Diabetes mellitus is a disease of the endocrine system associated with pathological changes in the hormonal background and malnutrition of metabolic processes.
So far, the disease is not suitable for extinction (complete liquidation).It is possible to slow down the destructive process in the body through medication 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 vary, so it is divided into several types.
Types of diabetes (SD) are determined by the World Health Organization and have no fundamental differences throughout the medical world.Diabetes of any kind does not apply to infectious diseases.
Pathology
There are several types of diseases joined by a main sign - an increased concentration of blood glucose.Typical diabetes is due to the causes of its appearance.Methods of therapy, gender and age of the patient are also occurring.
Types of diabetes accepted in medicine:
- The first type is insulin dependent (ISD 1), or minor;
- The second is insulin dependent (INZSD 2), or stable insulin;
- Gestational mellitus diabetes (HSD) in the perinatal period in women;
- Other specific types of diabetes, including:
- damage to pancreatic β cells at the genetic level (variety of modi-diabetes);
- pathologies of additional pancreas function;
- inherited and acquired pathologies of external secretion glands and their functions (endocrinopathy);
- Pharmacologically caused by diabetes;
- diabetes as a result of congenital infections;
- SD with regard to genomic pathologies and hereditary defects;
- Violation of glycemia (blood sugar) on an empty stomach and violation of glucose tolerance.
Before -Dibet is a body boundary condition, when glycemia levels are changed towards an increase (glucose tolerance is disturbed), however, blood sugar indicators "do not reach" generally accepted digital values corresponding to true diabetes.According to the World Health Organization (WHO 2014), more than 90% of 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 throughout the world.Over the past 20 years, the number of type 2 diabetics has doubled.GSD accounts for about 5% of pregnancy.Types of specific diabetes are extremely rare and occupy a small percentage in medical statistics.
In terms of INZSD 2 gender, it is more common in women in the preliminary period and during menopause.This is due to a change in hormonal status and a series of extra pounds.In men, the development factor 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 disability 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 blood glucose accumulation, the organs do not receive full food, including the pancreas itself.
To simulate the natural production of the endocrine hormone, the patient is prescribed by injections of medical insulin with varying temporary duration (short and long), as well as diet therapy.Diabetes classification of the first type is dictated by different etiology of the disease.The type of insulin 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 for later generations.With regard to diabetes, the child inherits a predisposition to the disease by parents or close relatives suffering from diabetes.
Important!A predisposition is inherited, but not the disease itself.A 100% guarantee of diabetes does not have a child.
Autoimmune reason
The onset 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's cells.Promotions (impulse) are used to start autoimmune processes:
- unhealthy nutritional behavior combined with hypodynamine;
- metabolic failure (carbohydrate, lipids 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 mumps of epidemic (pigs), measles, herpesis coxaci virus, Epstein-Barra virus, cytomegalovirus, viral hepatitis A, B, C;
- disturbance (prolonged stay in a state of neuropsychological stress);
- chronic alcoholism;
- Incorrect treatment with hormone -containing medical medicines.
The ISSD is formed in children, adolescents and adults who have not reached the age of thirty.The version of children for the development of diabetes 1A is associated with complex viral infections.Form 1b occurs in young people and children against the backdrop of autoimmune processes and inherited 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 insulin synthesis.Glucose is concentrated in the blood and does not surrender to the body's cells and tissues due to a lack of sensitivity to insulin resistance - insulin.Up to a certain point, treatment is performed through hypoglycemic (high sugar) and diet therapy.
To compensate the imbalance in the body, the pancreas activates the production of the hormone.Working in emergency mode, the body gets tired over time and loses intra -regional function.Type 2 diabetes passes into insulin dependent.The decrease or loss of cell sensitivity to the endogenous hormone is mainly associated with overweight in which the metabolism of fat and carbohydrates is concerned.
This is especially true for the visceral overweight (fat storage around the internal organs).In addition, with excess body weight, blood flow is difficult due to numerous cholesterol plaques within the vessels, which are formed with hypercholizterinemia, which always accompany obesity.The cells of the body, therefore, undergo a lack of food and energy sources.Other factors affecting the development of INZSD include:
- alcohol abuse;
- gastronomic dependence on sweet dishes;
- Chronic diseases of the pancreas;
- heart pathologies and vascular system;
- Food imperfection against the backdrop of a sedentary lifestyle;
- Incorrect hormone therapy;
- complicated pregnancy;
- Dysfunctional inheritance (diabetes to parents);
- Concern.
Most often, the disease develops in women and men aged 40+.In this case, the second type diabetes is a latent nature and may not show pronounced symptoms for several years.Timely testing for blood glucose can detect pre -military.With adequate therapy, the antiabetic condition is reversible.If time is lost, progresses and then diagnosed Inszd.
Lada
In medicine, the term "diabetes 1.5", or the name of diabetes Lada, has been found.It is an autoimmune violation of hormone production and a dysfunction of metabolism processes that occurs in adults (at age 25+).The disease combines the first and second varieties of diabetes.The development mechanism corresponds to the ISD, the latent course and the appearance of symptoms are similar to INZSD.
