Causes, signs and symptoms of diabetes
What is diabetes?
Diabetes mellitus is a metabolic carbohydrates and water in the body. The result is a dysfunction of the pancreas. That is the pancreas produces a hormone called insulin. Insulin is involved in the processing of sugar. And without it, the body cannot carry out the conversion of sugar to glucose. As a result, the sugar builds up in our blood and is excreted in large quantities from the body through urine.
In parallel with this disturbed water metabolism. Tissue does not hold water in itself, and as a result many defective water excreted through the kidneys.
If a person's sugar (glucose) levels are above normal, it is the main symptom of the disease – diabetes. In humans for insulin production are responsible cells of the pancreas (beta cells). In turn, insulin is a hormone that is responsible for ensuring that cells in the right amount of supplied glucose. What happens in the body in diabetes? The body produces inadequate amounts of insulin, the sugar and glucose in the blood increased, but the cells begin to suffer from lack of glucose.
This metabolic disease can be hereditary or acquired. From a lack of insulin develop pustular and other skin lesions, affects the teeth, develops atherosclerosis, angina pectoris, hypertension, affects the kidneys, nervous system, deteriorating eyesight.
Etiology and pathogenesisPathogenetic basis of occurrence of diabetes depend on the type of the disease. There are two varieties which essentially differ from each other. Although modern endocrinologists call the division of diabetes is very conditional, but still the type of the disease is important in determining treatment tactics. Therefore, it is advisable on each ofthem separately to stay.
In General, diabetes mellitus belongs to the diseases, which in essence is a violation of metabolic processes. While most affected carbohydrate metabolism that manifests with persistent and permanent, increase in the blood glucose. This figure is called hyperglycemia. The main core of the problem is the distortion of the interaction of insulin with tissues. This is the only hormone in the body contributing to the decline in glucose by its implementation in all cells as the main energy substrate for the maintenance of life processes. If a failure occurs in the system of interaction of insulin with tissues, glucose is unable to engage in normal metabolism, which contributes to its continuous accumulation in the blood. These causal relationships and are called diabetes mellitus.
It is important to understandthat not all hyperglycemia is a true diabetes mellitus, but only one that caused the primary violation action of insulin!
It is worth to specify, when else can cause hyperglycemia:
Pheochromocytoma – a tumor of the adrenal glands that produce hormones with the opposite effect of insulin;
Glucagonoma and somatostatinoma – neoplastic proliferation of cells that synthesize insulin competitors;
Overactive adrenal glands (hyperadrenocorticism);
Violated susceptibility (tolerance) to the carbohydrate – poor absorption after a meal with relatively normal fasting;
Transient hyperglycemia is a short – term increase in blood glucose.
Appropriateness of the allocation of all these States is that they occur when the hyperglycemia is secondary. It is a symptom of these diseases. Therefore, eliminating the underlying cause, leaving and diabetes, which bears a temporary character. Of course, if the hyperglycemia persists for a long time, it causes typical signs of diabetes, what gives you the right to state the fact of the true form of this disease on the background of a particular disease organism.
Why there are two types of disease?Such a need is mandatory, as it completely determines the treatment of the patient, which in the initial stagesdisease is radically different. The more durable and heavier flows diabetes, the more the division into types is a mere formality. Indeed, in such cases, the treatment is almost identical in any form and origin of the disease.
Diabetes mellitus type 1
This type is also called insulin-dependent diabetes. Most often this type of diabetes affects young people under the age of 40 years, thin. The disease is difficult, treatment requires insulin. The reason: the body produces antibodies that destroy cells in the pancreas that produce insulin.
From diabetes of the first type to heal completely is almost impossible, although there are instances restore functions of the pancreas, but this is possible only in special circumstances and natural raw foods. To maintain the body's required with a syringe injected into the body insulin. So as insulin is destroyed in the gastrointestinal tract, insulin in pill form is impossible. Injected insulin with a meal. It is very important to follow a strict diet, from the diet completely excluded easily digestible carbohydrates (sugar, sweets, fruit juices, sugar-containing lemonades).
