diabetes

It is believed that people who eat a lot of sweets will develop diabetes. In fact, it is a more complex pathology that is only partially dependent on nutrition and can occur in anyone.

Diabetes: Definition of the Disease

Diabetes mellitus (DM) is a group of diseases related to metabolic disorders. People with diabetes are unable to digest carbohydrates properly. As a result, their glucose (blood sugar) concentration increases significantly.

Glucose is a type of sugar and is the body's main source of energy.

Excess glucose has toxic effects and can damage blood vessel walls, nerve fibers, and internal organs.Diabetes occurs for many reasons. Some types of diseases are hereditary, while others are related to lifestyle or environmental factors.The name of this disease was given by the ancient Greeks. δίαβαίνω is translated from Greek and means "to pass" and refers to the main symptom of diabetes, polyuria or frequent urination. Therefore, a person is constantly losing water and trying to replenish it by drinking as much water as possible.However, this is not always the case. Some forms of diabetes can be asymptomatic for long periods of time, or be so mild that people don't even notice there's a problem. Even with a typical disease course, excess glucose in the blood can cause symptoms of the disease to appear, often over many years. Moreover, this man had been suffering from hyperglycemia and, at the time of diagnosis, had developed severe and irreversible disease in his kidneys, blood vessels, brain, peripheral nerves, and retina.This disease can cause severe damage to the body. If left untreated, excess glucose can cause the function of kidneys, heart, and nerve cells to deteriorate. But such complications can be prevented. Modern doctors have enough effective drugs and techniques to treat diabetes.

Prevalence

In 2019, diabetes was the direct cause of 1. 5 million deaths worldwide. Additionally, in almost half of cases, the disease is fatal in people under 70 years of age. The other half of the patients died from complications of the disease: kidney failure, heart and blood vessel damage.In addition to humans, animals also suffer from diabetes. For example, dogs and cats.From 2000 to 2019, diabetes mortality increased by 3% in developed countries and by 13% in low- and middle-income countries. Meanwhile, people aged 30 to 70 are globally less likely to die from complications of the disease by 22%. This is thought to be due to improved diagnosis of diabetes and effective methods for early prevention of its complications.

Classification of diabetes

my country adopts the diabetes classification approved by the World Health Organization in 1999.

type 1 diabetes

With this type of disease, a person's pancreas is less able to produce insulin, which is needed to transport glucose into cells. As a result, the glucose that enters the blood cannot be completely absorbed by the cells and remains in the blood vessels, where it is transported to the tissues and gradually destroys them. Type I diabetes is divided into two subtypes based on the cause of pancreatic dysfunction: immune-mediated and idiopathic.immune-mediated diabetesThe result of autoimmune destruction of pancreatic cells, causing the immune system to mistakenly attack its own healthy tissue. Diabetes usually begins in childhood or adolescence, but people of all ages can develop diabetes.Immune-mediated diabetes is often associated with other autoimmune diseases, such as Graves' disease, Hashimoto's thyroiditis, Addison's disease, vitiligo, or pernicious anemia.Type 1 diabetes is most common in children and teenagers, but can occur at any age.Idiopathic diabetes.A rare variant of the disease. Such patients have no laboratory signs of autoimmune damage, but symptoms of absolute insulin deficiency are observed.

Type II diabetes

In this condition, the pancreas produces enough insulin, but the cells are insensitive or resistant to it, so they are unable to absorb glucose and it builds up in the blood.According to the main cause, type II diabetes is divided into type II diabetes mainly characterized by insulin resistance and relative insulin deficiency; type II diabetes mainly characterized by impaired insulin secretion with or without insulin resistance.

other specific types of diabetes

Other specific forms of the disease include pathologies that have a clear genetic component, are related to infectious diseases or the taking of certain medications, etc.Genetic defects in pancreatic beta cell functionThose diseases in which a defective gene is evident in their development.Genetic defects in insulin actionThe development of the pathology is associated with the peripheral actions of insulin, which are disrupted by mutations in the insulin receptor gene.Exocrine pancreatic diseases.For example, chronic pancreatitis and other inflammatory diseases.endocrine diseasesPathologies associated with excessive secretion of other hormones, such as acromegaly, Cushing's disease, and hyperthyroidism.Drug or chemical-induced diabetes, may occur during administration of hormonally active substances, alpha- and beta-adrenergic agonists, psychotropic drugs, diuretics and chemotherapeutic drugs.Diabetes is associated with infectious diseases.Usually, the disease is caused by a viral infection (pathogens: coxsackie virus, rubella virus, Epstein-Barr virus).Abnormal forms of immune-mediated diabetes.For example, immobility syndrome and systemic lupus erythematosus.Other genetic syndromes, sometimes combined with diabetes.

