Diabetes mellitus is a group of metabolic diseases that cause an uncontrolled increase in blood sugar levels (hyperglycemia). Normally, the hormone insulin, produced by the pancreas, controls the uptake of glucose by cells and the metabolism of carbohydrates in the body. Various pathological conditions can cause insufficient secretion of insulin (diabetes type I) or resistance of cells to this hormone (diabetes type II). Doctors include frequent urination, constant thirst and a strong feeling of hunger as symptoms of the disease. Without treatment, elevated blood sugar levels can be complicated by diseases of the heart, blood vessels, nervous system, lower limbs and organs of vision.
Diabetes mellitus is one of the most common diseases of the endocrine system. Various types of diabetes are diagnosed in approximately 8% of people during their lifetime, and widespread dietary patterns increase the number of patients each year. With proper symptomatic treatment and diet, the quality of life of patients is maintained at a decent level.
About the disease
Diabetes is the second most frequently detected among all endocrine pathologies. The disease occurs in every tenth person, and there are also hidden forms, when the patient is not even aware of the problem. The main reason is the 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 certain disease and disappears after the removal of the cause. True diabetes is divided into two types.
- Type I: insulin-dependent or juvenile diabetes. It usually develops in childhood or adolescence. It is 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 need constant external insulin.
- Type II: non-insulin-dependent or adult-onset diabetes. It most often develops in adulthood, but it is now common among children and adolescents. It is caused by the insensitivity of body tissues to insulin, as a result of which they cease to absorb glucose normally. People with this type of diabetes can control their blood sugar levels with proper diet, exercise, and blood sugar-lowering medications. In severe cases, the use of insulin may be necessary.
Diabetes in pregnant women (gestational diabetes) stands separately. It develops exclusively during pregnancy and disappears after birth. It requires diet and, if that doesn't 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 being based on the level of glycated hemoglobin (HbA1c). This is an indicator reflecting the average level of blood sugar over the past 2-3 months.
- Mild degree (HbA1c less than 6. 5%): blood sugar levels are within normal limits or close to normal, manifestations of pathology are minimal.
- Moderate (HbA1c 6. 5-7. 9%): glucose levels are slightly elevated, there are specific symptoms or initial signs of complications.
- Severe (HbA1c 8% or higher): characterized by a significant level of glycemia, severe symptoms and complications.
According to similar criteria, compensated, subcompensated and decompensated diabetes are distinguished.
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 any symptoms for a long time. Often the pathology can be detected only with the help of special tests.
Possible symptoms and signs:
- Frequent urges to urinate and increased urine volume;
- Strong thirst and consumption of large amounts of liquid;
- Dryness of the oral mucosa;
- Impaired visual acuity and vertigo;
- Expressed appetite, gluttony;
- The appearance of ulcers on various parts of the skin, prolonged healing of wounds;
- Insomnia and fatigue;
- Reduced working capacity;
- Unexplained weight loss or obesity;
- Frequent occurrence of infectious diseases.
Only a doctor can accurately distinguish the signs of different types of diabetes. The long course of the disease contributes to the appearance of additional symptoms associated with complications.
Causes of diabetes
Diabetes mellitus occurs due to pancreatic dysfunction or cellular dysregulation, where even sufficient insulin production does not help to reduce blood sugar levels. Doctors include obesity, pancreatic pathologies, low physical activity, unfavorable heredity and other 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 are more likely to have type II diabetes. At the same time, different types of disorders can appear in patients of any age, so you should not focus only on risk factors.
Possible causes and risk factors:
- Genetic disorders that contribute to the development of autoimmune diseases and pancreatic pathologies. Having relatives with diabetes is an important risk factor;
- obesity. Accumulation of excess adipose tissue contributes to metabolic disorders in which tissues become less sensitive to insulin;
- Immune dysfunction characterized by pancreatic tissue damage;
- Viral infections and the effects of toxins on the pancreas;
- Taking corticosteroids and other drugs that contribute to the development of diabetes;
- Adrenal dysfunction;
- Cardiovascular pathologies.
