Diabetes mellitus is a group of metabolic diseases that lead to an uncontrolled increase in blood sugar levels (hyperglycemia). Normally, the hormone insulin produced by the pancreas controls the uptake of glucose by cells and carbohydrate metabolism in the body. Various pathological conditions can lead to insufficient secretion of insulin (type I diabetes) or cellular resistance to this hormone (type II diabetes). Doctors include frequent urination, constant thirst and a strong feeling of hunger among the symptoms of the disease. Without treatment, elevated blood sugar levels can be complicated by diseases of the heart, blood vessels, nervous system, lower extremities and organ of vision.
Diabetes mellitus is one of the most common diseases of the endocrine system. About 8% of people will be diagnosed with various types of diabetes during their lifetime, and widespread dietary habits increase the number of patients every year. With proper symptomatic treatment and nutrition, patients' quality of life remains at an appropriate level.
About the disease
Diabetes ranks second among all endocrine pathologies in terms of frequency of detection. The disease occurs in one in ten people, but there are also hidden forms in which the patient is not even aware of the problem. The main reason is a lack of insulin, which leads to disruption of all metabolic processes.
species
According to the classification of diabetes mellitus, there are symptomatic and true forms. The first develops against the background of a specific disease and disappears after eliminating the cause. True diabetes is divided into two types.
- Type I: Insulin-dependent diabetes or childhood diabetes. Usually develops in childhood or adolescence. Caused by a lack of insulin in the body against the background of damage to the cells of the pancreas. People with this type of diabetes constantly need external insulin.
- Type II: non-insulin-dependent or adult-onset diabetes. It most commonly occurs in adults, but is now also widespread in children and adolescents. It is caused by the body's tissues becoming insensitive to insulin, causing them to normally no longer absorb glucose. People with this type of diabetes can control their blood sugar levels through proper diet, physical activity, and blood sugar-lowering medications. In severe cases, the use of insulin may be necessary.
An exception is diabetes in pregnant women (gestational diabetes). It develops exclusively during pregnancy and disappears after birth. Requires diet and, if this does not help, insulin therapy.
The severity of diabetes depends on the level of blood sugar control and the presence of complications. There are several classifications, the main one of which is based on the level of glycated hemoglobin (HbA1c). This is an indicator that reflects the average blood sugar level over the last 2-3 months.
- Mild degree (HbA1c less than 6. 5%): Blood sugar level is within normal limits or close to normal, pathological manifestations are minimal.
- Moderate (HbA1c 6. 5-7. 9%): Glucose levels are slightly elevated, specific symptoms or early signs of complications appear.
- Severe (HbA1c 8% or higher): characterized by significant blood sugar levels, severe symptoms and complications.
Similar criteria are used to differentiate between compensated, subcompensated and decompensated diabetes mellitus.
Symptoms of diabetes
Symptoms depend on the form and severity of the disease. Type 1 diabetes develops more quickly and often causes complications in young people, while type 2 diabetes may not show symptoms for a long time. Pathologies can often only be detected with the help of special studies.
Possible symptoms and signs:
- Frequent urge to urinate and increased urine volume;
- Severe thirst and intake of large amounts of fluid;
- dryness of the oral mucosa;
- Impaired visual acuity and dizziness;
- Pronounced appetite, gluttony;
- The appearance of ulcers in various parts of the skin, prolonged wound healing;
- insomnia and fatigue;
- Decreased performance;
- Unexplained weight loss or obesity;
- Frequent occurrence of infectious diseases.
Only a doctor can accurately distinguish the signs of different types of diabetes. The prolonged course of the disease contributes to the appearance of additional symptoms associated with complications.
Causes of diabetes
Diabetes mellitus arises from a dysfunction of the pancreas or a disorder of cell regulation in which even sufficient insulin production does not help lower blood sugar levels. Doctors include obesity, pancreatic diseases, low physical activity, unfavorable heredity and other medical conditions as risk factors for the disease. Type 1 diabetes is usually diagnosed in men and women before the age of 30. Older people who are obese have a higher risk of developing type II diabetes. At the same time, different types of disorders can occur in patients of any age, so one should not focus only on risk factors.
Possible causes and risk factors:
- Genetic disorders that contribute to the development of autoimmune and pancreatic diseases. Relatives with diabetes are an important risk factor;
- Obesity. The accumulation of excess adipose tissue contributes to metabolic disorders in which the tissue becomes less sensitive to insulin;
- Immunodeficiency, characterized by damage to pancreatic tissue;
- Viral infections and the effects of toxins on the pancreas;
- taking corticosteroids and other medications that contribute to the development of diabetes;
- adrenal dysfunction;
- Cardiovascular diseases.
Diabetes mellitus is rarely a congenital disease, however, hereditary factors lead to the rapid development of this disease at any age.
