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

Glucometer and drugs for the treatment of diabetes

Diabetes Mellito is one of the most common that tend to increase statistics on incidence and ruining diseases.The symptoms of diabetes do not appear on the same day, the process flows chronically, with the increase and aggravation of endocrine exchange disorders.True, the debut of type I diabetes is significantly different from the initial phase of the second.

Among the entire endocrine pathology, the diabetes safely holds the championship and represents over 60% of all cases.In addition, disappointing statistics indicate that 1/10 of the "diabetics" are children.

The probability of acquiring the disease increases with age and, therefore, every ten years the number of the group doubles.This is explained by an increase in life expectancy, improving early diagnostics, a decrease in physical activity and an increase in the number of people with excess weight.

Types of diabetes

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

URTRA NON ADALAR

Nonhachario diabetes is an endocrine disease that occurs due to neuroinfections, inflammatory diseases, tumors, intoxications and due to insufficiency and sometimes the complete disappearance of ADG -Vasopressin (antidiochuretic hormone)

This explains the clinical picture of the disease:

  • Constant dryness of the mucous membranes of the oral cavity, incredible thirst (a person can drink up to 50 liters of water in 24 hours, lengthening the large stomach);
  • The assignment of a huge amount of urine of unconditional light with low specific gravity (1000-1003);
  • Lead of catastrophic weight, weakness, decrease in physical activity, digestive system disorders;
  • A characteristic change in the skin ("parchment" skin);
  • Atrophy of muscle fibers, weakness of the muscle system;
  • The development of dehydration syndrome in the absence of absence of fluids for more than 4 hours.

The disease in terms of complete care has an adverse prognosis, performance is significantly reduced.

Short anatomy and physiology

A non -re organ - Pancreas performs a mixed secretory function.Its exogenous part of external secretion, producing enzymes involved in the digestion process.The endocrine part, which is entrusted to the mission of internal secretion, is engaged in the development of various hormones, includingInsulin and glucagon.They are essential to guarantee the constancy of sugar in the human body.

The endocrine section of the gland represents the islands of Langganes, composed of:

  1. A-Celle that occupy a quarter of the entire space of the islands and are considered the place of glucagon products;
  2. The B cells that occupy up to 60% of the cell population synthesize and accumulate insulin, whose molecule is a polypeptide of two chains, which transports a certain sequence of 51 amino acids;
  3. D-Cellular that produce somatostatin;
  4. Cells that produce other polypeptides.

Therefore, the conclusion suggests itself:The damage to the pancreas and the islands of Langganes, in particular, is the main mechanism that inhibits the production of insulin and triggers the development of the pathological process.

Special types and forms of the disease

The lack of insulin leads to a violation of the constancy of sugar (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)Insulin -dependenta pathological process that refers toType I diabetes (ISD);
  • The lack of insulin (relative deficiency), which triggers a violation of the metabolism of carbohydrates in the initial phase, slowly but certainly leads to developmentinsulin -dependentDiabetes (Inzsd), which is calledType II diabetes.

Because of violations in the body of the use of glucose and, therefore, of its increase in the serum in the blood (hyperglycaemia), which, in principle, is a manifestation of the disease, the signs of diabetes mellitus, or a total disorder of metabolic processes at all levels, begin over time.

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

  1. Secondary diabetes,The pancreas deriving from the acute and chronic inflammation of the pancreas (pancreatitis), malignant neoplasms in the parenchyma of the gland, cirrhosis of the liver.Numerous endocrine disorders, accompanied by an excessive production of insulin antagonists (acromigaly, kushing disease, foocromocytoma, thyroid disease) lead to the development of secondary diabetes.Many drugs consumed for a long time have a diabetogenic effect: diuretics, some drugs and antihypertensive hormones, oral contraceptives, etc.;
  2. Diabetes in pregnant women (gestational),Due to the peculiar mutual influence of the hormones of the mother, the child and the placenta.The pancreas of the fetus that produces its insulin begins to slow down the products of insulin with the mother gland, following which this special form is formed during pregnancy.However, with adequate control, gestational diabetes usually disappears after childbirth.Subsequently, in some cases (up to 40%) in women with a similar history of pregnancy, this fact can threaten the development of type II diabetes (within 6-8 years).

Why is there a "sweet" disease?

The "sweet" disease forms a rather "heterogeneous" group of patients, therefore it becomes obvious that the ISSD and its "counterparty" dependent on insulin have occurred genetically differently.There is evidence of the connection of insulin-dependent diabetes with the genetic structures of the HLA system (the main histocompatibility complex), in particular, with some genes of the locus of the D. Region for Inzsd, such a relationship has not been seen.