Diabetes mellitus type 2
This type of diabetes is insulin-independent. Most often type 2 diabetes affects the elderly, after 40 years, fat. Reason: loss of sensitivity of cells to insulin due to excess nutrients in them. The use of insulin for treatment, must not each patient. Only a qualified specialist can prescribe treatment and dose.
To start such patients assigned diet. It is very important to comply fully with the recommendations of the doctor. It is recommended to reduce weight slowly (2-3 kg per month) to achieve normal weight should be maintained throughout life. In cases where diet is not enough, use glucose-lowering pills, and only in very extreme cases prescribe insulin.
Harmful than a high level of glucose in the blood?The higher and longer is hyperglycemia in diabetes mellitus, the more severe the disease. It is associated with such pathological mechanisms that are triggered by the body to dump glucose:
The transformation of the glucose in fat deposits, leading to obesity;
Glycosylation (a kind ?the sugared?) proteins of cell membranes. This is the basis of the disruption of the normal structure of allinternal organs: brain, heart, lungs, liver, stomach and intestines, muscle and skin;
Activation arbitrajnogo the path of discharge of glucose. While there are toxic compounds that cause specific lesions of nerve cells that underlies diabetic neuropathy.
The involvement of small and large vessels. This is due to the glycosylation of proteins and the progression of the deposits of cholesterol. As a consequence of diabetic microangiopathy internal organs and eyes (nephropathy, retinopathy), and angiopathy of lower extremities.
Thus, hyperglycemia gradually causes damage to almost all organs and tissues with the predominant spread on one of the systems of the body!
Topic: 10 facts about the dangers of sugar! Why immunity weakens in 17 times?
Signs and symptoms of diabetesClinical signs of the disease in most cases are characterized by a gradual flow. Diabetes rarely manifests in lightning form with the rise of index glycemic (glucose) to critical numbers with the development of various diabetic com.
With the beginning of the disease patients appear:
Constant dryness in the mouth;
The feeling of thirst with the inability to quench it . Sick people drink several liters of fluid daily;
The increase in urine output – a significant increase and the total portion allocated per night urine;
Reduction or sudden weight gain and body fat;
Severe itching of the skin and dryness;
Increased tendency to pustular processes in the skin and soft tissues;
Muscle weakness and increased sweating;
Poor healing of any wounds;
Usually these complaints are the first call disease. Their appearance should be a mandatory reason for an immediate examination of the blood for glycemia (glucose).
As the progression of the disease, can appear the symptoms of complications of diabetes that affect almost all organs. In critical cases, there may be life-threatening condition with impaired consciousness,severe intoxication and multiple organ failure.
The main manifestations of complicated diabetes include:
Headaches and neurological disorders;
Heart pain, enlargement of the liver, if they were noted before the appearance of diabetes;
Pain and numbness of the lower extremities with dysfunction of the walk;
Reduced sensitivity of the skin, especially the feet;
The appearance of the wounds that long to heal;
The progressive increase in arterial (systolic and diastolic) pressure;
The odor of acetone from the patient;
The appearance of the characteristic signs of diabetes or development of its complications – alarm, which indicates progression of the disease or inadequate medical treatment.
Causes of diabetesThe most important causes of diabetes are such as:
- Heredity. Need other factors that affect the development of diabetes to nullify.
- Obesity. To actively fight obesity.
A number of diseasesthat contribute to lose the beta cells responsible for insulin production. These conditions include diseases of the pancreas – pancreatitis, cancer of pancreas, disease of other glands of internal secretion.
Viral infections (rubella, varicella, epidemic hepatitis , and other diseases this includes the flu). These infections are starting to the development of diabetes. Especially for people who are at risk.
- Nervous stress. People who are at risk, you should avoid nervous and emotional tension.
- Age. Withage for every ten years the risk of developing diabetes is doubled.
