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Diabetes: Types and causes of their development, course and manifestations, how to treat, possible consequences

Glucometer and medicines to treat diabetes

Diabetic sugar is one of the most common conditions for increasing frequency and spoiling disease statistics.Symptoms of diabetes do not seem on the same day, the process is chronic, with an increase and deterioration of endocrine exchanges.It is true that the type I diabetes debut is significantly different from the early stage of the second.

Among the whole endocrine pathology, diabetes confidently owns the championship and represents more than 60% of all cases.In addition, disappointing statistics show that 1/10 of Diabetics are children.

The likelihood of the disease increases with age and thus the number of the group is doubled every ten years.This is explained by increasing life expectancy, improving early diagnosis, reducing physical activity and increasing the number of people with excess weight.

Diabetes

Many have heard of such a disease as non -lying diabetes.So later the reader does not confuse diseases that have the name "diabetes", the clarification of their differences will probably be useful.

Non -adhesive urethra

Non -adept diabetes is an endocrine disease that occurs due to neuroinfection, inflammatory diseases, tumors, intoxics and deficiency, and sometimes the complete disappearance of ADG -vasopressin (antidichuretic hormone)

This explains the clinical picture of the disease:

  • Constant dryness of the mucous membranes of the oral cavity, incredible thirst (one can drink up to 50 liters of water for 24 hours, stretching the stomach to large sizes);
  • The distribution of a huge amount of unconditional light urine with low specific gravity (1000-1003);
  • Catastrophic weight loss, weakness, reduction of physical activity, disorders of the digestive system;
  • Characteristic change in skin ("parchment" skin);
  • Muscle fiber atrophy, muscle weakness;
  • The development of dehydration syndrome in the absence of fluid intake for more than 4 hours.

The disease with respect to full treatment has an adverse prognosis, the effectiveness is significantly reduced.

A brief anatomy and physiology

A body that is not - the pancreas performs a mixed secretory function.Its exogenous part of external secretion producing enzymes involved in the digestion process.The endocrine part entrusted to the mission of internal secretion deals with the development of various hormones, includingInsulin and glucagon.They are key to ensuring the persistence of sugar in the human body.

The endocrine area of the gland represents the Langgana Islands, consisting of:

  1. A-cells that occupy a quarter of the entire space of the islands and are considered the place of glucagon products;
  2. In cells occupying up to 60% of the synthesizing cell population and the accumulation of insulin, whose molecule is a polypeptide of two chains, which is carried in a certain sequence of 51 amino acids;
  3. D-cells producing somatostatin;
  4. Cells producing other polypeptides.

Thus the conclusion suggests itself:Damage to the pancreas and islands of Langgan, more special, is the main mechanism that inhibits the production of insulin and causes the development of the pathological process.

Types and special forms of the disease

The lack of insulin leads to a violation of sugar constant (3.3 - 5.5 mmol/l)and contributes to the formation of a heterogeneous disease called diabetes (diabetes):

  • The complete absence of insulin (absolute deficiency) formsInsulin -dependenta pathological process that refers toType I diabetes (ISD);
  • Lack of insulin (relative deficiency) that triggered in the initial stage disorder of carbohydrate metabolism, slowly but certainly leads to developmentInsulin -dependentDiabetes (Inzsd), which is calledType II diabetes.

Due to disorders in the body of the use of glucose and therefore its increase in blood serum (hyperglycemia), which is generally a manifestation of the disease, signs of diabetes mellitus, begins to occur in time.

In addition to diabetes of the first and second types, special types of this disease are distinguished:

  1. Secondary diabetes,The pancreas resulting from acute and chronic inflammation of the pancreas (pancreatitis), malignant neoplasms in the parenchyma of the gland, cirrhosis of the liver.A number of endocrine disorders, accompanied by excessive production of insulin antagonists (acromigalia, Cushing disease, phochoromocytoma, thyroid disease) lead to the development of secondary diabetes.Many medicines consumed for a long time have a diabetogenic effect: diuretics, some antihypertensive drugs and hormones, oral contraceptives, etc.;
  2. Diabetes in pregnant women (gestational),Due to the special mutual influence of the hormones of the mother, the child and the placenta.The pancreas of the fetus, which produces its own insulin, begins to slow down insulin products with the mother's gland, resulting in this special form formed during pregnancy.However, with proper control, gestational diabetes usually disappears after birth.Subsequently, in some cases (up to 40%) in women with a similar history of pregnancy, this fact may endanger the development of type II diabetes (within 6-8 years).

