Diabetes mellitus early clinical signs of complication types. Diabetes mellitus - types of diabetes mellitus, symptoms, diagnosis, treatment

Diabetes mellitus is one of the most common diseases that tend to increase in incidence and spoil statistics. Symptoms of diabetes mellitus do not appear in one day, the process flows chronically, with an increase and aggravation of endocrine and metabolic disorders. True, the onset of type I diabetes is significantly different from the early stage of the second.

Among all endocrine pathologies, diabetes confidently holds the lead and accounts for more than 60% of all cases. In addition, disappointing statistics show that 1/10 of the “diabetics” are children.

The probability of acquiring the disease increases with age, and thus the size of the group doubles every decade. This is due to increased life expectancy, improved methods of early diagnosis, reduced physical activity and an increase in the number of people who are overweight.

Types of diabetes

Many have heard of such a disease as diabetes insipidus. So that the reader does not subsequently confuse the diseases that are called "diabetes", it will probably be useful to explain their differences.

diabetes insipidus

Diabetes insipidus is an endocrine disease that occurs as a result of neuroinfections, inflammatory diseases, tumors, intoxications and is caused by deficiency, and sometimes complete disappearance of ADH-vasopressin (antidiuretic hormone).

This explains the clinical picture of the disease:

• Constant dryness of the mucous membranes of the oral cavity, incredible thirst (a person can drink up to 50 liters of water in 24 hours, stretching the stomach to a large size);
• Isolation of a huge amount of non-concentrated light urine with a low specific gravity (1000-1003);
• Catastrophic weight loss, weakness, decreased physical activity, disorders of the digestive system;
• A characteristic change in the skin ("parchment" skin);
• Atrophy of muscle fibers, weakness of the muscular apparatus;
• The development of dehydration syndrome in the absence of fluid intake for more than 4 hours.

The disease in terms of complete cure has an unfavorable prognosis, performance is significantly reduced.

Brief anatomy and physiology

An unpaired organ - the pancreas performs a mixed secretory function. Its exogenous part carries out external secretion, producing enzymes involved in the digestion process. The endocrine part, which is entrusted with the mission of internal secretion, is engaged in the production of various hormones, including - insulin and glucagon. They are key in ensuring the consistency of sugar in the human body.

The endocrine gland is represented by the islets of Langerhans, consisting of:

1. A-cells, which occupy a quarter of the entire space of the islets and are considered the site of glucagon production;
2. B-cells, occupying up to 60% of the cell population, synthesizing and accumulating insulin, the molecule of which is a polypeptide of two chains, carrying 51 amino acids in a specific sequence. The sequence of amino acid residues for each representative of the fauna is different, however, in relation to the structural structure of insulin, pigs are closest to humans, which is why their pancreas is primarily used to produce insulin on an industrial scale;
3. D-cells producing somatostatin;
4. Cells that produce other polypeptides.

Thus, the conclusion is: damage to the pancreas and the islets of Langerhans, in particular, is the main mechanism that inhibits the production of insulin and triggers the development of the pathological process.

Types and special forms of the disease

The lack of insulin leads to a violation of the constancy of sugar (3.3 - 5.5 mmol / l) and contributes to the formation of a heterogeneous disease called diabetes mellitus (DM):

• The complete absence of insulin (absolute deficiency) forms insulin dependent pathological process, which is type I diabetes mellitus (IDDM);
• A lack of insulin (relative deficiency), which triggers a violation of carbohydrate metabolism in the initial stage, slowly but surely leads to the development non-insulin dependent diabetes mellitus (NIDDM), which is called diabetes mellitus type II.

Due to a violation in the body of glucose utilization, and, consequently, its increase in blood serum (hyperglycemia), which, in principle, is a manifestation of the disease, signs of diabetes begin to appear over time, that is, a total disorder of metabolic processes at all levels. Significant changes in the hormonal-metabolic interaction ultimately involve all the functional systems of the human body in the pathological process, which once again indicates the systemic nature of the disease. How quickly the formation of the disease occurs depends on the degree of insulin deficiency, which, as a result, determines the types of diabetes.

In addition to type 1 and type 2 diabetes, there are special types of this disease:

1. secondary diabetes, resulting from acute and chronic inflammation of the pancreas (pancreatitis), malignant neoplasms in the parenchyma of the gland, cirrhosis of the liver. A number of endocrine disorders accompanied by excessive production of insulin antagonists (acromegaly, Cushing's disease, pheochromocytoma, thyroid disease) lead to the development of secondary diabetes. Many drugs used for a long time have a diabetogenic effect: diuretics, some antihypertensive drugs and hormones, oral contraceptives, etc.;
2. Diabetes in pregnancy (gestational), caused by a peculiar mutual influence of the hormones of the mother, child and placenta. The pancreas of the fetus, which produces its own insulin, begins to inhibit the production of insulin by the maternal gland, as a result of which this special form is formed during pregnancy. However, with proper management, gestational diabetes usually disappears after delivery. Subsequently, in some cases (up to 40%) in women with a similar history of pregnancy, this fact may threaten the development of type II diabetes mellitus (within 6-8 years).

Why does the "sweet" disease occur?

"Sweet" disease forms a rather "motley" group of patients, so it becomes obvious that IDDM and its non-insulin-dependent "brother" genetically originated differently. There is evidence of an association of insulin-dependent diabetes with the genetic structures of the HLA system (major histocompatibility complex), in particular, with some genes of the D-region loci. For INDSD, such a relationship was not observed.

For the development of type I diabetes mellitus, one genetic predisposition is not enough, the pathogenetic mechanism is triggered by provoking factors:

• Congenital inferiority of the islets of Langerhans;
• Unfavorable influence of the external environment;
• Stress, nervous stress;
• Traumatic brain injury;
• Pregnancy;
• Infectious processes of viral origin (influenza, mumps, cytomegalovirus infection, Coxsackie);
• Tendency to constant overeating, leading to excess body fat;
• Abuse of confectionery (sweet teeth are more at risk).

Before highlighting the causes of type II diabetes, it would be advisable to dwell on a very controversial issue: who suffers more often - men or women?

It has been established that at present the disease in the territory of the Russian Federation is more often formed in women, although back in the 19th century DM was a "privilege" of the male sex. By the way, now in some countries of Southeast Asia, the presence of this disease in men is considered predominant.

Predisposing conditions for the development of type II diabetes include:

• Changes in the structural structure of the pancreas as a result of inflammatory processes, as well as the appearance of cysts, tumors, hemorrhages;
• Age after 40 years;
• Overweight (the biggest risk factor for NIDDM!);
• Vascular diseases caused by atherosclerotic process and arterial hypertension;
• In women, pregnancy and the birth of a child with a high body weight (more than 4 kg);
• The presence of relatives suffering from diabetes;
• Strong psycho-emotional stress (hyperstimulation of the adrenal glands).

The causes of the disease of different types of diabetes in some cases coincide (stress, obesity, the influence of external factors), but the onset of the process in type 1 and type 2 diabetes is different, moreover, IDDM is the destiny of childhood and young age, and insulin-independent prefers older people.

Video: mechanisms for the development of type II diabetes

Why are you so thirsty?

The characteristic symptoms of diabetes mellitus, regardless of form and type, can be represented as follows:

Thus, the general signs of diabetes can be characteristic of any form of the disease, however, in order not to confuse the reader, it should still be noted the features inherent in this or that type.

Type 1 diabetes is a “privilege” for young people

IDDM is characterized by an acute (weeks or months) onset. Signs of type I diabetes are pronounced and manifested by clinical symptoms typical for this disease:

• A sharp drop in weight;
• Unnatural thirst, a person simply cannot get drunk, although he tries to do so (polydipsia);
• Large amounts of urine (polyuria)
• A significant excess of the concentration of glucose and ketone bodies in the blood serum (ketoacidosis). In the initial stage, when the patient may still not be aware of his problems, it is likely that a diabetic (ketoacidotic, hyperglycemic) coma will develop - a condition that is extremely life-threatening, so insulin therapy is prescribed as early as possible (as soon as diabetes is suspected).

In most cases, after the use of insulin, metabolic processes are compensated, the body's need for insulin declines sharply, a temporary "recovery" occurs. However, this short-term state of remission should not relax either the patient or the doctor, because after a certain period of time the disease will again remind of itself. The need for insulin as the duration of the disease increases, may increase, but, basically, in the absence of ketoacidosis, will not exceed 0.8-1.0 U / kg.

Signs indicating the development of late complications of diabetes (retinopathy, nephropathy) may appear in 5-10 years. The main causes of death in IDDM include:

1. Terminal renal failure, which is a consequence of diabetic glomerulosclerosis;
2. Cardiovascular disorders, as complications of the underlying disease, which occur somewhat less frequently than renal ones.

