Diabetes mellitus - Causes, Symptoms and Treatment .MF .
Diabetes - a disease caused by absolute or relative insulin deficiency and characterized by a disturbance of carbohydrate metabolism with an increase in the amount of glucose in the blood and urine, as well as other metabolic disorders.
Historical information about diabetes
Pro with aharny diabetes written a lot of opinions of various authors disagree and call some dates exactly pretty difficult.The first information about the disease appeared in the III century BC.With him, apparently knew the doctors of ancient Egypt, and, of course, the Greek physicians.Rome, medieval Europe and Eastern countries.Users can identify the symptoms of diabetes, but the causes of the disease are unknown, they tried to find any treatment of diabetes, but the results were unsuccessful, and those with diabetes detected were doomed to destruction.
term "diabetes" was first introduced Aretius Roman physician, who lived in the second century AD.He described the disease as: "Diabetes - a terrible suffering, not very co
At that time the disease is diagnosed in its external features. The treatment depended on the extent of the disease and the patient's age gravity. If the patient is a child or young person with a (insulin-dependent diabetes. 1 diabetes or type) IDDM That he was doomed to rapid death from diabetic coma if the disease developed in an adult 40-45 years of age and older. (according to modern classification - is non-insulin dependent diabetes mellitus (NIDDM) or type 2 diabetes)then such a patient treated. Or rather kept him alive through diet, exercise and herbal medicine.
Diabetes in Greek "diabaino" means "go through».
in 1776. English physician Dobson (1731-1784 biennium)found that the sweet taste of urine of patients due to the presence of sugar in it, and to this date diabetes, in fact, began to be called diabetes.
since 1796.doctors began to talk about what is needed a special diet for diabetics.special diet was offered to the patients in which the carbohydrate part was replaced by fat.Physical activity began to be used as a treatment for diabetes.
in 1841.It was first developed method of determining sugar in urine.Then they learn to identify the level of sugar in the blood.
in 1921.I managed to get the first insulin.
in 1922.insulin has been used to treat patients with diabetes aharnym.
in 1956.were studied properties of some sulfonylurea drugs, can stimulate the secretion of insulin.
in 1960.It was established chemical structure of human insulin.
in 1979.It was carried out a total synthesis of human insulin by genetic engineering.
- diabetes insipidus.
The disease is caused by an absolute or relative deficiency of antidiuretic hormone (vasopressin) and is characterized by increased urination (polyuria) and the emergence of thirst (polydipsia).
Diabetes - a chronic disease, which is characterized by metabolic disorder primarily carbohydrates (namely glucose) and fats.To a lesser extent proteins.
- type 1 (IDDM):
This type of diabetes is associated with insulin deficiency, so it's called insulin-dependent (IDDM).Damage of the pancreas can no longer cope with their responsibilities: it is either do not produce insulin or produces it in such meager amounts that it can not process even the minimum amount of glucose entering, resulting in an increase in blood glucose levels.Patients may be of any age, but most of them up to 30 years, and they are typically thin, usually note the sudden appearance of signs and symptoms.People with this type of diabetes have to inject additional insulin to prevent ketoacidosis (high ketones in the urine) and for the maintenance of life.
- type 2 (NIDDM):
This type of diabetes is known as non-insulin dependent (NIDDM), since it produces enough insulin, sometimes even in large quantities, but it may be completely useless, because the tissues lose him sensitive.This
diagnosed patients are usually older than 30 years.They are fat and relatively many classic symptoms.They have no inclination to ketoacidosis, except in periods of stress.They are not dependent on exogenous insulin.For treatment tableted formulations that reduce the resistance (resistance) of the cells to insulin or drugs that stimulate the pancreas to secrete insulin.
- Gestational diabetes with aharny:
glucose intolerance occurs or is detected during pregnancy.