Why is there a "sweet" disease?

The "sweet" disease forms a rather "colorful" group of patients, therefore it becomes obvious that ISSD and its insulin, dependent on a "colleague", are genetically found differently.There is evidence of the binding of insulin-dependent diabetes to the genetic structures of the HLA system (the main Histo-compatibility complex), in particular with some D-region genes.For Inzsd, such a connection has not been seen.

Diabetes Sugar - Sweet Disease

For the development of diabetes of the type of genetic predisposition, the pathogenetic mechanism is started by provocative factors:

  • Congenital inferiority of Langgan's islands;
  • Adverse effects on the external environment;
  • Stress, nerve loads;
  • Traumatic brain injuries;
  • Pregnancy;
  • Infectious processes of viral origin (influenza, "pig", cytomegalovirus infection, Coksaki);
  • Tendency to constantly overeating, leading to excess fat;
  • The abuse of confectionery (sweet tooth risks more).

Before illuminating the causes of type II diabetes, it would be advisable to opt for a very controversial question: Who suffers more often - men or women?

It has been found that the disease is currently more common in women, although in the 19th century SD is a "privilege" of men.By the way, now in some countries in Southeast Asia the presence of this disease in men is considered predominant.

The predisposing conditions for the development of type II diabetes mellitus can be attributed:

  • Changes in the structural structure of the pancreas as a result of inflammatory processes, as well as the appearance of cysts, tumors, bleeding;
  • Age after 40 years;
  • Excess weight (the most important risk factor for INZSD!);
  • Vascular diseases due to atherosclerotic process and arterial hypertension;
  • In women, pregnancy and birth of a high body weight (more than 4 kg);
  • The presence of relatives suffering from diabetes;
  • Strong psycho -emotional stress (hypermaxation of the adrenal glands).

The causes of the disease of different types of diabetes in some cases coincide (stress, obesity, influence of external factors), but the onset of the process in diabetes of the first and second type is different, moreover, in addition, in addition,ISSD is many children and young, and insulin -dependent prefers the older generation.

Why do you want to drink so much?

The characteristic symptoms of diabetes, regardless of form and type, can be presented in the following form:

Diabetics always torment a strong thirst
  1. Dry mucosa oral cavity;
  2. Thirst that can hardly be satisfied with dehydration;
  3. Excessive urine formation and its release from the kidneys (polyuria), which leads to dehydration;
  4. Increasing the concentration of glucose in the blood serum (hyperglycemia) due to the suppression of the discharge of sugar with peripheral tissues due to insulin deficiency;
  5. The appearance of sugar in the urine (glucose) and ketone bodies (ketonuria), which are usually present in insignificant quantities, but with diabetes mellitus are produced intensively by the liver and when separated from the body are found in the urine;
  6. Increased blood plasma (in addition to glucose) of urea and sodium ions (Na+);
  7. Weight loss, which in the case of decompensation of the disease is a characteristic characteristic of catabolic syndrome, which develops due to the breakdown of glycogen, lipolysis (mobilization of fat), catabolism and glucose (transformation in glucose) of proteins;
  8. Disruption of lipid spectrum indicators, increase of total cholesterol due to low -density lipoproteins, Nezhk (unsuccessful fatty acids), triglycerides.The increasing content of the lipids begins to actively go into the liver and there is an intense oxidized, leading to the excessive formation of ketone bodies (acetone + β-oxylin acid + acetux acid) and additional entry into their blood (hypercetonomy).Excessive concentration of ketone bodies threatens a dangerous condition calleddiabetic ketoacidosisS

Thus, the common signs of diabetes can be characteristic of any form of the disease, but in order not to confuse the reader, the traits inherent in this or that type must still be noted.

