Diabetes mellitus is an endocrine system disease associated with pathological changes in hormonal background and malnutrition of metabolic processes.
To date, the disease is not susceptible to eradication (complete liquidation).It is possible to slow down the destructive process in the body through medications 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 differ, so it is divided into several types.
The World Health Organization determines the types of diabetes (SD) and have no fundamental differences throughout the medical world.Diabetes of any kind does not apply to contagious diseases.
Typination of pathology
There are several types of diseases linked by a main sign: a greater concentration of blood glucose.The typification of diabetes is due to the causes of its occurrence.The methods of therapy, gender and age of the patient are also being carried out.
Types of diabetes accepted in medicine:
- The first type is insulin dependent (ISD 1) or youth;
- The second is insulin dependent (INZSD 2) or insulin resistant;
- Gestational diabetes mellitus (HSD) in the perinatal period in women;
- Other specific types of diabetes, including:
- Damage to the β cells of the pancreas at the genetic level (variety of mody-diabetes);
- Pancreas extension function pathologies;
- Hereditary and acquired pathologies of 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;
- Glycemia violation (blood sugar) with an empty stomach and the violation of glucose tolerance.
The pre -soupted is a limit state of the body, when the level of blood glucose is changed towards an increase (glucose tolerance is altered), however, the blood sugar indicators "do not reach" the generally accepted digital values corresponding to the 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 clearly dates back to the world.In the last 20 years, the number of type 2 diabetics has doubled.GSD represents approximately 5% of pregnancies.The types of specific 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 prelimacteric period and during menopause.This is due to a change in the hormonal state and a set of kilos of more.In men, the factor in the development of type 2 diabetes is most often the chronic inflammation of the pancreas, due to the toxic effects of ethanol.
Insulin dependent diabetes (type 1)
Type 1 diabetes is characterized by the inability of pancreatic cells.The organ does not perform its endocrine (intragional) function for insulin production, a hormone responsible for supplying glucose to the body.As a result of the accumulation of blood glucose, the organs do not receive full nutrition, including the pancreas itself.
To simulate the natural production of endocrine hormone, the patient is prescribed by injections of medical insulins with different temporal (short and long) durations, as well as diet therapy.The classification of diabetes of the first type is dictated by several etiology of the disease.The type of insulin dependent disease has two causes: genetics and autoimmune.
Genetic reason
The formation of pathology is associated with the biological characteristic of the human body to transmit its characteristics characteristics and pathological deviations to subsequent generations.With respect to diabetes, the child inherits a predisposition to the disease of parents or close relatives suffering from diabetes.
Important!A predisposition is inherited, but not the disease itself.A 100% guarantee of the development of diabetes does not have a child.
Autoimmune reason
The appearance 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 body cells.Triggers (impulse) are used to start autoimmune processes:
- Little healthy food behavior combined with hypodinamia;
- Metabolic insufficiency (carbohydrates, lipids and proteins);
- Critical deficiency in the body of Cholegalciferol and Ergocalciferol (Vitamins of Group D);
- pancreatic pathology of chronic nature;
- The presence in the anamnesis of epidemic papers (pigs), measles, herpes koksaki virus, the Epstein-Barra virus, cytomegalovirus, viral hepatitis A, B, C;
- anguish (prolonged stay in a state of neuropsychological stress);
- chronic alcoholism;
- Incorrect treatment with medical medicines that contain hormones.
ISSD is formed in children, adolescents and adults who have not reached the age of thirty years.The child version of the development of the diabetes form is associated with complicated viral infections.Form 1B occurs in young people and children in the context 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 stop insulin synthesis.Glucose is concentrated in the blood and is not administered to the cells and body tissues due to the lack of sensitivity to insulin resistance -insulin.To a certain point, treatment is carried out through hypoglycemic medications (sugar) and diet therapy.
To compensate for the imbalance in the body, the pancreas activates the production of the hormone.Working in emergency mode, the organ wears out over time and loses intraregional function.Type 2 diabetes goes to insulin dependent.The decrease or loss of the susceptibility of the cells to the endogenous hormone is mainly associated with the obesity in which fat and carbohydrate metabolism are altered.
This is especially true for visceral obesity (fat deposition around the internal organs).In addition, with excess body weight, blood flow is difficult due to numerous cholesterol plates inside the vessels, which are formed with hypercolysterinemia, which always accompanies obesity.Body cells, therefore, experience a deficiency of nutrition 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;
- Immodestrate in food at the bottom of a sedentary lifestyle;
- incorrect hormonal therapy;
- complicated pregnancy;
- dysfunctional inheritance (diabetes in parents);
- Distress.
Most of the time, the disease develops in women and men in the age of 40+.In this case, diabetes of the second type is latent and may not show pronounced symptoms for several years.The appropriate blood glucose tests can detect the pre -antiabeto.With adequate therapy, the anti -objective state is reversible.If time is lost, progress and subsequently diagnosed the INZSD.
