Diabetes mellitus is one of the most common, which increases statistics for incidence and degradation.The symptoms of diabetes do not occur on the same day, the process is chronically flowing, increasing and worsening endocrine disorders.It is true that the debut of type I diabetes is significantly different from the early stages of the second.
Of the total endocrine pathology, diabetes keeps the championship confidently and accounts for more than 60% of all cases.In addition, disappointing statistics show that 1/10 children are "diabetic".
The likelihood of acquiring the disease increases with age and thus the number of the group pair every ten years.This is explained by an increase in life expectancy, improvement of early diagnostics, a decrease in physical activity and an increase in the number of overweight people.
Types of diabetes
Many have heard of a disease like the longest diabetes.In order to prevent the reader from disturbing diseases called "diabetes", it is likely to be useful to clarify the differences.
No -adalaar urethra
Nonchary diabetes is an endocrine disease due to neuroinfection, inflammatory diseases, cancers, intoxications and insufficiency, and sometimes due to the complete disappearance of adg -isopressine (antidihuretic hormone).
This explains the clinical picture of the disease:
- The constant dryness of the mucous membranes of the oral cavity, an incredible thirst (somebody drink up to 50 liters of water within 24 hours, stretched to large size);
- Huge amount of unconditional light water allocation with low specific gravity (1000-1003);
- Disaster weight loss, weakness, decrease in physical activity, digestive system disorders;
- Characteristic change in the skin ("parchment" skin);
- Atrophy of muscle fibers, weakness of the muscle device;
- Dehydration syndrome develops for 4 hours in the absence of fluid intake.
From the point of view of complete cure, the disease is caused by harmful prognosis, and performance is significantly reduced.
Short anatomy and physiology
No -ire organ - The pancreas performs a mixed secretory function.Exogenous part of external secretion, production of enzymes involved in the digestive process.The endocrine part that is entrusted with the mission of internal secretion is various hormones includingInsulin and glucagon.They are key to ensuring the permanence of sugar in the human body.
The endocrine section of the gland represents the islands of Langerganes, which consist of:
- A cells that occupy a quarter of the entire area of the islands and consider the location of glucagon products;
- B cells that occupy 60% of the synthesizing and accumulated cell population of insulin, whose molecule is a polypeptide of two chains, which carries in a certain 51 amino acid sequence;
- D cells produce somatostatin;
- Cells producing other polypeptides.
So the conclusion itself suggests:In particular, damage to the pancreas and islands of the langergans is the main mechanism that inhibits the production of insulin and triggers the development of the pathological process.
Types and special forms of disease
Insulin deficiency leads to a violation of sugar status (3.3 - 5.5 mmol/l)and contributes to the formation of heterogeneous disease called diabetes (diabetes):
- A complete absence of insulin (absolute deficiency)Insulin -dependenta pathological process to which you refer toType I diabetes (ISD);
- Deficiency of insulin (relative deficiency) that triggers a violation of carbohydrate metabolism in the initial stages will lead to slow but surely developmentinsulin -dependentdiabetes (inzd) that is calledII.Type of diabetes.
Due to the use of glucose and, therefore, the growth of blood serum (hyperglycemia) (hyperglycemia), which is supposed to manifest the disease, signs of diabetes mellitus, that is, the total disorder of the metabolic processes.
In addition to first and second types of diabetes, special types of disease can be distinguished:
- Secondary diabetes,The pancreas, which comes from acute and chronic inflammation of the pancreas (pancreatitis), malignant tumors in the parenchyma of the glandular, liver cirrhosis.Many endocrine disorders, with excessive production of insulin antagonists (acromialy, kushing, phoochromocytoma, thyroid disease) lead to secondary diabetes.Many long -term drugs have diabetogenic effects: diuretics, some antihypertensive drugs and hormones, oral contraceptives, etc.;
- Diabetes in pregnant women (pregnancy),Because of the specific mutual effects of the mother, child and placenta hormones.The fetal pancreas, which produces its own insulin, begins to slow down insulin products with the mother gland, which results in this special form during pregnancy.However, with proper control, pregnancy diabetes usually disappear after childbirth.Subsequently, in some cases (up to 40%) in women with similar pregnancy history, this fact may endanger the II.Type of diabetes (within 6-8 years).
Why is there a "sweet" disease?
The "sweet" disease forms a rather "motley" patient group, so it becomes clear that the ISSD and its insulin -dependent "partner" are genetically different.There are evidence to combine insulin-dependent diabetes with the genetic structures of the HLA system (the main complex of histocomility), especially with some genes of the Locus of the D-region.In the case of InZD, no such relationship was seen.
