diabetes

the term"diabetes"There is a whole group of endocrine diseases listed, which have one common feature: they are all based on disorders of carbohydrate metabolism. The body lacks the insulin hormone produced by the pancreas, or the body's cells stop responding adequately to it, causing glucose levels in the plasma to rise. At the same time, even when adequate carbohydrates are provided in food, cells suffer from energy deficit and starvation.Of all endocrine diseases, the most common among women and men is diabetes. More than 250 million people in the world suffer from different types of this condition. In my country, patients with diabetes account for approximately 6% of the total population. In some people, carbohydrate metabolism disorders and diabetes have not yet been discovered, so the true percentage may be almost twice as high.

causes of diabetes

Currently, there is no consensus on why this disease occurs. Today, it is considered multi-causal - there are several theories as to how carbohydrate metabolism disorders and insulin problems occur. Unfavorable genetics play a special role if a close relative has diabetes.Additionally, certain factors and triggers can act as provocateurs. this:

• Malnutrition, too much light carbohydrates, refined foods, fast food, saturated fats and trans fats, and lack of dietary fiber;
• Overweight and obesity (BMI above 30 and fat deposits on the anterior abdominal wall are particularly dangerous);
• Chronic water and electrolyte balance disorders;
• Endocrine pathology (Cushing's disease, hyperthyroidism);
• long-term, chronic physical and psycho-emotional stress;
• Complications of "childhood infections, " especially measles, rubella, and chickenpox;
• Abdominal injuries affecting the pancreas;
• Chronic inflammatory processes and organ pathology - cysts, calcifications, pancreatitis, sclerosis, duct stones.

Babies born to mothers with gestational diabetes may be at high risk for developing diabetes; if a baby is born with a higher weight, he may have problems with blood sugar levels in his first few days of life.

disease symptoms

In its initial stages, diabetes has virtually no noticeable symptoms. Often, the first alarm bells are mistaken for overexertion, infection, or the consequences of stress. But it's important to be aware of combinations of symptoms that, by themselves, may be signs of other conditions, but in combination are indicative of diabetes.The main symptoms of diabetes are:

• Persistent dry mouth, severe thirst, and insufficient or excessive fluid intake;
• Frequent urination and large urine output (up to 3-5 liters or more);
• Dry and itchy skin on feet, elbows, and legs;
• Rapid weight gain or sudden weight loss;
• persistent hunger despite adequate nutrition;
• Increased sweating, and the sweat and breath have a special sweet smell;
• Scratches and wounds on the skin heal slowly;
• Persistent fatigue, lethargy, and decreased performance.

In addition, there may beFainting, loss of consciousness, discomfort, dizziness. Often people first learn of their diagnosis when they are admitted to the hospital in a hyperglycemic or ketoacidotic coma.

type of diabetes

There are two main forms of the disease, which have different causes and mechanisms of progression, and their treatment strategies differ significantly in their initial stages.Type 1 diabetes or insulin-dependent. It occurs when the immune system attacks the cells of the pancreas that synthesize insulin. As a result, hormone production gradually decreases, reaching critical levels, while blood glucose (plasma glucose) levels increase. This form of diabetes is more common in children and young adults; in older adults, pancreatic necrosis due to complicated pancreatitis or organ removal is possible. The basis of treatment is the use of insulin.Type 2 diabetes or insulin resistance (independent)It occurs more commonly in older people or people who are overweight. It occurs due to impaired cell sensitivity to insulin, which often occurs due to obesity and metabolic disorders. It can be corrected with diet and blood sugar-lowering medications.Additionally, there are other specific forms of diabetes:

• pregnancy– Occurs during pregnancy and is associated with metabolic disorders;
• pancreatic origin– Associated with injury, severe damage to the pancreas;
• LADA-Diabetes(stands for latent autoimmune diabetes), symptoms are mild and do not require insulin injection;
• MODY-Diabetes- This is a specific genetic disease.

Any form of diabetes may haveUncomplicated (controlled)andcomplex courses.

complications of disease

If a diabetic patient ignores his doctor's advice, does not follow a diet, or refuses to take medications, the disease may be complicated by serious pathological and physical changes that threaten disability or even life. this:

• Severe visual impairment, damage to the internal structures of the eyeball and its blood vessels;
• Development of persistent hypertension (increased blood pressure);
• Lipid metabolism disorder, "bad" cholesterol increases, leading to atherosclerosis;
• Severe swelling of limbs;
• Frequent headaches, affecting performance;
• Sensory disorders in the limbs (neuropathy), blood flow disorders (vascular disease).

In the context of metabolic disorders, life-threatening conditions may arise -coma. They occur both against the background of an increase in blood sugar and a sharp drop in blood sugar (with incorrect treatment selection and accompanying pathology).

• Hypoglycemia comaIt is dangerous because it develops quite quickly and can lead to serious consequences. This occurs when glucose levels fall below 2. 8 mmol/l. Doctors can help solve this problem by administering a dose of glucose based on an individual's chosen insulin level.
• ketoacidosis comaThis occurs when glucose metabolism in the blood is disrupted by increased metabolism. It breaks down into ketone bodies, which poison the body.
• lactic acid comaThis occurs when glucose metabolism fails and acidic metabolites accumulate, leading to respiratory and circulatory disorders that require intensive care treatment.

diagnosis

Diagnosis is based on laboratory tests, which will detect an increase in glucose in plasma. It is important to have a complete test as a single analysis does not provide enough information - external factors can affect blood sugar levels.Basic laboratory tests to confirm diabetes:

• Blood test for glucose levels (done in the morning on an empty stomach);
• Exercise test (to measure glucose tolerance (blood is collected fasting, then 1 hour and 2 hours after taking a glucose solution);
• Biochemical studies (protein, lipid, electrolyte levels);
• Assess glycated hemoglobin HbA1c levels;
• General and routine urinalysis to measure glucose and protein levels;
• Determination of endogenous insulin levels.

The doctor also prescribes a number of instrumental tests and consultations - an ophthalmologist examination to evaluate the fundus of the eye, a neurologist consultation to evaluate peripheral nerve conditions, blood pressure monitoring, an electrocardiogram, and an ultrasound examination of the internal organs and blood vessels.

treat

Treatment is based on a combination of nonpharmacological approaches, lifestyle changes, and individually selected medications to control diabetes blood glucose levels (fasting and postprandial glucose, activity). Treatment varies depending on the type of disease.for type 1 diabetesThe basis of drug treatment isInsulin injection(Short, long and other types depending on the condition and severity of the situation).with the second typeThe basis of blood sugar treatment and control isdiabetes medicine. They help in lowering blood sugar levels as well as dietary modification. It should be emphasized that treatment is lifelong, with dose adjustment and dynamic monitoring of patients.To manage diabetes, it's important to eat a diet that provides your body with all the necessary nutrients, vitamins, and minerals but doesn't cause sudden spikes in blood sugar. Doctors help correct the diet, teaching patients how to choose the right foods and how to combine them with taking medications or insulin. All products for treating diabetes are divided into categories: those that can be used with confidence, those that need to be reduced, and those that should be eliminated.In addition, doctors recommend lifestyle changes - weight control, physical exercise, regular visits to the doctor to prevent pathological complications.

prevention

To stay healthy and reduce the risk of disease, it is necessary to control your weight, regularly assess carbohydrate and lipid metabolism, and undergo physical examinations. Moderate physical activity, drinking enough fluids and eating a balanced diet that reduces carbohydrates, saturated fats, fast food and refined foods are important.