- Other types with aharnogo diabetes and impaired glucose tolerance:
- diseases of the pancreas (chronic pancreatitis, cystic fibrosis, hemochromatosis, pankreatektomiya);
- endocrinopathies (acromegaly, Cushing's syndrome, primary aldosteronism, glucagonoma, pheochromocytoma);
- use of drugs and chemicals (some antihypertensive drugs, thiazide-containing diuretics, glucocorticoids. Estrogen-containing medications. Psychotropic drugs, kateholominy).
- abnormality of insulin receptor;
- genetic syndromes (hyperlipidemia, muscular dystrophy, Huntington's chorea);
- mixed states (malnutrition -... "Tropical diabetes»
Symptoms of diabetes
In some cases diabetes from time to time makes itself known Symptoms of diabetes vary with diabetes I and II diabetes sometimes can not begenerally no symptoms, and diabetes control, for example, referring to the optometrist when viewed from the fundus, but there is a set of symptoms characteristic of diabetes both types of expression of a characteristic depends on the degree of reduction of insulin secretion, duration of the disease and the individual characteristics of the patient:..
- frequent urination and feeling an unquenchable thirst, leading to dehydration;
- rapid weight loss, often in spite of the constant feeling of hunger;
- feeling of weakness or tiredness;
- blurred vision ( "white veil" in front of the eyes);
- difficultysexual activity;
- numbness and tingling in the extremities numb;
- feeling of heaviness in the legs;
- slow healing of infectious diseases;
- slow wound healing;
- body temperature drop below the average mark;
- leg cramps;
- itching and itching in the perineum;
- pain in the heart.
Causes of diabetes
established that diabetes is caused by genetic defects, as well as firmly established that diabetes can not catch !!!Causes of IDDM is that insulin production is reduced or even discontinued due to the death of beta cells under the influence of a number of factors (for example - an autoimmune process, when it is beginning to develop antibodies and destroy them to their own normal cells).With NIDDM, which occurs four times more frequently in beta cells produce insulin with reduced activity as a rule.Because of the redundancy of adipose tissue receptors which have a reduced sensitivity to insulin.
- main importance is the genetic predisposition!It is believed that if the diabetes hurt your father or mother, the chances are that you are too ill, about 30%.If both parents are sick, then - 60%.
- Next on the cause of diabetes significance - obesity, which is the most typical of patients with NIDDM (type 2).If a person is aware of their genetic predisposition to this disease.That to him for his weight is necessary to strictly follow in order to reduce the risk of disease.At the same time it is obvious that not everyone who is obese, even severe, ill with diabetes.
- Some pancreatic diseases that result in loss of the beta cells.Precipitating factor in this case can be an injury.
- nervous stress, which is an aggravating factor.Especially to avoid emotional tension and stress to people with hereditary predisposition and overweight.
- Viral infections (rubella, chickenpox, infectious hepatitis and other diseases, including influenza), playing the role of starter in the development of the disease for people with aggravated heredity.
- Risk factors may also include age.The older a person is, the more reason to fear diabetes .Hereditary factor with age ceases to be decisive.The greatest threat comes obesity, which in combination with old age, an illness that usually weakens the immune system, leading to the development of predominantly diabetes type 2.
Many people believe that diabetes occurs in a sweet tooth.This is largely a myth, but there is some truth, if only because of the excessive consumption of excess weight appears sweet, and later obesity, which can be the trigger for diabetes 2tipa.
In rare cases, lead to diabetes, some hormonal disorders, diabetes is sometimes called the defeat of the pancreas occurring after the use of certain medications, or by prolonged alcohol abuse.Many experts believe that the first type of diabetes can occur in viral lesion of the pancreatic beta cells that produce insulin.In response, the immune system produces antibodies called insular.Even those causes that are precisely defined, are not absolute.
Accurate diagnosis can be set on the basis of the analysis of blood glucose.
The diagnosis is based on:
- presence of the classic symptoms of diabetes: increased fluid intake and excretion in the urine excretion of ketone bodies in urine, weight loss, increased levels of glucose in the blood;
- increase in fasting glucose after repeated definition (normal 3,3-5,5 mmol / l.).
