Diabetes is a disorder of glucose metabolism in the body related to insulin deficiency. Glucose is a substance that provides energy to cells and insulin is a hormone that helps it penetrate cells. Without insulin, glucose remains in the blood, causing hyperglycemia and the risk of complications in the kidneys, eyes, nerves, heart and blood vessels. Diabetes cannot be cured but can be controlled with proper diet, physical activity and medication. An endocrinologist talks about this in more detail.
Classification of diabetes
Most people only know about two types of diabetes. In fact, there are more of them. Depending on the cause and mechanism of development of the disease, the following types of pathology are distinguished:
Type 1 diabetes(insulin dependent). In this type, the pancreas cannot produce insulin because the beta cells that synthesize it are destroyed. The cause of this process is not fully known, but it is thought to be influenced by genetic and environmental factors. Type 1 diabetes is often diagnosed in childhood or adolescence and requires constant insulin injections.
Type 2 diabetes(non-insulin dependent). In this type of disease, the pancreas produces insulin but the quantity is not enough to maintain normal blood sugar levels or the cells become insensitive to it. This is due to overweight, obesity, sedentary lifestyle, malnutrition and genetic factors. Type 2 diabetes most often develops in adults.
Diabetes during pregnancy(pregnant). In this type of disease, high blood sugar levels occur during pregnancy and usually disappear after birth. This is due to changes in hormone levels and metabolism in the female body. They can lead to reduced insulin production or poorer insulin action. Women with gestational diabetes have a higher risk of developing type 2 diabetes in the future.
Other specific types of diabetes. This group includes rare forms of the disease that occur due to genetic defects, pancreatic diseases, endocrine disorders, certain medications or infections.
Symptoms of diabetes
The classic sign of diabetes is related to excess sugar in the blood. Including:
- Polyuria (frequent and frequent urination).
- Polydipsia (increased thirst).
- Polyphagia (increased appetite).
- Dry mouth.
- Fatigue, weakness, irritability.
- Weight loss (for type 1 diabetes) or weight gain (for type 2 diabetes).
- Itching of skin, mucous membranes, genitals.
- Wounds heal slowly and are susceptible to infection.
- Impaired vision, spots appearing before the eyes.
- Numbness, tingling, pain in the limbs.
Causes of diabetes
Diabetes mellitus is a multifactorial disease that can occur due to many reasons. Few of them:
- Genetic predisposition.The presence of diabetes in relatives increases the risk of developing the disease in children. This is especially true for type 1 diabetes, which is linked to a genetic defect of the immune system.
- Obesity and overweight.Excess fat in the body leads to poor insulin action and increased blood sugar levels. Particularly dangerous is visceral fat, which surrounds internal organs and releases inflammatory mediators that disrupt metabolism.
- Poor nutrition.Consuming large amounts of simple carbohydrates, fats, salt, alcohol, as well as a lack of complex carbohydrates, proteins, fiber, vitamins and minerals in the diet contributes to metabolic disorders and increased blood sugar levels. Regularity and frequency of meals are also important, as long breaks between meals can lead to hypoglycemia (low blood sugar levels) and frequent snacking can lead to hyperglycemia (increased blood sugar levels).
- Lack of physical activity.Physical activity helps reduce blood sugar levels by increasing energy expenditure and cellular glucose uptake. In addition, physical activity improves blood circulation, strengthens the cardiovascular system, improves immunity, promotes weight loss and prevents complications of diabetes.
- Emphasize.Stressful situations release adrenaline, cortisol and glucagon. They increase blood sugar, inhibit insulin production and increase inflammation. Stress can also lead to disruptions in diet, sleep, and physical activity.
- Pancreatic diseases.If the pancreas is damaged by inflammation, stones, tumors, chronic pancreatitis, this can lead to reduced insulin production and the development of diabetes. There are also genetic disorders that lead to pancreatic dysfunction, such as cystic fibrosis, Schwartz-Bartter syndrome, Johanson-Blitzer syndrome and others.