Diabetes Mellito - Sweet disease

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

  • Congenital inferiority of the Langgans islands;
  • Adverse influence of the external environment;
  • Stress, nerve loads;
  • Traumatic brain lesions;
  • Pregnancy;
  • Infectious processes of viral origin (influence, "pig", cytomegalovirus infection, coksaki);
  • A tendency to constant excessive consumption that leads to excess of fat deposits;
  • The abuse of pastry (sweet teeth risk more).

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

It has been established that at the moment the disease is most often formed in women, although in the nineteenth century the SD was a male "privilege".By the way, now in some countries of the South -est 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 following inflammatory processes, as well as the appearance of cysts, tumors, hemorrhages;
  • Age after 40 years;
  • Excess weight (the most important risk factor for Inzsd!);
  • Vascular diseases due to the atherosclerotic process and arterial hypertension;
  • In women, pregnancy and in the birth of a child with a high body weight (more than 4 kg);
  • The presence of relatives suffering from diabetes;
  • Strong psycho -emotional stress (hyperostation of the adrenal glands).

The causes of the disease of various types of diabetes in some cases coincide (stress, obesity, influence of external factors), but the beginning of the process in the diabetes of the first and second type is also different, moreover, moreover,ISSD is the lot of children and children and dependent on insulin prefers the older generation people.

Why do you want to drink so much?

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

Diabetics always torment a strong thirst
  1. Oral cavity dry mucosa;
  2. Thirst, which almost cannot be satisfied, associated with dehydration;
  3. Excessive urine formation and its release from the kidneys (polyuria), which leads to dehydration;
  4. An increase in the concentration of glucose in the blood serum (hyperglycaemia), due to the suppression of the disposal of sugar with peripheral tissues due to deficiency of insulin;
  5. The appearance of the sugar in the urine (glucose) and in the bodies of Keton (Ketonuria), which are normally present in negligible quantities, but with diabetes mellitus they are produced intensely by the liver and when the excrements from the body are detected in the urine;
  6. Increase in blood plasma (in addition to glucose) of urea and sodium ions (na+);
  7. The weight loss, which in the case of the decompexes of the disease is a characteristic characteristic of a catabolic syndrome, which develops due to the decay of glycogen, lipolysis (mobilization of fats), catabolism and glucose (transformation into glucose) of proteins;
  8. Violation of the indicators of the lipid spectrum, an increase in general cholesterol due to the fraction of low density lipoproteins, Nezhk (unfetrified fatty acids), triglycerides.The growing content of lipids begins to go actively to the liver and there is an intensely oxidized there, which leads to the excessive formation of ketone bodies (acetone acid + β-ossielican + acid acetouxus) and to enter further into their blood (hyperketonomy).The excessive concentration of ketone bodies threatens a dangerous state calleddiabetic ketoacidosis.

Therefore, the general signs of diabetes can be characteristic of any form of the disease, however, in order not to confuse the reader, the characteristics inherent in this or in that type should still be noted.

Type I diabetes - "privilege" of Young

The ISD is characterized by an acute start (weeks or months).The signs of type I diabetes are pronounced and manifest themselves from clinical symptoms typical of this disease:

  • A strong drop in weight;
  • An unnatural thirst, a person simply cannot get drunk, even if he tries to do it (Polidipsia);
  • A large amount of secret urine (polyuria);
  • Significant excess of the concentration of glucose and keton bodies in the blood serum (ketoacidosis).In the initial phase, when the patient may not yet know his problems, it is likely that developing diabetic coma (ketoacidotic, hyperglycemic) - an extremely threatening condition, therefore insulin therapy is prescribed as soon as possible (only diabetes will be accelerated).
Measure the level of glucose in the blood will help diagnose diabetes

In most cases, after the use of insulin, metabolic processes are compensated,The need of the body in insulin decreases abruptly, a temporary "recovery" comes.However, this short state of remission should not relax neither the patient nor the doctor, since after a certain period of time the disease will remember itself again.The need for insulin as the duration of the disease can increase, but, basically, in the absence of ketoacidosis, it will not exceed 0.8-1.0 units/kg.

The signs that indicate the development of late complications of diabetes (retinopathy, nephropathy) may appear in 5-10 years.The main reasons for the fatal outcome of the ISD include:

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

Changes related to disease or age?(type II diabetes)

Inzsd has been developing for many months or even years.The problems that arise, a person leads to various specialists (dermatologist, gynecologist, neurologist ...).The patient does not suspect that diseases are different in his opinion: Furunculosis, itching of the skin, fungal lesions, inferior limb pain - signs of type II diabetes.Patients get used to their conditions and diabetes continues to develop slowly, influencing all systems and mainly the vases.

