Diabetes mellitus: signs, types, stages and causes
Statistically, every 3 people in the world can be diagnosed with diabetes mellitus.This disease is on a par with such pathologies threatening humanity as oncology, tuberculosis, AIDS.Despite the fact that diabetes mellitus is a sufficiently studied disease, in order to conduct an accurate diagnosis it is necessary to undergo a complete examination of the body - several kinds and degrees of pathology are distinguished in medicine.Table of contents Diabetes mellitus is the essence of the disease Pathogenesis of the disease Types of diabetes
Diabetes mellitus is the essence of the diseaseWe recommend to read:
The metabolic disorders related to carbohydrates and water are classified in medicine as diabetes mellitus.For this reason, there are violations in the pancreas, which produces hormone insulin - it is actively involved in the processing of sugar in the body.It is insulin that promotes the processing of sugar into glucose, otherwise sugar accumulates in the blood, is excreted through the urinary tract( with urine), in this condition, the tissues of the body are unable to keep water in their cells - it also begins to be excreted from the body.
Diabetes mellitus is a high content of sugar and glucose in the blood, but a catastrophic shortage of these elements in the cells of the tissues of the organs.
The disease can be congenital( it is a question of burdened heredity) or acquired.This does not depend on the severity of the development of diabetes, patients still suffer from insulin deficiency, against which pimple skin diseases develop, atherosclerosis, hypertension, kidney and nervous system diseases, and vision impairment.
Pathogenesis of the disease
The pathogenesis of diabetes is a very conventional thing, because doctors only partially recognize it.Given that there are two main types of the disease in question, cardinally different from each other, one can not speak of an unconditional mechanism for the development of pathology.Nevertheless, the hyperglycemic index is taken as a basis for the pathogenesis.What it is?
Hyperglycemia is a condition in which the sugar entering the body is not processed for glucose because of the insufficient amount of insulin produced by the pancreas.In turn, this leads to the lack of glucose in the cells of the organs - insulin simply stops interaction with cells.
Why do doctors accept this explanation of the mechanism of diabetes as the only correct one?Because other diseases can lead to a hyperglycemic condition. These include:
- adrenal tumor - it produces hormones that have the opposite effect to insulin;
- hyperfunction of the adrenal glands;
- cirrhosis of the liver;
- transient hyperglycemia - short-term accumulation of sugar in the blood.
Important: not every hyperglycemia can be considered an unconditional diabetes mellitus - only one that develops against a background of a primary insulin damage.
When diagnosing a patient with hyperglycemia, doctors should differentiate the abovementioned diseases - if they are diagnosed, then the diabetes in this case will be conditional, temporary.After curing the underlying disease, the operation of the pancreas and the action of insulin are restored.
Types of diabetes
The division of the disease into two main types is an important task.Each of them is not only characterized by distinctive characteristics, even treatment in the initial stage of diabetes will occur according to completely different schemes.But the longer a patient lives with diagnosed diabetes, the less noticeable are the signs of his species, and the treatment usually comes down to the same pattern.
Diabetes mellitus type 1Recommended to read:
It is called insulin-dependent diabetes , it is considered quite a serious disease and patients are forced to stick to a strict diet all their lives.Diabetes mellitus type 1 - is the extermination of pancreatic cells by the body itself.Patients with this diagnosis are forced to constantly inject themselves with insulin and as it breaks down in the gastrointestinal tract, the effect will be only on injections. Important: is completely impossible to get rid of pathology, but in medicine there are cases when the recovery happened - the patients adhered to special conditions and natural raw food.
Diabetes 2 typesRecommended to read:
This type of disease is considered insulin-independent , develops in obese people older than 40 years.The following occurs: the cells of the body are overfilled with nutrients and lose sensitivity to insulin. The appointment of insulin injections to such patients is not mandatory and only a specialist can determine the feasibility of such treatment.Most often, patients with type 2 diabetes mellitus are prescribed a strict diet, as a result of which the weight will decrease gradually( not more than 3 kg per month).In an extreme case.
If the diet does not give positive dynamics, sugar-reducing tablets can be prescribed.Insulin is prescribed in the most extreme case, when pathology begins to pose a danger to the life of the patient.
Degrees of diabetes
This differentiation helps to quickly understand what happens to a patient at different stages of the disease.Such a classification is needed by doctors who can make the right decision about treatment in an emergency situation.
1 degree.This is the most favorable course of the disease under consideration - glucose level is not higher than 7 mmol / l, with urine glucose is not released, blood values remain within normal limits.The patient completely lacks any complications of diabetes, it is compensated by diet and special medications.