gestational diabetes

It first appears during pregnancy and is characterized by reduced sensitivity of cells to glucose. It is believed that this disease occurs due to a hormonal imbalance. After delivery, the condition returns to normal or may progress to type II diabetes.

causes of diabetes

Diabetes occurs for a variety of reasons, including genetic and autoimmune disorders, chronic pancreatic disease, and dietary habits.Common causes of diabetes:

• A malfunction in the immune system, causing it to attack pancreatic cells;
• Genetic disorders that impair tissue sensitivity to glucose, alter pancreatic function, and reduce or completely stop insulin synthesis required for glucose absorption;
• Viral infections: Coxsackie virus, rubella, Epstein-Barr virus, and retroviruses can penetrate pancreatic cells and destroy the organ;
• Chronic diseases affecting the pancreas, cystic fibrosis, pancreatitis, hemochromatosis;
• Endocrine diseases Cushing's syndrome, acromegaly;
• Toxins (e. g. , rodenticides used to kill rodents, heavy metals, nitrates);
• Dietary Habits Too much fat and simple carbohydrates in the diet can lead to obesity and reduced cell sensitivity to insulin;
• Medications, certain hormonal drugs (especially glucocorticoids), certain drugs to treat heart and nervous system conditions, B vitamin preparations (if taken in excess).

risk factors for diabetes

Depending on the type of diabetes, risk factors for the disease vary.Risk factors for type I diabetes:

• Genetics – If you have a blood relative with diabetes, you are more likely to develop the disease;
• Some viral infections (eg, rubella, infectious mononucleosis) trigger an autoimmune response in the body, causing the immune system to attack pancreatic cells.

Being overweight does not cause type I diabetes, but it does increase the risk of type II diabetes.The most common risk factors for type 2 diabetes are not directly related to elevated blood sugar levels: being overweight, having a sedentary lifestyle, and being pregnant.During physical activity, glucose is actively broken down to produce energy; substances provided in food as well as the body's own fat reserves are used as substrates. With obesity, the volume and area of cell membranes containing fat and other lipid inclusions increase, and the relative density of insulin receptors per unit area decreases. As a result, the cells become less sensitive to insulin and absorb blood glucose worse.Risk factors for type 2 diabetes:

• overweight and obesity;
• Sedentary lifestyle (without physical activity, glucose is broken down more slowly, so cells may become less sensitive to insulin);
• A blood relative has diabetes;
• Aged over 45 years old;
• Prediabetes is a disease in which glucose levels in the blood remain at the upper limit of normal for a long period of time. Prediabetes is considered present if the analysis shows a value between 5. 6 and 6. 9 mmol/l;
• Having diabetes during pregnancy (gestational diabetes);
• Children weighing more than 4 kg at birth;
• frustrated;
• Cardiovascular diseases;
• Arterial hypertension (pressure above 140/90 mm Hg);
• High levels of "bad" HDC (more than 0. 9 mmol/L) and triglycerides (more than 2. 82 mmol/L);
• Polycystic Ovary Syndrome.

symptoms of diabetes

Type I diabetes usually presents with noticeable symptoms; other types of disease may go unnoticed for a long time.Common symptoms of diabetes:

• intense thirst;
• weakness;
• Frequent urination;
• Bedwetting in children who have not previously wetted the bed;
• Sudden weight loss for no apparent reason;
• persistent and intense hunger;
• Frequent urinary tract infections or fungal infections.

Additionally, there are so-called secondary symptoms of diabetes, which appear later in the disease and portend complications.Secondary symptoms of diabetes:

• itchy skin;
• nausea;
• Vomit;
• stomach ache;
• dry mouth;
• muscle weakness;
• blurred vision;
• Poor wound healing;
• numbness in fingers or toes;
• Acanthosis nigricans darkens the skin of the neck, armpits, elbows, and knees;
• Diabetic skin disease is located in the bend of the lower limbs. Pigmented spots with skin atrophy and peeling often occur due to poor wound healing on the legs;
• Diabetic pemphigus causes blisters on the lower limbs, ranging in size from a few millimeters to several centimeters. Most commonly occurs in older patients with long-standing diabetes;
• Headache;
• The odor of acetone emanates from the mouth.

Acanthosis nigricans, or darkening of the skin on the neck, knees, elbows, and armpits, may be a sign of diabetes.

Diabetes complications

Complications commonly occur in patients with advanced diabetes and include retinopathy, nephropathy, and polyneuropathy.Destruction of large blood vessels leads to atherosclerosis, myocardial infarction, stroke, and encephalopathy.

