Diabetes mellitus is one of the most common diseases faced by people from different parts of the world and age does not really matter.
According to statistics, there are about 250 million people with one or another form of the disease.The real number of patients exceeds official figures, as many are unaware of existing violations.
Mostly children suffer from a disease whose manifestations cannot always be detected in time due to mild symptoms.
Due to negligence, patients do not consult an endocrinologist who can identify and diagnose the problem.
In order to avoid an unpleasant situation, you should learn in detail what diabetes mellitus means, what are the predisposing factors, symptoms and treatment methods.
What is diabetes mellitus?
This pathology is characterized by an insufficient level of insulin in the body, which is a peptide hormone concentrated in the cells of the pancreas.Diabetes mellitus is presented in the form of many diseases associated with damage to the endocrine system.There is an active production of glucose in the blood, which increases in the urine, and destabilization of metabolic processes also occurs.
If we consider the deviations that occur in the body, we find:
- The internal organs feed on glucose, and if it is not supplied in sufficient quantities, starvation will occur.This occurs due to the lack or small amount of insulin produced by the pancreatic cells.When the movement of accumulated sugar in the blood stops, further metabolic development does not occur;
- the cells responsible for hormone transport and glucose assimilation suddenly gain immunity and do not react in any way to a substance that is not able to undergo changes;
- sugar is not converted into nutrients, which causes the body to starve, a lot of glucose enters the blood, which has a negative effect on cells;
- the degree of damage to the endocrine system depends on the severity of the disease and timely treatment;
- It is easier to solve the problem at an early stage, but many patients come to the clinic later, which has a worse effect on the implementation of therapeutic measures.
Many doctors agree that diabetes is not a disease, but the cause of the problem, and it lies in the wrong lifestyle.
If you adjust your work and rest schedule, follow your doctor's recommendations, and monitor your well-being and blood sugar levels, you will be able to protect yourself from negative consequences.
If no measures are taken, there is a risk of damage to all organs.In advanced cases, the patient is at risk of falling into a coma due to serious complications.Even if there are small deviations, it is important to consult a doctor in time.
Diabetes types 1 and 2
Each of them has a classification of the disease that allows us to distinguish types with specific characteristics.
We are talking about such types:
- first type, called juveniles, are detected in adolescents and older patients.It is mainly transmitted to children from close relatives.Beta cells undergo changes that negatively affect their structure.Insulin is produced in small quantities, not enough for the normal life of the victim.About 10% have a problem of mainly autoimmune origin.Sometimes the cause of the pathology is an attack of pancreatitis or pancreatic necrosis, the person survives, but the pancreas eventually loses its original properties.The condition does not change over time, it remains until the end of life;
- the second kind- due to the deterioration of metabolism, the hormone is not produced in the required volume, which leads to a relative lack of insulin.Beta cells stop working stably;due to pathological processes, they cannot perform the functions determined by the body - to produce the necessary substance and reduce glucose in the blood.
Gestational diabetes in women occurs in pregnant women whose serum glucose level is higher than normal.Detected deviations should not be ignored, because inactivity has a negative effect on the fetus.It is possible to get rid of the disease after childbirth, but disorders related to the absorption of this organic compound can also be found in women who initially did not complain of their health condition.
The use of drugs, destabilization of the endocrine system, pancreatic dysfunction, etc.due to which the situation develops negatively there are other species.
Symptoms of type 1 and type 2 diabetes
The first type has a chronic form, is transitory and quickly passes from the initial stage to a more severe stage, which occurs against the background of the negative effects of various factors.
Different features include:
- sudden weight loss;
- nocturnal incontinence, which is more common in children;
- visual impairment;
- skin and mucous membranes dry;
- lack of moisture in the oral cavity even if the water balance is maintained;
- thirst causes more than 10 liters of drinking water;
- itching and purulent formations on the skin;
- urinary frequency, large amounts of urine;
- uncontrolled contraction of the muscles of the lower extremities;
- vomiting and nausea - the relief that comes after emptying the stomach is temporary;
- irritation;
- loss of strength, inability to work for a long time;
- increased appetite;
- persistent desire to eat after a short period of time.
One complication is hyperglycemia - elevated glucose levels, which can be fatal.Deterioration of the condition, manifested by a minimal amount or absence of hair on the legs, cannot be excluded.
