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Diabetes: the types and causes of their development, courses and manifestations, how to treat, the possibility of the consequences

Glucometer and drugs for the treatment of diabetes

Diabetes mellitus is one of the most common to improve disease statistics and damage statistics.Symptoms of diabetes do not appear on the same day, the process of flowing chronically, with increased and endocrine exchange disorders.True, the debut of type I diabetes is very different from the beginning of the second.

Among the entire endocrine pathology, diabetes confidently hold the tournament and account for more than 60% of all cases.In addition, disappointing statistics show that 1/10 of the "diabetics" is a child.

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

Type of diabetes

Many have heard of diseases such as non -alichest diabetes.So that the reader does not confuse the disease that has a "diabetes" name, perhaps, the explanation of their differences will be useful.

Non -adalar urethra

Inactive diabetes is an endocrine disease caused by neuroinfections, inflammation, tumors, intoxication and due to deficiency, and sometimes complete loss of adg -vasopressin (antidetic hormones)

This describes the clinical picture of the disease:

  • Persistent dryness of the mucous membranes of the oral cavity, unusual thirst (one can drink up to 50 liters of water in 24 hours, stretching the stomach to large size);
  • Allocation of large amounts of unconditional light with low specific gravity (1000-1003);
  • Weight loss, weakness, decreased physical activity, digestive system disorders;
  • Changes in skin characteristics ("skin");
  • Muscle fiber atrophy, muscle weakness;
  • Development of dehydration syndrome if there is no fluid intake for more than 4 hours.

Diseases in terms of complete healing have a bad prognosis, performance is significantly reduced.

A brief anatomy and physiology

Non -organs - the pancreas performs the secret function of the mixture.The exogenous part of its external secretion, produces the enzymes involved in the digestive process.The endocrine section, entrusted with the mission of internal secretion, is involved in the development of various hormones, includingInsulin and glucagon.They are the key to ensuring the strength of sugar in the human body.

The gland's endocrine portion represents the island -Langanes Island, consisting of:

  1. A-cell occupies a quarter of the island space and is considered a glucagon product place;
  2. B cells that occupy up to 60% of the cell population synthesis and collects insulin, the molecule is a two -chain polypeptide, which carries a certain sequence of 51 amino acids;
  3. D-cell that produces somatostatin;
  4. Cells that produce other polypeptides.

Therefore, the conclusion suggests itself:Damage to pancreas and islands -Langgenes, in particular, are the main mechanisms that hinder insulin production and trigger the development of pathological processes.

A special type and form of a disease

Insulin deficiency leads to a violation of sugar firmness (3.3 - 5.5 mmol/l)and contributes to the formation of heterogeneous diseases called diabetes (diabetes):

  • The absence of complete insulin (absolute deficiency)Insulin -depending ona pathological process that refers toType I Diabetes (ISD);
  • Insulin deficiency (relative deficiency), which triggered the early stages of carbohydrate metabolism, slowly but certainly leads to developmentInsulin -depending onDiabetes (inzsd), calledType diabetes II.

Due to the infringement in the body of glucose, and, therefore, increased blood serum (hyperglycemia), which, in principle, is a manifestation of the disease, the signs of diabetes mellitus, that is, the amount of metabolic processes at all levels, begins to emerge over time.

In addition to the first and second type diabetes, the special type of the disease is distinguished:

  1. Secondary diabetes,The pancreas arising from acute and chronic inflammation of the pancreas (pancreatitis), malignant neoplasms in gland parenchyma, liver cirrhosis.A number of endocrine disorders, accompanied by excessive production of insulin antagonists (acromigaly, kushing disease, foochromocytoma, thyroid disease) leading to the development of secondary diabetes.Many drugs used for a long time have diabetic effects: diuretics, some drugs and antihypertensive hormones, oral contraceptives, and so on;
  2. Diabetes in pregnant women (pregnancy),Due to the shared influence of the hormone of the mother, child and placenta.The fetal pancreas that produce insulin itself begins to slow down the insulin product with the mother gland, as a result this special form is formed during pregnancy.However, with proper control, gestational diabetes usually disappears after giving birth.Furthermore, in some cases (up to 40%) in women with the same pregnancy history, 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 group of "motley" patients, so it becomes clear that the ISSD and its insulin that depend on "friends" are genetically different.There is evidence of insulin-dependent diabetes connection with the genetic structure of the HLA system (major histocompatibility complex), in particular, with some d-regional locus genes.For INZSD, such a relationship has not been seen.