One of the types of genetic predisposition to develop a type of diabetes is triggered by provoking pathogenetic mechanism:
- Congenital inferiority of the islands of Langerganes;
- Harmful effects of the external environment;
- Stress, nervous load;
- Traumatic brain injuries;
- Pregnancy;
- Infectious processes of virus origin (influenza, "pig", cytomegalovirus infection, Coksaki);
- A constant excessive overdose trend, leading to excess fat deposits;
- Abuse of confectioners (sweet teeth risk more).
Before illuminating II.Type of diabetes, it would be advisable to reside on a very controversial question: who suffers more often - men or women?
It has been found that the disease is currently developing more often in women, although in the 19th century SD was the "privilege" of the man.Incidentally, in some countries of Southeast, the presence of the disease in men is considered to be dominant.
The II.Type of diabetes mellitus development can be attributed to:
- Changes in the structural structure of the pancreas as a result of the appearance of inflammatory processes and cysts, tumors, and bleeding;
- Age after 40 years;
- Overweight (the most important risk factor for inzs!);
- Vascular diseases due to the atherosclerotic process and arterial hypertension;
- In women, the birth of pregnancy and high body weight (more than 4 kg);
- The presence of relatives with diabetes;
- Strong psycho -emotional stress (hyper -news of adrenal glands).
In some cases, the causes of the disease of different types of diabetes coincide (stress, obesity, effect of external factors), but in the first and second types of diabetes, the process is different, moreover,The ISSD is a multitude of children and young people, and the insulin dependent prefers older generations.
Why do you want to drink so much?
Typical symptoms of diabetes, regardless of form and type, can be depicted in the following form:
- Dry mucosa oral cavity;
- Thirst, which is almost not satisfied, involves dehydration;
- Excessive urine formation and the release of kidneys (polyuria) leading to dehydration;
- Increase in glucose concentrations in blood serum (hyperglycemia) because it is suppressed by sugar disinfection with peripheral tissues due to insulin deficiency;
- The appearance of sugar in the urine (glucose) and ketone bodies (ketonuria), which are usually present in negligible amounts, but in the case of diabetes mellitus, the liver produces intensely and when the body is excreted from the urine;
- Increased blood plasma (other than glucose) carbamide and sodium ions (na+);
- Weight loss, which is a characteristic feature of catabolic syndrome in the case of decompensation of the disease, which is due to glycogen decomposition, lipolysis (mobilization of fats), catabolism and glucose glucose transformation (glucose transformation);
- Violation of the Lipid spectrum, the increase in overall cholesterol is a low -density lipoproteins fraction, nezhk (non -persecuted fatty acids), and triglycerides.The increasing content of lipids is actively in the liver and is intensively oxidized, leading to excessive formation of ketone bodies (acetone + β-oxielye acid + acetouxus acid) and further enters their blood (hyperketoninomia).Excessive concentrations of ketone bodies threaten a dangerous conditiondiabetic ketoacidosisOr
Thus, the general signs of diabetes can be characterized by any form of the disease in order to prevent the reader from disturbing, the properties of this or this type should still be noted.
Type I diabetes - the "privilege" of young people
The ISD is characterized by a sharp (weeks or months).Signs of type I diabetes are pronounced and clinical symptoms of the disease show:
- Sharp weight loss;
- Unnatural thirst, one simply cannot drunk, though he tries to do it (polidipsy);
- He chose large amounts of urine (polyuria);
- In the blood serum (ketoacidosis) it is a significant surplus of the concentration of glucose and ketone bodies.In the initial stage, when the patient is still unknown, diabetic (ketoacidotic, hyperglycemic) coma is likely to develop - a condition that is extremely life -threatening, so insulin therapy is prescribed as soon as possible (only diabetes will hurry).
In most cases, after using insulin, metabolic processes are compensated,The need for the body in insulin is sharply reduced, and a temporary "healing" comes.However, the patient or the doctor should not relax, as the disease reminds itself again after a while.The need for insulin, when the duration of the disease increases, may increase, but basically, in the absence of ketoacidosis, may not exceed 0.8-1.0 units/kg.
Signs indicating the development of late complications of diabetes (retinopathy, nephropathy) may occur in 5-10 years.The main reasons for the fatal result of ISD are as follows:
- Terminal renal failure resulting from diabetic glomerulosclerosis;
- Cardiovascular disorders, such as complications of the underlying disease, which occur slightly less frequently kidney.