Disease or aging? (type II diabetes)

NIDDM develops over many months and even years. Problems that arise, a person carries to various specialists (dermatologist, gynecologist, neurologist ...). The patient does not even suspect that different diseases in his opinion: furunculosis, pruritus, fungal infections, pain in the lower extremities are signs of type II diabetes mellitus. Often, NIDDM is discovered by pure chance (annual medical examination) or due to disorders that the patients themselves attribute to age-related changes: “vision has fallen”, “something is wrong with the kidneys”, “legs do not obey at all” .... Patients get used to their condition, and diabetes mellitus continues to develop slowly, affecting all systems, and first of all, blood vessels, until a person “falls down” from a stroke or heart attack.

NIDDM is characterized by a stable slow course, as a rule, without showing a tendency to ketoacidosis.

Treatment of type 2 diabetes usually begins with a diet that restricts easily digestible (refined) carbohydrates and, if necessary, the use of sugar-lowering drugs. Insulin is prescribed if the development of the disease has reached the stage of severe complications or there is resistance to oral drugs.

The main cause of death in patients with NIDDM is cardiovascular disease resulting from diabetes. Typically, this is or .

Video: 3 early signs of diabetes

Medications for the treatment of diabetes

The basis of therapeutic measures aimed at compensating for diabetes mellitus is represented by three main principles:

• Compensation for lack of insulin;
• Regulation of endocrine-metabolic disorders;
• Prevention of diabetes mellitus, its complications and their timely treatment.

The implementation of these principles is carried out on the basis of 5 main positions:

1. Nutrition in diabetes mellitus is assigned the party of "first violin";
2. The system of physical exercises, adequate and individually selected, follows the diet;
3. Sugar-lowering drugs are mainly used to treat type 2 diabetes;
4. Insulin therapy is given as needed for NIDDM, but is the mainstay for type 1 diabetes;
5. Teaching patients to exercise self-control (skills of taking blood from a finger, using a glucometer, administering insulin without assistance).

The laboratory control above these positions indicates the degree of compensation after the following:

Indicators	Good degree of compensation	Satisfactory	bad
Fasting glucose (mmol/l)	4,4 – 6,1	6,2 – 7,8	Ø 7.8
The content of sugar in the blood serum 2 hours after a meal (mmol / l)	5,5 – 8,0	8,1-10,0	Ø 10.0
Percentage of glycosylated hemoglobin (HbA1, %)		8,0 – 9,5	Ø 10.0
Serum total cholesterol (mmol/l)		5,2 – 6,5	Ø 6.5
Triglycerides (mmol/L)		1,7 – 2,2	Ø 2.2

The Important Role of Diet in the Treatment of NIDDM

Nutrition for diabetes mellitus is a very well-known table number 9, even for people far from diabetes mellitus. after a certain password is spoken: "I have the ninth table." What does all of this mean? How is this mystery diet different from all the others?

One should not be mistaken, looking after a diabetic who takes away his “porridge”, that they are deprived of all the joys of life. The diet for diabetes is not so different from the diet of healthy people, the right amount of carbohydrates (60%), fats (24%), proteins (16%) patients receive.

Nutrition in diabetes consists in replacing refined sugars in foods with slowly digested carbohydrates. Sugar sold in a store for everyone and confectionery based on it fall into the category of prohibited foods. Meanwhile, the trading network, in addition to diabetic bread, which we often stumble upon when choosing bakery products, provides such people with sweeteners (fructose), sweets, cookies, waffles and many other sweets that contribute to the production of "happiness hormones" (endorphins).

As for the balance of nutrition, everything is strict here: a diabetic must necessarily consume the required amount of vitamins and pectins, which should be at least 40 grams. per day.

Video: doctor about nutrition in diabetes

Strictly individual physical activity

Physical activity for each patient is selected individually by the attending physician, taking into account the following positions:

• Age;
• Symptoms of diabetes;
• The severity of the course of the pathological process;
• Presence or absence of complications.

The physical activity prescribed by the doctor and performed by the "ward" should contribute to the "burning" of carbohydrates and fats, without involving insulin. Its dose, which is necessary to compensate for metabolic disorders, drops noticeably, which should not be forgotten, since by preventing an increase, one can get an undesirable effect. Adequate physical activity reduces glucose, the injected dose of insulin breaks down the rest, and as a result, a decrease in sugar levels below acceptable values ​​(hypoglycemia).

In this way, the dosage of insulin and physical activity requires very close attention and careful calculation, so that complementing each other, together not to step over the lower limit of normal laboratory parameters.

Video: gymnastics complex for diabetes

Or maybe try folk remedies?

Treatment of type 2 diabetes mellitus is often accompanied by a search by the patient for folk remedies that can slow down the process and delay the time of taking dosage forms as far as possible. You can understand a person, because no one wants to feel inferior, dooming himself to dependence on pills or (even worse) on constant injections of insulin.

Despite the fact that our distant ancestors practically did not know about such a disease, folk remedies for the treatment of diabetes exist, but we should not forget that infusions and decoctions prepared from various plants are an adjuvant. The use of home remedies for diabetes does not relieve the patient from following a diet, controlling blood sugar, visiting a doctor and following all his recommendations.

To combat this pathology at home, quite well-known folk remedies are used:

1. Bark and leaves of white mulberry;
2. Oat grains and husks;
3. Partitions walnut;
4. Bay leaf;
5. Cinnamon;
6. acorns;
7. Nettle;
8. Dandelion.

When diet and folk remedies no longer help ...

The so-called first generation drugs, widely known at the end of the last century (bucarban, oranil, butamid, etc.), remained in the memories, and they were replaced by new generation drugs (dionil, maninil, minidiab, glurenorm), which make up 3 main groups drugs for diabetes produced by the pharmaceutical industry.

Which remedy is suitable for this or that patient - the endocrinologist decides, because representatives of each group, in addition to the main indication - diabetes mellitus, have a lot of contraindications and side effects. And so that patients do not self-medicate and do not take it into their heads to use these drugs for diabetes at their own discretion, we will give some illustrative examples.

Sulfonylureas

Currently, second-generation sulfonylurea derivatives are prescribed, acting from 10 hours to a day. Usually patients take them 2 times a day for half an hour before meals.

These drugs are absolutely contraindicated in the following cases:

In addition, the use of drugs in this group may threaten the development of allergic reactions, manifested by:

1. Skin itching and urticaria, sometimes reaching Quincke's edema;
2. Disorders of the function of the digestive system;
3. Changes in the blood (decrease in the level of platelets and leukocytes);
4. Possible violation of the functional abilities of the liver (jaundice due to cholestasis).

Hypoglycemic agents of the biguanide family

Biguanides (guanidine derivatives) are actively used to treat type 2 diabetes mellitus, often adding sulfonamides to them. They are very rational for use by obese patients, however, for people with liver, kidney and cardiovascular pathology, their appointment is sharply limited, switching to more benign drugs of the same group, such as metformin BMS or α-glucoside inhibitors (glucobay), which inhibit absorption carbohydrates in the small intestine.

The use of guanidine derivatives is also very limited in other cases, which is associated with some of their "harmful" abilities (accumulation of lactate in tissues, leading to lactic acidosis).

Absolute contraindications to the use of biguanine are:

• IDDM (type 1 diabetes);
• Significant weight loss;
• Infectious processes, regardless of localization;
• Surgical interventions;
• Pregnancy, childbirth, breastfeeding period;
• Coma states;
• Hepatic and renal pathology;
• oxygen starvation;
• (2-4 degrees) with impaired vision and kidney function;
• and necrotic processes;
• Circulatory disorders in the lower extremities due to various vascular pathologies.

Treatment with insulin

From the above it becomes obvious that the use of insulin is the main treatment for type 1 diabetes, all emergencies and severe complications of diabetes. NIDDM requires the appointment of this therapy only in cases of insulin-requiring forms, when correction by other means does not give the desired effect.

Modern insulins, called monocompetent, represent two groups:

1. Monocompetent pharmacological forms of human insulin substance (semi-synthetic or recombinant DNA), which undoubtedly have a significant advantage over preparations of porcine origin. They practically have no contraindications and side effects;
2. Monocompetent insulins derived from porcine pancreas. These drugs require an approximately 15% increase in drug dose compared to human insulins.

Diabetes is dangerous complications

Due to the fact that diabetes is accompanied by damage to many organs and tissues, its manifestations can be found in almost all body systems. Complications of diabetes are:

Prevention

Measures for the prevention of diabetes are based on the causes of its causes. In this case, it is advisable to talk about the prevention of atherosclerosis, including the fight against excess weight, bad habits and food addictions.

Prevention of complications of diabetes mellitus is to prevent the development of pathological conditions arising from diabetes itself. Correction of glucose in the blood serum, adherence to diet, adequate physical activity, the implementation of the doctor's recommendations will help to postpone the consequences of this rather formidable disease.