This list does not included those diseases in which diabetes mellitus or hyperglycemia are secondary, being merely a symptom. In addition, this hyperglycemia may be considered a true diabetes until, until you develop detailed clinical manifestations of diabetic complications. The diseases which cause hyperglycemia (increased blood sugar) include tumors of the adrenal hyperfunction, chronic pancreatitis, increased levels of kontrinsuljarnye hormones.
Diagnosis of diabetes
If there is a suspicion of diabetes mellitus the diagnosis must be either confirmed or refuted. For this there are a number of laboratory and instrumental methods. These include:
The study of the content of blood glucose – definition of fasting glucose levels;
Test of glucose tolerance – definition of tomakomai the relationship of glycemia to this figure in the incident two hours after ingestion of the carbohydrate components (glucose);
Glycemic profile is the study of numbers of blood glucose levels several times throughout the day. Performed to assess the effectiveness of treatment;
General analysis of urine glucose in urine (glycosuria), protein (proteinuria), white blood cells;
Urine test for content of acetone – if you suspect ketoacidosis.
Analysis of the blood concentration of glycosylated hemoglobin indicates the degree of impairment caused by diabetes;
Biochemical blood analysis – the study of hepato-renal samples, indicating the adequacy of the functioning of these bodies against the background of diabetes;
The study of electrolyte composition of blood is shown in development of severe forms of diabetes;
Trial of Rehberg – shows the degree of kidney damage in diabetes;
Determination of the level of endogenous insulin in the blood;
The study of the fundus;
Ultrasound examination of the abdominal organs, heart and kidneys;
ECG – to assess the degree of diabetic myocardial injury;
Ultrasonic Doppler, capillaroscopy, rheovasography of vessels of lower extremities – assesses the degree of vascular disorders withdiabetes;
All patients with diabetes must be counseled with:
Surgeon (vascular or special doctor – pediatrician);
The full range of these diagnostic procedures can help clearly define the severity of disease, its extent and the correct tactics in the treatment process. It is very important conduct this research not once, and to repeat in dynamics as many times as needed in the situation.
The blood sugar levels in diabetes
The first and the most informative method of primary diagnosis of diabetes mellitus and its dynamic assessment in the treatment process is to study the level of glucose (sugar) in the blood. This is a clear indicator from which to build all subsequent diagnostic and therapeutic measures.
Professionals has been revised several times normal and abnormal numbers of glucose. But today a clear their size, which shed a true light on the state of carbohydrate metabolism in the body. They should be guided not only endocrinologists, and other specialists, and patients themselves, especially diabetics of long standing of the disease.
The increased glucose level
The rate of sugar in the blood
On an empty stomach
2 hours after a carbohydrate load
Violation of tolerance to glucose
On an empty stomach
Of 5.5-6.7 mmol/l
2 hours after a carbohydrate load
On an empty stomach
2 hours after a carbohydrate load
As can be seen in the table, the diagnostic confirmation of diabetes is very simple and canto be held in any clinic or even at home with a personal electronic glucometer (device for determination of the indicator of glucose in the blood). Similarly, we developed criteria to assess the adequacy of therapy of diabetes those or other methods. The main of them is the same sugar level (glycemia).
Learn more: How to lower blood sugar?
According to the international standards a good indicator of treatment of diabetes is a blood glucose level below 7.0 mmol/L. unfortunately, in practice this is not always feasible, despite the real efforts and strong commitment of doctors and patients.
Degree of diabetes
A very important category in the classification of diabetes is its division into degrees of severity. The basis for this distinction based on the level of glycemia. Another element in the correct formulation of the diagnosis of diabetes is the indication of the payment process. The basis of this indicator is necessary the presence of complications.
But for ease of understanding what happens to patients with diabetes by looking at entries in the medical records, you can combine the severity with the stage of the process, in one category. Because naturally, the higher the blood sugar level, the more severe the diabetes and the higher the number of severe complications.
Diabetes 1 degree
Characterizes the most favorable course of the disease to which should seek any treatment. The extent of the process it is fully compensated, the glucose level does not exceed 6-7 mmol/l, no glucosuria (glucose secretion in the urine), indicators glycated hemoglobin and proteinuria do not go beyond normal values.