Disease or age -related changes?(Type II diabetes)
The insy develops for many months or even years.The problems that arise are worn by a person to various professionals (dermatologist, gynecologist, neurologist ...).The patient does not suspect that diseases differ in: furunculosis, itching of the skin, fungal lesions, pain in the lower limbs - II.Signs of type of diabetes.Patients become accustomed to their condition and diabetes continues to develop slowly, affecting all systems and primarily blood vessels.
Inzsd is characterized by a stable slow course, usually without being prone to ketoacidosis.
Treatment of type 2 diabetes usually begins according to the diet, limiting easily digestible (sophisticated) carbohydrates and reducing medications (if necessary).Insulin is prescribed when the disease has reached the stage of severe complications or is the immunity of oral drugs.
The main cause of the death of patients with InZD was called cardiovascular pathology, which has resulted in diabetes.As a general rule, it is a heart attack or stroke.
Diabetes
The basic principle of medical measures to compensate for diabetes is three main principles:
- Compensation for lack of insulin;
- Regulation of endocrine exchange disorders;
- Preventing diabetes mellitus, its complications and timely treatment.
The implementation of these principles is carried out based on 5 main positions:
- The diet for diabetes is appointed as the "First Violin" party;
- The system of appropriate and individually selected physical exercises comes after the diet;
- Sugar reduction drugs are used primarily to treat type 2 diabetes;
- Inzsd is prescribed if necessary, insulin therapy, but the main for type 1 diabetes is the main;
- Patients teaching for self -check (ability to take blood from finger, with a glucometer, introduction of insulin without external help).
Laboratory control of these positions indicates the extent of compensation after the following biochemical tests:
| Indicators | Good compensation | Lively | Bad |
|---|---|---|---|
| Glucose levels on an empty stomach (mmol/l) | 4.4 - 6.1 | 6.2 - 7.8 | Ø 7.8 |
| Sugar content in the blood serum 2 hours after a meal (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 index of full cholesterol (mmol/l) in serum | <5,2 | 5.2 - 6.5 | Ø 6.5 |
| Level of triglycerides (mmol/l) | <1,7 | 1.7 - 2.2 | Ø 2.2 |
An important role of diet in the treatment of inzs
Diabetes is very well known, even far from people's diabetes, Table 9.You are in the hospital about any illness and then a special nutrition that is always in separate dishes, differs from other diets and is issued after a certain password: "There is a Table Nine".What does this mean?What is the difference between everyone else in the mysterious diet?
Do not be mistaken, take care of the "porridge" of diabetics to deprive them of all the joy of life.The diet with diabetes is not so different from the nutrition of healthy people, with the right amount of carbohydrates (60%), fats (24%) and proteins (16%).
Power of diabetes consists of replacing refined sugars with slowly distributed carbohydrates.Sugar has been sold in a shop for everyone and, based on it, the confectionery falls into the category of prohibited foods.
As far as nutrition balance is concerned, everything is strict: Diabetes should be mandatory for the required amount of vitamins and pectins, which should be at least 40 g.daily.
Strictly individual physical activity
The physical activity of each patient is selected separately by the attending physician, while the following positions are taken into account:
- Circle;
- Symptoms of diabetes;
- Severity of the flow of the pathological process;
- The presence or absence of complications.
Physical activity prescribed by a doctor and performed by the "ward" should contribute to the "burning" of carbohydrates and fats without insulin attracting participation.The dose of compensation for metabolic disorders falls noticeably, which should not be forgotten because it may have an undesirable effect by preventing the increase in blood sugar.Proper physical activity reduces glucose, breaks down the introduced dose of insulin, and as a result, a reduction in sugar levels below the allowable values (hypoglycaemia).
So,Dosage of insulin and physical activity requires very close attention and thorough calculation,In order to complement each other, do not step up on the lower limit of normal laboratory indicators.
Or maybe you can try folk medicines?
Type 2 diabetes treatment is often accompanied by the search for patients with folk cure, who can inhibit the process and delay the time to adjust the dosage forms as much as possible.
Without examining the fact that our distant ancestors practically did not know about such a disease, there are folk drugs to treat diabetes, but we should not forget thatInfusions and decoctions made from various plants are complementary agents.The use of household medicines for diabetes does not relieve the patient from adherence to diet, blood glucose control, doctor's visit and all recommendations.
This pathology is used to combat the home of quite famous folk drugs:
- Bark and white strawberry leaves;
- Granules and peeling oats;
- Walnut partitions;
- Bay leaf;
- Cinnamon;
- Acorn;
- Nettle;
- Dandelion.
When diet and folk medicines no longer help ...
