
Diabetes mellitus is a misleading disease in which increased blood sugar levels can be observed.When the food is digested, carbohydrates and proteins decompose into simple sugar and amino acids.The liver converts all sugar and some amino acids into glucose used as a source of energy on all body body.Glucose with insulin, the hormone produced by the pancreas (a pear -shaped organ under the stomach) is in the blood.Fixed to receptors on the cell membrane surface, insulin promotes glucose from the depth of the cell to the surface where they are connected to glucose and carry it to the cell.In the case of diabetes mellitus, this process occurs several interventions: the production of pancreatic insulin is partially or completely disturbed, or the body of the body may be unable to react effectively to normal insulin.
Diabetes mellitus is a heterogeneous disease and is located in two forms: the first type of diabetes either the "insulin -dependent" and the second type of diabetes or the "insulin -dependent" diabetes. In the first type of diabetes, also known as youthful diabetes, the pancreas produces or does not produce a small amount of insulin.
This type of diabetes is suddenly developed and is most often found in people under the age of 30;The average age of its development is between 12 and 14 years.However, the first type of diabetes is only about 5 % of all cases of diabetes.The second type of diabetes, also known as adult diabetes, is much more common.In this type of diabetes, the production of insulin pancreas is slightly reduced, but cells are unable to react effectively to insulin, so this disease is considered to be insulin resistance.The second type of diabetes usually starts gradually and affects people over 40 years of age, and especially the whole people, one of the risk factors over the age of 50.Occasionally, the first type of diabetes is observed in adults.
The main causes of diabetes develop are: hereditary predisposition, pancreatic disease, survival (reading -overload the same pancreas, liver and stomach tract), excessive use of simple carbohydrates (sugar, sweets, jams, cakes, chocolate).In some cases, diabetes mellitus may be the result of mental trauma, intoxication or intoxication (including drugs).
In both types of diabetes, hyperglycemia leads to the release of glucose into urine, accompanied by an increase in the production of urine.If a patient with the first type of diabetes is prescribed poor amounts of insulin, excessive emptying of fatty acids from adipose tissue leads to overproduction of ketone bodies in the liver.The accumulation of ketone bodies can cause a life -threatening condition called diabetic ketoacitosis.Diabetic ketoacitosis is sometimes found in second type of diabetes at times when the body experiences severe tension, for example during a severe infectious disease.
People with a second type of diabetes tend to be another life threat, called hyperosmotic non -milling condition, characterized by extremely high blood sugar levels.This disease usually occurs in older people with any other serious illness.The first sign of diabetes may be an attack on diabetic ketoacitosis or hyperosmotic condition.
People with diabetes may also suffer from low blood sugar (hypoglycaemia) if too much insulin is given during treatment.
After 10-20 years of diabetes, patients may have complications, such as visual impairment, kidney impairment and degeneration of the peripheral nervous system (neuropathy).Strict control of glucose content in the blood can withhold or prevent these complications from appearance.Losing leg touch can lead to the fact that damage is left unrestrained and the infection occurs.
Symptoms
What signs can you say that you have diabetes or indicates that it existed?
- Excessive and frequent urination (about every hour).To wake up with the urine at night.The body is released through the kidneys in the urine to get rid of excess sugar.
- Severe thirst or increased need for plenty of fluids to drink.This is due to the fact that the increase in blood glucose levels, which "removes" the fluid from the tissues, is dehydrated.Therefore, patients are very forced to drink: 2-3-5 liters daily or more.
- Itching of the skin and genitals.
- Dry the mouth.
- Poor healing of wounds.
- Initially, a heavy weight, which was later reduced due to food absorption, especially carbohydrates.
- Reduction of immunity - frequent infections of banal influenza and colds until pneumonia.
- The disease is sometimes preceded by "strange" conditions: short -term forced hunger or intense physical activity, headache, pale, sweat and general weakness.As a man ate, he drank at least one cup of sweet tea, all the symptoms disappear quickly.Indirectly, this may indicate the malfunction of the pancreas: insulin has entered the blood more than usual and the sugar level is reduced below 3-3.5 levels.
- Increased appetite.
- Not closed weight loss.
- Poor vision.
- Fatigue and weakness.
- Frequent or constant infections of bladder, skin or gums.
- Numbness and tingling in the legs and hands.