Lada diabetes
In Medicine, there is the term "Diabetes 1.5", or the name of Diabetes Lada.This is an autoimmune violation of the production of hormones and a malfunction of the metabolism processes that occurs in adults (at the age of 25+).The disease combines the first and second varieties of diabetes.The development mechanism corresponds to the ISD, the latent course and the manifestation of the symptoms are similar to INZSD.
The triggers for the development of pathology are autoimmune diseases in the patient's history:
- Non -infectious inflammation of 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);
- Youth and rheumatoid arthritis;
- change in color (loss of pigment) of the skin (vitiligo);
- inflammatory pathology of the colon mucosa (ulcerative 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 diabetes-diabetes.To identify the disease, basic diagnostic methods are used, as well as blood microscopy, which determines the concentration of IgG to antigens class immunoglobulins –ife (immunomunification analysis).The therapy is carried out through regular insulin and nutrition correction injections.
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 detected more frequently during a second planned exam, when the future mother undergoes a complete exam.The main characteristic of GSD coincides with type 2 diabetes: This is insulin resistance.The cells of the body of a pregnant woman lose contact (sensitivity) with insulin due to the correlation of three main reasons:
- Hormonal restructuring.During the gestation period, progesterone synthesis (steroid sex hormone) that blocks insulin production increases.In addition, the endocrine hormones of the placenta are gaining strength, which have the property of inhibiting insulin production.
- Duplicate load in the female body.To guarantee a complete nutrition of the unborn child, the body requires a greater 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, which enters abundantly in the body, accumulates in the blood, since the cells refuse to perceive insulin due to obesity and hypodinamia.The future mother and fruit in such a situation are deficient in nutrients and hunger for energy.
Unlike the first and second type, gestational diabetes is a reversible process, since insulin molecules and functional capacities of the pancreas are preserved.
Properly selected therapeutic tactics guarantee the elimination of pathology after childbirth in 85% of cases.The main method of GDC treatment 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.
Besides
Specific types of diabetes are determined genetically (mody-diabetes, 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 front lobe of the pituitary gland (acromegaly);
- greater synthesis of thyroid hormones (thyrotoxicosis);
- Hypothalamic-political adultery (ICECO cover-up syndrome);
- Tumors of the adrenal cortex (aldosteror, pheochromocytoma, etc.).
Separate diabetic pathology: Shagal diabetes No -SHA is characterized by a decrease in the production of the hormone of the vasopressin hypothalamus, which regulates the balance of liquid in the body.
Diagnostic measures
The diagnosis of the diagnosis of diabetes (any type) is possible only based on the results of the blood laboratory microscopy.The diagnosis consists of several studies conducted consistently:
- A general clinical blood analysis to identify hidden inflammatory processes in the body.
- A blood test (capillary or venous) for glucose content.It occurs strictly with an empty stomach.
- GTT (glucosotolerant test).It is carried out to determine the body's ability to absorb glucose.A tolerance test is a blood near of twice: with an empty stomach and two hours after the "glycostrrol load", whose paper is an aqueous glucose solution prepared in a 200 ml ratio of water by 75 grams.Substances
- HBA1C analysis at the level of glucosylated hemoglobin (glycosada).According to the results of the study, a retrospective of blood sugar is evaluated in the last three months.
- Blood biochemistry.The indicators of the liver enzymes of the aspartateminotransferase (AST), the Alaninein-Orogram (ALT), the alpha-amylase, the alkaline phosphatase (SCF), the bilirubin (beast pigment), the cholesterol levels are evaluated.
- A blood test for the concentration of antibodies against glutamatdecarboxylase (gad antibodies) determines the type of diabetes.
Reference values of blood sugar and disease indicators
| Analysis | For sugar | Gluczotolerant test | GLICADA HEMOGLOBIN |
|---|---|---|---|
| rule | 3.3 - 5.5 | <7.8 | ⩽ 6% |
| Predial | 5.6 - 6.9 | 7.8 - 11.0 | 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 urine (glucosuria).In healthy people, there is no sugar in the urine (for diabetics, 0.061 - 0.083 mmol/L is considered the allowed standard).The reference sample is also carried out to identify albumin protein in the urine and an exchange of creatinine proteins.In addition, the diagnosis of hardware is prescribed, including an ECG (electrocardiogram) and an ultrasound of the abdominal cavity (with kidneys).
Results
Modern medicine classifies diabetes according to four basic types, depending on the pathogenesis (origin and development) of the disease: insulin dependent (ISD 1 type), dependent on insulin (type INZSD 2), gestational (GSD of pregnant women), specific (diabetes includes several types of diseases by genetic defects or chronic pathologies).Attractive diabetes formed in the perinatal period is the cure.The state of pre -the -diabetes (violation of glucose tolerance) is considered reversible subject to early diagnosis.