diabetes

Diabetes is a group of metabolic diseases that cause uncontrolled elevation of blood sugar levels (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 pathological conditions can lead to insufficient secretion of insulin (type I diabetes) or cellular resistance to this hormone (type II diabetes). Doctors consider frequent urination, constant thirst, and extreme hunger as symptoms of the disease. If left untreated, elevated blood sugar levels may be complicated by disorders of the heart, blood vessels, nervous system, lower limbs, and visual organs.Diabetes is one of the most common diseases of the endocrine system. Approximately 8% of people will be diagnosed with different types of diabetes during their lifetime, and a wide range of dietary patterns increases the number of patients every year. With appropriate symptomatic treatment and diet, the patient's quality of life is maintained at a good level.

About disease

Diabetes is the second most frequently detected of all endocrine diseases. One in 10 people develops the disease, and there are hidden forms when sufferers are 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, there are symptomatic and true types. The first develops in the context of a specific disease and disappears when the cause is eliminated. There are two types of true diabetes.

• Type I: Insulin-dependent or childhood diabetes. Usually occurs during childhood or adolescence. Caused by damage to pancreatic cells due to lack of insulin in the body. People with this type of diabetes require constant use of external insulin.
• Type II: Non-insulin-dependent or adult-onset diabetes. It occurs most commonly in adulthood, but is now also common in children and teenagers. It is caused by the body's tissues being insensitive to insulin, so they cannot absorb glucose properly. People with this type of diabetes can control blood sugar levels through proper diet, physical activity, and blood sugar-lowering medications. In severe cases, insulin may be needed.

Maternal diabetes (gestational diabetes) is another condition. It only appears during pregnancy and disappears after delivery. Diet is needed, and if that doesn't help, insulin therapy is needed.The severity of diabetes depends on the level of glycemic control and the presence of complications. There are various classifications, mainly based on levels of glycated hemoglobin (HbA1c). This is an indicator that reflects your average blood sugar level over the past 2-3 months.  

• Mild (HbA1c less than 6. 5%): blood sugar level is within the normal range or close to normal, and there are few pathological manifestations.
• Moderate (HbA1c 6. 5-7. 9%): Slightly elevated blood sugar levels with specific symptoms or early signs of complications.
• Severe (HbA1c 8% or higher): Characterized by significant blood sugar levels and severe symptoms and complications.

Based on similar criteria, a distinction can also be made between compensated, subcompensated, and decompensated diabetes.

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, whereas type 2 diabetes may not show any symptoms for a long time. Often the pathology can only be discovered with the help of special studies.Possible signs and symptoms:

• Frequent urinary urgency and increased urine output;
• Intense thirst and consumption of large amounts of fluid;
• Dry oral mucosa;
• decreased vision and dizziness;
• Obvious appetite and overeating;
• Ulcers appear on different parts of the skin, and wound healing takes longer;
• Insomnia, fatigue;
• performance degradation;
• Unexplained weight loss or obesity;
• Infectious diseases occur frequently.

Only a doctor can accurately differentiate between the signs of different types of diabetes. Prolonged disease course leads to the development of other symptoms associated with complications.

causes of diabetes

Diabetes occurs due to pancreatic dysfunction, or disturbance in cell regulation, in which even adequate insulin production does not help lower blood sugar levels. Doctors consider obesity, pancreatic lesions, physical inactivity, adverse genetics and other conditions as risk factors for the disease. Type 1 diabetes is usually diagnosed before the age of 30 in both men and women. Obese older adults are more likely to develop type II diabetes. At the same time, patients of any age can develop different types of disease, so you shouldn't just focus on risk factors.Possible causes and risk factors:

• Genetic disorders that lead to the development of autoimmune diseases and pancreatic pathology. Having a relative with diabetes is an important risk factor;
• obesity. The accumulation of excess adipose tissue can lead to metabolic disorders and make the tissue less sensitive to insulin;
• Immune dysfunction, characterized by damage to pancreatic tissue;
• Effects of viral infections and toxins on the pancreas;
• taking corticosteroids and other medications that contribute to the development of diabetes;
• Adrenal gland dysfunction;
• Cardiovascular pathology.

Diabetes is rarely a congenital disease, but genetic factors cause the disease to develop rapidly at any age.