- Endocrine disorders.The endocrine system is a collection of organs that produce hormones that regulate various body functions. Some hormones such as glucagon, glucocorticoid, growth hormone, thyroid hormone, and catecholamines work to counteract the effects of insulin and increase blood sugar levels.
- Take certain medications.Some medications can increase blood sugar, inhibit insulin production, or reduce insulin sensitivity. These drugs include glucocorticoids, thiazide diuretics, beta blockers, some anticonvulsants, some antivirals, some antipsychotics, and others. Taking these medications may temporarily or permanently increase blood sugar levels and may require dose adjustment or medication substitution.
- Infection.Infectious diseases such as viral hepatitis, cytomegalovirus infection, chickenpox, rubella, mumps, meningitis, sepsis and others can damage the pancreas, causing inflammation and impaired insulin production. Infections can also increase the release of stress hormones, which increase blood sugar levels.
Diagnosis of diabetes
Diagnosis requires a comprehensive examination. Initially, the patient was examined and interviewed by an endocrinologist. It identifies characteristic symptoms, taking into account the circumstances of their appearance, comorbidities and genetic factors. Then a detailed examination is prescribed:
Laboratory research.The main method for diagnosing diabetes is to determine blood sugar levels. To do this, the following tests are performed:
- Fasting blood sugar.
- Glucose tolerance test.
- Glycated hemoglobin (HbA1c)
Specific research.To determine the complications of diabetes and evaluate the condition of target organs, the following studies are performed:
- Eye fundus examination.This is an eye examination using a special device - an ophthalmoscope, which allows you to examine the retina, optic nerve and blood vessels of the eye.
- Kidney ultrasound.This is an ultrasound examination of the kidneys, allowing you to evaluate their size, shape, structure, presence of stones, tumors, cysts and inflammation.
- Dopplerography of lower limb blood vessels.This is an ultrasound examination of the vessels of the lower extremities, allowing you to evaluate the lumen, walls, blood flow, presence of blood clots, atherosclerotic plaques, stenosis and aneurysms.
- Electrocardiogram (ECG).This is a study of the heart, allowing you to evaluate the rhythm, electrical conductivity, contractility, the presence of ischemia, myocardial infarction, arrhythmias and blockade.
Neurological examination.This is an examination of the nervous system, allowing you to evaluate sensitivity, reflexes, coordination, muscle tone, the presence of paresthesias, pain and movement disorders. With diabetes, changes in the nerves may develop, such as demyelination, degeneration, inflammation, which can lead to disruption of nerve impulse transmission and the development of polyneuropathy, the diseaseautonomic neuropathy, mononeuropathy, radiculopathy. This condition is called diabetic neuropathy.
Dermatological examination.This is a skin examination that allows you to evaluate color, firmness, moisture, presence of wounds, cracks, ulcers, fungal infections, bacteria, viruses, allergic reactions, pigmentation, atrophy, scleroderma, acanthosis.
In diabetes, skin changes may develop, such as xerosis, diabetic dermatosis, diabetic bullous disease, diabetic urticaria, diabetic vasculopathy, footdue to diabetes, can lead to a violation of the protective function of the skin and the development of complications.
Consult with other experts.Depending on the presence of concomitant diseases and complications of diabetes, consultation with other specialists such as cardiologists, neurologists, surgeons, dentists may be necessary. doctors, psychologists and others. They will help evaluate the patient's condition, prescribe the necessary treatment and give preventive recommendations.
Insulin therapy for diabetes
Insulin therapy for diabetes is a treatment in which insulin is injected externally into the patient. It is essential for all patients with type 1 diabetes and also for some patients with type 2 diabetes when other treatments have not worked.
What types of insulin are there and how to use them?
There are many different types of insulin, varying in onset of action, peak activity, and duration of action. According to these parameters, insulin is divided into ultra-short-acting, short-acting and prolonged (long-lasting).