Continuously monitoring blood sugar and taking medications to lower blood sugar levels can prevent or delay the irreversible complications of diabetes.

Furthermore, the regeneration of small blood vessels is disturbed. As a result, wounds on the body do not heal well. Therefore, even a small cut can turn into a deeply festering ulcer.

diabetic coma

Diabetic coma is a complication of diabetes related to excessive blood sugar levels or vice versa.Diabetic coma is divided into two types based on the concentration of glucose in the blood: hypoglycemia (related to a decrease in blood sugar levels) and hyperglycemia (caused by an increase in blood sugar levels).Hypoglycemia comaUsually occurs in people with diabetes who are taking insulin.The cause of this coma is excess insulin, which prevents the body from raising blood sugar levels to normal levels. This usually occurs when the insulin dose is calculated incorrectly or when the diet is disrupted, where the amount of insulin administered does not match the proportion of carbohydrates in the food eaten.Signs of hypoglycemic coma:

• The body is shaking,
• Chills,
• Dizziness,
• nervous or anxious
• severe hunger
• nausea,
• blurred vision,
• Heart rhythm disturbance.

"Rule 15" to prevent hypoglycemia in diabetes:If your "sugar" levels are low, you should eat 15 grams of fast carbohydrates (drink juice, take glucose tablets) and measure your blood sugar 15 minutes later. If its levels are low, eat another 15 grams of fast carbs. Repeat these steps until the sugar content has risen to at least 3. 9 mmol/l.

In rare cases, low blood sugar may cause a person to pass out. In this case, he required an emergency injection of glucagon, which was administered by ambulance personnel.

Some people mistakenly believe that a person in a hypoglycemic coma needs to have a sweetened liquid poured into their mouth. However, this was not the case and was fraught with suffocation (suffocation).hyperglycemic comaIt is accompanied by severe insulin deficiency, which may be caused by severe stress or insufficient insulin doses after meals.Dangerous hyperglycemia occurs if blood sugar levels exceed 13. 9 mmol/L.Symptoms of high blood sugar:

• strong thirst
• Frequent urination,
• extreme fatigue
• blurred vision,
• Acetone or fruity breath smell,
• nausea and vomiting,
• stomach ache,
• Shortness of breath.

If such symptoms occur, you should sit down as soon as possible and let someone else call an ambulance, or call an ambulance yourself.

Diagnosis of diabetes

If a person develops symptoms of elevated blood sugar levels: frequent thirst, frequent urination, general weakness, blurred vision, and numbness in the limbs, a general practitioner should be consulted as soon as possible. But most of the time, diabetes is asymptomatic, so it is recommended that everyone get an annual screening test to detect the disease in its early stages and prevent complications from developing.

Which doctor should I contact if I suspect diabetes?

Often, people turn to their GP first. If diabetes is suspected, he will refer them to specialists who treat metabolic pathology, namely endocrinologists.During the consultation, the doctor conducts investigations and examinations, and performs laboratory and instrumental tests to confirm the diagnosis and determine the severity of diabetes.

examine

If diabetes is suspected, the doctor will clarify the medical history: related cases, chronic lesions of the pancreas, lifestyle, recent infectious diseases.

There are no specific signs of diabetes that can be detected during the exam.

During the exam, the doctor will also evaluate skin conditions: People with diabetes may develop dark areas of acanthosis nigricans on their skin. Additionally, specialists can perform rapid blood sugar tests. Exceeding normal values is a reason for further inspection.

laboratory research methods

For diagnosis, a blood sugar test is required. Its high levels are accompanied by characteristic symptoms such as frequent thirst, frequent urination, and frequent infections, and are clear signs of diabetes.Blood glucose concentration is measured using one of the following tests: fasting and postprandial plasma glucose tests, glycated hemoglobin (HbA1c) levels, reflecting average blood glucose levels over the past 3 months.An HbA1c level of no more than 6. 0% (42 mmol/l) and a glucose level of no more than 5. 5 mmol/l are considered normal.To make an accurate diagnosis, the study was performed at least twice on different days. If the results are equivocal, a glucose tolerance test is performed, which allows identification of damaged cells' sensitivity to glucose.Additionally, your doctor may order additional tests to differentiate between type 1 and type 2 diabetes: an autoantibody test and a urine ketone body test.Antibodies are typically found in people with type I diabetes, while ketone bodies are found in people with type II diabetes.To assess a cell's sensitivity to insulin, your doctor may order a test to calculate the HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) index, which takes into account glucose and insulin levels in the blood.If hereditary diabetes is suspected, experts may recommend genetic testing to identify mutations associated with hereditary diabetes and glucose intolerance.

