Diabetes mellitus is a group of metabolic diseases that cause an uncontrolled rise in blood sugar (hyperglycemia). Normally, the hormone insulin produced by the pancreas regulates the absorption of glucose by cells and the metabolism of carbohydrates in the body. Various pathological conditions can cause insufficient insulin secretion (type I diabetes) or resistance of cells to this hormone (type II diabetes). Doctors mention frequent urination, constant thirst and a strong feeling of hunger as symptoms of the disease. Without treatment, high blood sugar can be complicated by diseases of the heart, blood vessels, nervous system, lower limbs 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 about 8% of people during their lifetime, and due to widespread dietary habits, the number of patients is increasing every year. With appropriate symptomatic treatment and diet, the patients' quality of life remains at an adequate level.
About the disease
Diabetes ranks second among all endocrine pathologies in terms of detection frequency. The disease occurs in every tenth person, and there are also hidden forms when the patient does not even know about 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 specific disease and disappears after the cause is eliminated. True diabetes is divided into two types.
- Type I: insulin-dependent or childhood 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 pancreatic cells. People with this type of diabetes need constant external insulin.
- II. type: non-insulin-dependent or adult-onset diabetes. It most often develops in adulthood, but has now become common among children and adolescents as well. This is caused by the insensitivity of body tissues to insulin, as a result of which they do not 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, it may be necessary to use insulin.
Diabetes in pregnant women (gestational diabetes) is different. It only develops during pregnancy and disappears after childbirth. It requires diet and, if that doesn't help, insulin treatment.
The severity of diabetes depends on blood sugar control and the presence of complications. There are several classifications, the main one based on the level of glycated hemoglobin (HbA1c). This reflects your average blood sugar levels over the past 2-3 months.
- Mild degree (HbA1c less than 6. 5%): the blood sugar level is within or close to normal limits, the manifestation of pathology is minimal.
- Moderate (HbA1c 6. 5-7. 9%): the glucose level is slightly elevated, there are initial signs of specific symptoms or complications.
- Severe (HbA1c 8% or higher): characterized by significant blood sugar levels, severe symptoms and complications.
Compensated, subcompensated and decompensated diabetes mellitus are distinguished according to similar criteria.
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. Pathology can often be detected only with the help of special tests.
Possible symptoms and signs:
- Frequent urge to urinate and increased urine volume;
- Strong thirst and drinking large amounts of liquid;
- dryness of the oral mucosa;
- Decreased visual acuity and dizziness;
- Expressed appetite, gluttony;
- Appearance of ulcers on different parts of the skin, prolonged wound healing;
- Insomnia and fatigue;
- Reduced 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 related to complications.
Causes of diabetes
Diabetes develops due to a malfunction of the pancreas or a disturbance in cellular regulation, in which 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. Obese seniors are more likely to develop type II diabetes. However, 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 diseases and pancreatic pathologies. A diabetic relative is an important risk factor;
- Obesity. Accumulation of excess adipose tissue contributes to metabolic disorders in which tissues are less sensitive to insulin;
- Immune dysfunction characterized by damage to pancreatic tissue;
- Viral infections and the effect 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 cause the rapid development of the disease at any age.
Diagnosis of diabetes mellitus
An endocrinologist should be consulted to diagnose the disease. The doctor conducts a consultation during which he examines the patient's complaints and collects an anamnesis in order to identify risk factors for diabetes. A persistent rise in blood sugar level and other clinical symptoms of diabetes are detected with special tests, so the endocrinologist prescribes all the necessary procedures after consultation.
Tests 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 scrubber, and collects a small amount of blood in a special container. It can be a sign of diabetes mellitus if the sample obtained has a glucose content of more than 6. 5 mmol/l;
- Blood test for glycosylated hemoglobin content. The level of this substance indicates the level of glucose in the blood for 3 months, so the doctor prescribes such a test for the primary diagnosis and control of diabetes treatment. A glycosylated hemoglobin concentration above 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first stage of the test is the standard determination of the fasting blood sugar level. The doctor then asks the patient to drink a glass of sugar water and repeats the blood test after 2 hours. If the results of the first test show 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 (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 certain period of time;
- A blood test can be performed at any time. This test is used to confirm signs of the disease. A glucose concentration above 10 mmol/l in several blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urine test. Diabetics 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 is a very dangerous and common disease. It can be prevented by a long-term hyperglycemia that does not cause symptoms, but a rapid onset is also possible, when pronounced symptoms of diabetes mellitus appear under the influence of one or another factor. This disease must be treated for the rest of your life, because if it is not controlled, your 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 pathologies (diabetic neuropathy). In severe cases, gangrene develops, usually affecting the toes.
Treatment of diabetes
The endocrinologist examines the diagnostic results and prescribes appropriate treatment. The main objectives are to reduce blood sugar levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, the endocrinologist must prescribe a special diet for the patient to control blood sugar levels. Following 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. 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 blood sugar control. The listed medicines improve the insulin production of the pancreas, stimulate the glucose sensitivity of the tissues and reduce the absorption of glucose from food;
- Administration of insulin by injection. The endocrinologist prescribes this method of treatment for all type 1 and type 2 diabetes patients if 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 drug must be taken once a day, regardless of food. Rapid-acting insulin products are administered in hospitals to treat complicated forms of diabetes and those associated with a sharp rise in blood sugar. The doctor will explain the rules for using the injections and the required doses. The consultation also explains the importance of regular blood sugar monitoring with a glucometer.
The endocrinologist selects an individual treatment plan and adjusts the dose of the drugs and prescriptions during the treatment. Repeated consultations make it possible 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
Diabetes is diagnosed more and more every year. Medical advice helps prevent the development of the 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 fruit and vegetable consumption.
Questions and answers
How is diabetes mellitus diagnosed?
To identify the pathology, blood is first given to determine the blood sugar level. If there are discrepancies, the doctor prescribes additional tests.
How to prevent diabetes complications?
Follow your doctor's recommendations for diet and medication. The main criterion is normal blood sugar.