Video: diabetes in the Malakhov + program

Diabetes mellitus is a chronic disease in which the work of the endocrine system is subject to damage. Diabetes mellitus, the symptoms of which are based on a long-term increase in the concentration of glucose in the blood and on the processes accompanying an altered state of metabolism, develops, in particular, due to a lack of insulin, a hormone produced by the pancreas, due to which the body regulates the processing of glucose in body tissues and in his cells.

general description

In diabetes mellitus, a chronic increase in blood sugar levels develops, which determines a condition such as what happens due to insufficient secretion of insulin or due to a decrease in the sensitivity of body cells to it. On average, this disease is relevant for 3% of the population, while it is known that diabetes in children is somewhat less common, determining average rates within 0.3%. Meanwhile, there is also a trend in which the number of patients with diabetes mellitus is only increasing every year, and the annual growth corresponds to approximately 6-10%.

Thus, it can be argued that approximately every 15 years the number of patients with diabetes mellitus doubles. As part of a review of global figures for the number of cases in 2000, a figure was determined in excess of 120 million, but now the total number of people with diabetes is about more than 200 million people.

Let us dwell in more detail on those processes that are directly related to the development of diabetes, and let's start with the most important thing - with insulin.

Insulin, as we already noted initially, is a hormone produced by the pancreas and controls the concentration of glucose (i.e. sugar) in the blood. In our body, food is broken down in the intestines, due to which a number of different substances are released that the body needs for full-fledged work. One of these substances is glucose. Being absorbed from the intestines into the blood, it spreads, thereby, throughout the body. After eating, a high level of sugar has a stimulating effect on the secretion of insulin by the pancreas, due to which glucose enters the cells of the body through the blood, respectively, it is he who helps to reduce the concentration of glucose in the blood. In addition, certain cells without insulin are simply not capable of assimilating glucose from the blood.

As for glucose, it either accumulates in the cells of the body, or is immediately converted into energy, which, in turn, is consumed by the body for one or another of its needs. Throughout the day, there is a variation in indicators of the level of glucose contained in the blood, in addition, its indicators also change depending on food intake (that is, food intake has a direct effect on these indicators). Accordingly, after eating, there is an increase in glucose levels, after which they gradually normalize, this lasts for two hours following the meal. Normalization of blood glucose levels, as a rule, is accompanied by a decrease in insulin production, which, as is already clear, is carried out by the pancreas. In the event that insulin is produced in insufficient quantities, the cells no longer properly absorb glucose, due to which it accumulates in the blood. Due to the increased level of glucose in it (that is, with increased sugar), the symptoms of diabetes appear, respectively, as well as the complications associated with this disease.

Features of the mechanism of development of diabetes in children

Diabetes mellitus in children develops in accordance with the same principles as diabetes mellitus in adults. Nevertheless, it is characterized by the presence of certain own features. So, the pancreas in a child, due to which, as we found out, insulin is produced, has a small size. By the age of ten, it doubles in size, thus reaching 12 cm, and its weight is about 50 grams. The process of producing insulin is finally formed by the time a child reaches 5 years of age, it is from this age and until about the age of 11 years that children are especially susceptible to the development of diabetes mellitus.

In general, metabolic processes in children are much faster than in adults, and the absorption of sugar (and this is carbohydrate metabolism) in such processes is also no exception. Per day, per kilogram of a child's weight, he needs carbohydrates in the amount of 10 grams, which, in principle, explains the love of children for sweets, which is dictated by quite natural needs from their body. The nervous system also has a significant influence on the metabolic processes of carbohydrates, which, in turn, is also not completely formed, which is why various kinds of failures are allowed in it, which are also reflected in the blood sugar level.

It should be noted that although there is a belief that the consumption of sweets is the cause of diabetes, especially when it comes to significant amounts. Specifically, the love of sweets does not lead to the development of diabetes, this factor can only be considered as a predisposing factor - provoking, and with it the risk of developing this disease.

There are certain risks in terms of individual characteristics that predispose to the development of this disease. So, underdeveloped and premature babies, as well as adolescents (in this case we are talking about puberty), are most predisposed to diabetes mellitus. Excessive / significant physical activity, for example, due to visiting sports sections, also determines high risks in terms of predisposition to diabetes.

Diabetes mellitus: causes

Diabetes mellitus can develop for a number of reasons, in particular, the following can be distinguished.

Impact of viral infections. Viral infections contribute to the destruction of pancreatic cells, due to which the production of insulin is ensured. Among these viral infections, one can single out a viral one (aka mumps), etc. Some of these viral infections have a significant affinity for the gastric gland, more precisely, for its cells. Affinity in the general plan of consideration means the ability that one object has in relation to another, due to which, accordingly, the possibility of creating a new complex object is determined. In the case of the affinity of infections and gland cells, the development of complications in the form of diabetes is caused. Remarkably, among patients who have had rubella, there is an increase in cases of diabetes mellitus by an average of 20% or even higher. It is also important to emphasize that the impact of a viral infection is reinforced by the presence of a hereditary predisposition to the development of diabetes mellitus. It is a viral infection that in the vast majority of cases becomes the cause of the development of diabetes mellitus, which is especially true for children and adolescents.

Heredity. Often, diabetes mellitus develops several times more often in those patients who have relatives with the disease we are considering. With diabetes in both parents, the risk of developing diabetes in a child throughout life is 100%. In the same case, if diabetes mellitus is relevant only for one of the parents, the risk, respectively, is 50%, and if a sister/brother has this disease, this risk is 25%. Below we will dwell on the classification of diabetes mellitus in more detail, but for now we will only note the features of type 1 diabetes mellitus for this predisposing factor. They relate to the fact that with this type of diabetes, even the relevance of hereditary predisposition does not determine the mandatory and unconditional fact of the further development of this disease in the patient. For example, it is known that the probability of passing a defective gene from a parent to a child in the presence of type 1 diabetes is quite low - it is about 4%. In addition, there are known cases of morbidity when diabetes manifested itself in only one of a pair of twins, respectively, the second remained healthy. Thus, even predisposing factors are not a definitive statement that a patient will have type 1 diabetes unless they have been exposed to a specific viral disease.

Autoimmune diseases. These include those types of diseases in which the body's immune system begins to "fight" with its own tissues and cells. Among such diseases, one can distinguish, etc. Diabetes mellitus, respectively, in such cases acts as a complication, it develops due to the fact that pancreatic cells begin to break down, due to which insulin is produced, and this destruction is caused by the influence of the immune system.

Increased appetite (overeating). This reason becomes a predisposing factor to obesity, obesity, in turn, is considered as one of the factors leading to the development of type 2 diabetes mellitus. So, for example, people who are not overweight develop diabetes mellitus in 7.8% of cases, while people who are overweight, exceeding the norm by 20%, develop diabetes mellitus in 25% of cases, but overweight, exceeding the norm by 50%, increases the incidence of diabetes by 60%. At the same time, if patients achieve weight loss by an average of 10% due to appropriate physical activity and diet, then this determines for them the possibility of a significant reduction in the risk of developing the disease we are considering.

Stress. Stress is considered in the context of considering diabetes mellitus as an equally serious aggravating factor provoking its development. In particular, it is necessary to try to exclude stress and emotional overstrain for those patients who have a correspondence to one or another of the listed predisposition factors (obesity, heredity, etc.).

Age. Age is also a predisposing factor for the development of diabetes. So, the older the patient, the more likely it is that he may develop diabetes. It should be noted that with age, heredity as a predisposing factor loses its relevance for this disease. But obesity, on the contrary, acts as a practically decisive threat to this, especially in combination with a weakened immune system against the background of previous diseases. Most often, this picture contributes to the development of type 2 diabetes.

We repeat, again, in terms of the myth of diabetes in sweet tooth. There is only a grain of truth in it, and it lies in the fact that excessive consumption of sweets leads to the problem of overweight, which, in turn, is considered as a factor that we have identified above among the predisposing ones.

Somewhat less often, diabetes mellitus develops against the background of hormonal disorders, due to damage to the pancreas by certain medications, and also due to alcohol abuse over a long period of time. Additionally, among the predisposing factors, high blood pressure (arterial hypertension) and high cholesterol levels are distinguished.

Diabetes mellitus: risk factors for the development of the disease in children

The risk factors contributing to the development of this disease in children, in some respects, are similar to the above factors, however, they also have their own characteristics. Let's highlight the main factors:

• the birth of a child to parents with diabetes mellitus (if one or both of them have this disease);
• frequent occurrence of viral diseases in a child;
• the presence of certain metabolic disorders (obesity, etc.);
• birth weight of 4.5 kg or more;
• reduced immunity.

Diabetes: classification

Diabetes can actually manifest itself in several varieties of forms, which we will consider below.

Diabetes. Actually, our article is basically devoted to this form of the disease. As the reader has already been able to understand, this is a chronic disease, accompanied by a violation of the metabolism of glucose (primarily), fats and, to a lesser extent, proteins. There are two main types of this diabetes, these are type 1 and type 2.