In the clinical picture there are no signs of complications of diabetes: angiopathy, retinopathy, polyneuropathy, nephropathy, and cardiomyopathy. To achieve such results is possible with the help of diet and intake of drugs.
Sugar type 2 diabetes
This stage of the process indicates partial compensation. There are signs of complications of diabetes, and lesions typical target organs: eyes, kidneys, heart, blood vessels, nerves of the lower extremities.
Glucose levels increased slightly and is about 7-10 mmol/l Glycosuria is not defined. Indicators of glycosylated hemoglobin within the normalthe limits or slightly elevated. A severe impairment of the functioning of the organs are missing.
Diabetes grade 3
Such a process speaks to his constant progression and the inability of drug control. The level of glucose is in the range of 13-14 mmol/l, there is a persistent glucosuria (glucose secretion in the urine), high proteinuria (presence of protein in the urine), there are clear detailed manifestation of defeat of target organs in diabetes.
Progressive decreased visual acuity, continues to be severe hypertension (high blood pressure), reduced sensitivity with severe pain and numbness of the lower extremities. At a high level holds the level of glycosylated hemoglobin.
Diabetes 4 degrees
This degree characterizes the absolute decompensation process and the development of serious complications. The level of blood glucose rises to critical numbers (15-25 or more mmol/l), poorly amenable to correction by any means.
Progressive proteinuria with loss of protein. Characterized by the development of kidney failure, diabetic ulcers and gangrene of the limbs. Another criterion 4 degrees of diabetes is a tendency to frequent development of diabetic com: hyperglycemic, hyperosmolar, ketoatsidoticheskoy.
Complications and consequences of diabetes
By itself, diabetes does not pose a threat to human life. Dangerous complications and their consequences. Not to mention some of them, which either occur frequently, or bear direct threat of life of the patient.
Coma in diabetes mellitus
Symptoms of this complication are growing at lightning speed, regardless of the type of diabetic coma. The most important threatening symptom is dizziness or extreme retardation of the patient. Such people urgently need to be hospitalized in the nearest medical institution.
The most common diabetic coma ketoatsidoticheskaya. It is due to the accumulation of toxic products of metabolism, which can have a ruining effect on nerve cells. The main criterion is persistent smell of acetone in the breath of the patient. In the case of hypoglycemic coma consciousness darkened, the patient is covered with cold profuse sweat, but that is fixed by the critical decline in the levelglucose, which is possible with an overdose of insulin. Other types of whom, fortunately, are less common.
Swelling in diabetes
Edema can be local or common, depending on the degree of concomitant heart failure. In fact, this symptom is an indicator of renal dysfunction. The more pronounced the swelling, the more severe diabetic nephropathy.
If swelling are characterized by asymmetric distribution, capturing only one lower leg or foot, it says diabetic microangiopathy of the lower extremities, which is underpinned by neuropathy.
High/low blood pressure diabetes
Systolic and diastolic blood pressure also act as the criterion of severity of diabetes. It can be regarded in two planes. In the first case judged by the level of General arterial pressure at the brachial artery. Its increase indicates progressive diabetic nephropathy (kidney damage), resulting in the release of the substances that increase blood pressure.
The other side of the coin is the reduction of blood pressure in the blood vessels of the lower extremities, determined by Doppler ultrasound. This index indicates the degree of diabetic angiopathy of the lower extremities.
Foot pain in diabetes
Pain in the legs may indicate diabetic angio-and neuropathy. It can be judged according to their character. Microangiopathy is characterized by the appearance of pain in any exercise and walking, which forces patients to stop for a while to reduce their intensity.
The emergence of night pain and rest says about diabetic neuropathy. They are usually accompanied by numbness and decreased sensitivity of the skin. Some patients reported local pain in certain areas of the Shin or foot.
Trophic ulcers in diabetes mellitusSores are the stage of diabetic angio - and neuropathy after pain. The kind of wound surfaces in different forms of diabetic foot is radically different, and vary their treatment. In this situation it is important to properly assess all the minor symptoms, as it affects the possibility of saving the limb.
