Diabetes mellitus is a disease of the endocrine system associated with pathological changes in the hormonal background and malnutrition of metabolic processes.
To date, the disease is not amenable to eradication (complete liquidation).It is possible to slow down the destructive process in the body through medicines and diet therapy, but it is impossible to stop it and start in the opposite direction.
The main symptom of the disease is a chronic increase in blood glucose.The causes and nature of the course of the disease differ, so it is divided into several types.
Types of diabetes (SD) are determined by the World Health Organization and do not have fundamental differences in the entire medical world.Diabetes of any type does not apply to contagious diseases.
Tipination of pathology
There are several types of disease united by one main sign - an increased concentration of glucose in the blood.The typification of diabetes is due to the causes of its occurrence.The methods of therapy, gender and age of the patient are also taking place.
Types of diabetes accepted in medicine:
- The first type is insulin -dependent (ISD 1), or juvenile;
- The second is insulin -dependent (INZSD 2), or insulin -resistant;
- Diabetes gestational mellitus (HSD) in the perinatal period in women;
- Other specific types of diabetes, including:
- damage to β-cells of the pancreas at the genetic level (variety of Mody-diabetes);
- pathologies of the extension function of the pancreas;
- hereditary and acquired pathologies of the glands of external secretion and their functions (endocrinopathy);
- pharmacologically caused by diabetes;
- diabetes as a result of congenital infections;
- Sd related to genomic pathologies and hereditary defects;
- Violation of glycemia (blood sugar) on an empty stomach and violation of glucose tolerance.
The pre -diBet is a borderline state of the body, when the level of glycemia is changed towards an increase (glucose tolerance is disturbed), however, blood sugar indicators “do not reach” the generally accepted digital values corresponding to the true diabetes.According to the World Health Organization (WHO 2014), more than 90% of the endocrinologist patients suffer from the second type of disease.
According to medical statistics, a tendency to increase the number of sick people is clearly traced all over the world.Over the past 20 years, the number of type 2 diabetics has doubled.GSD accounts for about 5% of the pregnancies.Types of specific diabetes are extremely rare and occupy a small percentage in medical statistics.
In terms of gender affiliation of INZSD 2, it is more common in women in the prelimacteric period and during menopause.This is due to a change in hormonal status and a set of extra pounds.In men, the factor of the development of type 2 diabetes most often is chronic inflammation of the pancreas, due to the toxic effects of ethanol.
Insulin -dependent diabetes (1 type)
Type 1 diabetes is characterized by the incapacity of the pancreatic cells.The organ does not perform its endocrine (intra -regional) function for the production of insulin - a hormone responsible for supplying the body with glucose.As a result of accumulation of glucose in the blood, the organs do not receive a full nutrition, including the pancreas itself.
To simulate the natural production of the endocrine hormone, the patient is prescribed by injections of medical insulins with different temporary durations (short and long), as well as diet therapy.The classification of diabetes of the first type is dictated by various etiology of the disease.The insulin -dependent type of the disease has two causes: genetic and autoimmune.
Genetic reason
The formation of pathology is associated with the biological feature of the human body to convey its characteristic features and pathological deviations to subsequent generations.With regard to diabetes, the child inherits a predisposition to the disease from parents or close relatives suffering from diabetes.
Important!A predisposition is inherited, but not the disease itself.A 100% guarantee of the development of diabetes does not have a child.
Autoimmune reason
The occurrence of the disease is due to the functional failure of the immune system, when, under the influence of negative factors, it actively produces autoimmune antibodies that destroy the body cells.Triggers (impetus) are used to launch autoimmune processes:
- unhealthy food behavior combined with hypodynamia;
- metabolic failure (carbohydrate, lipid and protein);
- critical deficiency in the body of cholegalciferol and ergocalciferol (group D vitamins);
- pancreatic pathology of a chronic nature;
- the presence in the anamnesis of epidemic mumps (pigs), measles, the herpes Koksaki virus, the Epstein-Barra virus, cytomegalovirus, viral hepatitis A, B, C;
- distress (prolonged stay in a state of neuropsychological stress);
- chronic alcoholism;
- Incorrect treatment with hormone -containing medical drugs.
