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 into the 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 cite 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 extremities and organs 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 proper symptomatic treatment and nutrition, the patients' quality of life is maintained at a decent level.
About the disease
Diabetes is the second most frequently detected among all endocrine pathologies. The disease occurs 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.
Species
According to the classification of diabetes mellitus, symptomatic and true forms are distinguished. The first develops against the background of a certain disease and disappears after the removal of the cause. True diabetes is divided into two types.
- Type I: insulin-dependent diabetes or diabetes. It usually develops in childhood or adolescence. It causes a lack of insulin in the body, against the background of pancreatic cell damage. People with this type of diabetes require constant external insulin.
- Type II: non-insulin-dependent diabetes or adult-onset diabetes. It most often develops in adulthood, but has now become common among children and adolescents. It is caused by the insensitivity of body tissues to insulin, due to 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, insulin administration may be required.
Diabetes in pregnant women (gestational diabetes) is distinguished. It develops exclusively during pregnancy and disappears after childbirth. 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 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 last 2-3 months.
- Mild degree (HbA1c less than 6. 5%): the blood sugar level is within normal limits or close to normal, the manifestations of the 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 more): characterized by a significant level of 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 the 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 amounts of liquid;
- Dryness of the oral mucosa;
- Disturbance of visual acuity and dizziness;
- Expressed appetite, gluttony;
- The 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 associated with complications.
Causes of diabetes
Diabetes mellitus occurs due to pancreatic dysfunction or cell dysregulation, where even sufficient insulin production does not help reduce blood sugar levels. Doctors cite obesity, pancreatic pathologies, low physical activity, unfavorable heredity and other conditions as risk factors for the onset of 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 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. 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 damage to pancreatic tissue;
- Viral infections and effects of toxins on the pancreas;
- Taking corticosteroids and other drugs that contribute to the development of diabetes;
- Adrenal gland 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
In order to diagnose the disease, it is necessary to make an appointment with an endocrinologist. The doctor conducts a consultation, during which he examines the patient's complaints and collects anamnesis in order to identify risk factors for diabetes. A persistent increase in blood sugar levels and other clinical signs of diabetes are detected by special studies, so the endocrinologist prescribes all the necessary procedures after consultation.
Inspections performed:
- 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 study. During the procedure, the specialist treats the skin of the finger with an antiseptic, makes a small puncture with 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 of glucose in the obtained sample;
- Blood test for glycosylated hemoglobin content. The level of this substance indicates the level of glucose in the blood during 3 months, so the doctor prescribes such a test for the primary diagnosis and monitoring of diabetes treatment. Glycosylated hemoglobin concentration above 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first phase 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 repeat the blood test after 2 hours. 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 indicates a significant increase in the level (approximately 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;
- The blood test can be done at any time. This test is used to confirm signs of illness. A concentration of more than 10 mmol/L of glucose in several blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urinalysis. Patients with diabetes 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 in order to rule out dangerous complications of the disease. Pregnant women must consult an obstetrician-gynecologist.
Expert opinion
Diabetes mellitus is a very dangerous and 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 have to be treated for this disease for the rest of your life, because if it is not controlled, the sugar level will rise again. If the patient neglects 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 involving the toes.
Treatment of diabetes
The endocrinologist studies the diagnostic results and prescribes appropriate treatment. The main goals are to reduce the level of glucose in the blood, 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. Compliance with all the doctor's recommendations enables a significant improvement in the quality of life and avoiding 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 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 mentioned drugs 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 type 1 diabetes and patients with type 2 diabetes mellitus if drugs that lower blood sugar levels are ineffective or are 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 given in hospitals for the treatment of complicated forms of diabetes and for sudden increases in blood sugar levels. The doctor explains the rules for the use of injections and the required dosage. The consultation also explains the importance of regular monitoring of blood sugar levels using a glucometer.
The endocrinologist selects an individual treatment regimen and adjusts the dose of drugs and prescription during treatment. Repeated consultations make it possible to solve problems related to disease complications and side effects of drugs. In addition, the specialist must show how to apply the medicine and explain all the rules of treatment.
Prevention of diabetes
Every year, diabetes is diagnosed more and more often. The doctor's 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 consumption of vegetables and fruits.
Questions and answers
How does the diagnosis of diabetes mellitus begin?
In order to identify the pathology, first of all, blood is donated to determine the level of sugar in the blood. If there is a deviation, the doctor will order additional tests.
How to prevent diabetes complications?
Follow your doctor's recommendations regarding diet and medication. The main criterion is a normal concentration of glucose in the blood.