There is a certain algorithm of examination of patients with suspected diabetes.Healthy people with normal body weight and family history of puristic examine the level of glucose in the blood and urine (empty stomach).analysis glikilirovanny hemoglobin (GH) further necessarily surrenders Upon receipt of the normal range.The percentage of glycated hemoglobin reflects the average blood glucose concentration in the blood for 2-3 months prior to the study.At the control of diabetes treatment is recommended to maintain the level of glycated hemoglobin below 7% and revise the level of GH therapy in 8%.
Upon receiving a high level of glycosylated hemoglobin (screening a healthy patient) is recommended to determine the blood glucose level after 2 hours after glucose loading (75g).This test is especially required if the blood glucose level although higher than normal but not high enough to manifest symptoms of diabetes.The test is performed in the morning after an overnight fasting (at least 12 hours).Determine the initial level after glucose and 2 hours after taking 75 g of glucose dissolved in 300 ml of water.Normally (immediately after glucose load), its concentration in blood increases, which stimulates the secretion of insulin.This in turn reduces the concentration of glucose in the blood, through the level 2 chasa substantially returns to its original healthy person and does not return to normal baseline values exceeding twice in patients with diabetes.
to confirm the diagnosis in people with borderline impaired glucose tolerance, insulin being identified.Normally, the insulin level is 15-180 pmol / L (2-25 mU / L).
doctor may order additional studies and - determination of C-peptide, antibodies against beta-cells of islets of Langerhans, insulin antibody, antibody of GAD, leptin.The determination of these markers makes it possible to differentiate 97% of type 1 diabetes from type 2, when the symptoms of type 1 diabetes type 2 masquerades.
Prevention of diabetes
diabetes is primarily a genetic condition.Identified risk groups allow today to orient people to warn them of reckless and thoughtless attitude to their health.Diabetes is both inherited and acquired.The combination of several risk factors increases the likelihood of diabetes:. For obese patients, often suffering from viral infections - influenza, etc., this probability is about the same as for people with aggravated heredity.So all the people belonging to risk groups, should be vigilant.should be particularly attentive to their condition in the period from November to March, because the majority of cases of diabetes accounts for this period.The situation is complicated by the fact that during this period your condition may be mistaken for a viral infection.
Primary prevention of diabetes
In primary prevention activities are aimed at the prevention of diabetes : lifestyle changes and risk factors for diabetes, preventive measures only in individuals or in groups at high risk of developing diabetes in the future.
The main preventive measures include NIDDM adult population balanced diet, physical activity, obesity prevention and its treatment.It is necessary to restrict or even completely excluded from foods containing carbohydrate (refined sugar, etc.) and foods rich in animal fats.These restrictions relate primarily to persons with an increased risk of the disease: unfavorable heredity in relation to diabetes, obesity, especially when it is combined with diabetic family history, atherosclerosis, hypertension, as well as to women with gestational diabetes or impaired glucose tolerance in the pastduring pregnancy, women who gave birth to the fetus weighing more than 4500g.or who had a pathological pregnancy followed by fetal death.
Unfortunately, prevention of diabetes in the full sense of the word does not exist, but it has now successfully developed immunological diagnostic tools, with which you can identify the possibility of developing diabetes at an early stage on the background of a full measure of health.
Secondary prevention of diabetes
Secondary prevention includes activities aimed at prevention of complications diabetes - early disease control, warning its progression .
Complications of diabetes
Diabetes need to constantly monitor !!!If you have poor control and appropriate lifestyle frequent and sharp fluctuations in blood glucose levels may occur.That in turn leads to complications.First, a sharp, such as a hypo- and hyperglycemia, and then to chronic complications.The worst thing that they appear 10-15 years after onset of the disease, develop imperceptibly at first and did not affect the health.Because of high blood sugar occur gradually and rapidly progressing to diabetes-specific complications of the eyes, kidneys, feet, as well as non-specific - on the part of the cardiovascular system.But unfortunately, to cope with the complications already proved himself, it is very difficult.
- hypoglycemia - a drop in blood sugar can lead to hypoglycemic coma;