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

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

The main cause of death in patients with Inzsd has been recognized as a cardiovascular pathology that has become a consequence of diabetes.As a rule, this is a heart attack or stroke.

Diabetes treatment products

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

Various drugs for the treatment of diabetes
  • Compensation for lack of insulin;
  • Regulation of endocrine exchange disorders;
  • Prevention of diabetes mellitus, its complications and their timely treatment.

The implementation of these principles is performed on the basis of 5 main positions:

  1. Diabetes Nutrition is assigned the "first violin" party;
  2. The physical exercises system, adequate and selected individually, chases the diet;
  3. Medicines that reduce sugar are mainly used to treat type 2 diabetes;
  4. Insulin therapy is prescribed if necessary with Inzsd, but it is the main in the case of type 1 diabetes;
  5. Teaching of patients for the car -contollo (ability to take blood from a finger, using a glucometer, the introduction of insulin without external help).

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

Indicators A good degree of compensation Knowable Bad
Glucose level on an empty stomach (mmol/l) 4.4 - 6.1 6.2 - 7.8 Ø 7.8
The sugar content in the blood serum 2 hours after eating (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 the serum (MMOL/L) <5.2 5.2 - 6.5 Ø 6.5
Triglycerides level (MMOL/L) <1,7 1.7 - 2.2 Ø 2.2

An important role of a diet in the treatment of Inzsd

Diabetes nutrition is well known, also far from diabetes for people, table no.9. Being in a hospital for any disease, from time to time you can feel a special nutrition that is always in separate vases, differs from the rest of the diets and is emitted after a certain password has been spoken: "I have the ninth table".What does all this mean?What is the difference between this mysterious diet from all the others?

You shouldn't be wrong, taking care of his "porridge" of the diabetics who are deprived of all the joys of life.The diet in diabetes is not very different from the nutrition of healthy people, the right amount of carbohydrates (60%), fat (24%), proteins (16%) receive.

Dietary nutrition required by patients with diabetes

The diet for diabetes consists in the replacement of refined sugars in products with carbohydrates divided slowly.The sugar sold in a shop for everyone and the pastry based on it falls within the category of forbidden food.

As for the balance of nutrition, everything is severe here: the diabetic must use the required quantity of vitamins and pectins mandatory, which should be at least 40 g.per day.

Strictly individual physical activity

The physical activity for each patient is selected individually by the attending physician, while the following positions are taken into consideration:

Physical activity that helps to 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 "combustion" of carbohydrates and fats, without attracting insulin in participation.Its dose, which is necessary to compensate for metabolic disorders, has fallen considerably, which should not be forgotten, because, preventing the increase in blood sugar, it is possible to obtain an undesirable effect.Adequate physical activity reduces glucose, the dose introduced of insulin breaks and, consequently, a decrease in sugar levels below eligible values (hypoglycaemia).

As,The dosage of insulin and physical activity requires very close attention and a thorough calculation,To complete each other, do not go together to the lower limit of normal laboratory indicators.

Or maybe try folk remedies?

The treatment of type 2 diabetes is often accompanied by the search for patients with popular remedies who can inhibit the process and as far as possible to delay the time to take forms of dosage.

Without looking at the fact that our distant ancestors practically did not know such a disease, there are popular remedies for the treatment of diabetes, but we should not forget itInfusions and decoctions prepared by various plants are an auxiliary agent.The use of domestic drugs for diabetes does not alleviate the patient from compliance with the diet, the control of blood sugar, the visit of a doctor and the satisfaction of all his recommendations.

Medicinal plants that help in the fight against diabetes mellitus

To combat this pathology at home, quite famous popular remedies are used:

  1. Bark cortex and white mulberry;
  2. Cereals and peeled oats;
  3. Walnut partitions;
  4. Bay leaf;
  5. Cinnamon;
  6. Acorns;
  7. Nettle;
  8. Dandelion.

When the diet and popular remedies do not help anymore ...

The preparations thus called the first generation, widely known at the end of the last century, remained in the memories and have been replaced by new generation medicines, which constitute 3 main groups of diabetes produced by the pharmaceutical industry.

Several drugs are used to treat diabetes

What it means suitable for one or the other patient: he decides the endocrinologist.And so that patients do not pause and do not decide to use these drugs for diabetes at their discretion, we will give several visual examples.

Derivatives of sulfonilmochevini

Currently, derivatives of the second generation Sulfonema are prescribed, which act from 10 hours to one day.Usually patients take them 2 times a day half an hour before meals.

