Clinic and diagnosis of diabetes

The diagnosis of diabetes mellitus begins with knowing the main signs. Despite the similarity of the clinical manifestations of the disease, each diabetes has its own particular characteristics.

Diabetes mellitus was described by the ancient Egyptians about one and a half thousand years ago as an independent nosological unit. Then the diagnosis was established by various methods, which are not used today because they are irrelevant. For example, Hippocrates told his patients that they had diabetes mellitus, whose clinic is bright if the urine tastes sweet when tested. In Chinese medicine, to diagnose this dangerous disease, insects are used - flies, wasps, which, in the presence of sugar in the urine, sit on the container where the urine is placed.

Welding

Diabetes itself is a pathology of the endocrine system. Thus, the concentration of sugar in the blood is constantly increasing for various reasons. This is usually insulin deficiency, which can be absolute or relative. This hormone is produced in beta cells located in the tail of the pancreas.

The result of this process is always a violation of the metabolism of the human body at all levels, which eventually leads to severe complications of the cardiovascular and nervous systems to a greater extent, and the remaining functional units of the body suffer a little less.

To date, there are several types of diseases that have completely different treatment approaches. At the same time, whatever diabetes mellitus, the clinic of this condition is almost always the same.

The most common classifications in the literature are:

1. At a young age, as well as in children, diabetes mellitus with absolute insulin deficiency is the most common. It is called the first type.
2. Insulin -dependent diabetes occurs more frequently in adulthood and is characterized by a relative lack of insulin. Type 2 diabetes usually occurs in older people, but there are cases when the pathology also affects younger people. It is more common than the first type, and one of the factors provoking the pathology is overweight.
3. symptomatic. This type of disease can occur against the background of other pathological processes, so it is also called secondary.
4. Gestational diabetes that occurs during pregnancy. It often disappears on its own after childbirth.
5. With malnutrition, pathologies such as diabetes mellitus can also develop.

It should be noted again that the first and second types of pathology are distinguished by the development of absolute and relative insulin deficiency, respectively. Therefore, it is the first type of disease that requires continuous administration of insulin from the outside. And when pancreatic fatigue is achieved, especially in the case of chronic type 2 diabetes, such a need also arises.

By itself, the second type of disease can be characterized by insufficient insulin production, but the body’s cells are not sensitive to it for a variety of reasons: the organelles responsible for this process may be blocked or their numbers are insufficient for effective communication. As a result, the cells suffer from a lack of sugar, which serves as a signal for increased insulin production, which has little effect. As a result, the amount of insulin produced begins to decrease, which leads to an increase in glycemic indicators.

The reasons

The basis of absolute insulin insufficiency, which leads to the first type of disease, is an autoimmune process. It is caused by a violation of the immune system, which triggers the production of its own antibodies aimed at fighting the beta cells of the island of Langerhans. This leads to their destruction.

The main factors that provoke the disruption of the immune system with the subsequent production of antibodies are often various viral infections, among which the most aggressive can be rubella, chickenpox, mumps. There is a genetic predisposition to pathology.

Keep in mind that substances such as selenium increase the likelihood of a second type of pathology. But this is far from the most important factor in process development. These include similar hereditary predispositions and the presence of overweight. These factors should be considered in more detail.

1. The higher the level of obesity, the higher the risk of diabetes, while in the third stage it increases 10 -fold. Abdominal obesity, that is, when fat deposits are located in the abdomen, may be due to metabolic disorders, i. e. , prediabetes.
2. Hereditary predisposition suggests an increased risk of diabetes several times with this pathology in blood relatives. It does not matter whether an older or younger sibling has the disease. Sometimes there is a trend that the disease is transmitted through generations, but this is just a coincidence.

Keep in mind that if diabetes mellitus is detected, the clinic will develop very slowly and gradually, which complicates the diagnosis in time.

Secondary diabetes mellitus usually develops against the background of the following processes:

1. Organic pathology of the pancreas - inflammatory or oncological processes, trauma, violation of integrity due to resection.
2. Other hormonal pathologies - diseases of the thyroid gland, adrenal glands, pituitary gland.
3. Toxic effects of drugs and other chemical agents.
4. Changes in insulin sensitivity against the background of any pathological process.
5. The patient has a genetic disease.