• Type 1 diabetes mellitus, or insulin-dependent diabetes (IDDM). With this form of the disease, insulin deficiency is relevant, which is why it is defined as insulin-dependent diabetes. The pancreas in this case does not cope with its functions, due to which insulin is either produced in a minimal amount, due to which the subsequent processing of glucose entering the body becomes impossible, or insulin is not produced at all. In this case, the level of glucose in the blood rises. Given the peculiarities of the manifestation of the disease, patients with it must be provided with the possibility of additional administration of insulin, which will prevent the development of ketoacidosis in them - a condition accompanied by an increased content of ketone bodies in the urine, in other words, this is hypoglycemia. accompanied by a number of specific symptoms, in addition to changes in the composition of urine, and this is the appearance of the smell of acetone from the mouth, drowsiness and severe fatigue, nausea and vomiting, muscle weakness. The introduction of insulin in this type of diabetes in general allows you to maintain the life of patients. The age of patients can be any, but basically it varies within the limits of not exceeding 30 years. There are also other types of features. So, patients in this case, as a rule, are thin, the symptoms and signs of type 1 diabetes mellitus appear suddenly in them.
• Type 2 diabetes mellitus, or non-insulin dependent diabetes (NIDDM). This type of disease is non-insulin dependent, meaning that insulin production occurs in normal amounts, and sometimes even in excess of normal amounts. Nevertheless, there is practically no benefit from insulin in this case, which is caused by the loss of tissue sensitivity to it. The age group in most cases is patients over 30 years old, mostly obese, there are relatively few symptoms of the disease (their classical variants in particular). In the treatment, drugs in the form of tablets are applicable, due to their effect, it is possible to reduce the resistance to insulin of cells, in addition, drugs can be used, due to the effect of which the pancreas is stimulated to produce insulin. This type of disease can be divided according to the type of occurrence, that is, when it occurs in obese patients (obese persons) and when it appears in persons with normal weight. Based on research conducted by some experts, a slightly different condition, which is called prediabetes, can be distinguished. It is characterized by an increased level of sugar in the patient's blood, but on the verge of practically reaching those limits of marks at which diabetes mellitus is diagnosed (glucose corresponds to a value in the range of 101-126 mg / dl, which is slightly higher than 5 mmol / l). Pre-diabetes (and it is also latent diabetes) without the implementation of adequate therapeutic measures aimed at its correction, subsequently transforms into diabetes.

Gestational diabetes. This form of diabetes develops during pregnancy, and after childbirth, it can also disappear.

Diabetes mellitus: symptoms

Until a certain period, diabetes may not manifest itself for a long time. Signs of diabetes mellitus type 1 and 2 differ from each other, at the same time, any signs may be absent altogether (again, until a certain time). The severity of the main manifestations associated with both types of diabetes is determined by the degree of decrease in insulin production, the individual characteristics of the patient's body and the duration of the course of the disease. We single out the main complex of symptoms characteristic of both types of diabetes mellitus:

• unquenchable thirst, increased urination, against which the general organism develops;
• rapid weight loss, regardless of appetite;
• frequent dizziness;
• weakness, decreased performance, fatigue;
• heaviness in the legs;
• tingling, numbness of the extremities;
• pain in the region of the heart;
• cramps in the calf muscles;
• low temperature (below average levels);
• the appearance of itching in the perineum;
• skin itching;
• slow healing of skin lesions, wounds;
• violations of sexual activity;
• long-term cure for infectious diseases;
• visual impairment (general visual impairment, the appearance of a "veil" before the eyes).

There are some "special" signs that make it possible to suspect diabetes mellitus. For example, diabetes in children- symptoms of a special type in this case are the lack of gain in height and weight. In addition, diabetes mellitus in infants manifests itself in the form of white marks on diapers after urine has dried on them.

Diabetes in men also manifests itself in the form of a characteristic symptom, as such it is considered.

And finally, the signs of diabetes among women. Here, too, the symptoms are quite pronounced, it consists in manifestations in the vulva, and this is their itching, as well as persistent and prolonged manifestation. In addition, women with a latent form of type 2 diabetes mellitus that is relevant to them for a long period can be treated for and. In addition to the indicated manifestations of symptoms, it remains to add an excess of growth on the body and on the face of hair in women.

Type 1 diabetes mellitus: symptoms

This type of diabetes is a chronically elevated blood sugar condition. This form of diabetes develops due to insufficient secretion of insulin by the pancreas. Type 1 diabetes accounts for about 10% of cases in general.

The typical form of manifestation of the disease, especially in children and young people, is accompanied by a debut in the form of a fairly vivid picture, and its development is noted within a period of several weeks to several months. To provoke the development of this type of diabetes can be infectious diseases or other types of diseases associated with a violation of the general health of the patient. The earlier the debut of the disease occurs, the brighter its onset. The manifestation of symptoms is sudden, the deterioration occurs in a sharp way.

The symptoms that appear here are characteristic of all forms of diabetes caused by hyperglycemia, and these are: increased urination, accompanied by a possible increase in urine production (if this volume is exceeded by 2-3 l / day), constant thirst, weakness and weight loss (for a month the patient can lose 15 kilograms). Focusing on weight loss, it can be noted that the patient can even eat a lot, but at the same time loses about 10% of his total weight.

One of the signs of this disease may be the appearance, the same smell appears in the urine, in some cases vision may be impaired. Also, a companion of patients with this type of diabetes are frequent dizziness, heaviness in the legs. The following are considered as indirect signs of the disease:

• wounds heal much longer;
• recovery from infectious diseases also takes much longer;
• the area of ​​the calf muscles is prone to the appearance of convulsions;
• itching appears in the genital area.

Thirst in this type of diabetes is especially pronounced - patients can drink (respectively, excreting) liquid in a volume of about 5 or even 10 liters.
The onset of the disease in many cases is accompanied by an increase in appetite in patients, but later anorexia develops against the background of the parallel development of ketoacidosis.

Elevated blood pressure requires periodic measurements, while the upper pressure should not exceed 140 mm Hg / st., and the lower - 85 mm Hg / st. We also note that in some cases, with weight loss in patients, blood pressure can normalize, and with it the sugar level. In addition, it is important to reduce the amount of salt consumed. Without achieving significant changes in pressure indicators, additional drugs are prescribed to reduce it.

Foot injury in diabetes mellitus (diabetic foot)

Diabetic foot is considered as quite a serious complication accompanying diabetes mellitus. This pathology causes malnutrition of the lower extremities in patients with diabetes in the formation of ulcerative lesions and deformities of the feet. The main reason for this is that diabetes affects the nerves and vessels of the legs. As predisposing factors for this are obesity, smoking, long-term diabetes, arterial hypertension (high blood pressure). Trophic ulcers in diabetic foot can be superficial (with skin lesions), deep (skin lesions involving tendons, bones, joints). In addition, their occurrence can be defined as, which implies damage to the bones in combination with the bone marrow, as localized, accompanied by numbness in the patient's fingers, or widespread gangrene, in which the foot is completely affected, as a result of which its amputation is required.

Neuropathy, namely, it acts as one of the main causes of the formation of trophic ulcerative lesions, is diagnosed in approximately 25% of patients. It manifests itself in the form of pain in the legs, numbness in them, tingling and burning. In the indicated number of patients, it is relevant for the number of them who have diabetes for a period of about 10 years; in 50%, neuropathy is relevant for the course of the disease for a period of 20 years. With proper treatment, trophic ulcers have a favorable prognosis for a cure; treatment is carried out at home, averaging 6-14 weeks. With complicated ulcers, hospitalization is indicated (from 1 to 2 months), even more severe cases necessitate hospitalization of the part of the leg that has been affected.

Ketoacidosis as a complication of diabetes

We have already dwelled on this state, we will only note some of the provisions on it. In particular, we highlight the symptomatology, which consists in the appearance of dry mouth, thirst, the appearance of a headache, drowsiness and the characteristic smell of acetone from the mouth. The development of this condition leads to loss of consciousness and the development of coma, which requires a mandatory and immediate call to the doctor.

Hypoglycemia as a complication of diabetes

This condition is accompanied by a sharp decrease in blood glucose, which can occur against the background of a number of specific factors (increased physical activity, insulin overdose, excessive alcohol, the use of certain medications). The early symptoms of hypoglycemia are sudden onset of cold sweat, extreme hunger, pale skin, trembling hands, weakness, irritability, numbness of the lips, and dizziness.

As intermediate symptoms of this condition, symptoms are considered in the form of inadequate behavior of the patient (passivity, aggressiveness, etc.), palpitations, impaired coordination of movement, confusion and double vision. And finally, convulsions and loss of consciousness act as late manifestations of symptoms. The patient's condition is corrected by the immediate consumption of easily digestible carbohydrates (sweet tea, juice, etc.). It also requires immediate hospitalization. The main principle of treatment of this condition is the use of glucose (intravenous administration).

