recommendations and clarify whether this food may be consumed.