Diabetes mellitus is rarely a congenital disease, but hereditary factors are the reason for 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 collects an anamnesis to identify risk factors for diabetes. The continuous increase in blood sugar levels and other clinical signs of diabetes are detected by special tests, so the endocrinologist, after consultation, prescribes all the necessary procedures.
Examinations carried out:
- Fasting blood test. The endocrinologist asks the patient to refrain from eating a few hours before going to bed and in the morning before the examination. During the procedure, the specialist treats the skin of the finger with an antiseptic, makes a small puncture using a scarifier and collects a small amount of blood in a special container. A sign of diabetes mellitus can be a glucose content above 6. 5 mmol/l in the sample obtained;
- Blood test for glycosylated hemoglobin content. The level of this substance shows the level of glucose in the blood for 3 months, so the doctor prescribes such a test for primary diagnosis and monitoring the treatment of diabetes. A concentration of glycosylated hemoglobin above 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first stage of the study is a standard determination of fasting blood sugar levels. The doctor then asks the patient to drink a glass of water with sugar and after 2 hours conducts a repeat blood test. If the results of the first test reveal a moderate level of glucose in the blood (up to 6. 5 mmol/l), and the second test shows a significant increase in the level (approximately 11 mmol/l), then 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;
- A blood test is performed 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 the time of the meal, indicates the presence of diabetes mellitus;
- Urinalysis. Diabetic patients 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 rule out dangerous complications of the disease. Pregnant women should consult an obstetrician-gynecologist.
Expert opinion
Diabetes mellitus is a very dangerous and at the same time common disease. It can be preceded by a long period of hyperglycemia, which does not produce symptoms, but a rapid onset is also possible, when under the influence of one or another factor, pronounced symptoms of diabetes mellitus appear. You will need to be treated for this disease for the rest of your life, because if it is not controlled, your sugar level will rise again. If the patient neglects treatment, he may encounter complications of the pathology: hypo- or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), nerve fiber pathologies (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.
Treatment of diabetes
The endocrinologist studies the results of the diagnosis and prescribes 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 the doctor's recommendations allows you to significantly improve the quality of life and avoid the negative consequences of diabetes.
Two types of drug therapy are used to correct the pathology.
- Prescribing medications that lower blood sugar levels. Depending on the results of the diagnosis and the patient's history, the endocrinologist prescribes sulfonylureas, meglitinides, alpha-glucosidase inhibitors, biguanides or thiazolidinediones. It is often necessary to take several medications with strict adherence to dosage and monitoring of blood sugar levels. The listed drugs improve the production of insulin by the pancreas, stimulate the sensitivity of tissues to glucose and reduce the intake of glucose from food;
- Injection of insulin. The endocrinologist prescribes this type of treatment to all patients with diabetes mellitus type 1 and patients with diabetes mellitus type 2 if drugs that lower blood sugar levels are ineffective or contraindicated. Insulin therapy is also prescribed to pregnant women with gestational diabetes. First of all, the endocrinologist prescribes long-acting insulin injections - this drug must be taken once a day, regardless of meals. Rapid-acting insulin preparations are administered in hospitals to treat complicated forms of diabetes and in the event of a sharp increase in blood sugar levels. The doctor explains the rules for using injections and the required doses. The consultation also explains the importance of regular monitoring of blood sugar levels using glucometers.
The endocrinologist chooses an individual treatment regimen, and also adjusts the dosage of drugs and prescriptions during treatment. Repeated consultations allow you to solve problems related to the complications of the disease and side effects of drugs. In addition, the specialist must show how to administer the drug and explain all the treatment rules.
Prevention of diabetes
Every year, diabetes is diagnosed more and more often. Medical advice will help prevent the development of this disease.
Basic prevention methods:
- Normalization of body weight and moderate physical activity;
- Timely treatment of pancreatic diseases;
- A healthy diet including adequate consumption of vegetables and fruits.
Questions and answers
How is the diagnosis of diabetes mellitus started?
To identify the pathology, first of all, blood is donated to determine blood sugar levels. If there are deviations, the doctor will order additional tests.
How to prevent diabetes complications?
Follow your doctor's recommendations regarding diet and medication. The main criterion is the normal concentration of glucose in the blood.