The causes for the development of pathology are autoimmune diseases in the patient's history:
- non -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;
- color change (loss of pigment) of the skin (vitiligo);
- Inflammatory pathology of the colon mucosa (ulcerative colitis);
- Chronic damage to the connective tissue and the external secretion glands (prana syndrome).
In combination with an inherited predisposition, autoimmune disorders lead to the advance of Lada-diabetes.To identify the disease, basic diagnostic methods as well as blood microscopy are used, which determines the concentration of IgG class immunoglobulins in antigens -if (immune function analysis).Therapy is performed through regular insulin injections and food 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 scheduled examination when the expected mother undergoes a thorough examination.The main feature of GSD coincides with type 2 diabetes - this is insulin resistance.The cells of a pregnant woman's body lose touch (sensitivity) to insulin due to the correlation of the three main reasons:
- Hormonal restructuring.During the gestation period, the synthesis of progesterone (steroid sex hormone) that blocks insulin production increases.Plus, the endocrine hormones of the placenta are gaining strength, which have the property of inhibiting insulin production.
- Doubled load on the female body.To ensure full food of the unborn baby, the body requires an increased amount of glucose.A woman begins to use more monosaccharide, which forces the pancreas to synthesize more insulin.
- An increase in body weight against a decrease in physical activity.Glucose, entering abundantly into the body, accumulates in the blood, as cells refuse to perceive insulin due to overweight and hypodynamia.Mother and expected fruits in such a situation are deficient in nutrients and energy hunger.
Unlike the first and second type, gestational diabetes is a reversible process, as insulin molecules and the functional skills of the pancreas are stored.
Properly selected therapeutic tactic guarantees the elimination of postpartum pathology in 85% of cases.The main method of treating GDC is a diet for diabetics "Table no. 9".In difficult cases, injections of medical insulin are used.The winning drugs of companions are not used due to their teratogenic effects on the fetus.
Another
Specific types of diabetes are genetically determined (mod-diabetes, some types of endocrinopathy) or provoked by other chronic pathologies:
- Pancreatic diseases: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical damage and glandular surgery;
- functional failure of the front lobe of the pituitary gland (acromegaly);
- Increased thyroid hormone synthesis (thyrotoxicosis);
- hypothalamic-hypophysis-adulter (Iceco-Cushing's syndrome);
- Tumors of the adrenal cortex (aldosteror, feochromocytoma, etc.).
Special Diabetic Pathology - Non -Shagal Diabetes is characterized by a decrease in the production of the hormone of the hypothalamus of the vasopressin, which regulates the fluid balance in the body.
Diagnostic measures
Diagnosis of diagnosis of diabetes (any type) Diagnosis is only possible based on the results of laboratory blood microscopy.The diagnosis consists of several studies constantly conducted:
- A general clinical blood test to identify hidden inflammatory processes in the body.
- A blood test (capillary or venous) for glucose content.It is strictly produced on an empty stomach.
- GTT (glucosotolerant testing).Is performed to determine the body's ability to absorb glucose.A tolerance test is a two -time blood fence: on an empty stomach and two hours after the "glucostostostrole load", whose role is a aqueous solution of glucose prepared in a ratio of 200 ml of water to 75 grams.Substances.
- HBA1C analysis at the level of glycosilled (glyc) hemoglobin.Based on the results of the study, a retrospective of blood sugar is evaluated over the past three months.
- Biochemistry of blood.Indicators of the hepatic enzymes of aspartateamotransferase (AST), alanineine-orgrases (ALT), alpha-amylaza, alkaline phosphatase (SCF), bilirubin (gall pigment), cholesterol levels are estimated.
- A blood test for the concentration of antibodies to glutamatdecarboxylase (GAD antibodies) determines the type of diabetes.
Reference values of blood sugar indicators and diseases
| Analysis | Sugar | Gluczotolerant test | Glycated hemoglobin |
|---|---|---|---|
| RATE | 3.3 - 5.5 | <7.8 | ⩽ 6% |
| prediabetes | 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 is investigated for the presence of glucose in the urine (glycosuria).In healthy people, there is no sugar in the urine (for diabetics, 0.061 - 0.083 mmol/l is considered permitted rate).The reference sample is also performed to identify albumin protein in the urine and a creatinine protein exchange.Moreover, the hardware diagnosis is prescribed, including an ECG (electrocardiogram) and ultrasound of the abdominal cavity (with a kidney).
results
Modern medicine classifies diabetes according to the four basic types, depending on the pathogenesis (origin and development) of the disease: insulin dependent (ISSD 1 type), insulin dependent due to INZSD 2 genetic defects), gestational (GSD of pregnant women), specific (diabetes) (diabetes).The rapid diabetes formed in the perinatal period is cure.The pre -diabetes (violation of glucose tolerance) is considered a reversible subject of early diagnosis.