2 degree.Diabetes mellitus becomes partially compensated, the patient has signs of complications.There is a defeat of some organs - for example, eyesight, kidneys, blood vessels.
3 degree.This degree of diabetes mellitus can not be treated with medicines and diet, glucose is actively excreted in urine, and its level is 14 mmol / l.3 degree of diabetes mellitus is characterized by obvious signs of complications - eyesight rapidly decreases, active development of numbness of upper / lower extremities is detected, stable high blood pressure( hypertension) is diagnosed.
4 degree.The most severe course of diabetes mellitus, is characterized by a high glucose level - up to 25 mmol / l, with glucose and protein excreted in the urine, the condition is not corrected by any medications.At this degree of the disease under consideration, kidney failure, gangrene of the lower extremities, diabetic ulcers are often diagnosed.
Symptoms of diabetes
Diabetes mellitus never "starts" lightning - it is characterized by a gradual increase in signs, a long development. The first signs of the disease in question are:
- Strong thirst, which is almost impossible to quench.In the day, patients with diabetes consume up to 5-7 liters of fluid.
- Dryness of the skin and occasional itching, which is often referred to as nervous manifestations.
- Constant dryness in the mouth, no matter how much liquid the patient drinks per day.
- Hyperhidrosis - increased sweating, especially evident on the palms.
- Weight variation - a person either rapidly losing weight without any diets, or quickly becomes fuller.
- Muscle weakness - patients at the earliest stage of development of diabetes mellitus note fatigue, the inability to perform any physical work.
- Prolonged healing of skin wounds - even an ordinary scratch can develop into a purulent wound.
- Gingival processes are often noted on the skin for no apparent reason.
Note: , even if there is any of the above signs, you need to seek help from specialists as soon as possible - most likely the patient will be diagnosed with diabetes mellitus. But even if the disease under consideration has been diagnosed and is amenable to curative correction, it is possible to develop and complicated diabetes. Its symptoms include:
- Regular headaches and dizziness.
- Increased blood pressure - at certain points, indicators can reach critical numbers.
- Walking is broken, in the lower extremities there is always a pain syndrome.
- Pain in the heart.
- Liver enlargement - this syndrome is considered a complication only if it was absent before the diagnosis of diabetes.
- Severe swelling of the face and lower limbs.
- Significant decrease in foot sensitivity.
- Progressive drop in visual acuity.
- From the patient begins to emerge clearly palpable odor of acetone.
Causes of diabetes
The doctors identified several factors that could lead to the development of the disease in question. These include:
- Heredity.This factor does not at all mean the birth of a child with an existing diabetes, there is simply such a predisposition.It is necessary to reduce other risk factors to a minimum.
- Viral infections.Influenza, rubella, hepatitis of epidemic nature and chicken pox - these infections can become a "push" for the development of diabetes, especially if the patient is at risk for the disease.
- Obesity.In order to avoid the appearance of the first signs of diabetes, it is enough to reduce weight.
- Some diseases.Inflammation of the pancreas( pancreatitis), pancreatic cancer, pathological processes in other glandular organs can lead to the defeat of cells that produce insulin.
In addition, it is necessary to protect the body from nervous stresses, depressions and nervous states - this can serve as a kind of trigger mechanism in the development of diabetes mellitus.
Important: The older the person becomes, the higher the probability of occurrence of the disease in question.According to statistics every 10 years increase the chances of developing diabetes twice.
Diagnosis of diabetes
If there is a suspicion of diabetes, it is necessary to undergo a complete examination - you will need to pass several tests, use instrumental methods of examination. The list of diagnostic measures for diabetes mellitus includes:
- A laboratory blood test for the presence of glucose in it - fasting glycemia is determined.
- Test determination of glucose tolerance - examination is done after taking glucose.
- The dynamics of the disease is monitored - glycemia is measured several times a day.
- General analysis of urine for the presence of protein, glucose and leukocytes in it( normally these components are absent).
- Laboratory analysis of urine analysis for the presence of acetone in it.
- A blood test for the presence of glycosylated hemoglobin in it - this indicator determines the level of development of complications of diabetes mellitus.
- Biochemical blood test - a doctor can determine the degree of functioning of the liver and kidneys against the background of progressive diabetes.
- Reberg's test is performed - the extent of renal and urinary tract damage in diagnosed diabetes mellitus is determined.
- Blood test for determining the level of endogenous insulin.
- Consultation of an ophthalmologist and examination of the eye day.
- Ultrasound examination of the abdominal organs.
- Electrocardiogram - the work of the heart is monitored against the background of diabetes mellitus.