Diabetes mellitus - a sweet disease

For the development of diabetes Type type one genetic tendency, pathogenetic mechanisms are launched by provoking factors:

  • Low self -esteem of the island -Langgenes Island;
  • The adverse influence of the external environment;
  • Pressure, nerve load;
  • Traumatic brain injury;
  • Pregnancy;
  • Virus infectious processes (colds, "pigs", sitomegalovirus infections, coksaki);
  • The tendency for continuous excessive eating leads to excess fat deposits;
  • Sugar abuse -Gula (more sweet tooth risk).

Before illuminating the causes of type II diabetes, it is advisable to think of very controversial issues: who suffers more often - men or women?

It has been established that at this time the disease is more commonly formed in women, although in the 19th century SD was a "privilege" of men.In this way, nowadays in some countries in Southeast Asia the presence of the disease in men is considered key.

The state of predisposing for the development of type II diabetes mellitus can be attributed to:

  • Changes in the structure of the pancreas due to inflammation, as well as the appearance of cysts, tumors, bleeding;
  • Age after 40 years;
  • Overweight (the most important risk factor for INZSD!);
  • Vascular disease is caused by the process of atherosclerotic and arterial hypertension;
  • In women, pregnancy and birth with high weight (more than 4 kg);
  • Presence of relatives who suffer from diabetes;
  • Psycho -strong pressure (adrenal gland hypermostation).

Causes of disease of various types of diabetes in some cases (pressure, obesity, external factors), but the onset of the first and second type of diabetes is different, moreover,ISSD is a lot of children and young, and insulin relies on older people.

Why do you want to drink so much?

Symptoms of diabetes, regardless of shape and type, can be represented in the following forms:

Diabetes patients always attack strong thirst
  1. Dry mucous oral cavity;
  2. Thirst, which is almost impossible, is associated with dehydration;
  3. Excessive urine formation and its release by the kidneys (polyuria), leading to dehydration;
  4. Increased glucose concentration in blood serum (hyperglycemia), due to suppression of sugar disposal with peripheral tissue due to insulin deficiency;
  5. The appearance of sugar in urine (glucose) and ketone body (ketonuria), which is usually found in unavoidable quantities, but with diabetes mellitus is intensified by the liver, and when removing from the body is detected in the urine;
  6. Increased blood plasma (in addition to glucose) urea and sodium ions (na+);
  7. Weight loss, which is in the case of decomposition of the disease, is a characteristic of cathabolic syndrome, which develops due to glycogen damage, lipolysis (fat movers), catabolism and glucose (transformation into glucose) protein;
  8. In violation of lipid spectrum indicators, increased general cholesterol due to low lipoprotein fractions, nezhk (accidental fatty acids), triglycerides.The growing lipid content begins to actively go to the liver and is intensely oxidized there, leading to excess ketone body formation (acetone + β-oxielyic acid + acetouxus acid) and further into their blood (hyperketoninomia).Excessive ketone body concentration threatens a dangerous state calledDiabetic ketoacidosis.

Therefore, the general signs of diabetes can be a feature of any form of the disease, however, so as not to confuse the reader, it should still be observed the features that exist in this type or that.

Type i diabetes - "privilege" Young

ISD is characterized by a sharp start (week or month).Signs of Diabetes Type I are pronounced and indicated by the typical clinical symptoms of the disease:

  • Weight loss;
  • Improper wear, one just can't get drunk, even if he or she tries to do this (polydipsy);
  • Large amounts of urine secreted (polyuria);
  • Advantages of significant body glucose and ketones in blood serum (ketoacidosis).In the early stages, when the patient still did not know the problem, it might develop a diabetes (ketoasidotic, hyperglycemic) coma - a very life -threatening condition, so insulin therapy was prescribed as early as possible (only diabetes will be synchronized).
Measuring blood glucose levels will help diagnose diabetes

In most cases, after the use of insulin, the metabolic process is compensated,The need for the body in insulin dramatically decreases, "recovery" while coming.However, this brief remission condition cannot rest either to the patient or doctor, because after a while the disease will remind himself.The need for insulin as an increase in the disease may increase, but, in essence, if there is no ketoacidosis, it will not exceed 0.8-1.0 units/kg.

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

  1. Terminal kidney failure, which is a result of glomerulosclerosis of diabetes;
  2. Cardiovascular disorders, as a complication of underlying disease, which occur relatively less kidneys.

Disease or age -How related to?(Type II diabetes)

Inzsd has grown for several months or even years.Problems arise, a person leads to many specialists (dermatologists, gynecologists, neurologists ...).The patient does not suspect that the disease differs in his or her opinion: furunculosis, itching -gatal skin, fungal lesions, pain in the lower back -signs of type II diabetes.Patients are accustomed to their condition, and diabetes continues to grow slowly, affecting all systems, and especially vessels.

