Diabetes

Diabetes mellitus is an endocrine disease characterized by a chronic increase in blood sugar due to absolute or relative deficiency of insulin – the hormone of the pancreas. The disease leads to a violation of all types of metabolism, damage to blood vessels, the nervous system, as well as other organs and systems.

Types of diabetes

• Insulin-dependent diabetes mellitus (type 1 diabetes mellitus) develops mainly in children and young people;
• Non-insulin-dependent diabetes mellitus (type 2 diabetes mellitus) usually develops in people over 40 who are overweight;
• Secondary (or symptomatic) diabetes mellitus;
• Diabetes of pregnant women;
• Diabetes due to malnutrition.

Causes of diabetes

The main cause of type 1 diabetes is an autoimmune process caused by a malfunction of the immune system, in which antibodies against pancreatic cells are produced in the body that destroy them. The main factor provoking the occurrence of type 1 diabetes is a viral infection against the background of a genetic predisposition to this disease.

The main factors provoking the development of type 2 diabetes mellitus are two: obesity and a hereditary predisposition.

Non-insulin-dependent diabetes develops gradually and is characterized by moderate severity of symptoms.

The causes of so-called secondary diabetes can be:

• pancreatic diseases (pancreatitis, tumor, resection, etc.);
• hormonal diseases;
• exposure to drugs or chemicals;
• certain genetic syndromes, etc.

There are also pregnant diabetes and diabetes due to malnutrition.

Complications

High blood sugar damages organs and tissues throughout the body. The higher your blood sugar and the longer you live with it, the higher the risk of complications. Here are just a few figures: from 50 to 70% of all amputations in the world are caused by complications of diabetes, diabetics are 4-6 times more likely to suffer from cancer.

Possible complications caused by both types of diabetes:

• Narrowing the lumen of blood vessels, including large arteries;
• Cardiovascular disease – coronary heart disease, heart attack, thrombosis;
• Neuropathy – lowering the pain threshold, pain in the legs and arms;
• Peeling of cells of the surface layer of the skin as a result of dehydration of the skin;
• Decreased vision up to blindness;
• Nephropathy – impaired renal function;
• Diabetic foot – festering wounds with necrosis of soft tissues;
• Fungal lesions of the nail phalanx;
• Vascular disease of the lower extremities;
• Coma.

This is only a small part of those dangerous diseases that may result in a delayed diagnosis or its absence (or improper therapy). To prevent a new disease against diabetes mellitus, it is necessary to continuously take the prescribed drugs and monitor blood sugar.

Diagnosis

Diabetes is diagnosed with the help of various laboratory tests and other methods. The patient needs to do a general and biochemical blood test, a general urinalysis, perform a glycemic profile, a glucose tolerance test, a Reberg test. In some cases, a patient also undergoes an ultrasound scan of the heart and kidneys, funduscopic examination, ECG, and Doppler ultrasonography of the lower extremity arteries.

Symptoms of diabetes

Common symptoms of the disease include:

• thirst (patients can drink 3-5 liters or more of fluid per day);
• rapid urination (both day and night);
• dry mouth;
• itching of the skin (especially in the genital area of women);
• fatigue;
• poorly healing wounds;
• sharp weight loss in patients with type 1 diabetes;
• obesity in patients with type 2 diabetes.

Prediabetes

Prediabetes is a condition classified as elevated levels of HbA1c in red blood cells. They are not high enough to call it diabetes, but these people run the risk of getting this disease if they don’t change anything.

According to doctors, if prediabetes is not treated, approximately every third patient with this diagnosis will develop type 2 diabetes within 6 years. Out of every 100 people who have changed bad habits and began to lead a healthy lifestyle, only 13 get diabetes.

The development of diabetes slows down or stops if the patient increases physical activity, changes the diet and gets rid of excess weight.

Treatment

Patients with diabetes must be regularly monitored by an endocrinologist.

Treatment for diabetes includes:

1. Special diet: it is necessary to exclude sugar, alcohol, syrups, cakes, cookies, sweet fruits. Food should be taken in small portions, preferably 4–5 times a day;
2. Daily use of insulin (insulin therapy) is necessary for patients with type 1 diabetes mellitus and with the progression of type 2 diabetes;
3. The use of tablets that help lower blood sugar. As a rule, such drugs are used to treat type 2 diabetes. With the progression of the disease, insulin must be administered;
4. Exercise is useful for people with diabetes. The weight loss in patients with obesity also has a therapeutic role.
5. Diabetes treatment should be life-long. Self-control and accurate implementation of the doctor’s recommendations can prevent or significantly slow down complications of the disease.

Drugs for diabetes

The medications used in the treatment of diabetes are intended primarily to regulate the patient’s blood sugar by stimulating pancreatic insulin production.

Diabetes is traditionally treated with the following drugs:

• Preparations based on sulfonylurea derivatives – glimepiride, glibenclamide;
• Biguanides – metformin;
• Glinidovye – nateglinide, pioglitazone.

Medicines that suppress the activity of enzymes that contribute to the breakdown of glucose – acarbose.

Important: at the initial stage of non-insulin-dependent diabetes, you can achieve a stable decrease in blood glucose by correcting nutrition and increasing physical activity.

The drug regimen for lowering blood sugar is prescribed by an endocrinologist. To monitor the effectiveness of the prescribed drug, it is necessary to regularly check the sugar indicators with a glucometer.

Prevention

To prevent this disease, you should follow the given recommendations:

• restrict fat-containing foods, including vegetable oils;
• increase physical activity (at least up to 30 minutes of walking daily);
• restrict refined carbohydrates (sugars, fructose);
• reduce body weight by at least 10 percent of the original;
• care of the skin of the feet (keep the feet clean and dry, avoid using alcohol-containing solutions and fatty ointments to treat wounds, corn fluids and plasters in the treatment of corns, use only nail files when treating nails, use only closed, comfortable shoes with a compacted back and toe cap;
• follow the cardiologist’s recommendations, including close monitoring of blood pressure and blood lipids;
• visit an endocrinologist regularly;
• educate in diabetes schools (if possible).

Rules of good nutrition

It is necessary to reduce the consumption of fatty foods, increase green fruits and vegetables, increase white meat, reduce the number of simple sugars, and use gray porridges.

It is recommended to eat “slow” carbohydrates, i.e. containing a significant amount of fiber. Eat more vegetables, herbs, fruits, buckwheat, millet, barley. Limit the consumption of products made from flour containing sugar and sugar syrup, carbonated drinks, rice, semolina, potatoes. Eat sweets only as a dessert that is consumed after the main course or against a background of physical activity. Increase the amount of fiber in the diet.