Type I diabetes - "privilege" of young

ISD is characterized by a sharp (weeks or months) beginning.The signs of type I diabetes are pronounced and manifested by clinical symptoms characteristic of the disease:

  • A sharp decline in weight;
  • Unnatural thirst, one just can't get drunk, even though he tries to do it (polydipsia);
  • Large amounts of urine secreted (polyuria);
  • A significant excess of the concentration of glucose and ketone bodies in the blood serum (ketoacidosis).In the initial stage, when the patient is still unable to know about his problems, he is likely to develop diabetic (ketoacidic, hyperglycemic) coma - a condition that is an exceptional increase in life, therefore insulin therapy is prescribed as early as possible (only diabetes will be fast).
Measuring blood glucose level will help diagnose diabetes

In most cases, after the use of insulin, the metabolic processes are offset,The need for the body in insulin decreases sharply, there is a temporary "recovery".However, this short state of remission should not release either the patient or the doctor, since after a period of time the disease will remind of himself again.The need for insulin with an increase in the duration of the disease may be increased, but in principle, in the absence of ketoacidosis, it will not exceed 0.8-1.0 units/kg.

Signs showing the development of late complications of diabetes (retinopathy, nephropathy) can occur in 5-10 years.The main reasons for the fatal result of ISD include:

  1. Terminal renal failure, which is a consequence of diabetic glomerulosclerosis;
  2. Cardiovascular disorders, such as complications of the underlying disease, which occur a little more kidney.

Illness or age -related changes?(Type II Diabetes)

Inzsd has been developing for many months or even years.The emerging problems, one carries to various specialists (dermatologist, gynecologist, neurologist ...).The patient does not suspect that the diseases are different according to him: furunculosis, itching of the skin, fungal lesions, pain in the lower limbs - signs of type II diabetes.Patients get used to their condition and diabetes continues to develop slowly, affecting all systems and mainly vessels.

Inzsd is characterized by a stable slow course, as a rule, without showing a tendency for ketoacidosis.

Treatment of type 2 diabetes usually begins in accordance with the diet with limitation of easily digestible (refined) carbohydrates and use (if necessary) to reduce drugs of drugs.Insulin is prescribed if the development of the disease has reached the stage of severe complications or has immunity to oral drugs.

The main cause of death in patients with INZSD was recognized as a cardiovascular pathology, which became a result of diabetes.As a rule, it is a heart attack or stroke.

Diabetes Treatment Products

The basis of medical measures aimed at compensating for diabetes are three basic principles:

Various medicines to treat diabetes
  • Compensation for lack of insulin;
  • Regulation of endocrine disorders;
  • Prevention of diabetes mellitus, its complications and their timely treatment.

The application of these principles is carried out on the basis of 5 main positions:

  1. Diabetic nutrition was appointed the party of the "first violin";
  2. The system of exercise, adequate and individually selected, continues after the diet;
  3. Drugs that reduce sugar are mainly used to treat type 2 diabetes;
  4. Insulin therapy is prescribed if necessary with INZSD, but is the main one in the case of type 1 diabetes;
  5. Training patients for self -control (skills for taking blood from the finger, using a glucometer, introduction of insulin without external help).

Laboratory control over these positions shows the degree of compensation after the following biochemical studies:

Indicators Benefit Satisfying Badly
Glucose level on an empty stomach (mmol/l) 4.4 - 6.1 6.2 - 7.8 Ø 7.8
Sugar content in blood serum 2 hours after meals (mmol/l) 5.5 - 8.0 8.1 - 10.0 Ø 10.0
The percentage of glycosylated hemoglobin (HBA1, %) <8.0 8.0 - 9.5 Ø 10.0
The total cholesterol indicator in serum (mmol/l) <5.2 5.2 - 6.5 Ø 6.5
Triglyceride level (mmol/l) <1.7 1.7 - 2.2 Ø 2.2

An important role of diet in the treatment of INZSD

Nutrition of diabetes is very good -known, even far from diabetes for people, Table No. 9. Being in a hospital for each disease, you can occasionally hear about a special meal, which is always in separate pots, is different from other diets and is issued after a specific password: "I have the ninth table."What does all this mean?What is the difference between this mysterious diet of everyone else?