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

Type 2 diabetes treatment usually begins with a diet with easy digestive (fine) carbohydrate limitations and use (if necessary) to reduce drugs.Insulin is prescribed if the development of the disease has reached severe levels of complications or there is an oral drug immunity.

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

Diabetes treatment products

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

A variety of medications for the treatment of diabetes
  • Compensation for insulin deficiency;
  • Rules of endocrine exchange disruption;
  • Prevention of diabetes mellitus, complications and timely treatment.

The implementation of these principles is based on 5 key positions:

  1. Diabetes nutrition is given the "first violin" party;
  2. Physical training system, which is sufficient and individually selected, follows the diet;
  3. Medications that reduce sugars are mainly used to treat type 2 diabetes;
  4. Insulin therapy is prescribed if necessary with INZSD, but it is a key in terms of type 1 diabetes;
  5. Patients teach for themselves (blood -dropping skills, using glucometer, introduction of insulin without external assistance).

Laboratory control over this position shows the level of compensation after the following biochemical studies:

Indication A good level of compensation Stobable Bad
Glucose levels on an empty stomach (mmol/l) 4.4 - 6.1 6.2 - 7.8 Ø 7.8
Sugar content in blood serum 2 hours after meals (mmol/l) 5.5 - 8.0 8.1 - 10.0 Ø 10.0
Percentage of hemoglobin glycosylated (HBA1, %) <8.0 8.0 - 9.5 Ø 10.0
Indicator of the amount of cholesterol in the serum (mmol/l) <5.2 5.2 - 6.5 Ø 6.5
Triglyceride level (mmol/l) <1.7 1.7 - 2.2 Ø 2.2

An important role in the diet in the treatment of inzsd

Diabetes nutrition is very famous, even far from diabetes to the public, Table No.9. Being in the hospital about any illness, now and then you can hear about the special nutrition that is always in a separate pot, different from the rest of the diet and removed after a specific password is spoken: "I have a Ninth schedule".What does this mean?What is the difference between this mysterious diet from others?

You cannot be mistaken, keeping his "porridge" diabetes that they are stripped of all the joys of life.Diet in diabetes is not very different from healthy people's nutrition, the right amount of carbohydrates (60%), fat (24%), protein (16%) receives.

Nutrition Needs needed by diabetic patients

The power supply for diabetes consists of replacing fine sugar in products with slow carbohydrates.The sugar is sold in the store for everyone and the cake based on it falls into the forbidden food category.

For nutritional balance, everything is tight here: Diabetes must use the amount of vitamins and pecters needed, which should be at least 40 g.a day.

Individual's strict physical activity

Physical activity for each patient is individually selected by the attending physician, while the following position is taken into account:

Physical activity that helps reduce blood glucose levels
  • Age;
  • Symptoms of diabetes;
  • Severity of pathological process flow;
  • The presence or absence of complications.

Physical activity prescribed by the doctor and performed by the "ward" should contribute to the "burning" of carbohydrates and fats, without attracting insulin to participation.The dose, which is needed to balance metabolic disorders, has fallen, which is unforgettable, because, by preventing increased blood sugar, you can get an unwanted effect.Adequate physical activity reduces glucose, the dose of insulin introduced, and as a result, a decrease in sugar levels below the allowable value (hypoglycemia).

Therefore,Insulin doses and physical activity require very close attention and comprehensive calculations,To complement each other, do not be together to step into the lower border of the regular laboratory indicator.

Or maybe try folk medicine?

Type 2 diabetes treatment is often accompanied by finding patients with folk medicine that can hinder the process and as far as the time delays may take the form of doses.

Regardless of the fact that our ancestors practically unaware of such a disease, folk remedies for the treatment of diabetes exist, but we cannot forget itInfusions and decoctions provided from various plants are additional agents.The use of domestic drugs for diabetes does not relieve patients from dietary compliance, control blood sugar, visit doctors and fulfill all their recommendations.

Medicinal plants help fight diabetes mellitus

To combat this pathology at home, well -known folk medicine is used:

  1. Skin and white mulberry leaves;
  2. Cereals and peel oats;
  3. Walnut partition;
  4. Bay leaf;
  5. Cinnamon;
  6. Acorns;
  7. Nettle;
  8. Dandelion.

When people's diet and remedies no longer help ...

The first known first -generation preparations, known in the last century, remained in the memoir, and they were replaced by new generation of medicines, which formed 3 major groups of diabetes produced by the pharmaceutical industry.

Different drugs are used to treat diabetes

What does it mean for one or another patient - an endocrinologist decides.And so that patients do not and do not decide to use these drugs for diabetes at their discretion, we will provide some visual examples.

