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 uptake 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 a strong feeling of 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 organ 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 every year. With proper 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 diseases. The disease occurs in one in ten people and there are also hidden forms in which the patient is not even 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 a particular disease and disappears after the cause is eliminated. True diabetes is divided into two types.
- Type I: insulin-dependent or childhood diabetes. It usually develops during childhood or adolescence. Caused by lack of insulin in the body, against the background 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 become common among children and adolescents as well. It is caused by the insensitivity of body tissues to insulin, as a result of which they cease to 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 more 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 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 different classifications, the main of which is based on the level of glycated hemoglobin (HbA1c). This is an indicator that reflects the average blood sugar level over the last 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, specific symptoms or first signs of complications are present.
- Severe (HbA1c 8% or higher): characterized by a significant level of blood sugar, severe symptoms and complications.
Compensated, undercompensated and decompensated diabetes mellitus is also distinguished according to similar criteria.
Symptoms of diabetes
Symptoms depend on the form and severity of the disease. Type 1 diabetes develops more quickly and often causes complications in younger people, while type 2 diabetes may not show any symptoms for a long time. Often pathology can be detected only with the help of special studies.
Possible symptoms and signs:
- Frequent urge to urinate and increased urine volume;
- Severe 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 healing of wounds;
- Insomnia and tiredness;
- 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 a dysfunction of the pancreas or a disorder of cell 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 older 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 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 diseases. Having relatives with diabetes is a major 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 drugs that contribute to the development of diabetes;
- Adrenal dysfunction;
- Cardiovascular diseases.
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, during which he examines the patient's complaints and collects medical history to identify risk factors for diabetes. A persistent increase in blood sugar levels and other clinical signs of diabetes are detected through special studies, then the endocrinologist, after consultation, prescribes all the necessary procedures.
Exams conducted:
- Fasting blood test. The endocrinologist asks the patient 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 a glucose content greater than 6. 5 mmol/l in the obtained sample;
- Blood test for the content of glycosylated hemoglobin. The level of this substance indicates the level of glucose in the blood for 3 months, so the doctor prescribes such a test for primary diagnosis and monitoring of diabetes treatment. A concentration of glycosylated hemoglobin greater than 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first phase 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 takes a new 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 indicates a significant increase in the level (about 11 mmol/l), the diagnosis is confirmed;
- Blood test for C-peptide content. An endocrinologist prescribes this test to reliably evaluate 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 concentration greater than 10 mmol/L of glucose in several blood samples, regardless of the time of the meal, indicates the presence of diabetes mellitus;
- Urinalysis. Patients with diabetes have high levels of glucose in their urine. Additionally, the patient's urine may contain ketone bodies, indicating a disturbance 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, as if left unchecked, your sugar level will rise again. If the patient ignores the treatment, he may encounter complications of the pathology: hypo- or hyperglycemic coma, cardiovascular complications, vision disorders (diabetic retinopathy), pathologies of the nerve fibers (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.
Diabetes treatment
The endocrinologist studies the diagnostic results and prescribes the 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 doctor's recommendations allows you to significantly improve the quality of life and avoid the negative consequences of diabetes.
Two types of drug therapy are used to correct the pathology.
- Prescribe medications that lower 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 drugs while strictly adhering to the dosage and monitoring blood sugar levels. The listed drugs improve the production of insulin 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 mellitus and to patients with type 2 diabetes mellitus 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 medicine should be taken once a day, regardless of nutrition. Rapid-acting insulin preparations are administered in hospitals for the treatment of complicated forms of diabetes and with a sharp increase in blood sugar levels. The doctor explains the rules for using injections and the required 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 drugs and prescriptions during treatment. Repeated consultations allow you to resolve problems associated with complications of the disease and side effects of medications. In addition, the specialist must show how to administer the medicine 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.
Main prevention methods:
- Normalization of body weight and moderate physical activity;
- Timely treatment of pancreatic diseases;
- A healthy diet that includes adequate consumption of fruit and vegetables.
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 further tests.
How to prevent diabetes complications?
Follow your doctor's recommendations regarding diet and medications. The main criterion is normal blood glucose concentrations.