You should not be fooled, taking care of his "mess" of diabetics that they are devoid of all the joys of life.Diabetes diet is not so different from the diet of healthy people, the right amount of carbohydrates (60%), fat (24%), proteins (16%) patients receive.

Dietary nutrition required by patients with diabetes

Diabetes power consists in replacing refined sugars in products with slowly separated carbohydrates.Sugar is sold in a store for all and confectionery based on it falls into the category of forbidden food.

As for the balance of nutrition, everything is strict here: the diabetic must use the required amount of vitamins and pectins, which should be at least 40 g.a day.

Strictly individual physical activity

Physical activity for each patient is selected individually by the attending physician, while the following positions are taken into account:

Physical activity that helps reduce blood glucose levels
  • Age;
  • Symptoms of diabetes;
  • Severity of the flow of the pathological process;
  • The presence or absence of complications.

The physical activity prescribed by the doctor and performed by the "ward" should contribute to the "burning" of carbohydrates and fats without attracting insulin to participation.Its dose, which is needed to compensate for the metabolic disorders, is noticeably the drop, which should not be forgotten, because by preventing an increase in blood sugar, you can get an undesirable effect.Adequate physical activity reduces glucose, the administered dose of insulin breaks down and as a result of this decrease in sugar levels below the permissible values (hypoglycaemia).

Thus,The dosage of insulin and physical activity requires a lot of attention and in -depth calculation,To complement yourself, do not jointly step over the lower limit of normal laboratory indicators.

Or maybe try folklore means?

Treatment of type 2 diabetes is often accompanied by the search for patients with folk remedies who can inhibit the process and, as far as possible, slows down the time of dosage forms.

Without considering the fact that our distant ancestors have practically unaware of such a disease, folk remedies for the treatment of diabetes exist, but we must not forget thatThe infusions and decisions prepared by different plants are an auxiliary agent.The use of domestic medicines for diabetes does not relieve the patient from adherence to diet, control of blood sugar, attending a doctor and fulfill all his recommendations.

Medicinal plants helping to fight diabetes mellitus

To combat this pathology at home, many well -known folk remedies are used:

  1. Bark and white black leaves;
  2. Cereals and peeling oats;
  3. Walnut barriers;
  4. Bay leaf;
  5. Cinnamon;
  6. Acorns;
  7. Nettle;
  8. Dandelion.

When diet and folk remedies no longer help ...

The first -generation Soo, widely known at the end of the last century, remained in the memoirs and they were replaced by new generation drugs, which make up 3 major groups of diabetes produced by the pharmaceutical industry.

Various medicines are used to treat diabetes

Which means is suitable for one or the other patient - decides the endocrinologistSSo patients do not self -assess and do not decide to use these diabetes medicines at their discretion, we will give some visual examples.

Sulfonylmochevin derivatives

The second -generation sulphonema derivatives, which act from 10 hours to the day, are currently prescribed.Usually patients take them twice a day half an hour before meals.

These drugs are absolutely contraindicated in the following cases:

  • Type 1 diabetes;
  • Diabetic, hyperosmolar, lactacidotic coma;
  • Pregnancy, childbirth, lactation;
    • Sulfonyl gross derivatives in type 2 diabetes
  • Diabetic nephropathy, accompanied by impaired filtration;
  • Diseases of the hematopoietic system with concomitant decrease in white blood cells - leukocytes (leukocytopenia) and platelet hematopoiesis (thrombocytopenia);
  • Severe infectious and inflammatory liver lesions (hepatitis);
  • Diabetes complicated by vascular pathology.