ISSD is formed in children, adolescents and adults who have not reached the age of thirty.The children's version of the development of diabetes form 1a is associated with complicated viral infections.Form 1b occurs in young people and children against the background of autoimmune processes and hereditary predisposition.The disease, as a rule, develops in forced mode for several weeks or months.
Insulin -resistant diabetes (type 2)
The difference between the second type of diabetes mellitus and the first is that the pancreas does not stop the synthesis of insulin.Glucose is concentrated in the blood and is not delivered to the cells and tissues of the body due to the lack of sensitivity to insulin - insulin resistance.Until a certain point, treatment is carried out through hypoglycemic (sugar -lowering) medicines and diet therapy.
To compensate for the imbalance in the body, the pancreas activates the production of the hormone.Working in emergency mode, the organ wears out over time and loses the intra -regional function.Type 2 diabetes passes into insulin -dependent form.The decrease or loss of the susceptibility of cells to the endogenous hormone is primarily associated with obesity in which fat and carbohydrate metabolism is disturbed.
This is especially true for visceral obesity (deposition of fat around internal organs).In addition, with excess body weight, blood flow is difficult due to numerous cholesterol plaques inside the vessels, which are formed with hypercholysterinemia, which always accompanies obesity.The body's cells, thus, experience a deficiency of nutrition and energy resources.Other factors affecting the development of INZSD include:
- alcohol abuse;
- gastronomic addiction to sweet dishes;
- chronic pancreatic diseases;
- pathologies of the heart and vascular system;
- immodesty in food against the background of a sedentary lifestyle;
- incorrect hormone therapy;
- complicated pregnancy;
- dysfunctional heredity (diabetes in parents);
- Distress.
Most often, the disease develops in women and men of the age category 40+.In this case, diabetes of the second type is latent in nature and may not show pronounced symptoms for several years.Timely testing for blood glucose can detect pre -antiabet.With adequate therapy, the antiabetic state is reversible.If time is lost, progresses and subsequently diagnosed the INZSD.
Lada Diabetes
In medicine, the term “diabetes 1.5” is found, or the name Lada Diabetes.This is an autoimmune violation of the production of hormones and a malfunction of metabolism processes that occurs in adults (at the age of 25+).The disease combines the first and second varieties of diabetes.The development mechanism corresponds to ISD, latent course and the manifestation of symptoms are similar to the INZSD.
The triggers for the development of pathology are autoimmune diseases in the history of the patient:
- non -infectious inflammation of the intervertebral joints (ankylosing spondylitis);
- an irreversible disease of the central nervous system - multiple sclerosis;
- granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
- chronic inflammation of the thyroid gland (Hashimoto thyroiditis);
- Juvenile and rheumatoid arthritis;
- change in color (loss of pigment) of the skin (vitiligo);
- inflammatory pathology of the colon mucosa (ulcerative colitis);
- Chronic damage to the connective tissue and glands of external secretion (Shegren syndrome).
In combination with a hereditary predisposition, autoimmune disorders lead to the progression of Lada-diabetes.To identify the disease, basic diagnostic methods are used, as well as blood microscopy, which determines the concentration of IGG class immunoglobulins to antigens –ifs (immuno -function analysis).Therapy is carried out through regular insulin injections and nutrition correction.
The gestational form of the disease
GSD is a specific type of diabetes that develops in women in the second half of the perinatal period.The disease is most often detected during a second planned screening, when the expectant mother undergoes a full examination.The main characteristic of GSD coincides with type 2 diabetes - this is insulin resistance.The cells of the body of a pregnant woman lose touch (sensitivity) to insulin due to the correlation of three main reasons:
- Hormonal restructuring.During the gestation period, the synthesis of progesterone (steroid sex hormone) that blocks the production of insulin increases.Plus, the endocrine hormones of the placenta are gaining strength, which have the property of inhibiting the production of insulin.