Treatment

The diagnosis of "diabetes mellitus" is established on the basis of test results. In particular, these are blood and urine tests for the content of glucose in it, a glucose tolerance test, an analysis for the detection of glycated hemoglobin, as well as an analysis for the detection of C-peptide and insulin in the blood.

Treatment of type 1 diabetes mellitus is based on the implementation of measures in the following areas: exercise, diet and drug therapy (insulin therapy with the achievement of insulin levels within the daily norm of its production, elimination of the manifestations of the clinical symptoms of diabetes mellitus).

Similar principles have been defined for the treatment of type 2 diabetes, i.e. exercise, diet and drug therapy. In particular, emphasis is placed on weight loss - as we have already noted, this can contribute to the normalization of carbohydrate metabolism, as well as a decrease in glucose synthesis.

Anemia, more commonly called anemia, is a condition in which there is a decrease in the total number of red blood cells and / or a decrease in hemoglobin per unit volume of blood. Anemia, the symptoms of which are manifested in the form of fatigue, dizziness and other types of characteristic conditions, occurs due to an insufficient supply of oxygen to the organs.

Migraine is a fairly common neurological disease, accompanied by severe paroxysmal headache. Migraine, the symptoms of which consist in pain itself, concentrated from one half of the head mainly in the region of the eyes, temples and forehead, in nausea, and in some cases in vomiting, occurs without reference to brain tumors, stroke and serious head injuries, although and may indicate the relevance of the development of certain pathologies.

Diabetes- a group of diseases of the endocrine system that develop due to a lack or absence of insulin (hormone) in the body, resulting in a significant increase in the level of glucose (sugar) in the blood (hyperglycemia).

Diabetes mellitus is basically a chronic disease. It is characterized by metabolic disorders - fat, carbohydrate, protein, water-salt and mineral. In diabetes, the function of the pancreas, which actually produces insulin, is impaired.

Insulin- a protein hormone produced by the pancreas, the main function of which is to participate in metabolic processes - the processing and conversion of sugar into glucose, and the further transportation of glucose into cells. In addition, insulin regulates blood sugar levels.

In diabetes, the cells do not receive the necessary nutrition. It is difficult for the body to retain water in the cells, and it is excreted through the kidneys. Violations occur in the protective functions of tissues, the skin, teeth, kidneys, nervous system are affected, the level of vision decreases, develops,.

In addition to humans, this disease can also affect some animals, such as dogs and cats.

Diabetes mellitus is inherited, but it can be acquired in other ways.

Diabetes. ICD

ICD-10: E10-E14
ICD-9: 250

The hormone insulin converts sugar into glucose, which is an energy substance necessary for the normal functioning of body cells. When there is a failure in the production of insulin by the pancreas, disturbances in metabolic processes begin. Glucose is not delivered to the cells and settles in the blood. Cells, in turn, starving, begin to fail, which outwardly manifests itself in the form of secondary diseases (diseases of the skin, circulatory system, nervous and other systems). At the same time, there is a significant increase in blood glucose (hyperglycemia). The quality and effect of the blood deteriorate. This whole process is called diabetes.

Diabetes mellitus is only called hyperglycemia, which is initially caused by the dysfunction of insulin in the body!

Why is high blood sugar harmful?

High blood sugar levels can cause dysfunction in almost all organs, up to and including death. The higher the blood sugar level, the more obvious the result of its action, which is expressed in:

- obesity;
- glycosylation (saccharification) of cells;
- intoxication of the body with damage to the nervous system;
- damage to blood vessels;
- the development of secondary diseases affecting the brain, heart, liver, lungs, gastrointestinal tract, muscles, skin, eyes;
- manifestations of fainting, coma;
- lethal outcome.

Normal blood sugar

On an empty stomach: 3.3-5.5 mmol / l.
2 hours after carbohydrate loading: less than 7.8 mmol/l

Diabetes mellitus in most cases develops gradually, and only occasionally there is a rapid development of the disease, accompanied by an increase in glucose levels to a critical level with various diabetic coma.

The first signs of diabetes

- constant feeling of thirst;
- persistent dry mouth
- increased urine output (increased diuresis);
- increased dryness and severe itching of the skin;
- increased susceptibility to skin diseases, pustules;
- prolonged healing of wounds;
- a sharp decrease or increase in body weight;
- increased sweating;
- muscular.

Signs of diabetes

In addition, diabetes can develop against the background of:

- hyperfunction of the adrenal glands (hypercorticism);
- tumors of the digestive tract;
- increased levels of hormones that block insulin;
— ;
— ;
- poor digestibility of carbohydrates;
- short-term increase in blood sugar levels.

Classification of diabetes

Due to the fact that diabetes mellitus has many different etiologies, signs, complications, and of course, the type of treatment, experts have created a fairly voluminous formula for classifying this disease. Consider the types, types and degrees of diabetes.

By etiology:

I. Type 1 diabetes mellitus (insulin-dependent diabetes, juvenile diabetes). Most often, this type of diabetes occurs in young people, often thin. It runs hard. The reason lies in the antibodies produced by the body itself, which block the β-cells that produce insulin in the pancreas. Treatment is based on the constant intake of insulin, by injection, as well as strict adherence to the diet. From the menu it is necessary to completely exclude the use of easily digestible carbohydrates (sugar, sugar-containing lemonades, sweets, fruit juices).

Divided by:

A. Autoimmune.
B. Idiopathic.

II. Type 2 diabetes mellitus (non-insulin-dependent diabetes). Most often, type 2 diabetes affects obese people over 40 years old. The reason lies in the overabundance of nutrients in the cells, due to which they lose sensitivity to insulin. Treatment is based primarily on a weight loss diet.

Over time, it is possible to prescribe insulin tablets, and only as a last resort, insulin injections are prescribed.

III. Other forms of diabetes:

A. Genetic disorders of b-cells
B. Genetic defects in insulin action
C. Diseases of the endocrine cells of the pancreas:
1. trauma or pancreatectomy;
2. ;
3. neoplastic process;
4. cystic fibrosis;
5. fibrocalculous pancreatopathy;
6. hemochromatosis;
7. other diseases.
D. Endocrinopathy:
1. Itsenko-Cushing's syndrome;
2. acromegaly;
3. glucoganoma;
4. pheochromocytoma;
5. somatostatinoma;
6. hyperthyroidism;
7. aldosteroma;
8. other endocrinopathies.
E. Diabetes as a result of side effects of drugs and toxic substances.
F. Diabetes as a complication of infectious diseases:
1. rubella;
2. cytomegalovirus infection;
3. other infectious diseases.

IV. Gestational diabetes. Blood sugar levels rise during pregnancy. Often passes suddenly, after childbirth.

According to the severity of the course of the disease:

Diabetes mellitus 1 degree (mild form). A low level of glycemia (blood sugar) is characteristic - no more than 8 mmol / l (on an empty stomach). The level of daily glucosuria is not more than 20 g / l. May be accompanied by angioedema. Treatment at the level of diet and taking certain medications.

Diabetes mellitus of the 2nd degree (medium form). A relatively small, but with a more obvious effect, increase in the level of glycemia at the level of 7-10 mmol / l is characteristic. The level of daily glucosuria is not more than 40 g / l. Periodically, manifestations of ketosis and ketoacidosis are possible. Gross violations in the work of the organs do not occur, but at the same time, there may be some violations and signs in the work of the eyes, heart, blood vessels, lower extremities, kidneys and nervous system. There may be signs of diabetic angioneuropathy. Treatment is carried out at the level of diet therapy and oral administration of sugar-lowering drugs. In some cases, the doctor may prescribe insulin injections.

Diabetes mellitus 3 degrees (severe form). Typically, the average level of glycemia is 10-14 mmol / l. The level of daily glucosuria is about 40 g/l. There is a high level of proteinuria (protein in the urine). The picture of clinical manifestations of target organs is intensifying - eyes, heart, blood vessels, legs, kidneys, nervous system. Vision decreases, numbness and pain in the legs appear, increases.

Diabetes mellitus 4 degrees (super severe form). A characteristically high level of glycemia is 15-25 mmol / l or more. The level of daily glucosuria is over 40-50 g/l. Proteinuria increases, the body loses protein. Almost all organs are affected. The patient is subject to frequent diabetic coma. Life is supported purely on insulin injections - at a dose of 60 OD and more.

For complications:

- diabetic micro- and macroangiopathy;
- diabetic neuropathy;
- diabetic nephropathy;
- diabetic retinopathy;
- Diabetic foot.

For the diagnosis of diabetes mellitus, the following methods and tests have been established:

- measuring the level of glucose in the blood (determination of glycemia);
- measurement of daily fluctuations in the level of glycemia (glycemic profile);
- measuring the level of insulin in the blood;
- glucose tolerance test;
- a blood test for the concentration of glycated hemoglobin;
— ;
- Urinalysis to determine the level of leukocytes, glucose and protein;
- abdominal organs;
Rehberg's test.