The appearance of benign yellowish formations is observed in tendons, mucous membranes of internal organs and skin.Inflammation can be observed on the surfaces of the genital organs in both men and women.Bones are fragile and easily susceptible to external influences.As for immunity, it practically loses its protective properties.
The symptoms of the second type of diabetes mellitus have some similarities, but there are manifestations that allow you to determine which type you are dealing with.The following signs are identified:
- wounds heal for a long time;
- infection of the epidermis;
- feeling of thirst;
- frequent urination, forcing you to go to the toilet both during the day and at night;
- exhaustion, slow reaction, sleep disturbance;
- mucous membranes are dry;
- numbness, tingling in the limbs;
- increased appetite as a result of pathology of leptin synthesis;
- dry mouth, you need to drink about 3-5 liters a day;
- itching in the groin area - confusion arises, prompting to contact a gynecologist or dermatologist instead of an endocrinologist;
- Hunger 1-2 hours after eating;
- swelling of the face and lower legs;
- childhood enuresis, manifested at night;
- high blood pressure;
- headache and dizziness.
Symptoms occur when glucose levels exceed levels that can be easily detected by the appearance of sugar in the urine.
Pathogenesis of the disease
Factors causing diabetes mellitus have been determined.Among them:
- heredity - if the parents make the same diagnosis, the risk of developing the first type of disease in the child increases;
- overweight - 80-90% of patients are overweight, because fat tissue cannot use insulin as intended.Newborns should weigh 2.5-3.5 kg;if the indicators increase, an endocrinologist's examination is necessary;
- viruses - cause abnormalities of the pancreas, so it can cause the death of cells in the digestive system due to rubella, measles, chicken pox, which a child previously suffered;
- age-related changes;
- regular stressful situations;
- unhealthy lifestyle and poor diet - a body mass index of more than 30 complicates the condition that causes insulin resistance, the probability of which increases by 2 times.35 or more indicators indicate a 100% probability of diabetes;
- fat deposits around the abdomen;
- disruption of the pancreas for various reasons, including damage to the organ;
- pathological processes in the endocrine system caused by acromegaly, Itsenko-Cushing syndrome, etc.
The main factors causing the deterioration of the situation are listed;they can have a one-time effect, thereby increasing the danger.Completely healthy people are at risk and it is recommended to consult a doctor.
Sugar level after meal and before meal
On an empty stomach, there is a low glucose level, which is normally in the range of 3.4-5.5 mmol / l.Indicators in diabetic patients exceed the specified value and are calculated as follows:
- the first type - up to 9.3 mmol/l;
- the second type - 8.5 mmol/l.
After eating, the metabolism is activated, as a result of which glucose is released.How much the level of organic compound increases depends on the ability to absorb it.In practice, the examination is not performed on an empty stomach.The most accurate information will be obtained 1-3 hours after eating.
Normal blood sugar levels for diabetes for women, men and children over 12 years of age:
- after 1 hour - up to 8.6-8.9;
- after 2 hours - up to 7.0-7.2;
- After 3 hours - up to 5.8-5.9.
For type 1 diabetes patients with the same duration:
- until 11;
- up to 10-10.3;
- Up to 7.5.
If you have type 2 diabetes:
- 9.0;
- 8.7;
- 7.5.
After three or more hours, the glucose level continues to decrease until it returns to normal.
What are the stages of diabetes?
Classification is based on the degree of development of pathologies of carbohydrate metabolism, therefore it is divided into the following stages:
- compensation- achieving glucose content according to natural indicators;
- subcompensation- sometimes the volume of the substance increases;
- decompensation- lack of response to insulin, implementation of therapy is difficult.
The disease is classified according to the severity of the course;three forms are known.Among them:
- light- The improvement of the condition occurs due to choosing the right diet and regimen.The positive effect is obvious when following a diet, and the use of a hypoglycemic agent will bring double benefits.The probability of transition from one stage to another is minimized;
- medium– You can't do without drugs that lower the sugar level.They are used continuously, but it is impossible to protect against vascular pathologies;
- heavy- the use of hypoglycemic agents and insulin, sometimes used in combination with other drugs, should not be discontinued.There is a danger of developing encephalopathy, neuropathy and vascular angiopathy.
