Diabetes mellitus is a group of metabolic diseases that cause an uncontrolled increase in blood sugar (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 pathologies 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 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 habits increase the number of patients each 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 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, 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 infantile diabetes. Usually develops during 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 constant external insulin.
- Type II: non-insulin-dependent diabetes or adult-onset diabetes. It most often develops in adulthood, but has now also become common in children and adolescents. It is caused by the insensitivity of body tissues to insulin, preventing them from 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 childbirth. Requires diet and, if that 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 of which is based on the level of glycated hemoglobin (HbA1c). This is an indicator reflecting the average blood sugar level over the past 2-3 months.
- Mild degree (HbA1c less than 6. 5%): blood sugar is within normal limits or close to normal, pathological manifestations 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 more): Characterized by high blood sugar levels, serious 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 younger people, while type 2 diabetes may have no 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 volume of urine;
- Strong thirst and consumption of large volumes of fluid;
- 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 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 a malfunction 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 age 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 loved ones with diabetes is a significant 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 provoke 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 anamnesis to identify risk factors for diabetes. A persistent increase in blood sugar and other clinical signs of diabetes are detected through special studies, so the endocrinologist, after consultation, prescribes all the necessary procedures.
Examinations carried out:
- 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 content of more than 6. 5 mmol/l of glucose in the sample obtained;
- Blood test for glycosylated hemoglobin content. 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 above 6. 5% indicates the presence of diabetes mellitus;
- Load test. The first stage of the study is a standard determination of fasting blood sugar. Then the doctor asks the patient to drink a glass of sugar water and after 2 hours takes another 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), 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 taken at any time. This test is used to confirm signs of illness. A concentration above 10 mmol/L of glucose in several blood samples, regardless of meal time, indicates the presence of diabetes mellitus;
- Urinalysis. Diabetic patients have high levels of glucose in their urine. Additionally, the patient's urine may contain ketone bodies, which indicates 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 disease that is both very dangerous and common. 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 need to be treated for this condition for the rest of your life, because if you don't control it, your sugar levels will rise again. If the patient ignores treatment, he or she 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 sugar levels, prevent the development of complications and eliminate unpleasant symptoms. In addition to drug treatment, 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.
To correct the pathology, two types of drug therapy are used.
- Prescribe medications that lower blood sugar. 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, strictly adhering to the 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 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 should be taken once a day, regardless of diet. Rapid-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 the 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 help resolve issues related to complications of the disease and side effects of medications. In addition, the specialist must show how to administer the drug and explain all the rules of treatment.
Diabetes prevention
Every year, diabetes is diagnosed more and more often. Medical advice will help prevent the development of this disease.
Main methods of prevention:
- Normalization of body weight and moderate physical activity;
- Prompt 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 pathology, first of all, blood is given to determine blood sugar levels. In case of deviations, the doctor will prescribe additional tests.
How to prevent diabetes complications?
Follow your doctor's recommendations regarding diet and medications. The main criterion is normal blood sugar levels.