In addition, if necessary, carry out:

— study of the electrolyte composition of the blood;
- urine test to determine the presence of acetone;
- examination of the fundus;
— .

Before starting treatment, it is necessary to conduct an accurate diagnosis of the body, because. a positive prognosis of recovery depends on this.

Treatment for diabetes aims to:

- lowering blood sugar levels;
- normalization of metabolism;
- prevention of complications of diabetes.

Treatment of type 1 diabetes (insulin dependent)

As we already mentioned in the middle of the article, in the section "Classification of Diabetes Mellitus", patients with type 1 diabetes constantly need insulin injections, since the body cannot produce enough of this hormone on its own. There are currently no other methods of delivering insulin to the body, except for injections. Insulin-based tablets will not help with type 1 diabetes.

In addition to insulin injections, treatment for type 1 diabetes includes:

- adherence to a diet;
- performance of dosed individual physical activity (DIFN).

Treatment of type 2 diabetes (non-insulin dependent)

Treatment of type 2 diabetes is treated with diet and, if necessary, taking sugar-lowering drugs, which are available in tablet form.

Diet for type 2 diabetes is the main method of treatment due to the fact that this type of diabetes just develops due to malnutrition of a person. With improper nutrition, all types of metabolism are disturbed, therefore, by changing your diet, a diabetic in many cases gets cured.

In some cases, with persistent types of type 2 diabetes, the doctor may prescribe insulin injections.

In the treatment of any type of diabetes, a mandatory item is diet therapy.

A nutritionist with diabetes, after receiving tests, taking into account age, body weight, gender, lifestyle, paints an individual nutrition program. When dieting, the patient must calculate the amount of calories, proteins, fats, carbohydrates, vitamins and trace elements consumed. The menu must be followed strictly according to the prescription, which minimizes the risk of developing complications of this disease. Moreover, following a diet for diabetes, it is possible to defeat this disease without additional medication.

The general emphasis of diet therapy for diabetes is on eating food with a minimum or no content of easily digestible carbohydrates, as well as fats, which are easily converted into carbohydrate compounds.

What do people with diabetes eat?

The menu for diabetes consists of vegetables, fruits, meat and dairy products. The diagnosis of "Diabetes" does not mean that it is necessary to completely give up glucose in food. Glucose is the “energy” of the body, with a lack of which protein breaks down. Food should be rich in protein, and.

What can you eat with diabetes: beans, buckwheat, oatmeal, pearl barley, wheat and corn grits, grapefruit, orange, apples, pears, peaches, apricots, pomegranates, dried fruits (prunes, dried apricots, dried apples), cherries, blueberries, blackberries, currants, gooseberries, walnuts, pine nuts, peanuts, almonds, black bread, butter or sunflower oil (no more than 40 g per day).

What not to eat with diabetes: coffee, alcoholic drinks, chocolate, confectionery, sweets, jam, muffins, ice cream, spicy dishes, smoked meats, salty dishes, fat, pepper, mustard, bananas, raisins, grapes.

What is better to refrain from: watermelon, melon, store juices. In addition, try not to use the product about which you know nothing or little.

Conditionally allowed products for diabetes:

Physical activity in diabetes

In the current "lazy" time, when the world has been taken over by television, the Internet, sedentary, and at the same time often highly paid work, an increasing number of people are moving less and less. Unfortunately, this is not the best way to affect health. Diabetes mellitus, hypertension, heart failure, visual impairment, spinal diseases are just a small part of the ailments in which a sedentary lifestyle is indirectly, and sometimes directly, to blame.

When a person leads an active lifestyle - walks a lot, rides a bike, does exercises, plays sports games, the metabolism speeds up, the blood "plays". At the same time, all cells receive the necessary nutrition, the organs are in good shape, the immune system works perfectly, and the body as a whole is less susceptible to various diseases.

That is why, moderate exercise in diabetes has a beneficial effect. When you exercise, your muscles oxidize more glucose from your blood, which lowers your blood sugar levels. Of course, this does not mean that you will suddenly change into a sports uniform and run several kilometers in an unknown direction. The necessary set of exercises will be prescribed for you by the attending physician.

Medicines for diabetes

Consider some groups of medications against diabetes mellitus (sugar-lowering drugs):

Drugs that stimulate the pancreas to produce more insulin: Sulfonylureas (Gliclazide, Gliquidone, Glipizide), Meglitinides (Repaglinide, Nateglinide).

Pills that make body cells more sensitive to insulin:

- Biguanides ("Siofor", "Glucophage", "Metformin"). Contraindicated in people with heart and kidney failure.
- Thiazolidinediones ("Avandia", "Pioglitazone"). Increase the effectiveness of insulin action (improvement of insulin resistance) in adipose and muscle tissues.

Means with incretin activity: DPP-4 inhibitors (Vildagliptin, Sitagliptin), glucagon-like peptide-1 receptor agonists (Liraglutide, Exenatide).

Drugs that block the absorption of glucose in the gastrointestinal tract: alpha-glucosidase inhibitor ("Acarbose").

Can diabetes be cured?

A positive prognosis in the treatment of diabetes mellitus largely depends on:

- type of diabetes;
- the time of detection of the disease;
- an accurate diagnosis;
- strict observance by the diabetic of the doctor's prescriptions.

According to modern (official) scientists, it is currently impossible to completely recover from type 1 diabetes, as well as persistent forms of type 2 diabetes. At least, such drugs have not yet been invented. With this diagnosis, treatment is aimed at preventing the occurrence of complications, as well as the pathological effect of the disease on the work of other organs. After all, you need to understand that the danger of diabetes lies precisely in the complications. With the help of insulin injections, you can only slow down the pathological processes in the body.

Treatment of type 2 diabetes mellitus, in most cases, with the help of nutritional correction, as well as moderate physical activity, is quite successful. However, when a person returns to the old way of life, hyperglycemia does not take long.

I would also like to note that there are unofficial methods of treating diabetes, for example, therapeutic fasting. Such methods often end with resuscitation for a diabetic. From this it must be concluded that before using various folk remedies and recommendations, be sure to consult your doctor.

Of course, I cannot fail to mention another way of healing from diabetes - prayer, turning to God. Both in the Holy Scriptures and in the modern world, an incredibly huge number of people received healing after turning to the Lord, and, in this case, it does not matter what the person is ill with, for what is impossible for a person, everything is possible with God.

Alternative treatment of diabetes

Important! Before using folk remedies, be sure to consult your doctor!

Celery with lemon. Peel 500 g of celery root and grind them together with 6 lemons in a meat grinder. Boil the mixture in a saucepan in a water bath for 2 hours. Next, put the product in the refrigerator. The mixture must be taken in 1 tbsp. spoon for 30 min. Before breakfast, for 2 years.

Lemon with parsley and garlic. Mix 100 g of lemon zest with 300 g of parsley root (you can also put leaves) and 300 g. We twist everything through a meat grinder. We put the resulting mixture in a jar and put it in a cool dark place for 2 weeks. Take the resulting remedy 3 times a day, 1 teaspoon 30 minutes before meals.

Linden. If your blood sugar level has risen, drink lime blossom infusion instead of tea for several days. To prepare the remedy, put 1 tbsp. a spoonful of lime blossom in 1 cup of boiling water.

You can also prepare a decoction of linden. To do this, pour 2 cups of lime blossom into 3 liters of water. Boil this product for 10 minutes, cool, strain and pour into jars or bottles. Store in refrigerator. Drink lime decoction every day for half a glass when you want to drink. When you drink this portion, take a break for 3 weeks, after which the course can be repeated.

Alder, nettle and quinoa. Mix half a glass of alder leaves, 2 tbsp. spoons of quinoa leaves and 1 tbsp. a spoonful of flowers Pour the mixture with 1 liter of water, shake well and leave to infuse for 5 days in a lit place. Then add a pinch of soda to the infusion and consume 1 teaspoon in 30 minutes. Before meals, morning and evening.

Buckwheat. Grind with a coffee grinder 1 tbsp. a spoonful of buckwheat, then add it to 1 cup of kefir. Infuse the remedy during the night, and in the morning drink 30 minutes before meals.

Lemon and eggs. Squeeze the juice from 1 lemon and mix 1 raw egg well with it. Drink the resulting remedy 60 minutes before meals, for 3 days.

Walnut. Pour partitions of 40 g of walnuts with a glass of boiling water. Next, sweat them in a water bath for about 60 minutes. Cool the infusion and strain. You need to take the infusion 1-2 teaspoons 30 minutes before meals, 2 times a day.

Walnut leaf remedy also helps a lot. To do this, pour 1 tbsp. a spoonful of well-dried and ground leaves 50 ml of boiled water. Next, boil the infusion for 15 minutes over low heat, then leave to infuse for about 40 minutes. The broth should be filtered and taken 3-4 times a day for half a glass.