Sulfonylmochevins derivatives

Currently, second -generation sulfonema derivatives are prescribed, acting from 10 hours to a day.Patients usually carry them 2 times a day and a half hours before meals.

These drugs are true -are actually contraindicated in the following cases:

  • Type 1 diabetes;
  • Diabetes, hyperosmolar, lactacidotic coma;
  • Pregnancy, childbirth, breastfeeding;
    • Rough sulfonyl derivates in type 2 diabetes
  • Diabetes nephropathy, accompanied by affected filtering;
  • Hematopoietic system disease with reduction of white blood cells - leukocytes (leukocytopenia) and thrombocytic hematopoiesis (thrombocytopenia) links;
  • Infectious liver lesions and severe inflammation (hepatitis);
  • Diabetes is complicated by vascular pathology.

In addition, the use of drugs can threaten the development of real allergic reactions:

  1. Itching and urticaria, sometimes reaching Quincke edema;
  2. Disruption of the digestive system;
  3. Changes from the blood (reduction of platelet and leukocytes);
  4. It may be a violation of the liver (yellow disease due to cholestasis).

Sahabro -Biguanides Family

Biguanides (Guanidine derivatives) are actively used for the treatment of type 2 diabetes, often adding sulfonamides to them.They are very rational for patients with obesity, however, people with liver, kidneys and cardiovascular pathology are limited, switching to more drugs similar to the same group or α-glucosid inhibitor that prevents the absorption of carbohydrates in the small intestine.

Absolute contraindications for the use of biguanides are considered:

  • Isd (type 1 diabetes);
  • Significant weight loss;
  • Infectious process, regardless of localization;
  • Surgical intervention;
  • Pregnancy, childbirth, breastfeeding period;
  • Coma State;
  • Liver and kidney pathology;
  • Oxygen starvation;
  • Microangiopathy (2-4 degrees) with visual disorders and kidney function;
  • Trophic ulcer and necrotic process;
  • Violation of blood circulation in the lower leg due to various vascular pathology.

Insulin treatment

Insulin injection - the main treatment of type 1 diabetes

From above, the fact that the above thing becomes thatThe use of insulin is a major treatment of type 1 diabetes, all emergency conditions and severe diabetes complications.Inzsd requires the appointment of this therapy only in the case of insulin forms, when correction in other ways does not have the right effect.

Modern insulin, called Monocetent, represents two groups:

  1. Monocetent pharmacological forms of human insulin (semi-synthetic or DNA-rocombinant), which, no doubt, have a significant advantage of pig preparation.They have no contraindications and side effects;
  2. Insulin Monocetent obtained from a pig pancreas.These drugs compared to human insulin require an increase in drug doses of about 15%.

Diabetes is a dangerous complication

Because diabetes is accompanied by damage to many organs and tissues, its manifestations are available in almost all body systems.Diabetes complications are considered:

  • Pathological changes in the skin: Dermopathy diabetes, lipoid necrobiosis, furunculosis, xanthoma, skin fungal lesions;
  • Bone disease:
    1. Osteoarthropathy diabetes (joint joints - changes in the ankle joint), which occurs in the background of micro -circulation and trophic disorders, accompanied by dislocation, subluxis, spontaneous fractures before its formationThe feet of diabetes;
      2. Organ with complications of diabetes mellitus
    2. Hypathy diabetes, characterized by stiffness in the joints, which is more commonly formed in children with diabetes;
  • Respiratory disease: Long -termprolonged bronchitis, inflammation of the lungs,Increase the frequency of development of tuberculosis;
  • The pathological process that affects the digestive organs:Enteropathy diabetesaccompanied by increased peristalsis, diarrhea (up to 30 times a day), weight loss;
  • Diabetes retinopathy- one of the most serious complications characterized by damage to the vision;
  • The most common diabetes complications consideredDiabetic neuropathyAnd variety -Polyneuropathyreached 90% of all forms of pathology.Diabetes polyneuropathy frequently foundDiabetes foot syndrome;
  • The pathological condition 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 heart disease and blood vessels (coronary heart disease, myocardial infarction, heart failure, cerebrovascular disorders).

Prevention

Steps for the prevention of diabetes are based on the causes of it.In this case, it is advisable to talk about the prevention of atherosclerosis, arterial hypertension, including excess weight struggle, bad habits and food addiction.

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

Prevention of diabetes complications consists of preventing the development of pathological conditions arising from diabetes itself.Correction of glucose in blood serum, dietary compliance, adequate physical activity, implementation of a doctor's recommendation will help induce the result of this relatively awesome disease.