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 cellular resistance to this hormone (type II diabetes). Doctors include frequent urination, constant thirst, and intense hunger as symptoms of the disease. Without treatment, increased blood sugar levels 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. Different 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 adequate symptomatic treatment and diet, the quality of life of patients is maintained at a decent level.
About the disease
Diabetes ranks second in terms of frequency of detection 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 a 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 eliminating the cause. True diabetes is divided into two types.
- Type I: insulin-dependent or childhood diabetes. It usually develops in childhood or adolescence. Caused by a lack of insulin in the body, in a context of damage to pancreatic cells. People with this type of diabetes require constant external insulin.
- Type II: non-insulin-dependent or adult-onset diabetes. It most often develops in adulthood, but has now also become common among children and teenagers. It is caused by the insensitivity of the body's tissues to insulin, causing them to no longer 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 necessary.
Diabetes in pregnant women (gestational diabetes) stands out. 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 blood sugar level over the past 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 early signs of complications.
- Severe (HbA1c 8% or higher): characterized by a significant level of blood glucose, severe symptoms and complications.
According to similar criteria, compensated, subcompensated and decompensated diabetes mellitus are also distinguished.
Diabetes symptoms
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. Often, pathology can only be detected with the help of special studies.
Possible symptoms and signs:
- Frequent urge to urinate and increased urine volume;
- Intense thirst and consumption of large volumes of liquids;
- Dryness of the oral mucosa;
- Impaired visual acuity and dizziness;
- Pronounced 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 dysfunction of the pancreas or a disorder of cellular regulation, in which even sufficient insulin production does not help 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 elderly people 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. The 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 medications 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 this disease at any age.
Diagnosis of diabetes mellitus
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 an anamnesis to identify risk factors for diabetes. A persistent increase in blood sugar levels and other clinical signs of diabetes are detected through special studies, therefore the endocrinologist, after consultation, prescribes all necessary procedures.
Exams carried out:
- Fasting blood test. The endocrinologist asks the patient to avoid eating a few hours before bed and 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 may be a glucose content greater than 6. 5 mmol/l in the sample obtained;
- Blood test to check the content of glycosylated hemoglobin. The level of this substance indicates the blood glucose level for 3 months, which is why the doctor prescribes this test for the primary diagnosis and monitoring of diabetes treatment. A concentration of glycosylated hemoglobin above 6. 5% indicates the presence of diabetes mellitus;
- Load testing. The first step 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 does a new blood test. If the results of the first test reveal a moderate blood glucose level (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. An endocrinologist prescribes this test to reliably assess insulin production over a certain period of time;
- Blood test performed at any time. This test is used to confirm signs of the disease. A glucose concentration greater than 10 mmol/L 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, indicating a disorder in glucose metabolism.
If necessary, the endocrinologist prescribes consultations with a neurologist, cardiologist, nephrologist and other specialists to exclude 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 have 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 ignores treatment, he may encounter complications of the pathology: hypo- or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), pathologies of nerve fibers (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.
Diabetes treatment
The endocrinologist studies the diagnostic results and prescribes appropriate treatment. The main goals are to reduce blood glucose levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug therapy, the endocrinologist must prescribe the patient a special diet to control blood sugar levels. Compliance with all the doctor's recommendations allows you 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 medications that reduce blood glucose levels. 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 monitoring blood sugar levels. The listed drugs improve the production of insulin by the pancreas, stimulate the sensitivity of tissues to glucose and reduce the intake of glucose from food;
- Administration of insulin by injection. The endocrinologist prescribes this type of treatment to all patients with type 1 diabetes mellitus and to patients with type 2 diabetes mellitus if medications that lower blood sugar levels are ineffective or contraindicated. Insulin therapy is also prescribed for pregnant women with gestational diabetes. First of all, the endocrinologist prescribes long-acting insulin injections - this medication 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 a sharp increase in blood sugar levels. The doctor explains the rules for using injections and the necessary dosages. The consultation also explains the importance of regularly monitoring blood sugar levels using glucometers.
The endocrinologist selects an individual treatment regimen and also adjusts the dosage of medications and prescriptions during treatment. Repeated consultations allow you to resolve problems associated with complications of the disease and side effects of medications. Furthermore, the specialist must show how to administer the medicine and explain all the treatment rules.
Diabetes prevention
Every year, diabetes is diagnosed more and more frequently. Medical advice will help prevent the development of this disease.
Main prevention methods:
- 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 does the diagnosis of diabetes mellitus begin?
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 normal blood glucose concentrations.