Hazel (bark). Finely chop and pour 400 ml of clean water 1 tbsp. a spoonful of hazel bark. Leave the product to infuse overnight, after which we place the infusion in an enamel pan and put it on fire. Boil the remedy for about 10 minutes. After that, the broth is cooled, divided into equal parts and drunk throughout the day. Store the decoction in the refrigerator.

Aspen (bark). Put a handful of planed aspen bark in an enameled pan, pour 3 liters of water over it. Bring the product to a boil and remove from heat. The resulting decoction should be drunk instead of tea for 2 weeks, then take a break for 7 days and repeat the course of treatment again. Between the 2nd and 3rd course, a break is made for a month.

Bay leaf. Put 10 dry bay leaves in an enamel or glass bowl and pour 250 ml of boiling water over them. Wrap the container well and let the product brew for 2 hours. The resulting infusion for diabetes should be taken 3 times a day for half a glass, 40 minutes before meals.

Flax seeds. Grind into flour 2 tbsp. tablespoons of flax seeds and pour 500 ml of boiling water over them. Boil the mixture in an enameled container for about 5 minutes. The broth must be drunk completely at a time, in a warm state, 30 minutes before a meal.

For wound healing in diabetes mellitus, use lotions based on insulin.

Prevention of diabetes

To prevent the onset of diabetes, experts recommend adhering to preventive rules:

- monitor your weight - prevent the appearance of extra pounds;
- to live an active lifestyle;
- eat right - eat fractionally, and also try to avoid eating foods rich in easily digestible carbohydrates, but focus on foods rich in vitamins

Video about diabetes

Diabetes mellitus is a chronic disease that develops due to absolute or relative insufficiency of the pancreatic hormone insulin. It is necessary to bring glucose to the cells of the body, which enters the blood from food and provides tissues with energy. With a lack of insulin or insensitivity of body tissues to it, the level of glucose in the blood rises - this condition is called hyperglycemia. It is dangerous for almost all body systems.

Important

There are two types of diabetes mellitus, which, with a certain similarity, have significant differences.

Type 1 diabetes- a condition in which the beta cells of the pancreas die for some reason. It is these cells that produce insulin, so that their death leads to an absolute deficiency of this hormone. Such diabetes is more often detected in childhood or adolescence. According to modern concepts, the development of the disease is associated with a viral infection, inadequate functioning of the immune system and hereditary causes. But diabetes itself is not inherited, but only a predisposition to it.

Type 2 diabetes, as a rule, develops after 30-40 years in people who are overweight. In this case, the pancreas produces insulin, but the cells of the body cannot respond to it correctly, their sensitivity to insulin is reduced. Because of this, glucose cannot penetrate the tissues and accumulates in the blood.

Over time, insulin production can also decrease in type 2 diabetes, as long-term high blood glucose levels adversely affect the cells that produce it.

Test yourself

There is a simple test to find out if you have symptoms of diabetes. Consent even with one of the proposed statements is a reason to consult an endocrinologist.

1. No matter how much I quench my thirst, I just can’t get drunk.

2. Because of the frequent urge to urinate, I feel uncomfortable when I have to leave home for a long time.

3. Dried drops of urine leave dense white spots on the laundry, resembling traces of starch.

4. I am overcome by weakness and drowsiness.

5. I notice a deterioration in vision: the contours of objects blur, as if looking through fog.

6. Periodically there is a feeling of goosebumps, numbness and tingling in the palms and soles.

7. I just can't get rid of acne.

8. I have very dry skin, cuts and scratches do not heal well.

9. Worried about itchy skin, especially in the perineum.

10. In recent months, I lost (a) 3-5 kg ​​or more without putting the slightest effort into it;

11. I eat and can’t eat, I constantly feel very hungry.

However, it is important to consider that the classic signs of diabetes described here - thirst, dry mouth, itchy skin, increased urine output, weight loss, visual impairment - do not appear at the onset of the disease, but only when insulin deficiency becomes serious. Therefore, according to experts, for every diagnosed diabetic patient in Russia, there are three to four people who are unaware of the disease they already have.

In order to be able to start treatment in a timely manner, every person after 45 years of age needs to be tested once a year to determine the level of fasting blood glucose. If a person is at risk, this analysis should be carried out more often, and in addition to it, another test with a food load or a test for glucose tolerance should be taken.

Another important analysis is the determination of glycated hemoglobin. It is able to show what was the average blood glucose level in the last three months.

Risk factors

Can lead to diabetes:

Treatment

In type 1 diabetes, the most important part of therapy is insulin injections, which the patient must do all his life. In recent years, making them has become more convenient due to the appearance of dosing syringe pens. Another useful development is continuous subcutaneous insulin pumps, the most modern of which have an alert system for too low or too high blood glucose in a patient and are able to automatically adjust the dose of insulin.

If pancreatic insufficiency is not complete, drugs that stimulate the production of the patient's own insulin in the patient's body can be used.

In type 2 diabetes, drugs are prescribed that eliminate insulin resistance - the body's resistance to insulin. If the blood glucose level exceeds the permissible norm during long-term treatment with the maximum doses of such drugs, the patient should receive replacement therapy with insulin preparations.

Prevention

To avoid the development of type 2 diabetes, it is important to normalize weight, limit calorie intake, and increase physical activity. This tactic gives good results not only in healthy people with risk factors, but also at the stage of pre-diabetes, when the disease has not yet begun, but glucose is already poorly absorbed.

If at this time you correctly build tactics of behavior, in 50-60% a person can avoid the development of the disease.

Diet plays an important role in compensating for diabetes. The choice of products for a person suffering from this disease can be compared to the principle of a traffic light.

Red light These are foods that lead to a sharp increase in blood glucose levels. These include white bread, buns, sweets, beer, kvass, cola, lemonade, sweet juices, instant cereals, white rice, fried potatoes, and mashed potatoes. This group also includes fatty foods. Fat is the most caloric component of food, so if you abuse it, you risk gaining weight. And animal fats have a bad effect on the heart, and it is already under attack with diabetes.

yellow light- foods that increase blood glucose levels are not so sharp, they can be consumed, but in reasonable quantities. These are rye bread and wholemeal flour products, beets, carrots, green peas, raisins, pineapple, banana, melon, apricot, kiwi, potatoes.

Green light lit for vegetables such as zucchini, cabbage, cucumbers, tomatoes, apple and orange juice, cherries, plums, pears, lettuce, dairy products, boiled meat and fish.

SOS!

One of the most dangerous conditions in diabetes mellitus is hypoglycemia - a decrease in blood glucose below 2.8 mmol / l. It can occur if the patient inaccurately calculated the dose of glucose-lowering drugs he needed.

At its first symptoms (an acute feeling of hunger, sweating, trembling in the arms or legs, weakness, dizziness), you should immediately take 20-30 g of pure glucose or other quickly digestible carbohydrates.

Therefore, every diabetic, leaving the house even for a short time, should have 3-4 pieces of sugar or a small package of juice with him.

Preparations

Remember, self-medication is life-threatening, consult a doctor for advice on the use of any medications.

Diabetes due to relative or absolute insufficiency of insulin in the human body. With this disease, the metabolism of carbohydrates is disturbed, and the amount of glucose in the blood and urine increases. Diabetes mellitus also causes other metabolic disorders in the body.

Cause Diabetes mellitus is a deficiency of insulin, a pancreatic hormone that controls the processing of glucose at the level of tissues and cells of the body.

Risk factors for developing diabetes

Risk factors for the development of diabetes, that is, conditions or diseases that predispose to its occurrence, are:
hereditary predisposition;
overweight - obesity;
arterial hypertension;
elevated level .

If a person has several facts at the same time, the risk of developing diabetes for him increases up to 30 times.

Causes of diabetes

Destruction of insulin-producing cells in the pancreas as a result of viral infections. A number of viral infections are often complicated by diabetes, as they have a high affinity for pancreatic cells. Mumps (viral mumps), rubella, viral hepatitis, chickenpox, etc. cause the greatest risk of developing diabetes. So, for example, in people who have had rubella, diabetes mellitus develops in 20 % cases. But especially often a viral infection is complicated by diabetes in those who also have a hereditary predisposition to this disease. This is especially true for children and teenagers.
hereditary factor. Relatives of people with diabetes tend to have diabetes several times more often. If both parents have diabetes, the disease manifests itself in children in 100 % cases, if only one of the parents is sick - in 50 % cases, in case of diabetes mellitus in a sister or brother - at 25%.

