Diabetes mellitus is an illness of the endocrine system that are associated with pathological changes in the hormonal background and the malnutrition of metabolic processes.
So far, the disease is not accessible to the extermination (complete liquidation).It is possible to slow the destructive process in the body through medication and diet therapy, but it is impossible to stop it and start the opposite direction.
The main symptom of the disease is a chronic increase in blood sugar.The causes and the type of illness differ, so that it is divided into different ways.
Types of diabetes (SD) are determined by the World Health Organization and have no fundamental differences in the entire medical world.Diabetes of any kind does not apply to contagious diseases.
Tipping the pathology
There are different types of diseases combined by a main sign - an increased glucose concentration in the blood.The typification of diabetes is due to the causes of his occurrence.The methods of therapy, gender and age of the patient also take place.
Types of diabetes that are accepted in medicine:
- The first type is insulin -dependent (ISD 1) or teenager;
- The second is insulin -dependent (inzsd 2) or insulin resistant;
- Diabetes pregnancy mellitus (HSD) in the perinatal time in women;
- Other specific types of diabetes, including:
- Damage of β cells of the pancreas on a genetic level (variety of mody diabetes);
- Pathologies of the extension function of the pancreas;
- Hereditary and acquired pathologies of the glands of external secretion and their functions (endocrinopathy);
- Pharmacologically caused by diabetes;
- Diabetes as a result of innate infections;
- SD in connection with genomic pathologies and hereditary defects;
- Violation of glycemia (blood sugar) on an empty stomach and violation of glucose tolerance.
The PRE -Dibet is a border state of the body when glycemia is changing towards an increase (glucose tolerance is disturbed).However, blood sugar indicators do not the generally recognized digital values that correspond to the true diabetes.According to the World Health Organization (WHO 2014), more than 90% of patients with endocrinologists suffer from the second type of illness.
According to medical statistics, the tendency to increase the number of sick people around the world is clearly pursued.In the past 20 years, the number of type -2 diabetics has doubled.GSD accounts for about 5% of pregnancies.Types of specific diabetes are extremely rare and prove a low percentage in medical statistics.
With regard to the gender -specific belonging of INZSD 2, it is more common in women in preparation time and in menopause.This is due to a change in the hormonal status and a number of additional pounds.In men, the factor of the development of type -2 diabetes due to the toxic effects of ethanol is the most common chronic inflammation of the pancreas.
Insulin -dependent diabetes (1 type)
Type -1 diabetes is characterized by the inability of the pancreatic cells.The organ does not carry out its endocrine (intra -regional) function for the production of insulin - a hormone that is responsible for the supply of the body with glucose.As a result of the accumulation of glucose in the blood, the organs do not receive a complete diet, including the pancreas itself.
In order to simulate the natural production of the endocrine hormone, the patient is prescribed by injections of medical insulins with different temporary persistence (short and long) and through nutritional therapy.The classification of diabetes of the first type is dictated by various etiology of the disease.The insulin -dependent type of disease has two causes: genetic and autoimmune.
Genetic reason
The formation of pathology is connected to the biological characteristic of the human body in order to convey its characteristic characteristics and pathological deviations to subsequent generations.With regard to diabetes, the child inherits a disposition for the disease of parents or narrow relatives who suffer from diabetes.
Important!An assessment is inherited, but not the disease itself. No child has a 100% guarantee for the development of diabetes.
Autoimmungsrund
The occurrence of the disease is due to the functional failure of the immune system if it actively generates autoimmunantibodies under the influence of negative factors that destroy the body cells.Trigger (impulse) are used to start autoimmune processes:
- unhealthy food behavior in combination with hypodynamy;
- Metabolic failure (carbohydrate, lipid and protein);
- critical deficiency in the body of cholegalciferol and ergocalciferol (group d -vitamine);
- Pancreasic pathology of chronic nature;
- The presence in the anamnesis of epidemic mumps (pigs), measles, the herpes-Koksaki virus, the Epstein-Barra virus, the cytomegalovirus, the viral hepatitis A, b, c;
- Load (longer stay in a state of neuropsychological stress);
- Chronic alcoholism;
- Wrong treatment with hormone -containing medical medication.
ISSD is founded in children, adolescents and adults who have not reached the age of thirty years.The child version of the development of diabetes form 1a is associated with complicated virus infections.Form 1b occurs in young people and children against the background of autoimmune processes and hereditary dispositions.The disease usually develops in compulsory 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.The glucose concentrates in the blood and, due to the lack of sensitivity to insulin insulin resistance, is not released to the body's cells and tissues.Up to a certain point, treatment is carried out by hypoglycemic (sugar -containing) medication and nutritional therapy.
To compensate for the imbalance in the body, the pancreas activates the production of the hormone.The organ works in emergency mode and loses the intra -regional function.Type -2 diabetes applies to the insulin -dependent form.The decrease or loss of the susceptibility of cells for the endogenous hormone is mainly associated with obesity in which fat and carbohydrate metabolism is disturbed.
