Diabetes mellitus is a disease of the endocrine system associated with pathological changes in the hormonal context and the malnutrition of metabolic processes.
To date, the disease has not lends itself to eradication (complete liquidation).It is possible to slow down the destructive process in the body by drugs and food 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 sugar.The causes and the nature of the course of the disease differ, so it is divided into several types.
The types of diabetes (SD) are determined by the World Health Organization and have no fundamental differences in all medical people.Diabetes of any type does not apply to contagious diseases.
Tipination of pathology
There are several types of diseases united by a main sign - an increased concentration of blood glucose.The typography of diabetes is due to the causes of its occurrence.Therapy, sex and age methods of the patient also take place.
Types of diabetes accepted in medicine:
- The first type is dependent on insulin (ISD 1) or juvenile;
- The second is dependent on insulin (Inzsd 2), or insulin resistant;
- Diabetes Gestational Mellitus (HSD) in the perinatal period in women;
- Other specific types of diabetes, in particular:
- Damage to β cells of the pancreas at the genetic level (variety of mody-diabetes);
- pathologies of the pancreas extension function;
- Hereditary and acquired pathologies of the external secretion glands and their functions (endocrinopathy);
- pharmacologically caused by diabetes;
- Diabetes following congenital infections;
- SD linked to genomic pathologies and hereditary defects;
- Violation of blood sugar (blood sugar) with an empty stomach and violation of glucose tolerance.
The pre-decibet is a limit state of the body, when the blood sugar level is modified towards an increase (glucose tolerance is disturbed), however, blood sugar indicators "do not reach" the generally accepted digital values corresponding to true diabetes.According to the World Health Organization (WHO 2014), more than 90% of endocrinologists suffer from the second type of disease.
According to medical statistics, a tendency to increase the number of sick people is clearly traced worldwide.Over the past 20 years, the number of diabetics of type 2 has doubled.The GSD represents around 5% of pregnancies.The types of specific diabetes are extremely rare and occupy a low percentage of medical statistics.
In terms of sexual affiliation of Inzsd 2, it is more common in women in the preliminary period and during menopause.This is due to a change in hormonal status and a set of extra pounds.In men, the factor of type 2 diabetes development is most often the chronic inflammation of the pancreas, due to the toxic effects of ethanol.
Diabetes dependent on insulin (1 type)
Type 1 diabetes is characterized by the inability of pancreatic cells.The organ does not perform its endocrine (intra -regional) function for insulin production - a hormone responsible for supplying the body in glucose.Due to the accumulation of glucose in the blood, the organs do not receive complete nutrition, including the pancreas itself.
To simulate the natural production of the endocrine hormone, the patient is prescribed by injections of medical insulins with different temporary durations (short and long), as well as food therapy.The classification of diabetes of the first type is dictated by various etiology of the disease.The type of disease dependent on insulin 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 characteristic characteristics and its pathological differences to subsequent generations.Regarding 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 diabetes development has no children.
Autoimmune reason
The occurrence of the disease is due to the functional failure of the immune system, when, under the influence of negative factors, it actively produces autoimmune antibodies which destroy cells from the body.Triggers (pulse) are used to launch autoimmune processes:
- unhealthy eating behavior combined with hypodynamia;
- Metabolic failure (carbohydrates, lipids and proteins);
- a critical deficiency in the body of cholegalciferol and the ergocalciferol (vitamins of group D);
- Chronic pancreatic pathology;
- The presence in the anamnesis of epidemic mumps (pigs), measles, the Koksaki herpes virus, the Epstein-Barra virus, cytomegalovirus, viral hepatitis A, B, C;
- distress (extended stay in a state of neuropsychological stress);
- Chronic alcoholism;
- Incorrect treatment with medical medications containing hormones.
The ISSD is trained in children, adolescents and adults who have not reached the age of thirty.The version of children in the development of diabetes 1A is associated with complex viral infections.Form 1B occurs in young people and children in the context of autoimmune processes and hereditary predisposition.The disease, as a rule, is developing in forced mode for several weeks or months.
Insulin resistant diabetes (type 2)
The difference between the second type of diabetes mellitus and the first is that the pancreas does not stop the synthesis of insulin.Glucose is concentrated in the blood and is not delivered to the cells and tissues of the body due to the lack of sensitivity to insulin resistance to insulin.Up to a certain point, the treatment is carried out by hypoglycemic drugs (diffusion of sugar) and food therapy.
To compensate for the imbalance in the body, the pancreas activates the production of the hormone.Working in emergency mode, the body wears out over time and loses intra-regional function.Type 2 diabetes passes in a form dependent on insulin.The decrease or loss of the sensitivity of endogenous hormone cells is mainly associated with obesity in which the metabolism of fat and carbohydrates is disrupted.
This is particularly true for visceral obesity (fat deposit around the internal organs).In addition, with excess body weight, blood circulation is difficult due to numerous cholesterol plates inside the vessels, which are formed with hypercholystermia, which still accompanies obesity.Body cells therefore experience nutrition and energy resources deficiency.Other factors affecting the development of the INZSD include:
- Alcohol abuse;
- Gastronomic dependence on sweet dishes;
- chronic pancreatic diseases;
- pathologies of the heart and the vascular system;
- Immodesty in food in the context of a sedentary lifestyle;
- Incorrect hormone therapy;
- complicated pregnancy;
- Dysfunctional inheritance (diabetes among parents);
- Distress.
Most often, the disease develops in women and men in the 40+ age category.In this case, the second type diabetes is latent nature and may not show pronounced symptoms for several years.A timely tests of blood sugar can detect the pre-antiabet.With adequate therapy, the anti -abutive state is reversible.If the weather is lost, progresses and then diagnosed the Inzsd.