Diabetes during pregnancy and diabetes due to malnutrition are quite different because it can be a reversible process.

What happens in the body

Due to one or more of the above reasons, a process occurs in the body in which excess sugar in the form of glycogen in muscle and liver tissues is no longer stored. Sugar that cannot be processed by the body remains in the bloodstream, and only a small portion of it is excreted by the kidneys. This has a very negative effect on all organs and systems of the body.

Since glucose does not enter the cells, they begin to actively break down fat for energy. This leads to an increase in the formation of waste nitrogen - ketone bodies, which disrupt all metabolic processes.

Clinical picture

The most characteristic symptoms of undiagnosed pathology, or with a significant increase in sugar, can be:

• excessive thirst, accompanied by severe dryness in the mouth;
• increased urination during the day and at night;
• appearance of general weakness, drowsiness, fatigue and heaviness in the muscles;
• appetite increased significantly;
• itchy skin and genitals;
• the surface of the wound heals for a very long time;
• in type 1 diabetes, the patient loses a lot of weight, and in type 2 diabetes, on the other hand, the patient quickly gains it.

Usually, with the development of type 1 diabetes, clinical symptoms develop at lightning speed, and the second type of pathology is characterized by a gradual increase in the clinic, sometimes symptoms can be undulating (normal conditions alternate with the clinical picture of diabetes). ).

Complications of the disease

Both types of pathology are characterized by the development of complications that usually develop in a person in old age. Diabetes also contributes to the early development of such conditions.

1. Severe diseases of the cardiovascular system: atherosclerosis, ischemic conditions.
2. Development of microangiopathy in the lower legs, kidneys, eyes.
3. Damage to the nervous system, which manifests itself in the form of dry skin, severe pain and cramps in the legs, reduces pain sensitivity.
4. Decreased vision.
5. Damage to the kidneys with violation of its function and an increase in protein excretion.
6. Ulcerative defects develop on the feet, which eventually lead to necrotic and purulent processes. The basis for this is the development of neuropathy and angiopathy in the lower extremities.
7. The development of infectious complications on the skin - abscesses, fungal infections.
8. Due to poor glycemic control, a coma with high or low sugar can develop. It is observed that hypoglycemia (low sugar) conditions are more difficult to treat than hyperglycemia (high sugar).

Sometimes with type 1 diabetes, there is a deterioration in well-being, which is accompanied by general weakness. He may be accompanied by pain in the abdomen until vomiting, there is the smell of acetone from the mouth. This change is explained by the accumulation of ketone bodies, which must be removed from the blood as soon as possible. If this does not happen, a ketoacidotic coma develops.

Probably a coma with an incorrect dose of insulin, when an excessive amount is given. To prevent the development of any type of diabetic coma, you should constantly monitor blood sugar levels and choose an adequate dose of insulin.

Diagnostics

Patients who have been diagnosed with diabetes are under the control of an endocrinologist. The pathological diagnosis involves the following tests:

1. Glycemic profile analysis.
2. Glucose tolerance test.
3. Analysis of urine for the presence of sugar and acetone, for this there is a special test strip.
4. The blood test for glycated hemoglobin, in healthy people, it never exceeds the norm.
5. Determination of C-peptides, which are depleted in the first type of pathology. In the latter type, it may remain in the normal range.

Treatment

To treat the process, patients need:

1. Stick to dietary recommendations. They mean limiting foods that contain fast carbohydrates. Nutrition should be reviewed, priority given to five times a day.
2. Insulin therapy is prescribed for patients with type one or with secondary insulin -dependent diabetes. It is injected subcutaneously with a syringe or a special syringe pen. Sometimes patients install insulin pumps. To date, the development of an artificial pancreas is underway, which by itself can measure sugar and inject the right amount of insulin.
3. The second type of disease involves the intake of sugar -lowering drugs in tablet form.
4. Special physiotherapy exercises are prescribed, as physical activity helps normalize glycemia and helps fight obesity.

Keep in mind that the disease is treated for life. The higher the level of self -control in the patient, the fewer life -threatening complications the patient will develop, and their progression will be slower.