Diabetes mellitus What we need to know

19.05.2022

What is diabetes?

Table of Contents

Diabetes mellitus It is a chronic metabolic disease with an increase in the level of sugar (glucose) in the blood.

Most of the structures in food are broken down into glucose and transferred into the blood. Glucose is vital because it is the main source of energy for cells. It is the main source of energy for the brain.

It is released into the blood in response to an increase in glycemic levels insulin. It is a hormone produced by the beta cell islets of the pancreas; It is considered the main anabolic hormone of the body and regulates the transport of glucose from the blood into the cells. Beta cells are sensitive to blood sugar levels – insulin enhances glucose uptake and metabolism, thereby lowering blood sugar levels.

When diabetes develops, the pancreas either cannot produce enough insulin, or the insulin produced cannot be used properly for the cells to absorb glucose. As a result, we experience high blood glucose levels for long periods of time, resulting in damage to the cardiovascular system, the visual system, the kidneys, and other organs.

exists Type 1 და Type 2 diabetes. Potentially reversible forms of diabetes include prediabetes and gestational diabetes.

Type I diabetes It is an autoimmune disease in which the immune system attacks the beta cells of the pancreas, which are involved in the production of insulin. It is unclear what triggers this process. Approximately 10% of diabetics have type I diabetes. Symptoms of the disease often develop quickly. It usually occurs in young people (children and adolescents).

Type II diabetes It develops when the produced insulin is insufficient, or the body is resistant to insulin and the glucose accumulated in the blood cannot be converted. This type of disease occurs in almost 90-95%. Type II diabetes may be practically asymptomatic for a long time, so regular glycemic control is the only option for onitoring.

Overweight, obesity, sedentary lifestyle, genetic predisposition, family history are factors that increase the risk of developing the disease.

Prediabetes Occurs when your blood sugar level is above normal, but it is not high enough to diagnose type 2 diabetes. Prediabetes increases the risk of developing type 2 diabetes, heart disease and stroke.

during gestational diabetes There is an increase in blood sugar concentration during pregnancy. This type of diabetes is caused by insulin antagonist hormones produced by the placenta. Gestational diabetes is a risk factor for the development of post-pregnancy type II diabetes for both mother and child.

Symptoms of diabetes

The symptoms of type II diabetes depend on the level of glycemia in the blood, although for a long time it may be practically asymptomatic, or with minimal manifestations, which people usually do not pay attention to. In type I diabetes, the symptoms appear quickly and more severely.

General symptoms of diabetes:

increased feeling of hunger;
increasing the feeling of thirst;
Lose weight;
Frequent urination;
Deterioration of vision;
general weakness and fatigue;
Ulcers that do not heal.

In addition to the general symptoms of diabetes, men with diabetes may have impaired libido, erectile dysfunction, and muscle weakness.

Even women with diabetes may also have frequent urinary tract infections, fungal infections, and dry, itchy skin.

Symptoms of type I diabetes mellitus:

Feeling of strong hunger;
Feeling strong thirst;
dry mouth;
Weight changes. An increase in abdominal circumference is common;
Urinary frequency, especially with rumen;
Impaired vision;
Fatigue;
mood swings;
ketones in urine);

Symptoms of type II diabetes mellitus:

Feeling of strong hunger;
Feeling strong thirst;
Frequent urination;
Impaired vision;
Fatigue;
Ulcers that heal slowly;
Ketones in the urine
Discomfort in the affected parts of the body (hearts of the hands and feet, fingers, etc.)
Recurrent infectious processes

Symptoms of gestational diabetes

Most women with gestational diabetes have no symptoms. The disease is diagnosed during a routine sugar test or glucose tolerance test. In rare cases, there is a strong thirst and frequent urination.

Risk factors contributing to the development/progression of diabetes

Risk factors for developing diabetes depend on the type of diabetes.

Type I diabetes

Although the exact cause of type 1 diabetes is unknown, there are factors that increase the risk of developing the disease, including:

Family history. The same diagnostics of family members increases the risk of developing the disease
Environmental factors. Various infectious diseases, including viruses, may cause damage to pancreatic beta cells
Autoantibodies. In type I diabetes, research on pancreatic beta cell autoantibodies sometimes gives positive results. However, in all cases of detection of autoantibodies, type I diabetes mellitus does not develop.
Geography. Some countries, such as Finland and Sweden, have a high prevalence of type XNUMX diabetes.