Diagnosis of diabetes mellitus
To diagnose the disease, you need to make an appointment with an endocrinologist. The doctor conducts a consultation during which he examines the patient's complaints and takes an anamnesis to identify risk factors for diabetes. Through special examinations, a persistent increase in blood sugar levels and other clinical signs of diabetes are detected, so the endocrinologist, after consultation, prescribes all the necessary procedures.
Tests carried out:
- Fasting blood test. The endocrinologist asks the patient to avoid eating for a few hours before bedtime and in the morning before the study. During the procedure, the specialist treats the skin of the finger with an antiseptic, makes a small puncture with a scarifier and collects a small amount of blood in a special container. A sign of diabetes mellitus can be a glucose content of more than 6. 5 mmol/l in the sample taken;
- Blood test for the content of glycosylated hemoglobin. The level of this substance indicates the level of glucose in the blood for 3 months, so the doctor prescribes such a test for primary diagnosis and monitoring of diabetes treatment. A concentration of glycosylated hemoglobin above 6. 5% indicates the presence of diabetes mellitus;
- Stress test. The first phase of the study is a standard determination of fasting blood glucose levels. Then the doctor asks the patient to drink a glass of water with sugar and takes another blood test after 2 hours. If the results of the first test show a moderate blood sugar level (up to 6. 5 mmol/L) and the second test shows a significant increase in blood sugar levels (about 11 mmol/L), the diagnosis is confirmed;
- Blood test for C-peptide content. An endocrinologist prescribes this test to reliably assess insulin production over a period of time;
- Blood test possible at any time. This test is used to confirm signs of the disease. A concentration of more than 10 mmol/L glucose in several blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urinalysis. Patients with diabetes have high levels of glucose in their urine. In addition, the patient's urine may contain ketone bodies, which indicates a disorder of glucose metabolism.
If necessary, the endocrinologist prescribes consultations with a neurologist, cardiologist, nephrologist and other specialists to exclude dangerous complications of the disease. Pregnant women must consult an obstetrician-gynecologist.
Expert opinion
Diabetes mellitus is a very dangerous and at the same time common disease. It may be preceded by prolonged hyperglycemia, which does not cause any symptoms, but a rapid onset is also possible when pronounced symptoms of diabetes mellitus appear under the influence of one or another factor. You will need to be treated for this disease for the rest of your life because if it is not controlled, your sugar levels will rise again. If the patient ignores treatment, complications of pathology may occur: hypo- or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), pathologies of nerve fibers (diabetic neuropathy). In severe cases, gangrene develops, usually affecting the toes.
Treatment of diabetes
The endocrinologist examines the diagnostic results and prescribes the appropriate treatment. The main goals are to reduce blood sugar levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, the endocrinologist must prescribe the patient a special diet to control blood sugar levels. Compliance with all doctor's recommendations makes it possible to significantly improve the quality of life and avoid the negative consequences of diabetes.
To correct the pathology, two types of drug therapy are used.
- Prescribing medications that lower blood sugar levels. Depending on the diagnostic result and the patient's medical history, the endocrinologist prescribes sulfonylureas, meglitinides, alpha-glucosidase inhibitors, biguanides or thiazolidinediones. Often it is necessary to take several medications with strict adherence to the dosage and monitoring blood sugar levels. The listed drugs improve insulin production by the pancreas, stimulate tissue sensitivity to glucose and reduce the absorption of glucose from food;
- Administration of insulin by injection. The endocrinologist prescribes this type of treatment to all patients with type 1 diabetes mellitus and patients with type 2 diabetes mellitus when blood sugar-lowering drugs are ineffective or contraindicated. Insulin therapy is also prescribed for pregnant women with gestational diabetes. First, the endocrinologist prescribes long-acting insulin injections - this medicine must be taken once a day, regardless of diet. Fast-acting insulin preparations are administered in hospitals to treat complicated forms of diabetes and when blood sugar levels rise sharply. The doctor explains the rules for using injections and the required dosages. The consultation will also explain the importance of regularly monitoring blood sugar levels using blood glucose meters.
The endocrinologist selects an individual treatment regimen and also adjusts the dosage of medications and prescriptions during treatment. Repeated consultations allow you to solve problems related to disease complications and side effects of medications. In addition, the specialist must show how the medicine is administered and explain all the rules of treatment.
Prevention of diabetes
Every year, diabetes is diagnosed more and more frequently. Medical advice can help prevent the development of this disease.
Main prevention methods:
- Normalization of body weight and moderate physical activity;
- Timely treatment of pancreatic diseases;
- A healthy diet that includes sufficient consumption of vegetables and fruits.
questions and answers
How does the diagnosis of diabetes mellitus begin?
To detect the pathology, blood is first donated to determine blood sugar levels. If there are any deviations, the doctor will order additional examinations.
How can you prevent diabetes complications?
Follow your doctor's recommendations regarding diet and medication. The main criterion is normal blood sugar concentrations.