These drugs are absolutely contraindicated in the following cases:

  • Type 1 diabetes;
  • Diabetic coma, hyperosmular, lactacidotic;
  • Pregnancy, childbirth, lactation;
    • Solfonil gross derivatives in type 2 diabetes
  • Diabetic nephropathy, accompanied by compromised filtration;
  • Hematopoietic system diseases with a concomitant reduction in white blood cells - leukocytes (leukocytopenia) and trombocytic hematopoiesis link (trombocytopenia);
  • Serious infectious and inflammatory liver lesions (hepatitis);
  • Complicated diabetes from vascular pathology.

In addition, the use of drugs of this group can threaten the development of allergic reactions that occur:

  1. Itching and urticaria, sometimes reaching Quincke's edema;
  2. Digestive system disorders;
  3. Changes on the blood side (reduction of the level of platelets and leukocytes);
  4. Perhaps a violation of the functional capacity of the liver (jaundice due to the cholestasis).

Sahabro -Biguanides' virginer

Biguanids (Guanidine derivatives) are actively used for the treatment of type 2 diabetes, often adding them sulfonamides.They are very rational for use by patients with obesity, however the people who have liver, kidneys and cardiovascular pathology are clearly limited, moving on to more spared drugs of the same group or α-glucoside inhibitors that inhibit the absorption of carbohydrates in the small intestine.

They are considered absolute contraindications to the use of Biguanids:

  • ISD (type 1 diabetes);
  • Significant weight loss;
  • Infectious processes, regardless of location;
  • Surgery;
  • Pregnancy, childbirth, breastfeeding period;
  • States of coma;
  • Liver and renal pathology;
  • Hunger for oxygen;
  • Microangiopathy (2-4 degrees) with visual impairment and renal function;
  • Trophic ulcers and necrotic processes;
  • Violation of blood circulation in the lower ends due to various vascular pathology.

Treatment of insulin

Insulin injections - the main treatment of type 1 diabetes

From the above, the fact that the above becomes thatThe use of insulin is the main treatment of type 1 diabetes, all emergency conditions and serious complications of diabetes.Inzsd requires the appointment of this therapy only in case of forms of insulin, when correction by other means does not give the adequate effect.

Modern insulins, called monocompetent, represent two groups:

  1. The monocompental pharmacological forms of human insulin substance (semi-synthetic or dna-cumbing), which, without a doubt, have a significant advantage compared to pork preparations.They practically do not have contraindications and side effects;
  2. Monocompetent insulins obtained from the pork pancreas.These drugs compared to human insulins require an increase in the drug dose by about 15%.

Diabetes is dangerous complications

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

  • Pathological changes in the skin: diabetic dermopathy, necrobious lipoid, furunculosis, xantoma, fungal lesions of the skin;
  • Bone joint diseases:
    1. Diabetic osteoartropathy (joint articulation - a variation in the artery articulation), which occurs against the background of a violation of microcirculation and trophic disorders, accompanied by disputes, subluxis, spontaneous fractures that precede the formationdiabetic foot;
      2. Organs to which complications of diabetes mellitus
    2. Diabetic iropathy, characterized by rigidity in the articulations of the hands, which is most often formed in children with diabetes of children;
  • Respiratory diseases: long -termProlonged bronchitis, pneumonia,Increase the frequency of tuberculosis development;
  • Pathological processes that affect the digestive organs:Diabetic enteropathyAccompanied by an increase in peristalsis, diarrhea (up to 30 times a day), a decrease in body weight;
  • Diabetic retinopathy- one of the most serious complications characterized by damage to the organs of vision;
  • The most common complication of diabetes is consideredDiabetic neuropathyand its variety -PolyuropathyReach 90% of all forms of this pathology.The frequently found in diabetic polyninopathy isDiabetic foot syndrome;
  • The pathological state of the cardiovascular system, in most cases, is the cause of the death of diabetes mellitus.Hypercholesterolemia and vascular atherosclerosis, which, with 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, cerebrovascular failure).

Prevention

The measures for the prevention of diabetes are built according to the causes of its challenge.In this case, it is advisable to talk about the prevention of atherosclerosis, arterial hypertension, including the struggle with excess weight, bad habits and food dependencies.

Glucose correction in blood serum - The method of prevention of diabetes

The prevention of complications of diabetes consists in preventing the development of pathological conditions deriving from diabetes itself.The correction of glucose in blood serum, respect for the diet, adequate physical activity, the implementation of the doctor's recommendations will help to push the consequences of this rather formidable disease.