Differences between type 1 and 2 diabetes
In addition to type 2 diabetes having an E11 ICD-10 code and type 1 diabetes having an E10 code, it is important to familiarize yourself with other different characteristics of these types in order to have an idea about each of them and to be able to determine the type of disease based on its characteristics.
| Features | The first kind | The second type |
|---|---|---|
| Period | Autumn, winter, spring | Not mentioned |
| Jobs (%) | 10-20% | 80-90% |
| Sex | More often men | More often women |
| Age | Up to 40 years | Children, adults over 40 years old |
| Weight | Standard or reduced | Additional kg |
| Development | Transient | It's slow, it doesn't look bright |
| Vascular anomalies | Mostly small | Mostly big |
| Cell sensitivity to insulin | Yes | Down |
| Antibodies against insulin and beta cells | Yes | no |
| Therapy | Insulin | Diet, glucose-lowering drugs, insulin (later stage) |
Diagnosis of the disease
Before learning how to treat diabetes, a blood sugar test is performed, which is the main method for calculating the current and daily glucose level.
Additional diagnostic measures include polyuria, polygraph, excess body weight or significant weight loss.The following also apply:
- Ultrasound;
- determination of pathological insulin;
- electrocardiography - study of electrical fields of the heart;
- Rehberg test - assessment of kidney condition;
- biochemical blood test;
- fundus study.
Based on the received information, a clinical picture emerges, after which a therapeutic technique is proposed.
Type 1 drugs
The main tool is insulin, but in addition, the doctor prescribes tablets that help to cope with glucose metabolism disorders combined with obesity, which aggravates the condition.
We are talking about drugs from the biguanide group, which reduce the acute need for insulin and also alleviate the patient's condition.
Insulin lispro
The analogue of insulin produced in the human body has a rapid effect - 15 minutes after injection.Glucose metabolism is controlled, anti-catabolic and anabolic effects appear in the tissue.
The drug was the best in the list of similar drugs;per day, sugar concentration decreases by 22% and glycemic data improves.
Insulin glulisine
A substitute for human insulin with a faster effect, but the result does not last long.
The substance used on an empty stomach or after a meal enters the body by injection.The duration and dosage of the course is determined taking into account the individual characteristics of the patient.
Insulin aspart
A hypoglycemic agent of the latest generation whose action is aimed at correcting glucose levels.There are slight differences compared to the human hormone, which allows the results to appear faster.After use, it is allowed to start eatinge, because there is no need to pause.
At night, hypoglycemia occurs more easily, the glucose level normalizes.Due to the strong effect, it is possible to avoid increasing the dose.
Second type of drugs
The type is not as rare as the first type, so more drugs have been developed to cure the problem.
Biguanide
It has a hypoglycemic effect, reduces the concentration of glucose in the blood and does not stimulate the production of insulin.
Weight loss, cholesterol, lipoprotein and triglyceride levels decrease.In the first stages of therapy, 2-3 tablets are prescribed for 2-3 doses per day, otherwise indigestion will occur.
The maximum amount is 6 tablets taken in three doses.If there are no complications, the dose is gradually increased.Children and adolescents over 10 years old need 1 tablet a day, after two weeks the dose changes.It is not allowed to pass the course, which involves the daily use of 4 tablets distributed three times.
Exenatide-based GLP-1 receptor agonist
It is administered using a syringe designed for home procedures.
There is a hormone similar to the hormone produced in the digestive system, which releases a substance when food is ingested.
Insulin begins to be actively produced, because it has a beneficial effect on the pancreas, which is responsible for the creation of this substance.
A GLP-1 receptor agonist based on liraglutide
A formula has been invented to prolong the effect.
Course - 1 hour before meals once a day.
The procedure should be done at the same time, this will ensure the functioning of the pancreas and the gastrointestinal tract.
DPP-4 inhibitor based on sitagliptin
Tablets are used before or after meals, you just need to follow a certain time.
100 mg is needed for 1 daily dose.
It can be used both as a separate drug and in combination with other drugs.
DPP-4 inhibitor based on saxagliptin
It belongs to the category of DPP-4 inhibitors suitable for combination therapy and monotherapy.
Type 1 diabetes becomes a complication that requires the administration of insulin after meals.
Vildagliptin-based DPP-4 inhibitor
It is necessary once a day, the required dose is 50 mg, regardless of meal time.
The result remains during the day, the negative effect of the drug decreases.
