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 insulin secretion (type I diabetes) or cell resistance to this hormone (type II diabetes). Doctors include frequent urination, constant thirst and strong hunger as symptoms of the disease. Without treatment, high blood sugar can be complicated by diseases of the heart, blood vessels, nervous system, lower legs 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 symptomatic treatment and proper diet, the patient's quality of life is maintained at a good level.
About the disease
Diabetes is in second place in terms of detection frequency among all endocrine pathologies. This disease occurs in every tenth person, and there is also a hidden form when the patient is not aware of the problem. The main reason is the lack of insulin, which leads to the 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 certain diseases and disappears after the cause is eliminated. True diabetes is divided into two types.
- Type I: insulin-dependent or childhood diabetes. Usually develops in childhood or adolescence. Caused by a lack of insulin in the body, against the background of damage to pancreatic cells. 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 is now also common among children and adolescents. It is caused by the insensitivity 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, physical activity and blood sugar-lowering medications. In severe cases, the use of insulin may be necessary.
Diabetes in pregnant women (gestational diabetes) stands out. It develops exclusively during pregnancy and disappears after delivery. Requires diet and, if this does not 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 that reflects the average level of sugar in the blood over the past 2-3 months.
- Mild degree (HbA1c less than 6. 5%): blood sugar levels are within normal limits or almost normal, pathological manifestations are minimal.
- Moderate (HbA1c 6. 5-7. 9%): the glucose level rises slightly, there are specific symptoms or early signs of complications.
- Severe (HbA1c 8% or higher): characterized by significant levels of glycemia, severe symptoms and complications.
According to the same criteria, compensated, subcompensated and decompensated diabetes mellitus are also 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 only be detected with the help of special studies.
Possible symptoms and signs:
- Frequent urge to urinate and increased amount of urine;
- Strong thirst and consumption of large amounts of liquid;
- dryness of the oral mucosa;
- Impaired visual acuity and dizziness;
- Significant appetite, gluttony;
- The appearance of ulcers on different parts of the skin, prolonged wound healing;
- 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 disruption of cell regulation, where adequate insulin production does not help reduce blood sugar levels. Doctors include obesity, pancreatic pathology, low physical activity, unfavorable heredity and other conditions as risk factors for this 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 develop type II diabetes. At the same time, various types of disorders can occur 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 pathology. Having a relative with diabetes is an important risk factor;
- Obesity. The accumulation of excess fat tissue contributes to metabolic disorders, where the tissue becomes less sensitive to insulin;
- Immune dysfunction, characterized by damage to pancreatic tissue;
- Viral infections and toxin effects on the pancreas;
- Taking corticosteroids and other drugs that contribute to the development of diabetes;
- Adrenal dysfunction;
- Cardiovascular pathology.
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 need to make an appointment with an endocrinologist. The doctor conducts a consultation, where he examines the patient's complaints and collects an anamnesis to identify risk factors for diabetes. A constant increase in blood sugar levels and other clinical signs of diabetes are detected through special studies, so the endocrinologist, after consultation, prescribes all the necessary procedures.
Exams conducted:
- Fasting blood test. Endocrinologists ask patients to refrain from eating 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 may be the content of more than 6. 5 mmol/l glucose 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 doctors prescribe such tests for primary diagnosis and monitoring of diabetes treatment. Glycosylated hemoglobin concentration above 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first stage of the study is the 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 conduct 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 (about 11 mmol/l), then the diagnosis is confirmed;
- Blood test for C-peptide content. Endocrinologists prescribe this test to reliably assess insulin production over a certain period of time;
- Blood tests are done at any time. This test is used to confirm the signs of the disease. A concentration of more than 10 mmol/L of glucose in some blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urinalysis. Diabetics have high levels of glucose in their urine. In addition, the patient's urine may contain ketone bodies, indicating a disturbance in glucose metabolism.
If necessary, the endocrinologist appoints a consultation with a neurologist, cardiologist, nephrologist and other specialists to exclude 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. It may 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, significant symptoms of diabetes mellitus arise. You 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 experience pathological complications: hypo- or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), nerve fiber pathology (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.
Diabetes treatment
Endocrinologists review diagnostic results and prescribe appropriate treatment. The main objective is to reduce blood glucose levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, endocrinologists must prescribe patients a special diet to control blood sugar levels. 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.
- Prescribe medication that lowers blood glucose levels. Depending on the diagnostic results and the patient's medical history, endocrinologists prescribe 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 increase insulin production by the pancreas, stimulate tissue sensitivity to glucose and reduce glucose intake from food;
- Administration of insulin by injection. Endocrinologists prescribe this type of treatment to all type 1 diabetes mellitus patients and type 2 diabetes mellitus patients 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 diet. Fast-acting insulin preparations are administered in hospitals for the treatment of complicated forms of diabetes and with a sudden increase in blood sugar levels. The doctor explains the rules for using the injection and the required dosage. The consultation also explained the importance of constantly monitoring blood sugar levels using a glucometer.
The endocrinologist selects the individual treatment regimen and also adjusts the drug dosage and prescription during the treatment. Repeated consultations allow you to solve problems related to disease complications 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 disease;
- A healthy diet that includes adequate intake of vegetables and fruits.
Questions and answers
How is diabetes mellitus diagnosed?
To identify the pathology, first of all, blood is donated to determine the blood sugar level. If there are abnormalities, the doctor will order additional tests.
How to avoid diabetes complications?
Follow your doctor's recommendations regarding diet and medications. The main criterion is a normal blood glucose concentration.