Diagnosis of diabetes

To diagnose this disease, you need to make an appointment with an endocrinologist. The doctor conducts a consultation, during which he examines the patient's complaints and takes a medical history to identify risk factors for diabetes. Persistent elevation of blood sugar levels and other clinical symptoms of diabetes are detected through specialized studies, so the endocrinologist prescribes all necessary procedures after consultation. Inspections carried out:

• Fasting blood test. Endocrinologists ask patients not to eat in the hours before bed and in the morning before the study. During the procedure, the specialist treats the skin of the fingers with antiseptic, makes a small puncture using a scarifier, and collects a small amount of blood in a special container. A sign of diabetes may be that the glucose content in the sample obtained exceeds 6. 5mmol/l;
• Blood tests for glycated hemoglobin levels. Levels of this substance can indicate glucose levels in the blood over a 3-month period, so doctors prescribe such tests for initial diagnosis and monitoring of diabetes treatment. A glycosylated hemoglobin concentration higher than 6. 5% indicates the presence of diabetes;
• Load testing. The first phase of the study was a standard measurement of fasting blood glucose levels. The doctor then asked the patient to drink a glass of water with sugar, and 2 hours later performed another blood test. The diagnosis is confirmed if the first test results show moderate blood glucose levels (up to 6. 5 mmol/L) and the second test shows significantly elevated blood glucose levels (about 11 mmol/L);
• Blood tests for C-peptide levels. Endocrinologists prescribe this test to reliably assess insulin production over time;
• Get a blood test anytime. This test is used to confirm signs of disease. Glucose concentrations exceeding 10 mmol/L in some blood samples, regardless of meal time, indicate the presence of diabetes;
• Urinalysis. People with diabetes have high levels of glucose in their urine. In addition, patients may have ketone bodies in their urine, indicating a disorder in glucose metabolism.

If necessary, the endocrinologist will recommend consultation with a neurologist, cardiologist, nephrologist and other specialists to rule out dangerous complications of the disease. Pregnant women must consult their obstetricians and gynecologists.

Expert opinion

Diabetes is a very dangerous disease and a common disease. This may be preceded by long periods of high blood sugar without causing any symptoms, but may also occur rapidly when overt diabetes symptoms appear under the influence of one or another factor. You will have to deal with this disease for the rest of your life because if not controlled, your blood sugar levels will rise again. If the patient neglects treatment, he may encounter pathological complications: hypoglycemic or hyperglycemic coma, cardiovascular complications, visual impairment (diabetic retinopathy), neurofibropathy (diabetic neuropathy). In severe cases, gangrene develops, usually involving the toes.

diabetes treatment

An endocrinologist studies the diagnosis and develops an appropriate treatment plan. The main goal is to lower blood sugar levels, prevent the occurrence of complications and eliminate unpleasant symptoms. In addition to medication, endocrinologists must prescribe special diets for patients to control blood sugar levels. Following all your doctor's recommendations can significantly improve your quality of life and avoid the negative consequences of diabetes. To correct the pathology, two types of drug treatment are used.

• Medications to lower blood sugar levels are prescribed. Depending on the diagnosis and the patient's medical history, the endocrinologist may prescribe a sulfonylurea, meglitinide, alpha-glucosidase inhibitor, biguanide, or thiazolidinedione. It is often necessary to take multiple medications, strictly adhere to dosages, and monitor blood sugar levels. Listed drugs improve insulin production by the pancreas, stimulate tissue sensitivity to glucose, and reduce glucose uptake from food;
• Insulin is administered by injection. Endocrinologists prescribe such treatments for all patients with type 1 diabetes and for patients with type 2 diabetes if medications to lower blood sugar levels are ineffective or contraindicated. Pregnant women with gestational diabetes can also receive insulin treatment. First, the endocrinologist prescribes a long-acting insulin injection—a drug that must be taken once a day, regardless of nutrition. Rapid-acting insulin preparations are used in hospitals to treat complex diabetes and conditions in which blood sugar levels rise sharply. The doctor explains the rules of the injection and the required dosage. The consultation also explains the importance of regular monitoring of blood sugar levels using a glucometer.

Endocrinologists choose an individualized treatment plan and adjust the dosage of medications and prescriptions during treatment. Repeated consultations can help you resolve issues related to disease complications and medication side effects. In addition, the specialist must show how to administer the drug and explain all the rules of treatment.

Prevent diabetes

Every year, diabetes is diagnosed more and more frequently. Medical advice will help prevent the development of this disease.Main prevention methods:

• weight normalization and moderate physical activity;
• Prompt treatment of pancreatic diseases;
• Eat a healthy diet, including plenty of vegetables and fruits.

Q&A

How does the diagnosis of diabetes begin?

To determine the pathology, blood is first donated to determine blood sugar levels. If there is a deviation, the doctor will order additional tests.

How to prevent complications of diabetes?

Follow your doctor's advice about diet and medications. The main criterion is normal blood glucose concentration.