- Doubled load on the female body.To ensure a full nutrition of the unborn child, the body requires an increased amount of glucose.A woman begins to use more monosaccharides, which forces the pancreas to synthesize more insulin.
- An increase in body weight against a decrease in physical activity.Glucose, abundantly entering the body, is accumulated in the blood, since cells refuse to perceive insulin due to obesity and hypodynamia.The expectant mother and fruit in such a situation are deficient in nutrients and energy hunger.
Unlike the first and second type, gestational diabetes is a reversible process, since insulin molecules and the functional capabilities of the pancreas are preserved.
Properly selected therapeutic tactics guarantees the elimination of pathology after delivery in 85% of cases.The main method of treatment of GDC is a diet for diabetics "Table No. 9".In difficult cases, injections of medical insulin are used.Sahabro-winning drugs are not used due to their teratogenic effects on the fetus.
Additionally
Specific types of diabetes are genetically determined (Mody-diabetes, some types of endocrinopathy) or provoked by other chronic pathologies:
- pancreatic diseases: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical injuries and gland surgery;
- functional failure of the front lobe of the pituitary gland (acromegaly);
- increased synthesis of thyroid hormones (thyrotoxicosis);
- hypothalamic-pituitary-adultery (ICECO-Cushing Syndrome);
- tumors of the adrenal cortex (aldosteror, pheochromocytoma, etc.).
Separate diabetic pathology - non -sha shagal diabetes is characterized by a decrease in the production of the hormone of the hypothalamus of vasopressin, which regulates the balance of fluid in the body.
Diagnostic measures
The diagnosis of diabetes (any type) diagnosis is possible only on the basis of the results of laboratory microscopy of the blood.Diagnosis consists of several consistently conducted studies:
- A general clinical blood test to identify hidden inflammatory processes in the body.
- A blood test (capillary or venous) for the content of glucose.It is produced strictly on an empty stomach.
- GTT (glucosotolerant testing).It is carried out to determine the ability of the body to absorb glucose.A tolerance test is a two -time blood fence: on an empty stomach and two hours after the “glucostostrole load”, the role of which is a aqueous solution of glucose prepared in a ratio of 200 ml of water by 75 grams.Substances.
- HBA1C analysis to the level of glycosylated (glycated) hemoglobin.Based on the results of the study, a retrospective of sugar in the blood over the past three months is evaluated.
- Biochemistry of blood.The indicators of the hepatic enzymes of aspartateaminotransferase (AST), alanineine-orgrase (ALT), alpha-amylase, alkaline phosphatase (SCF), bilirubin (gall pigment), cholesterol levels are evaluated.
- A blood test for the concentration of antibodies to glutamatdecarboxylase (GAD antibodies) determines the type of diabetes.
Reference values of blood sugar and disease indicators
| Analysis | For sugar | Gluczotolerant test | Glycated hemoglobin |
|---|---|---|---|
| norm | 3.3 - 5.5 | <7.8 | ⩽ 6% |
| Prediabet | 5.6 - 6.9 | 7.8 - 11.0 | from 6 to 6.4% |
| diabetes | > 7.1 | > 11,1 | More than 6.5% |
In addition to blood microscopy, a general urine analysis for the presence of glucose in the urine (glycosuria) is investigated.In healthy people, there is no sugar in the urine (for diabetics, 0.061 - 0.083 mmol/l is considered the permissible norm).Referega sample is also carried out to identify albumin protein in the urine and a protein exchange of creatinine.Additionally, hardware diagnostics is prescribed, including an ECG (electrocardiogram) and ultrasound of the abdominal cavity (with a kidneys).
Results
Modern medicine classifies diabetes according to four basic types, depending on the pathogenesis (origin and development) of the disease: insulin -dependent (ISSD 1 type), insulin -dependent (INZSD 2 type), gestational (gsd of pregnant women), specific (diabetes includes several types of disease due to genetic defects or chronic pathologies).Hasteful diabetes formed in the perinatal period is cure.The state of pre -the -diabetes (violation of glucose tolerance) is considered reversible subject to early diagnosis.