How to monitor your glucose level
The patient should monitor the sugar concentration independently.For these purposes, it is advisable to keep a diary where you need to make important notes.It is necessary to regularly check the glucose level using a glucometer;you should not eat before observations;you should measure before and after eating in the morning.Based on the information obtained, the diet and lifestyle are adjusted to bring the indicators back to normal.However, you will still need to do tests at an outpatient clinic, where more reliable data is provided.
Documents for prescribing drugs
A system has been developed that allows those who need it to receive insulin for free.The doctor writes a prescription to the patient, and before receiving it, he must provide a list of the following documents:
- identity card;
- health insurance;
- personal insurance policy;
- document confirming disability;
- a document confirming that the patient has not refused the social package.
Diet for diabetes
An approximate diet for a week that will alleviate the patient's condition is drawn up.
Diabetes mellitus type 2 is shown in the table showing the weekly diet of what you can eat.
| Breakfast | Second breakfast | Lunch | Afternoon snack | Dinner | |
|---|---|---|---|---|---|
| 1 day | Buckwheat, cottage cheese, milk 1% fat | A glass of milk | Cabbage soup, boiled meat, fruit jelly | Two apples | Cabbage schnitzel, boiled fish, tea |
| Day 2 | Barley porridge, soft-boiled eggs, cabbage salad | A glass of milk | Mashed potatoes, pickles, boiled beef liver, dried fruit compote | Fruit jelly | A piece of boiled chicken, boiled cabbage, tea.Kefir before bed |
| Day 3 | Cottage cheese with milk, oatmeal, coffee | Kissel | Borsch without meat, boiled chicken, buckwheat porridge | Two pears | Vinaigrette, egg, tea.Yogurt before going to bed |
| 4 days | Buckwheat, cottage cheese, coffee | Kefir | Cabbage soup, boiled beef without fat, compote | 1-2 pears | Schnitzel, boiled fish, tea |
| 5 days | Potato-free vinaigrette with 1 tsp.slice of rye bread with vegetable oil, egg, coffee, butter | Two apples | Boiled meat with sauerkraut, pea soup | Fresh fruit | Boiled chicken, vegetable pudding, tea.Yogurt before going to bed |
| 6th day | Cooked meat, millet porridge, coffee | Wheat bran decoction | Boiled meat, fish soup, fat-free mashed potatoes | Kefir | Oatmeal, cottage cheese, milk, apple |
| 7th day | Buckwheat, hard-boiled eggs | Two apples | Beef cutlet, pearl barley, vegetable soup | Milk | Boiled fish, steamed potatoes, vegetable salad, tea.Kefir before bed. |
Natural medicine
Treatment with folk remedies for diabetes is considered a way to eliminate the disease, so some of the most effective recipes are considered.
Namely:
- Fill the vessel with 1 liter of boiled water, add 100 g of cinnamon powder, mix, add 200 g of honey.Let it brew for 3 hours in a cool place.Course - 3 times a day;
- linden flower 1 tbsp.l.Pour 1 cup of boiling water, decoction can replace black tea;
- Put 300 g of peeled garlic and the same amount of parsley roots, 100 g of lemon peel in a meat grinder.Put the soil ingredients in a jar, cover with a lid and leave in a dark, dry place for 2 weeks.drink 1 tsp.2 times a day;
- chop dried walnut leaves, select 1 tbsp.l., pour ½ l of filtered water.Cook for 15 minutes, then remove from heat, set aside in a dry place for 1 hour.Strain, take ½ cup 3 times a day.
Before use, you should consult a doctor to avoid complications.
Sports and physical education
With physical activity, a lot of glucose is burned, the metabolism and the activity of the cardiovascular system are also stabilized, so it is important to do at least simple exercises daily.
Excessive tension should not be allowed, because there will be negative consequences.Increased appetite forces you to consume large amounts of food, so the efforts made earlier lose their meaning.
When fatigue occurs, stress occurs, adrenal hormones are released, and then glucose levels rise.
The best options for getting excellent results are morning exercises, exercises with dumbbells, walking, running, cycling, swimming.
Prognosis for type 1 and type 2 diabetes
If you allow the disease to enter the decompensation stage, it will not be possible to eliminate the problem, because the body's reserves are significantly reduced.
It is always easier to fight the disease in the initial stage than in advanced cases.By choosing the most effective therapy, the patient's condition is alleviated, thereby prolonging life.It is possible to improve the condition with a healthy lifestyle and physical activity.