Prediabetes and type II diabetes

Some aspects of the mechanism of development of prediabetes and type II diabetes mellitus are not fully explained, however, there are risk factors whose influence on the development of this disease is undeniable. these are:

Weight. The more adipose tissue in the body, the higher the probability of developing insulin resistance
Passive lifestyle. Lack of physical activity reduces excess glucose consumption by muscles, promotes deposition in fat and development of insulin resistance.
Family history. The risk increases if a family member has been diagnosed with type II diabetes.
Age. The risk increases with age. This is due to a decrease in muscle mass, low physical activity and an increase in fat mass.
Gestational diabetes. Gestational diabetes during pregnancy increases the risk of developing prediabetes and type 2 diabetes.
Polycystic ovary syndrome, which is characterized by irregular menstrual cycle, hairiness and obesity - increases the risk of developing diabetes.
High content of cholesterol and triglycerides in the blood. An excess of atherogenic lipoproteins (low and very low density) increases the risk of developing diabetes.

Complications

High blood sugar levels damage organs and tissues throughout the body. The higher the blood sugar level and the longer it is maintained, the greater the risk of complications.

Complications associated with diabetes include:

Cardiovascular diseases - heart attack, stroke;
Neuropathy;
Nephropathy;
Retinopathy and vision loss;
Hearing loss;
Dyscirculatory disorders of peripheral tissues and associated trophic ulcers
Discirculatory and trophic processes of the skin
Depression;
Dementia.

Uncontrolled gestational diabetes can cause problems that affect both the mother and the baby. Complications that affect a child may include:

Premature birth;
Overweight at birth;
Increased risk of developing type 2 diabetes in the future;
Low blood sugar levels;
Jaundice;
Stillbirth.

The mother may develop complications such as preeclampsia or type 2 diabetes.

The mother's risk of gestational diabetes also increases during subsequent pregnancies.

Diabetes in children

Children can get both type 1 and type 2 diabetes. Blood sugar control is especially important in young people because the disease can damage important organs such as the heart and kidneys.

Untreated diabetes can cause early complications in children, often even life-threatening.

Prevention

For the prevention of diabetes:

Walk or bike for at least 150 minutes a week;
Exclude saturated and trans fats from the diet, along with refined carbohydrates;
Eat more fruits, vegetables and whole grains;
Enjoy small favors;
Try to lose 7% of your body weight if you are overweight or obese.

Type 1 diabetes is impossible to prevent.

Diagnosis

Anyone who has symptoms of diabetes or is at risk of developing the disease should undergo diagnostic tests for diabetes.

Regular testing for gestational diabetes is necessary in the second or third trimester of pregnancy.

Diagnostic tests for type 1 diabetes include:

Determining blood sugar levels
Determining blood sugar levels on an empty stomach
Determination of glycated hemoglobin (HbA1C). Glycated hemoglobin determines the average blood sugar level for the last 2-3 months. The higher the blood sugar level, the more glucose is bound to hemoglobin. A glycated hemoglobin level equal to or greater than 6,5% indicates diabetes. If you have already been diagnosed with diabetes, glycated hemoglobin should be checked regularly as it is a more important marker of therapeutic adequacy than the circadian dynamics of blood sugar.
Autoantibodies to pancreatic insulin-producing cells: A test that distinguishes type 1 diabetes from type 2 diabetes.
Ketones in urine: Ketones are a product of fat metabolism. In diabetes, they accumulate in the blood because cells can not use glucose as an energy source and begin to break down more fat. Ketones in the urine are more commonly found in type 1 diabetes.

Diagnostic tests for type 2 diabetes include:

Determining blood sugar levels
Determining blood sugar levels on an empty stomach
Glucose Tolerance Test: This test is used less often than others. Its purpose is to determine blood sugar levels before and after carbohydrate loading.
Glycated Hemoglobin (HbA1C)

Diagnosis of gestational diabetes

Your doctor will likely assess your risk factors for developing gestational diabetes in early pregnancy:

If you are at high risk for gestational diabetes - For example, if you were obese in early pregnancy, had gestational diabetes during a previous pregnancy, or have a diabetic mother, father, sibling or child - your doctor may perform diagnostic tests for diabetes at your first prenatal visit.

If you are at moderate risk for gestational diabetes, A gestational diabetes screening test will likely be performed in the second trimester - typically 24 to 28 weeks of pregnancy.

Your doctor may use the following screening tests:

Glucose test (at 1 hour intervals): If your blood sugar level is higher than normal, it just means that you are at high risk of developing gestational diabetes. Your doctor will order the following test to determine if you have gestational diabetes:
Glucose tolerance test.

Treatment

An important part of managing diabetes is maintaining a healthy weight through a healthy diet and physical activity.

Type 1 diabetes Treatment includes insulin injections or the use of an insulin pump, constant monitoring of blood sugar levels and control of the amount of carbohydrates taken. For some patients who have type 1 diabetes, a pancreas transplant may be a treatment option.

Treatment of type 2 diabetes It includes a tablet form of anti-diabetic treatment, an active lifestyle, monitoring of saturated carbohydrates and blood glucose levels. Insulin therapy as needed.

Prediabetes, A healthy lifestyle and diet is enough to normalize blood sugar levels.