The first generation preparations called SO, which were widely known at the end of the last century, remained in memory and replaced by new generational drugs, which are the main group of 3 diabetes produced by the pharmaceutical industry.
What is suitable for one or the other patient - the endocrinologist decides- And to prevent patients from walking alone, and they do not decide to use these drugs for diabetes at their own discretion, we will give many visual examples.
Sulfonyil -mochevins' derivatives
Currently, the second -generation sulfonema derivatives are prescribed from 10 o'clock.Usually patients take them twice a day for half an hour before meals.
These drugs are completely contraindicated in the following cases:
- Type 1 diabetes;
- Diabetic, hyperosmolar, lacticidotic coma;
- Pregnancy, childbirth, breastfeeding;
- Diabetic nephropathy, accompanied by impaired filtration;
- Diseases of the hematopoietic system with the simultaneous decrease of white blood cells (leukocytopenia) and thrombocytic hematopoiesis (thrombocytopenia);
- Severe infectious and inflammatory liver damage (hepatitis);
- Vascular pathology is a complex diabetes.
In addition
- Itching and urticaria, sometimes reaching Quincke's edema;
- Disorders of the digestive system;
- Changes from the blood side (reducing the levels of platelets and leukocytes);
- Perhaps a violation of the functional capabilities of the liver (jaundice due to cholestasis).
The Biguanides Family Sahabro winning facilities
Biguanides (guanidine derivatives) are actively used to treat type 2 diabetes, often adding sulfonamides to them.They are very rational to patients with obesity, but people with liver, kidneys and people with cardiovascular pathology are sharply limited, changing the same group or α-glucoside inhibitors that inhibit carbohydrate absorption in the small intestine.
The absolute contraindication of the use of biguanides is considered:
- ISD (type 1 diabetes);
- Significant weight loss;
- Infectious processes regardless of localization;
- Surgical interventions;
- Pregnancy, childbirth, breastfeeding period;
- Coma declares;
- Liver and kidney pathology;
- Oxygen starvation;
- Microangiopathy (2-4 degrees) with visual impairment and kidney function;
- Tropical ulcers and necrotic processes;
- Violation of blood circulation in the lower limbs due to various vascular pathologies.
Insulin treatment
From the above is the fact that it becomes the aboveThe use of insulin is the main treatment of type 1 diabetes, all emergency conditions and serious complications of serious diabetes.Inzsd only requires the appointment of treatment for insulin uses if otherwise correction does not give the appropriate effect.
Modern insulins, so -called monocompeetens, represent two groups:
- Monocompetental pharmacological forms of human insulin (semi-synthetic or DNA rocombinant), which undoubtedly have a significant advantage over pork preparations.There is virtually no contraindications and side effects;
- Monocompetental insulins obtained from pork pancreas.These drugs increase the dose of the drug by about 15%compared to human insulins.
Diabetes is hazardous complications
Due to the fact that diabetes is accompanied by many organs and tissues, its manifestation is found in almost every body system.Complications of diabetes are considered:
- Abnormal changes in skin: diabetic dermopathy, lipoid necrobiosis, furunculosis, xanthoma, fungal lesions of the skin;
- Bone-articular disease:
- Diabetic osteoarthropathy (joint joint - change in ankle joint), which occurs in the background of microcirculation and tropical disorders, dislocations, subluxis, spontaneous fractures that pre -formation formationdiabetic leg;
- Diabetic hyropathy characterized by stiffness in the joints of the hand, which is more common in children with diabetes in children;
- Respiratory diseases: long -termlong -lasting bronchitis, pneumoniaToTo increase the frequency of tuberculosis;
- Pathological processes affecting digestive organs:Diabetic enteropathyIncreased peristaltis, diarrhea (30 times a day), with 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 variety -PolyneuropathyReaching 90% of all forms of this pathology.Diabetic polyneuropathy is often foundDiabetic foot syndrome;
- The abnormal condition of the cardiovascular system in most cases is the cause of death of diabetes mellitus- hypercolesterinemia and vascular atherosclerosis, which begins to develop in a youth of diabetes, leads to heart and blood vessels (coronary heart disease, myocardial infarction, heart failure, cerebrovascular damage).
Prevention
Measures for the prevention of diabetes are built on the basis of defiance.In this case, it is advisable to talk about the prevention of atherosclerosis, arterial hypertension, including overweight struggle, bad habits and food addictions.
Prevention of diabetes complications consists of preventing the development of abnormal conditions from diabetes.Correction of glucose in blood serum, diet, proper physical activity, and implementing your doctor's recommendations promotes the consequences of this rather scary disease.