Diabetes Lada
In medicine, the term "diabetes 1.5" is found, or the name of Lada diabetes.It is an autoimmune violation of the production of hormones and a dysfunction of the metabolism processes that occur in adults (at the age of 25 and more).The disease combines the first and second varieties of diabetes.The development mechanism corresponds to the CIO, in the latent course and the manifestation of symptoms is similar to the INZSD.
The triggers of the development of pathology are autoimmune diseases in the patient's history:
- Non -infectious inflammation of the intervertebral joints (ankylosing spondylitis);
- An irreversible disease of the central nervous system - multiple sclerosis;
- Granulomatous inflammatory pathology of the gastrointestinal tract (Crohn's disease);
- Chronic inflammation of the thyroid gland (Hashimoto thyroidite);
- Juvenile and rheumatoid arthritis;
- color change (loss of pigment) of the skin (vitiligo);
- inflammatory pathology of the colon mucosa (ulcerative colitis);
- Chronic damage to the connective tissue and the glands of external secretion (Shegren syndrome).
In combination with a hereditary predisposition, autoimmune disorders lead to the progression of Lada-Diabetes.To identify the disease, basic diagnostic methods are used, as well as blood microscopy, which determines the concentration of IGG class immunoglobulins with antigens-Immuno-functioning).Therapy is carried out by regular insulin injections and a nutritional correction.
The gestational form of the disease
The GSD is a specific type of diabetes that develops in women in the second half of the perinatal period.The disease is most often detected during a second planned screening, when the pregnant woman undergoes a complete examination.The main characteristic of the GSD coincides with type 2 diabetes - it is insulin resistance.The cells of the body of a pregnant woman lose contact (sensitivity) to insulin due to the correlation of three main reasons:
- Hormonal restructuring.During the gestation period, the synthesis of progesterone (steroid sex hormone) which blocks the production of insulin increases.In addition, the Endocrine Hormones of the placenta gain strength, which have the property of inhibiting insulin production.
- Load doubled on the female body.To ensure complete nutrition of the unborn child, the body requires an increased amount of glucose.A woman begins to use more monosaccharides, which forces the pancreas to synthesize more insulin.
- An increase in body weight against a decrease in physical activity.Glucose, entering abundantly into the body, is accumulated in the blood, because the cells refuse to perceive insulin due to obesity and hypodynamia.The pregnant woman and the fruits in such a situation are deficient in nutrients and hunger energy.
Unlike the first and second type, gestational diabetes is a reversible process, because insulin molecules and pancreas functional capacities are preserved.
The properly selected therapeutic tactics guarantee the elimination of pathology after childbirth in 85% of cases.The main method of treatment of GDC is a diet for diabetics "Table 9".In difficult cases, medical insulin injections are used.Sahabro winning drugs are not used due to their teratogenic effects on the fetus.
In addition
The specific types of diabetes are genetically determined (Mody diabetes, certain types of endocrinopathy) or caused by other chronic pathologies:
- Pancreatic diseases: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical injuries and gland surgery;
- Functional failure of the lobe before the pituitary gland (acromegaly);
- Increased synthesis of thyroid hormones (thyrotoxicosis);
- Hypothalamic-Piturary-Adultry (Iceco-Cushing syndrome);
- Adrenal cortex tumors (aldosterator, pheochromocytoma, etc.).
Separate diabetic pathology - Shagal Diabetes Non Sha is characterized by a decrease in the production of the hormone of the hypothalamus of vasopressin, which regulates the balance of liquid in the body.
Diagnostic measures
The diagnosis of diabetes diagnosis (any type) is only possible on the basis of the results of blood laboratory microscopy.The diagnosis consists of several studies conducted systematically:
- A general clinical blood test to identify the inflammatory processes hidden in the body.
- A blood test (capillary or venous) for glucose content.It is strictly produced on an empty stomach.
- GTT (Glucosotolerant tests).It is carried out to determine the body's ability to absorb glucose.A tolerance test is a blood fence at two o'clock: in an empty stomach and two hours after the "Glucostostrole load", the role of which is an aqueous glucose solution prepared in a 200 ml of water report by 75 grams.Substances.
- HBA1C analysis in the hemoglobin glycosylated (glycée).Based on the study results, a blood sugar retrospective in the past three months is evaluated.
- Blood biochemistry.The indicators of the liver enzymes of aspartateamnotransferase (AST), alanine-organgraase (alt), alpha-amylase, alkaline phosphatase (SCF), bilirubin (bile pigment), 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 | Glycated hemoglobin |
|---|---|---|---|
| standard | 3.3 - 5.5 | <7.8 | ⩽ 6% |
| Prediabet | 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 analysis of urine for the presence of glucose in urine (glycosuria) is studied.In healthy people, there is no sugar in the urine (for diabetics, 0.061 - 0.083 mmol / L is considered the authorized standard).The referee sample is also made to identify albumin proteins in the urine and an exchange of creatinine proteins.In addition, the material diagnostics are prescribed, including an ECG (electrocardiogram) and an ultrasound of the abdominal cavity (with kidneys).
Results
Modern medicine classifies diabetes according to four basic types, according to pathogenesis (origin and development) of the disease: dependent on insulin (ISSD 1 type), dependent on insulin (inzsd 2), gestational (GSD of pregnant women), specific (diabetes includes several types of diseases due to genetic defects or chronic pathologies).Impatient diabetes formed in the perinatal period is a remedy.The state of pre-diabetes (violation of glucose tolerance) is considered to be reversible subject to an early diagnosis.