Diabetes mellitus is an endocrine system disease associated with pathological changes in the hormonal background and the malnutrition of metabolic processes.
To date, the disease is not subject to eradication (complete settlement).It is possible to slow down the destructive process in the body through medicines and dietary, 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 various types.
Types of diabetes (PD) are determined by the World Health Organization and have no fundamental differences around the medical world.Diabetes of any kind apply to contagious diseases.
Pathology Type
There are several types of diseases united by a main signal - an increased concentration of blood glucose.The typification of diabetes is due to the causes of its occurrence.The therapy, gender and age of the patient are also occurring.
Types of diabetes accepted in medicine:
- The first type is dependent on insulin (ISD 1) or youth;
- The second is dependent on insulin (inzsd 2) or insulin resistant;
- Gestational Mellitus of Diabetes (HSD) in the perinatal period in women;
- Other specific types of diabetes, including:
- Damage to Pancreas β cells at the genetic level (variety of modes);
- Pathologies of the pancreas extension function;
- Hereditary and acquired pathologies of the external secretion glands and their functions (endocrinopathy);
- Pharmacologically caused by diabetes;
- Diabetes as a result of congenital infections;
- SD related to genomic pathologies and hereditary defects;
- In violation of blood glucose (blood sugar) in the empty stomach and violation of glucose tolerance.
Pre -dibete is a boundary state of the body, when the blood glucose level is altered 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 endocrinologists suffer from the second type of disease.
According to medical statistics, a tendency to increase the number of sick people is clearly tracked around the world.Over the past 20 years, the number of type 2 diabetics has doubled.GSD is responsible for about 5% of pregnancies.Specific types of 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 prelimatérica period and during menopause.This is due to a change in hormone status and a set of extra pounds.In men, the factor in the development of type 2 diabetes is usually chronic pancreas inflammation due to toxic effects of ethanol.
Insulin -dependent diabetes (1 type)
Type 1 diabetes is characterized by the inability of pancreatic cells.The organ does not perform its endocrine (intra -regional) function for insulin production - a hormone responsible for providing glucose to the body.As a result of blood glucose accumulation, organs do not receive complete nutrition, including the pancreas itself.
To simulate the natural production of endocrine hormone, the patient is prescribed by injections of medical insulin with different temporary durations (short and long) as well as diet.The classification of diabetes of the first type is dictated by various etiology of the disease.The type of insulin -dependent disease has two causes: genetic and autoimmune.
Genetic reason
The formation of pathology is associated with the biological characteristic of the human body to transmit its characteristics and pathological deviations to subsequent generations.With regard to diabetes, the child inherits a predisposition to the illness of parents or close relatives suffering from diabetes.
Important!A predisposition is inherited, but not the disease itself.A 100% guarantee of diabetes development does not have a child.
Autoimmune
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 cells of the body.Triggers (impetus) are used to launch autoimmune processes:
- Sick eating behavior combined with hypodinamia;
- metabolic failure (carbohydrate, lipid and protein);
- Critical deficiency in the body of Cholegalciferol and Ergocalciferol (Group D vitamins);
- Pancreatic pathology of chronic nature;
- The presence in the anamnesis of epidemic mumps (pigs), measles, herpes virus Koksaki, Epstein-Barra virus, cytomegalovirus, viral hepatitis A, B, C;
- Suffering (prolonged stay in a state of neuropsychological stress);
- Chronic alcoholism;
- Incorrect treatment with medical medicines containing hormones.
The ISSD is formed in children, adolescents and adults who have not reached the age of thirty.The infant version of the development of form of diabetes 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 interrupt insulin synthesis.Glucose is concentrated in the blood and is not delivered to body cells and tissues due to lack of sensitivity to insulin resistance - insulin.To some extent, treatment is performed through hypoglycemic drugs (sugar fighters) and diet.
To compensate for body imbalance, the pancreas activates hormone production.Working in emergency mode, the organ wears out over time and loses the intra -regional function.Type 2 diabetes goes to the dependent form of insulin.The decrease or loss of cell susceptibility to endogenous hormone is mainly associated with obesity in which fat and carbohydrate metabolism is disturbed.
This is especially true for visceral obesity (fat deposition around internal organs).In addition, with excess body weight, blood flow is difficult due to numerous cholesterol plates within the vessels, which are formed with hypercolistreinemia, which always accompanies obesity.Body cells, therefore, experience a nutrition deficiency and energy resources.Other factors that affect the development of INZSD include:
- alcohol abuse;
- Gastronomic addiction to sweet dishes;
- Chronic pancreatic diseases;
- heart pathologies and vascular system;
- Imodomy in food against the bottom of a sedentary lifestyle;
- Incorrect hormone therapy;
- complicated pregnancy;
- dysfunctional heredity (diabetes in parents);
- Suffering.
