Diabetes mellitus

Diabetes.  Photo from www.sciencephoto.com

Even a half thousand years BC, the ancient Egyptians in his medical treatise "Ebers Papyrus" described diabetes as a distinct disease. The great doctors of ancient Greece and Rome constantly speculated about this mysterious disease. Doctor Aretaius coined it the name "diabetes" — in Greek "Leaky, pass through." Scientist Celsus argued that in the occurrence of diabetes guilty indigestion, and the great Hippocrates diagnosed, the patient's urine sampling tastes. By the way, the ancient Chinese also knew that in diabetes the urine becomes sweet. They came up with an original method of diagnosis using flies (and wasps). If the flies land on a saucer in the urine, so the urine is sweet, and the patient is sick.

Diabetes mellitus— Endocrine disease is characterized by a chronic increase in blood sugar levels due to an absolute or relative insulin deficiency — pancreas hormone. The disease leads to disruption of all kinds of metabolism of the affected vessels, nervous system and other organs and systems.

Classification

Distinguish:

  1. Insulin-dependent diabetes (type 1 diabetes) occurs mainly in children and young people;
  2. Non-insulin-dependent diabetes (type 2 diabetes) usually develops in people over 40 years who are overweight. This is the most common type of disease (found in80-85% Of cases);
  3. The secondary (or symptomatic) diabetes mellitus;
  4. Gestational diabetes.
  5. Diabetes is caused by malnutrition

At type 1 diabetes mellitus there is an absolute deficiency of insulin due to a violation of the pancreas.

Attype 2 diabetes notes relative deficiency of insulin. The cells of the pancreas with produce enough insulin (sometimes even an increased amount). However, on the surface of cells is blocked or reduced the number of agencies that provide his contact with the cell and helps the glucose from the blood to enter into the cell. Glucose deficiency in cells is the signal for the further production of insulin, but this has no effect, and eventually production of insulin is greatly reduced.

Causes

The main cause of type 1 diabetes mellitus is an autoimmune process due to failure of the immune system, in which the body produces antibodies against the cells of the pancreas, destroying them. The main factor that provokes the emergence of type 1 diabetes, is a viral infection (rubella, chicken pox, hepatitis, mumps (mumps), etc.) due to a genetic predisposition to the disease.

Regular intake of dietary supplements containing selenium increases the risk of developing diabetes type …

The main factors causing the development of Type 2 diabetes Two obesity and family history:

  1. Obesity. In the presence of obesity I, Art. the risk of developing diabetes is increased by 2 times, while Article II. — 5 times, in Article III. — More than 10 times. With the development of a disease associated abdominal form of obesity — when the fat is distributed in the abdomen.
  2. Hereditary predisposition. In the presence of diabetes in parents or close relatives increases the risk of developing the disease in2-6 times.

Non-insulin dependent diabetes develops gradually and is characterized by moderate severity of symptoms.

The reasons for the so-called secondary diabetes may be:

  • diseases of the pancreas (pancreatitis, tumor resection, etc.);
  • hormonal nature of the disease (syndrome Cushing, acromegaly, Graves' disease, pheochromocytoma);
  • effects of drugs or chemical substances;
  • change of insulin receptors;
  • certain genetic syndromes etc.

Separately isolated diabetes pregnancy and diabetes, caused by malnutrition.

What's going on?

Whatever the cause of diabetes, one consequence: the body can not make full use of glucose (sugar) from food and stores the surplus in the liver and muscles. Unused glucose is circulated in excess in the blood (partially excreted in the urine), which adversely affects all organs and tissues. Since the glucose uptake into cells is not enough as a power source starting fats used. As a result, increased quantities generates toxic to the body and especially the brain substance called ketone bodies disrupted fat, protein and mineral metabolism.

Symptoms of diabetes:

  • thirst (patients can drink 3-5 l or more of fluid per day);
  • frequent urination (both day and night);
  • dry mouth;
  • General and muscle weakness;
  • increased appetite;
  • itching of the skin (especially in the genital area in women);
  • drowsiness;
  • fatigue;
  • poorly healing wounds;
  • dramatic weight loss in patients with type 1 diabetes;
  • obese patients with type 2 diabetes.

Usually, type 1 diabetes (insulin-dependent) is developing rapidly, sometimes all at once. Non-insulin dependent diabetes develops gradually and is characterized by moderate severity of symptoms.

Complications of diabetes:

  • cardiovascular disease (atherosclerosis, coronary heart disease, myocardial infarction);
  • peripheral arterial disease, including arteries of the lower extremities;
  • microangiopathy (damage to small blood vessels) of the lower extremities;
  • Diabetic retinopathy (reduced vision);
  • neuropathy (decreased sensitivity, dryness and flaking of the skin, pain or cramps in the limbs);
  • nephropathy (urinary excretion of protein, impaired renal function);
  • Diabetic foot — foot disease (ulcers, necrotic processes) in the background of peripheral nerves, blood vessels, skin, soft tissues;
  • various infectious complications (frequent pustular skin lesions, fungi nogtey.i etc.);
  • coma (diabetic hyperosmolar, hypoglycemic).

Diabetes type sometimes seen a sharp deterioration with marked weakness, abdominal pain, vomiting, acetone odor of breath. This is due to the accumulation in excluding toxic ketone bodies (ketoacidosis). If not quickly resolve this condition, the patient may lose consciousness — a diabetic coma — and die. Coma may also occur with an overdose of insulin and a sharp decrease in blood glucose levels — hypoglycemic coma.

To prevent the development of complications of diabetes need constant care and tight control of blood sugar.

Diagnosis and treatment

Diabetics have to be registered atendocrinologist.

To Diagnostic diabetes have the following study.

  • Analysis of blood glucose: fasting glucose determined in capillary blood (blood from a finger).
  • Glucose tolerance test: Fasting takes about 75 g of glucose dissolved in1-15 cups of water, then the concentration of glucose in the blood at 0.5 for 2 hours.
  • Analysis of urine for glucose and ketone bodies: detection of ketone bodies and glucose confirms the diagnosis of diabetes.
  • Determination of glycosylated hemoglobin: the amount is significantly increased in patients with diabetes mellitus.
  • Determination of insulin andC-peptide levels: the first type of diabetes and insulinC-peptide greatly reduced, and the second type of possible values within the normal range.

Treatment of diabetes comprising:

  • special diet: it is necessary to exclude sugar, alcoholic drinks, syrups, cakes, cookies, sweet fruit. Food should be taken in small portions, better 4-5 once a day. Recommended pro
    ducts containing various sweeteners (aspartame, saccharin, xylitol, sorbitol, fructose, etc.).
  • daily use of insulin (insulin) — to patients with diabetes first type and the progression of type II diabetes. The drug is available in special pen, which make it easy to get shots. In the treatment of insulin to self-monitor glucose levels in blood and urine (using special strips).
  • the use of pills that can help reduce blood sugar levels. Typically, such formulations begin treatment of diabetes mellitus of second type. With the progression of the disease to the administration of insulin.

People suffering from diabetes are useful exercise. Therapeutic role has, and weight loss in obese patients.

Treatment of diabetes is held for life. Self-control and strict compliance with the doctor's recommendations can be avoided or significantly slow the progression of complications of the disease.

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