Instrumental Research Methods

Instrumental examination helps identify complications of diabetes: retinal damage, heart, blood vessel, kidney damage, and nerve conduction disorders. Ultrasound examination of internal organs is prescribed to evaluate the condition of the kidneys and pancreas. In addition, doctors may recommend that patients undergo an electrocardiogram to detect heart abnormalities.To diagnose a vision disorder, you need to consult an ophthalmologist. During an eye exam, the doctor evaluates the condition of the retina and examines the cornea with a slit lamp or ophthalmoscope.

diabetes treatment

There is no cure for diabetes. The goals of treatment are to maintain acceptable blood sugar levels and prevent complications of the disease.People diagnosed with diabetes need to regularly measure their blood sugar levels and take insulin injections for type 1 diabetes or pills for type 2 diabetes, or insulin injections to control their blood sugar levels.To prevent complications of the disease, your doctor may recommend other medications. For example, medications to control blood pressure, thin the blood, and prevent cardiovascular disease, as well as medications to lower blood cholesterol.

Monitor blood sugar levels

To monitor blood sugar levels, both classic blood glucose meters and modern continuous monitoring systems are used.A blood glucose meter is a device with a thin needle. A person pricks their finger with it and drops blood onto a special test strip. The blood glucose meter displays results immediately.The monitoring system is a sensor mounted on the shoulder, stomach or leg. These sensors continuously monitor blood sugar levels. Data from the device is automatically downloaded to a special monitor or an app on your phone. Such devices can signal blood sugar spikes, plot blood sugar curves over time, send messages to your doctor, and even make recommendations on emergency and routine measures and the need for changes in diabetes treatment strategies.There is no harm caused by wearing the monitoring system; there is no sensation on the body.

diabetes diet

There are no special dietary habits for people with diabetes, but it is important for people with this disease to calculate the amount of carbohydrates they eat each day and keep a food diary.

carb counting

Carbohydrates have the greatest impact on blood sugar levels, so it's important for people with diabetes not to eliminate them but to count them.Carbohydrate counting is the basis of the diet for diabetics receiving insulin treatment. To do this, use the generic parameter bread unit (XE).1 XE is equivalent to approximately 15 grams of net carbohydrates or 20-25 grams of bread, with an average increase in blood sugar levels of 2. 77 mmol/l. To absorb this amount of glucose, a dose of 1. 4 units of insulin is required.

The average carbohydrate content in the diet of people with type I diabetes should not exceed 17 units of bread per day.

The amount of carbohydrates a person with diabetes can typically tolerate varies from person to person and is based on body weight, physical activity level, daily caloric needs, and how the body metabolizes carbohydrates. You can work with a nutritionist or doctor to calculate the amount of carbohydrates you need each day. After converting the carbohydrates you eat into bread units, your doctor will help you determine the amount of insulin needed to absorb glucose. Over time, a person will learn to calculate on their own.Additionally, there are other dietary recommendations for people with diabetes:

• Limit caloric intake in all overweight patients;
• Minimize the amount of fat (mainly of animal origin) and sugar in food;
• Consume carbohydrates primarily from vegetables, whole grains, and dairy products;
• Eliminate or limit the consumption of alcoholic beverages (no more than 1 regular unit per day for women and 2 regular units per day for men).

Diabetes prediction and prevention

Diabetes is a chronic disease that cannot be completely cured. But medications and healthier lifestyle changes can help avoid complications and slow the progression of the disease.Without treatment, the prognosis for diabetes is unfavorable: a person may die from damage to the cardiovascular system.Ways to prevent diabetes:

• engage in regular physical activity;
• A varied diet containing adequate fiber, protein, fat, and carbohydrates;
• healthy weight control;
• reduce alcohol consumption;
• Quit drinking and smoking.

Nutrition to prevent type 2 diabetes

An important part of preventing type II diabetes is eating a healthy and varied diet. The Healthy Plate principle or method was developed for this purpose.The Healthy Plate Method divides foods into five categories: fruits and vegetables, slow-release carbohydrates, dairy, protein, and fat. You can combine these groups using regular boards. Fruits and vegetables should account for one-third or half. A third or more of slow carbs. The rest is dairy, a little more protein, and a small portion is fat.Eat according to the principles of the Healthy Plate: half fiber, ⅓ slow carbs, and the rest protein foods.In addition, other important principles of healthy eating should be observed:

• drink when you are thirsty;
• Eat less salt, no more than one teaspoon (5-6 grams) per day;
• Limit the consumption of trans fats (found in many prepared and processed fast food products, cakes and pastries);
• Reduce consumption of saturated fat (found in sweet pastries, fatty meats, sausages, butter and lard);
• Eat less sugar, no more than 7 teaspoons (30 grams) per day.