In addition, the use of drugs in this group may endanger the development of allergic reactions that occur:

  1. Itching and urticaria, sometimes reaching Quinke's swelling;
  2. Disorders of the digestive system;
  3. Changes from blood side (decrease in platelet levels and leukocytes);
  4. Perhaps impaired liver functional capacity (jaundice due to cholestasis).

Sahabro courts

Biguanides (guanidine derivatives) are actively used to treat type 2 diabetes, often adding sulfonamides to them.They are very rational for use by patients with obesity, but people who have liver, kidneys and cardiovascular pathology are sharply limited, moving to more sparing drugs than the same group or α-glucoside inhibitors inhibiting carbohydrate absorption in the small intestine.

Absolute contraindications to the use of Biguanides are considered:

  • ISD (type 1 diabetes);
  • Significant weight loss;
  • Infectious processes, regardless of location;
  • Surgical interventions;
  • Pregnancy, childbirth, breastfeeding period;
  • Coma declares;
  • Liver and renal pathology;
  • Oxygen starvation;
  • Microangiopathy (2-4 degrees) with visual impairment and renal function;
  • Trophic ulcers and necrotic processes;
  • Disruption of blood circulation in the lower limbs due to various vascular pathologies.

Insulin treatment

Insulin Injections - The main treatment of type 1 diabetes

By the above fact that the above becomesThe use of insulin is the main treatment of type 1 diabetes, all emergencies and severe complications of diabetes.Inzsd requires the appointment of this therapy only in cases of forms of use of insulin when the correction by other means does not have the right effect.

Modern insulins, called mono -complicit, represent two groups:

  1. Monocompetent pharmacological forms of human insulin substance (semi-synthetic or DNA-controlled combine), which undoubtedly have a significant advantage over pork preparations.They have virtually no contraindications and side effects;
  2. Monocompetent insulins derived from the pig pancreas.These drugs, compared to human insulins, require an increase in the dose of the drug by approximately 15%.

Diabetes is dangerous complications

Due to the fact that diabetes is accompanied by damage to many organs and tissues, its manifestations can be found in almost all bodily systems.Diabetes complications are considered:

  • Pathological changes in the skin: Diabetic dermopathy, lipoid necrobiosis, boils, xanthoma, fungal lesions of the skin;
  • Bone-articular diseases:
    1. Diabetic osteoarthropathy (joint joint - change in the ankle joint) that occurs against the background of microcirculation disorders and trophic disorders accompanied by dislodes, subloxis, spontaneous fractures prior to formationdiabetic foot;
      2. Organs to which complications of diabetes mellitus
    2. Diabetic chiropathy, characterized by stiffness in the joints of the hands, which is more commonly formed in children with diabetes of children;
  • Respiratory Diseases: Long -termProlonged bronchitis, pneumonia.,Increasing the frequency of development of tuberculosis;
  • Pathological processes affecting the digestive organs:Diabetic enteropathyAccompanied by increased peristalsis, diarrhea (up to 30 times a day), weight loss;
  • Diabetic retinopathy- one of the most serious complications characterized by damage to the visual organs;
  • Is considered the most frequent complication of diabetesDiabetic neuropathyAnd its diversity -PolyneuropathyReaching 90% of all forms of this pathology.It is often found to be diabetic polyneuropathyDiabetic syndrome;
  • The pathological condition of the cardiovascular system in most cases is the cause of the death of diabetes mellitusSHypercholesterolemia and vascular atherosclerosis, which in diabetes begin to develop at a young age, inevitably lead to diseases of the heart and blood vessels (coronary heart disease, myocardial infarction, heart failure, cerebral damage).

Prevention

Measures to prevent diabetes are built on the basis of the causes of its challenge.In this case, it is advisable to talk about preventing atherosclerosis, arterial hypertension, including the fight against excess weight, poor habits and nutritional addiction.

Glucose correction in blood serum - the method of diabetes prevention

The prevention of complications of diabetes consists in preventing the development of pathological conditions arising from the diabetes itself.Glucose correction in blood serum, adherence to diet, adequate physical activity, applying the doctor's recommendations will help to push the effects of this rather great disease.