Most of the time, the disease develops in women and men in the 40+ age category.In this case, diabetes of the second type is latent in nature and may not show pronounced symptoms for several years.Oportpentive tests for blood glucose may detect pre -santiabet.With adequate therapy, the antiabetic state is reversible.If the weather is lost, it will progress and later diagnose the INZSD.
Diabetes Lada
In medicine, the term "diabetes 1.5" is found, or the name Lada Diabetes.This is an autoimmune violation of hormone production and malfunctioning metabolism processes that occurs in adults (at 25 years of age).The disease combines the first and second variety of diabetes.The development mechanism corresponds to ISD, latent course and symptom manifestation are similar to INZSD.
The triggers for the development of the pathology are autoimmune diseases in the patient's history:
- Non -infectious inflammation of intervertebral joints (ankylosing spondylitis);
- an irreversible central nervous system disease - multiple sclerosis;
- Granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
- Chronic inflammation of the thyroid gland (thyroiditis hashimoto);
- Youth and rheumatoid arthritis;
- color change (pigment loss) skin (vitiligo);
- Inflammatory Pathology of the colon mucosa (ulcer colitis);
- Chronic damage to connective tissue and external secretion glands (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 in antigens –FS (immunal function analysis).Therapy is performed through regular insulin injections and nutritional 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 complete examination.The main feature of GSD coincides with type 2 diabetes - this is insulin resistance.A pregnant woman's body cells lose the touch (sensitivity) to insulin due to the correlation of three main reasons:
- Hormonal restructuring.During the pregnancy period, progesterone synthesis (steroid sex hormone) that blocks insulin production increases.In addition, placenta endocrine hormones are gaining strength, which have the property of inhibiting insulin production.
- Cargo doubled in the female body.To ensure complete nutrition of the child not yet born, the body requires a growing 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, entering the body abundantly, is accumulated in the blood, since cells refuse to perceive insulin due to obesity and hypodinâmia.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 functional pancreas capabilities are preserved.
The therapeutic tactics properly selected ensure 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, medical insulin injections are used.Sahabro winning drugs are not used due to their teratogenic effects on the fetus.
Additionally
Specific types of diabetes are genetically determined (diabetes mody, some types of endocrinopathy) or caused by other chronic pathologies:
- Pancreatic Diseases: Pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical lesions and gland surgery;
- Functional failure of the frontal lobe of the pituitary gland (acromegaly);
- Increased synthesis of thyroid hormones (thyreotoxicosis);
- hypothalamic adulteration (Cushing Ideco syndrome);
- Adrenal cortex tumors (aldosteror, feochromocytoma, etc.).
Separate diabetic pathology - NO -SHA -SHAGE diabetes is characterized by a decrease in the production of vasopressin hypothalamus hormone, which regulates fluid balance in the body.
Diagnostic measures
The diagnosis of diagnosis of diabetes (any type) is possible only based on the results of laboratory microscopy of the blood.The diagnosis consists of several studies conducted consistently:
- A general clinical blood test to identify hidden inflammatory processes in the body.
- A blood test (hair or venous) for the content of glucose.It is produced strictly with an empty stomach.
- GTT (glucosotolerant test).It is performed to determine the body's ability to absorb glucose.A tolerance test is a couple of time in the blood: in the empty stomach and two hours after the “glycosestrol load”, whose role is an aqueous glucose solution prepared in a ratio of 200 ml of water in 75 grams.Substances.
- HBA1C analysis at the level of glycosilated hemoglobin (glycated).Based on study results, a retrospective of blood sugar is evaluated in the last three months.
- Biochemistry of Blood.Indicators of hepatic enzymes of Aspartateaminotransferase (AST), Alanine-Orgraph (ALT), alpha-amylase, alkaline phosphatase (SCF), bilirubin (biliary pigment), cholesterol levels are evaluated.
- A blood test for antibody concentration in glutamatdecarboxylase (GAD antibodies) determines the type of diabetes.
Reference values of blood sugar indicators and diseases
| Analysis | For sugar | Gluczotolerant | Glycated hemoglobin |
|---|---|---|---|
| standard | 3.3 - 5.5 | <7.8 | ⩽ 6% |
| Presiabet | 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 analysis of urine for the presence of glucose in 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 allowed norm).The referee sample is also performed to identify albumin protein in the urine and an exchange of creatinine proteins.In addition, hardware diagnosis is prescribed, including an ECG (electrocardiogram) and abdominal cavity ultrasound (with kidneys).
Results
Modern medicine classifies diabetes according to four basic types, depending on the pathogenesis (origin and development) of the disease: insulin dependent (ISSD type 1), insulin dependent (inzsd 2 of the type), gestational (GSD of pregnant women), specific (diabetes include various types of diseases due to genetic defects or chronic patologists).The prisoner diabetes formed in the perinatal period is healing.The state of pre -diabetes (violation of glucose tolerance) is considered reversible subject to early diagnosis.