- Ultrashort-acting and short-acting insulin mimics the physiological release of postprandial insulin and is administered 15-30 minutes before meals.
- Extended-release insulin provides basal levels of insulin in the blood throughout the day and is taken once or twice a day.
- There are also ready-made insulin mixtures with different durations of action that are convenient for use.
Insulin is injected under the skin using special devices such as a pen, pump, or inhaler. The dose of insulin is selected individually for each patient depending on blood sugar level, volume and composition of food, physical activity and other factors.
To control blood sugar levels, patients should measure regularly with a blood glucose meter or continuous blood glucose monitor.
What rules and recommendations should be followed during insulin treatment?
Insulin therapy requires strict adherence to diet, physical therapy, and doctor's recommendations. With insulin therapy, side effects such as hypoglycemia (low blood sugar), allergic reactions, lipodystrophy - violation of the distribution of subcutaneous fat, can occur at the site of insulin therapy. inject insulin regularly.
To avoid this, change the insulin injection site and use a thin needle. Therefore, patients need to learn the basics of insulin therapy and consult their doctor if they have questions or concerns.
Nutrition for diabetes
Nutrition for diabetes is the most important component of treatment. In mild forms of diabetes, diet alone is sometimes enough to achieve target blood sugar levels. In more severe cases, drug treatment (oral hypoglycemic drugs, insulin) comes to the rescue.
General dietary rules for diabetics must be followed:
- Meals should be frequent and small(5-6 times a day), in small portions. This will help avoid spikes in blood sugar levels.
- Meals should be eaten at the same time. The same applies to taking hypoglycemic drugs and insulin injections.
- Diets and hunger strikes are strictly prohibited, as they can lead to hypoglycemia (low blood sugar), as well as disrupt fat and protein metabolism.
- These are prioritiescooking methodsuch as: stewing, boiling, steaming and grilling. Fried, smoked, salted and pickled foods should be excluded or minimized.
- ShouldRemove easily digestible carbohydrates from foods(sugar, honey, confectionery, jam, baked goods, white flour). They quickly increase blood sugar levels and contribute to obesity. Instead, you can use sugar substitutes (xylitol, sorbitol, fructose, stevia, etc. ) in moderation.
- Food should contain lots of fibersince such carbohydrates are absorbed more slowly and do not increase blood sugar levels so sharply. Fiber also helps normalize intestinal function, reduce cholesterol and appetite. Sources of fiber include vegetables, fruits, herbs, whole-grain breads and cereals, legumes, nuts and seeds.
- Limit consumption of animal fats(butter, lard, fatty meat). They contain saturated fatty acids, which increase cholesterol levels and contribute to the development of atherosclerosis and coronary heart disease. Priority should be given to vegetable oils (sunflower, olive, corn, etc. ), which contain unsaturated fatty acids that are beneficial for the heart and blood vessels. Also useful are fish and seafood, which are sources of omega-3 fatty acids, which have anti-inflammatory and anti-sclerotic effects.
- That's the right thing to doThe calorie content of food and the amount of carbohydrates are approximately the sameon different days, which is especially important when choosing insulin doses. To calculate the amount of carbohydrates, you can use special tables that indicate how many grams of carbohydrates are in different foods.
- ShouldControl your salt intake, as excess salt can lead to increased blood pressure, edema and impaired kidney function. The recommended daily salt intake is no more than 5 g (1 teaspoon).
Nutrition for diabetes needs to be balanced, varied and delicious. You don't have to give up your favorite dishes, you just need to learn how to cook them correctly, taking into account your physical condition and needs.
Diabetes is a serious disease that requires constant medical monitoring and adherence to a lifestyle regimen. If you notice signs of diabetes in yourself or a loved one, don't delay seeing a doctor. The earlier the diagnosis and treatment begin, the less likely it is that complications will develop and the better the prognosis.