- Signs of hypoglycaemia.
- Strong symptoms of hyperosmotic gender -monetary state: extreme thirst, lethargy, weakness, awareness disorder, coma.
- Strong symptoms of diabetic ketoacidosis are nausea and vomiting, shortness of breath, confusion, coma.
The symptoms described are observed well in 40-90% of patients with diabetes before diagnosis.But there are also "non -human" symptoms that lead to increased blood glucose levels:
The skin gradually dries, wrinkled, palms and soles are coarse, nails thicken, dry and fragile hair, increases on the limbs and disappears completely on the skin as general immunity, pustular rashes, boiling, carbunels, decrease, decrease.The skin is often affected by fungi, eczema and lichen.
- The appearance and progression of vascular disorders - atherosclerosis, hypertension, angina pectoris, memory is reduced (brain vessels suffer);
- Changes in diabetes in the lower blood vessels (retinopathy), reducing vision;
- Reduction of kidney function (nephropathy, pyelonephritis);
- Diabetic legs (“legs in cold burns and heat” - violation of blood supply to the lower limbs);
- Sometimes the character (mental disorders) changes;
- One sign of diabetes is gum injury - periodontitis, bleeding, gums blue, and teeth begin to collapse, sometimes leaving their legal places painlessly.
- Diabetes mellitus affects the glands of the internal secretion.Men lose interest in women, not only because of libido but also because of efficiency.In women, the menstrual cycle is "lost", and the menstruation may disappear completely.
This is the reason why diabetes mellitus is called endocrine exchange disease, with pancreatic lesion characterized by an increase in blood sugar and violation of all types of body.
In diabetes mellitus, antiabet, hidden diabetes mellitus and diabetes (explicit) are distinguished.The latter light is manifested in moderate and severe severity.
In the case of pre -antiabet, hidden diabetes and mild diabetes, nutrition is the only therapeutic factor.And with moderate and severe forms - a necessary condition for successful treatment and maintaining an acceptable quality of life.
In addition, people with diabetes are more prone to narrowing coronary arteries and reducing the blood vessels of the brain and legs.A combination of infectious diseases of the legs and reduce blood supply can lead to gangrene (death), which requires amputation.
Treatment of the first type of diabetes requires daily insulin injection.(Insulin cannot be taken orally because the digestive system destroys it.) In addition, you should pay attention to a diet and exercise to make your blood sugar not too high or too low.In the case of second type of diabetes, a combination of diet, exercises and weight loss can also be used, although medicines (including insulin) are generally necessary.The treatment is highly dependent on self -control.Although there is no tool for healing diabetes, almost all patients can control the symptoms and live a full life.
- The first type of diabetes is an autoimmune disease that is a result of incorrect attack on the immune system against insulin -producing pancreatic cells.
- Genetic factors are important with the diabetes of the second tin.
- Due to excessive completeness, people tend to develop second type of diabetes.
- Some drugs, such as corticosteroids or diureticia thiazides, may increase the risk of developing second type of diabetes.
- Other diseases such as hemochromatosis, chronic pancreatitis, kushing or acromegalia syndrome can lead to diabetes.Surgery removal of pancreatic can also cause diabetes.
- Pregnant women can develop diabetes, which usually disappears after childbirth.In the future, these women are at risk of developing second types of diabetes.
- Contrary to existing opinions, large amounts of sweet use do not contribute to the development of diabetes.
The general principles of dietary nutrition are reduced to simple rules.
The calorie content of the diet should be reduced to 2000-2200 kcal by reducing the consumption of simple carbohydrates: sugar, cakes, ice cream, chocolate, sweets, jam, pasta, rice, honey and similar products.Black bread, legumes, vegetables, fruits are complex carbohydrates (except banana, grapes, watermelons) and their consumption within normal limits.Seafood is useful due to well-acquired high quality protein and minerals, especially due to the component needed to produce zinc insulin.Bab zinc contents, such as diabetes patients and copper, need a champion of vegetables.The use of beans reduces thirst and restores normal rhythm in the presence of atherosclerosis simultaneously with the heart rate!
We recommend that you eat 3-4 times a day.Between meals, drink water.This should be restricted up to 10 g of sodium daily, to 50 g of animals and vegetable fats, and reduce the consumption of dairy products, high fat (cheeses, ice cream, cream, sour cream), meat, sausage, smoked spots, chocolate, cakes, cakes.