But when it comes to diabetes 1 type, the disease may not appear, even with hereditary predisposition. In this type of diabetes, the likelihood that a parent will pass on to a child defective gene, is approximately 4 %. Science also knows cases when only one of the twins fell ill with diabetes. The risk that type 1 diabetes will still develop increases if, in addition to the hereditary factor, there is also a predisposition resulting from a viral infection.
Autoimmune diseases, in other words, those diseases when the body's immune system "attacks" its own tissues. These diseases include autoimmune thyroiditis, glomerulonephritis, lupus, hepatitis, etc. In these diseases, diabetes develops due to the fact that cells of the immune system destroy pancreatic tissue, responsible for insulin production.
Overeating, or increased appetite leading to obesity. In people with normal body weight, diabetes mellitus occurs in 7,8 % cases, when the normal body weight is exceeded by 20 % the incidence of diabetes is 25 %, with an excess of mass 50 % - diabetes appears in 60 % cases. Obesity leads to the development of diabetes 2 type.

You can even reduce the risk of this disease reduced through diet and exercise total body weight 10 %.

Classification of diabetes

The World Health Organization (WHO) classifies diabetes mellitus into 2 type:
insulin-dependent - type 1;
insulin-independent - type 2.

non-insulin dependent diabetes also divided into two varieties: 1) diabetes in persons with normal body weight; 2) diabetes in obese individuals.

In the studies of some scientists, a condition called prediabetes (hidden diabetes). With it, the level of sugar in the blood is already above the norm, but not yet high enough to make a diagnosis of diabetes. For example, the glucose level between 101 mg/dl to 126 mg/dL (slightly higher 5 mmol/l). When there is no right treatment Prediabetes turns into diabetes itself. However, if prediabetes is detected on time and measures are taken to correct this condition, the risk of developing diabetes is reduced.

A form of diabetes mellitus has also been described gestational diabetes. It develops in women during pregnancy, and may disappear after childbirth.

Diabetes mellitus type 1. In insulin-dependent diabetes mellitus ( 1 type) are destroyed more 90 % insulin-secreting pancreatic cells. The reasons for this process can be different: autoimmune or viral diseases, etc.

In patients with diabetes 1 type, the pancreas secretes less insulin than necessary, or does not secrete this hormone at all. Of those people who suffer from diabetes, diabetes 1 type suffer only in 10 % sick. Usually diabetes 1 type manifests itself in people before 30 years. Experts believe that the start to the development of diabetes 1 type gives a viral infection.

The destructive role of an infectious disease is also expressed in the fact that it not only destroys the pancreas, but also causes the immune system of a sick person to destroy the pancreas' own insulin-producing cells. So, in the blood of people suffering from insulin-dependent diabetes mellitus, contains antibodies against insulin-producing b-cells.

Normal absorption of glucose without insulin is impossible, that is, the normal functioning of the organism is also impossible. Those with diabetes 1 type, are constantly dependent on insulin, which they need to receive from the outside, since their own body of these people does not produce it.

Diabetes mellitus type 2. In non-insulin dependent diabetes mellitus ( 2 type) the pancreas secretes insulin in some cases even in larger quantities than necessary. However, the cells of the patient's body as a result of the action of any factors become resistant - their sensitivity to insulin decreases. Because of this, even with a large amount of insulin in the blood, glucose does not enter the cell in the right amount.

diabetes mellitus 2 kind of get sick too 30 years. The risk factors for its occurrence are obesity and heredity. Diabetes 2 type may also result from the misuse of certain drugs, in particular corticosteroids for Cushing's syndrome, acromegaly, etc.

Symptoms and signs of diabetes

The symptoms of both types of diabetes are very similar. As a rule, the first symptoms of diabetes are caused by high blood glucose levels. When its concentration reaches 160-180 mg/dl (above 6 mmol/l), glucose enters the urine. Over time, when the disease begins to progress, the concentration of glucose in the urine becomes very high. At this point, the first symptom of diabetes appears, which is called polyuria- allocate more 1,5-2 l of urine per day.

Frequent urination leads to polydipsia - constant feeling of thirst to satisfy which you need to consume a large amount of fluid daily.

Calories are also excreted with glucose through the urine, therefore the patient begins to lose weight. Patients with diabetes have an increased appetite.

So there is a classic triad of symptoms characteristic of diabetes mellitus:
polyuria - allocation of more 1,5-2 l of urine per day;
polydipsia - constant feeling of thirst;
polyphagy - increased appetite.

Each type of diabetes has its own characteristics. The first symptoms of diabetes 1 types usually come on suddenly or develop over a very short period of time. Even diabetic ketoacidosis this type of diabetes can develop in a short time.

In patients with diabetes mellitus 2 type, the course of the disease is asymptomatic for a long time. If certain complaints appear, then the manifestation of symptoms is still not pronounced. Blood glucose levels at the onset of diabetes 2 type can even be downgraded. This condition is called "hypoglycemia".

In the body of such patients, a certain amount of insulin is secreted, therefore, in the early stages of diabetes 2 type of ketoacidosis, as a rule, does not occur.

There are also less characteristic non-specific signs of diabetes mellitus [b]2 type:
frequent occurrence of colds;
weakness and fatigue;
abscesses on the skin, furunculosis, hard-healing ulcers;
severe itching in the groin area.

Patients suffering from diabetes 2 type, often find out that they are sick, by chance, sometimes after several years from the moment the disease appeared. In such cases, the diagnosis is established on the basis of a detected increase in blood glucose levels or when diabetes is already causing complications.

Diagnosis of type 1 diabetes

Diagnosis of diabetes mellitus 1 type is put by the doctor on the basis of an analysis of the symptoms identified in the patient and the analysis data. To diagnose diabetes, you need to perform the following laboratory tests:
a blood test for glucose to detect its elevated content (see table below);
urinalysis for glucose;
glucose tolerance test;
determination of the content of glycosylated hemoglobin in the blood;
determination of C-peptide and insulin in the blood.

Treatment of type 1 diabetes

For the treatment of diabetes 1 type apply the following methods: drugs, diet, exercise.

The insulin treatment regimen for each diabetic patient is individually compiled by the attending physician. In this case, the doctor takes into account the patient's condition, and his age, and weight, and the characteristics of the course of his illness, and the body's sensitivity to insulin, as well as other factors. For this reason, there is no single treatment regimen for insulin-dependent diabetes. Self-medication for diabetes 1 type (both insulin preparations and any folk remedies) strictly prohibited and extremely dangerous to life!

Diagnosis of type 2 diabetes

If there is a suspicion that the patient has diabetes mellitus 2 Type, you need to determine the level of sugar in the blood and urine.

Usually diabetes 2 type, unfortunately, is detected at a time when the patient has already developed complications of the disease, usually this happens through 5-7 years since the onset of the disease.

Type 2 Diabetes Treatment

For the treatment of diabetes 2 type, you need to follow a diet, exercise, take drugs prescribed by a doctor that reduce blood glucose levels.

For those suffering from diabetes 2 type, oral antidiabetic drugs are usually prescribed. Most often they need to be taken once a day. However, in some cases, more frequent medication is required. The combination of drugs helps to increase the effectiveness of therapy.

In a significant number of cases of diabetes mellitus 2 type drugs gradually lose their effectiveness in the process of application. These patients are treated with insulin. In addition, at certain periods, for example, if a patient with diabetes mellitus 2 such as seriously ill with another disease, most often it is required to temporarily change the treatment with tablets to treatment with insulin.

Only the attending physician can determine when taking pills should be replaced with insulin. Purpose of insulin therapy in the treatment of diabetes mellitus 2 type - compensation of the level of glucose in the blood, and consequently, the prevention of complications of the disease. It is worth considering the use of insulin in diabetes mellitus 2 type if:
the patient quickly loses weight;
symptoms of complications of diabetes are revealed;
other methods of treatment do not provide the necessary compensation for the level of glucose in the patient's blood.

People with diabetes have to strictly follow the diet, limiting yourself in many products. Food products for such patients are divided into three categories:
1) products for which there are no restrictions in use for diabetes: cucumbers, tomatoes, cabbage, radishes, radishes, green beans, green peas (no more than three tablespoons), fresh or pickled mushrooms, zucchini, eggplant, carrots, herbs, spinach, sorrel; allowed drinks: mineral water, tea and coffee without sugar and cream (you can add a sugar substitute), drinks with a sweetener;
2) foods that can only be consumed in limited quantities: low-fat chicken and beef meat, eggs, low-fat boiled sausage, low-fat fish, fruits (except those included in the third category, see below), berries, pasta, potatoes, cereals, cottage cheese with a fat content of not more than 4 % (preferably without additives), kefir and milk with a fat content of not more than 2 %, low-fat cheese (less 30 % fat), beans, peas, lentils, bread.
3) Foods to be excluded from the diet: fatty meat (even poultry), fish, lard, sausages, smoked meats, mayonnaise, margarine, cream; fatty varieties of cottage cheese and cheese; canned food in oil, seeds, nuts, sugar, honey, all confectionery, chocolate, jam, ice cream, grapes, bananas, persimmons, dates. It is strictly forbidden to drink sugary drinks, juices, alcoholic drinks.