Diabetes mellitus is a group of metabolic diseases that cause an uncontrolled increase in blood glucose levels (hyperglycemia). Normally, the hormone insulin, 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 cellular resistance to this hormone (type II diabetes). Doctors include frequent urination, constant thirst and a strong feeling of hunger as symptoms of the disease. Without treatment, high blood sugar levels can be complicated by diseases of the heart, blood vessels, nervous system, lower extremities and the organ 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 the right symptomatic treatment and the right diet, the quality of life of patients is maintained at a good level.
About the disease
Diabetes is in the second place in terms of detection frequency among all endocrine pathologies. The disease appears 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.
The types
According to the classification of diabetes mellitus, there are symptomatic and true forms. The first develops against the background of a particular disease and goes away after the cause is eliminated. True diabetes is divided into two types.
- Type I: insulin-dependent diabetes or childhood diabetes. It usually develops in childhood or adolescence. Caused by the lack of insulin in the body, against the background of damage to the cells of the pancreas. People with this type of diabetes need continuous external insulin.
- Type II: non-insulin-dependent or adult-onset diabetes. It most often develops in adulthood, but has now become common in 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, physical activity, and blood sugar-lowering medications. In severe cases, the use of insulin may be required.
Diabetes in pregnant women (gestational diabetes) stands apart. It develops exclusively during pregnancy and goes away 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 of which is based on the level of glycated hemoglobin (HbA1c). This is an indicator that reflects the average level of sugar in the blood during the last 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, undercompensated 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 increased volume of urine;
- Strong thirst and consumption of large volumes of liquids;
- Dryness of the oral mucosa;
- impaired visual acuity and dizziness;
- Strong appetite, gluttony;
- The appearance of ulcers in different parts of the skin, prolonged healing of wounds;
- 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 occurs due to pancreatic dysfunction or a disorder of cell regulation, in which even sufficient insulin production does not help lower 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 effects of toxins on the pancreas;
- Taking corticosteroids and other drugs that contribute to the development of diabetes;
- Kidney dysfunction;
- Cardiovascular pathologies.
Diabetes mellitus is rarely a congenital disease, but hereditary factors cause the rapid development of this disease at any age.
Diagnosis of diabetes mellitus
To diagnose the disease, you must make an appointment with an endocrinologist. The doctor conducts a consultation, during which he examines the patient's complaints and collects history to identify risk factors for diabetes. A continuous increase in the blood sugar level and other clinical signs of diabetes are detected through special studies, so the endocrinologist, after consultation, prescribes all the necessary procedures.
Completed exams:
- Fasting blood test. The endocrinologist asks the patient to abstain from food 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 using a scarifier and collects a small amount of blood in a special container. A sign of diabetes mellitus can be a content of more than 6. 5 mmol/l glucose in the sample taken;
- 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 of diabetes treatment. 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 glucose levels. Then the doctor asks the patient to drink a glass of water with sugar and after 2 hours he performs a repeated 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 certain period of time;
- The 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 some blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urine analysis. Patients with diabetes have high levels of glucose in their urine. In addition, the patient's urine may contain ketone bodies, which indicates a disturbance in 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 you do not control it, the sugar level will rise again. If the patient ignores the treatment, he may encounter complications of the pathology: hypo- or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), nerve fiber pathology (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.
Treatment of diabetes
The endocrinologist studies the results of the diagnosis and prescribes the appropriate treatment. The main objectives are to reduce blood glucose levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, the endocrinologist must prescribe a special diet to the patient to control the blood sugar level. Compliance with all the 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.
- Description of drugs that lower the level of glucose in the blood. 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 certain medications with strict adherence to dosage and monitoring of blood sugar levels. The listed medications improve insulin production by the pancreas, stimulate tissue sensitivity to glucose, and reduce glucose intake from food;
- Administration of insulin by injection. The endocrinologist prescribes this type of treatment to all patients with diabetes mellitus type 1 and patients with diabetes mellitus type 2 if medications that lower the blood sugar level 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 food. Fast-acting insulin preparations are administered in hospitals for the treatment of complicated forms of diabetes and with a sharp increase in blood sugar levels. The doctor explains the rules for using injections and the necessary 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 complications of the disease and side effects of drugs. In addition, the specialist must show how to administer the drug and explain all the rules of treatment.
Prevention of diabetes
Every year, diabetes is diagnosed more and more often. Medical advice will help prevent the development of this disease.
The main methods of prevention:
- Normalization of body weight and moderate physical activity;
- Timely treatment of pancreatic diseases;
- A healthy diet that includes 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 medications. The main criterion is the normal concentration of glucose in the blood.