Diabetes mellitus is a group of metabolic diseases that cause an uncontrolled increase in blood glucose levels (hyperglycemia). The hormone insulin, normally produced by the pancreas, controls the absorption of glucose by cells and the metabolism of carbohydrates in the body. Various pathological conditions can cause insufficient secretion of insulin (type I diabetes) or cell resistance to this hormone (type II diabetes). Doctors mention frequent urination, constant thirst and strong hunger as symptoms of the disease. Without treatment, the increase in 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. Different types of diabetes are diagnosed in about 8% of people during their lifetime, and widespread dietary patterns increase the number of patients every year. With proper symptomatic treatment and diet, the quality of life of patients is maintained at a decent level.
About the disease
Diabetes ranks second among all endocrine pathologies according to the frequency of detection. The disease occurs in every tenth person, and there are hidden forms when the patient is not even aware of the problem. The main reason is the lack of insulin, which causes disruption of all metabolic processes.
Species
According to the classification of diabetes mellitus, there are symptomatic and true forms. First, it develops against the background of a certain disease and goes away after the cause is eliminated. True diabetes is divided into two types.
- Type I: insulin-dependent or childhood diabetes. It usually develops during childhood or adolescence. Lack of insulin in the body occurs against the background of damage to pancreatic cells. 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 is now common among children and adolescents. This is due to the sensitivity of body tissues to insulin, as a result of which they stop absorbing 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 required.
Diabetes in pregnant women (gestational diabetes) is separate. It develops only 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 basis of which is based on the level of glycosylated hemoglobin (HbA1c). This is an indicator that reflects the average level of blood sugar in the last 2-3 months.
- Mild degree (HbA1c less than 6. 5%): the blood sugar level is within the normal range or close to normal, the manifestations of the pathology are minimal.
- Moderate (HbA1c 6. 5-7. 9%): the glucose level rises slightly, there are specific symptoms or initial signs of complications.
- Severe (HbA1c 8% or higher): characterized by significant glycemia, severe symptoms, and complications.
According to similar criteria, compensated, subcompensated and decompensated diabetes mellitus 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 pathology can be detected only with the help of special studies.
Possible symptoms and signs:
- Frequent urge to urinate and increase in urine volume;
- Strong thirst and large volume of fluid consumption;
- Dryness of the oral mucosa;
- Violation of visual acuity and dizziness;
- Open appetite, gluttony;
- The appearance of ulcers in different parts of the skin, long-term wound healing;
- Insomnia and fatigue;
- Decreased performance;
- Unexplained weight loss or obesity;
- Frequent occurrence of infectious diseases.
Only a doctor can accurately distinguish the symptoms of different types of diabetes. The long duration of the disease contributes to the emergence of additional symptoms associated with complications.
Causes of diabetes
Diabetes mellitus occurs due to pancreatic dysfunction or cell dysregulation, when even sufficient insulin production does not help to reduce blood sugar levels. Doctors mention obesity, pancreatic pathologies, low physical activity, unfavorable heredity and other conditions as risk factors for the disease. Type 1 diabetes is usually diagnosed before the age of 30 in men and women. Older people who suffer from obesity are more prone to type II diabetes. At the same time, patients of any age can experience various types of disorders, so you should not focus only on risk factors.
Possible causes and risk factors:
- Genetic disorders contributing 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, when tissues become less sensitive to insulin;
- Immune dysfunction characterized by pancreatic tissue damage;
- Effects of viral infections and 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 cause rapid development of this disease at any age.
Diagnosis of diabetes mellitus
To determine 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 anamnesis to identify risk factors for diabetes. A continuous increase in blood sugar level and other clinical signs of diabetes are detected through special studies, so the endocrinologist prescribes all the necessary procedures after consultation.
Conducted examinations:
- Fasting blood test. The endocrinologist asks the patient to refrain from eating a few hours before going to bed and before work in the morning. 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 can be a glucose level of more than 6. 5 mmol/l in the sample taken;
- Blood test for the content of glycosylated hemoglobin. The level of this substance shows the level of glucose in the blood for 3 months, so the doctor prescribes such a test for the initial diagnosis and monitoring of diabetes treatment. A concentration of glycosylated hemoglobin above 6. 5% indicates the presence of diabetes;
- Load test. The first stage of the study is the standard determination of the fasting blood glucose level. Then the doctor asks the patient to drink a glass of water with sugar and after 2 hours he takes a blood test again. If the results of the first examination reveal an average level of glucose in the blood (up to 6. 5 mmol/l), and the second analysis shows a significant increase in the level (about 11 mmol/l), then the diagnosis is confirmed;
- Blood test for C-peptide content. The 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 the symptoms of the disease. A glucose concentration of more than 10 mmol/L in several blood samples, regardless of meal time, indicates the presence of diabetes;
- Urinalysis. Diabetics have high levels of glucose in their urine. In addition, the patient may have ketone bodies in the urine, which indicate impaired glucose metabolism.
If necessary, the endocrinologist appoints consultations with a neurologist, cardiologist, nephrologist and other specialists to rule out 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. Before this, there may be hyperglycemia for a long time without causing symptoms, but a rapid onset is also possible when obvious signs of diabetes 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 left unchecked, your sugar levels will rise again. If the patient ignores the treatment, he may experience 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 diagnostic results and prescribes the appropriate treatment. The main goals are to reduce the blood glucose level, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, the endocrinologist must prescribe 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 prevent the negative consequences of diabetes.
Two types of drug therapy are used to correct the pathology.
- Prescribing drugs that lower blood glucose levels. Depending on the diagnostic results and the patient's medical 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 insulin production by the pancreas, stimulate glucose sensitivity of tissues and reduce glucose intake from food;
- Administration of insulin by injection. The endocrinologist prescribes this treatment to all patients with type 1 diabetes and to patients with type 2 diabetes when blood sugar-lowering drugs are ineffective or contraindicated. Pregnant women with gestational diabetes are also prescribed insulin therapy. First of all, the endocrinologist prescribes long-term insulin injections - this drug must be taken once a day, regardless of food. Rapid-acting insulin preparations are used in hospitals for the treatment of complex forms of diabetes and a sharp increase in blood sugar. The doctor explains how to use the injections and the required doses. The consultation also explains the importance of regularly monitoring 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 to solve problems related to complications of the disease and side effects of drugs. In addition, the specialist must show how to administer the drug and explain all treatment procedures.
Prevention of diabetes
Every year, diabetes is diagnosed more often. Medical advice will help prevent the development of this disease.
The main methods of prevention:
- Normalization of body weight and average physical activity;
- timely treatment of pancreatic diseases;
- A healthy diet that includes adequate consumption of vegetables and fruits.
Questions and answers
How is diabetes mellitus diagnosed?
To determine the pathology, first of all, blood is given to determine the level of blood sugar. If there are deviations, the doctor will prescribe additional tests.
How to prevent complications of diabetes?
Follow your doctor's advice on diet and medication. The main criterion is the normal concentration of glucose in the blood.