- Investigations aimed at determining the level of lesion of the vessels of the lower limbs - this helps prevent the development of the diabetic foot.
Patients with diagnosed diabetes mellitus or suspected of this disease should be examined by narrow specialists within the framework of diagnostic measures. Compulsory attendance includes doctors:
- vascular surgeon;
Blood sugar level indicators
One of the most important indicators of the state of health in diabetes mellitus, which can serve as a diagnostic for the functioning of organs and systems, is the level of sugar in the blood.It is from this indicator that doctors "repulse" in carrying out more specialized diagnostics and prescribing treatment.There is a clear amount that will tell the patient and the doctor about the state of carbohydrate metabolism.
Note: to exclude false positive results requires not only to measure blood sugar level, but also to conduct a test for glucose tolerance( blood sample with sugar load).
To take a blood sample with a sugar load, you must first take a routine blood test for sugar, then take 75 grams of soluble glucose( sold in pharmacies) and after 1 or 2 hours to re-assay.The values are given in the table( measurement value - mmol / L): After two tests are performed, the following values should be determined:
- Hyperglycemic coefficient - the ratio of the glucose level after an hour after the glucose load to the fasting blood glucose level.Normally, the indicator should not exceed 1.7.
- Hypoglycemic coefficient - the ratio of blood glucose level after 2 hours after the sugar load to the fasting blood glucose level.Normally, the indicator should not exceed 1.3.
Possible complications of diabetes
In fact, diabetes mellitus does not pose a threat to the health and life of the patient, but with the development of complications, the most unfortunate consequences that lead to disruption of normal life activity are possible.
Symptoms of diabetic coma grow rapidly, at lightning speed - you can not delay a minute, and leaving the patient in this state directly threatens his life.The most dangerous sign is a violation of a person's consciousness, which is characterized by his oppression, inhibition of the patient. The most frequently diagnosed ketoacidotic coma is a condition provoked by accumulation of toxic substances.At the same time, nerve cells get into the pernicious effect of poisonous substances, and the main, and sometimes the only, symptom of ketoacidotic coma is the persistent, intense odor of acetone from the patient.
The second most frequent type of coma is hypoglycemic, which can be triggered by an overdose of insulin. In this case, the patient has the following symptoms of :
- clouding consciousness - semi-fainting condition;
- face and palms are covered with cold sweat - its amount is large enough and is visible to the naked eye;
- fixes a rapid / critical decrease in blood glucose levels.
There are other types of diabetic com, but they are extremely rare.
Unstable blood pressure
Blood pressure indicators can become a determinant of the severity of the development of the disease in question.For example, if a constant increase in pressure is noted with a regular measurement of pressure, this may indicate the occurrence of one of the most dangerous complications-diabetic nephropathy( the kidneys do not work).Often, doctors recommend that patients with diagnosed diabetes mellitus regularly measure blood pressure on the lower limbs - its decrease indicates the damage to the vessels of the legs.
Edema in diabetes
They indicate the development of heart failure and nephropathy.With permanent swelling accompanied by an unstable level of blood sugar, it is necessary to urgently seek help from doctors - the situation is very serious and at any time can completely refuse the kidneys or happen myocardial infarction.
They arise only in those patients who are struggling with diabetes for a long time and develop, first of all, on the feet( there is the concept of "diabetic foot").The problem is that people do not pay attention to the first signs of the complication of diabetes mellitus - the puffiness, accompanied by pain in the legs and their puffiness.On admission to the doctor, patients fall, when the foot becomes red, swelling reaches a maximum( the patient can not stand on his foot and put on shoes).
Very serious complication, which develops against the background of the lesions of large and small blood vessels.Most often, gangrene is diagnosed on the lower limbs, can not be treated, and almost always leads to leg amputation( but there are exceptions).
Prevention of complications of diabetesRecommended to read:
If the diagnosis of diabetes is already approved by a doctor, then it is necessary to exert maximum efforts to prevent the development of its complications. It's possible to live with the disease under consideration, and live fully, but only if there are no serious complications.The preventive measures include:
- weight control - if the patient feels that he is gaining extra pounds, you need to consult a dietician and get advice on how to make a rational menu;
- constant physical activity - how much they should be intense, the attending physician will tell;
- constant monitoring of blood pressure.
Diabetes mellitus is recognized as an incurable disease, but if there is a diagnosis of type 2 diabetes, there is a chance of a full recovery - you just need to choose a diet that is aimed at normalizing carbohydrate metabolism.The main task of the patient with the disease in question is to prevent the development of complications, which pose a real threat to human health and life.For more information on diagnostic methods, types, stages and treatment of diabetes mellitus, you will receive this video review:
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category