Immediately it is worth noting the relative favorability of neuropathic ulcers. They are caused by a decrease in the sensitivity of the stop to lesions of the nerves (neuropathy) in the backgrounddeformation of the foot (diabetic osteoarthropathy). In a typical friction points of the skin in areas over bony prominences, plantar callosities appear that patients do not feel. Under them are formed the hematoma with further suppuration. Patients pay attention to the foot only when it's already red, swollen and with a massive trophic ulcer on the surface.
Gangrene in diabetes
Gangrene is often the consequence of diabetic angiopathy. This should be a combination of lesions of the small and large arterial trunks. Usually the process starts in one of the toes. The result of the lack of blood flow to it, a severe pain occurs in the foot and redness of her. Over time the skin becomes cyanotic, edematous, cold, and then covered with blisters with turbid contents, and the black spots of necrosis of the skin.
The described changes are irreversible, so to save a limb is not possible in all circumstances, shown amputation. Of course, it is desirable to do it as below because the operations on the foot have no effect if the gangrene, the optimal level of amputation is considered to be Shin. After surgery, it is possible to recover the walk with a good functional prostheses.
Prevention of complications of diabetes
Prevention of complications is early detection of disease and adequate and proper treatment. It requires from doctors a clear knowledge of all the intricacies of diabetes progression, and patients strictly observing all the dietary and therapeutic recommendations. There is a special section in the prevention of diabetic complications is to provide the proper daily care of the lower extremities in order to prevent them from damage, and if found, immediately seek help from the surgeons.
Prevention of diabetes
Unfortunately, not all cases can affect the inevitable emergence of diabetes of the first type. Because its main reasons is the hereditary factor and small viruses faced by every person. But the disease is not developing at all. Although scientists determined that diabetes occurs much less frequently in children and in adults who were breast-fed and treated the respiratory infection with antiviral medications, it can not be attributed to specific prevention. So really effective methods does not exist.
Completely different situation with the prevention of type II diabetes. After all, it is very often the result of poor lifestyle.
Therefore, comprehensive prevention measures include:
Control of arterial hypertension and lipid metabolism;
The correct fractional food diet with minimal content of carbohydrates and fats are capable of easy assimilation;
Dosed physical load. Assume the fight against physical inactivity and refusal from excessive loads.
Normalization of body weight;
Is it possible to cure diabetes?
Very ambiguous is considered today the possibility of complete cure from diabetes. The complexity of the situation is that it is very hard to get back what is already lost. The only exceptions are those forms of diabetes of the second type, which are well control under the influence of diet. In this case, normalizing eating patterns and physical activity, it is possible to get rid of diabetes. It should be borne in mind that the risk of recurrence of the disease in case of violation of the regime is extremely high.
According to official medicine - diabetes mellitus of the first type and resistant forms of type II diabetes completely cure impossible. But a regular drug treatment can prevent or slow the progression of complications of diabetes. After all, they are dangerous to humans. It is therefore extremely important to regularly control the value of glycemia of the blood, monitoring the efficacy of therapeutic interventions. You need to remember that they must be lifelong. It is acceptable to only change their volumes and varieties depending on the condition of the patient.
However, there are many former patients who were able to cure this incurable disease with fasting. But forget about this method, if you can't find a good specialist in your city who would be able to control you and not let the situation get out of control. Because there are many cases when the experiments end up in intensive care!
With regard to the operational methods of eliminating diabetes with implantation of a kind of artificial pancreas, which is a device which converts the level of hyperglycemia and automatically produce the required amount of insulin. The results of this treatment are impressive for their efficiency, but not without significant drawbacks and problems. So far no one has managed to replace the natural insulin a particular person a synthetic analogue, which not all may be suitable for a person with diabetes.
Continues to be development in the field of synthesis of those species of insulin, which will consist of identical components that are specific to each patient. And although this isstill remains a distant reality, every man, worn out with diabetes, believes that a miracle occurred.