Prevention
- In order to prevent the development of the second type of diabetes, you should lose weight if your weight exceeds the norm by 20 % and keep normal weight.
- Exercise regularly.
- There is no well -known method to prevent first type of diabetes.
- People with any type of diabetes should regularly face the early detection and treatment of diabetes of visual impairment.
Diagnosis
- Pursuant and physical examination can provide a basis for assuming the presence of the disease.
- The diagnosis can be made if the blood test on the empty stomach shows high glucose levels at least twice (126 mg/dl or above).
- If the results of the tests are unclear, a sample of glucose tolerance can be made.The patient drinks a drink containing 75 g of glucose and the blood sugar level is measured every 30 minutes every two hours.
- Urine analysis can be performed to determine the protein content.
- Measure the blood glycoglobin;This shows the average content of glucose in the blood in the last two to three months.
For the first type of diabetes:
- Daily insulin injections are required.It requires one -four injections a day to control the glucose levels of the blood.There are long -term drugs and rapid actions and is often prescribed in combination.
- A strict diet and a diet schedule are needed to maintain the desired glucose levels in the blood.Your doctor may recommend low -fat foods with salt and cholesterol and advise you to visit a nutritionist for food design.
- Because both physical exercises and insulin reduce glucose levels, the exercises and the introduction of insulin should be designed so that their effects are not applied and does not cause dangerous decrease at blood sugar (hypoglycemia).
- Proper regulation of the disease requires strict injection, eating and implementation exercises.
For second type of diabetes:
- The use of low fatty and low calorie foods is required in combination with the right performance of exercise.
- Oral drugs can be formulated to increase the production of insulin pancreas if exercises and diets do not suffer sufficient blood sugar.
- Other oral drugs can reduce insulin resistance or slow the absorption of sugar from the intestines.
- Insulinin injections may require strong attacks on type second type of diabetes, or if a patient with second type of diabetes has other illnesses.
For both types of diabetes:
- Blood testing is needed to measure glucose levels, one -four times a day (depending on the doctor's recommendation).Your doctor advises which device to use at home to measure blood sugar levels.
- Particular attention should be paid to the development of atherosclerosis as it is often combined with diabetes.Patients with diabetes should not smoke, eat low fat, cholesterol and salt and take medication for hypertension or high cholesterol.
- People with diabetes should drink large amounts of water when patients with another disease, such as influenza, to fill the lost fluid and prevent diabetes coma.During the disease, the first type of diabetics should check the urine of the ketone body every four to six hours.
- People with diabetes should take care of their feet and check them every day.Damage to the nerves of diabetes reduces the sensitivity of the legs and can lead to serious infectious diseases.
- Laser photocoagulation can help prevent or cure diabetic retinopathy to prevent cracks in opposing small blood vessels.Most patients with diabetes should check their eyes at least once a year to detect the very first manifestations of retinopathy.
- Dialysis, artificial blood screening requires for kidney failure.In severe cases, kidney transplantation may be required,
- Clear regulation of glucose levels in the blood retains or prevents later complications that affect the eyes, kidney and nervous system.
- Kidney impairment can be slowed down when controlling blood pressure.
When you need a doctor
- Contact your doctor if you notice the sudden or gradual increase in thirst, or increases the amount of urine produced.
- Contact your doctor when you are in diabetes, and at the same time you have been ill with runny nose or flu, which has not been checked for blood sugar.Do not use the medicine sold without a prescription without a medical consultation.
- Attention!Call an ambulance when a patient with diabetes loses consciousness.Tell the doctor that a person suffers from diabetes.
- Attention!(In the second type of diabetes.) Call the ambulance immediately when it is hyperosmotic non -brown condition;These include severe thirst, lethargy, weakness and disorder.
- Attention!(In the first type of diabetes.) Call the ambulance immediately when diabetic ketoacitosis has symptoms;These include dry mouth, dry and red skin, sweet or mouth -based fruit aroma, breathing difficulty, vomiting and abdominal pain in combination with excessive urination and severe thirst.
- Attention!(With the first type of diabetes.) Take the doctor immediately, if the presence of ketone bodies and measures prescribed by your doctor is found in the urine, do not help cope with the problem.