This applies in particular to visceral obesity (deposition of fat by internal organs).In addition, the blood flow with excess body weight is difficult due to numerous cholesterol -plaques within the vessels, which are formed with hypercholysterinemia that always accompanies obesity.The body's cells experience a lack of nutrition and energy resources.Other factors that influence the development of INZSD are:
- Alcohol abuse;
- Gastronomic addiction to sweet dishes;
- Chronic pancreatic diseases;
- Pathologies of the heart and the vascular system;
- Carelessly in the food against the background of a seated lifestyle;
- Wrong hormone therapy;
- complicated pregnancy;
- dysfunctional inheritance (diabetes in parents);
- Not.
Most of the time, the disease develops 40+ in women and men in age category.In this case, diabetes of the second type is latent and may show pronounced symptoms for several years.Traveled Test for blood sugar can detect Pre -Antiabet.With adequate therapy, the antapick state is reversible.If time is lost, progress and then diagnosed the INZSD.
Lada diabetes
The term “diabetes 1.5” or the name Lada diabetes is found in medicine.This is an autoimmune injury to the production of hormones and a malfunction of metabolic processes in adults (at the age of 25).The disease combines the first and second varieties of diabetes.The development mechanism corresponds to ISD, latent course and the manifestation of symptoms is similar to the INZSD.
The trigger for the development of pathology are autoimmune diseases in the patient's history:
- Non -infectious inflammation of the gang (ankylosinus spondylitis);
- an irreversible illness of the central nervous system - multiple sclerosis;
- Granulomatous inflammatory pathology of the stomach intestine tract (Crohn's disease);
- Chronic inflammation of the thyroid gland (Hashimoto -thyreoiditis);
- Juvenile and rheumatoid arthritis;
- Color change (loss of pigment) of the skin (vitiligo);
- Inflammation pathology of the colon mucosa (ulcerative colitis);
- Chronic damage to the connective tissue and glands of the external secretion (Shegren syndrome).
In combination with an inherited disposition, autoimmune diseases lead to the progress of Lada diabetes.In order to identify the disease, basic diagnostic methods and blood microscopy are used, which determines the concentration of the IgG class -class immununglobulins on antigens (immuno -function analysis).The therapy is carried out by regular insulin injections and nutritional correction.
The form of pregnancy of the disease
GSD is a certain type of diabetes that develops in women in the second half of the perinatal period.The disease is most frequently found during a second planned screening when the expected mother takes a complete examination.The main feature of GSD coincides with type -2 diabetes -that 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 pregnancy 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 that have the inhibition of insulin production.
- Doubled load on the female body.In order to ensure a complete diet of the unborn child, the body needs 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 that penetrates the body is accumulated in the blood because the cells refuse to perceive insulin due to obesity and hypodynamy.The expectant mother and the expectant mother in such a situation are poor.
In contrast to the first and second type, pregnancy diabetes is a reversible process, since insulin molecules and the functional skills of the pancreas are preserved.
The removal of the pathology after delivery in 85% of cases guarantees properly selected therapeutic tactics.The main method for the treatment of GDC is a diet for diabetics "Table No. 9".In difficult cases, injections of medical insulin are used.Due to their teratogenic effects on the fetus, Saupabro winners are not used.
Additionally
Specific types of diabetes are genetically determined (mody diabetes, some types of endocrinopathy) or by other chronic pathologies:
- Pancreatic diseases: pancreatitis, hemochromatosis, tumor, cystic fibrosis, mechanical injuries and gland surgery;
- Functional failure of the front lobe of the pituitary gland (acromegaly);
- increased synthesis of thyroid hormones (thyrotoxicosis);
- Hypothalamic hypophysis adult (IceCO-Kush syndrome);
- Tumors of the adrenal cortex (Aldosteror, Phäochromocytom etc.).
A separate diabetic pathology - Non -shagal diabetes is characterized by a decrease in the production of the hormone of the hypothalamus of vasopressin, which regulates the balance of the liquid in the body.
Diagnostic measures
The diagnosis of diabetes (any kind) diagnosis is only possible due to the results of the blood of the blood.The diagnosis consists of several consistently carried out studies:
- A general clinical blood test to identify hidden inflammatory processes in the body.
- A blood test (capillary or venous) for the content of glucose content.It is strictly generated on empty stomach.
- GTT (Glucosotlerant test).It is carried out to determine the body's ability to absorb glucose.A tolerance test is a two -time bloodun: on an empty stomach and two hours after the "Glucostostostrollast", the role of which is an aqueous solution of glucose, which is produced in a ratio of 200 ml of water by 75 grams.Substances.
- HBA1C analysis on the level of the glycosylated (glycated) hemoglobin.Based on the results of the study, a retrospective sugar in the blood has been evaluated in the past three months.
- Biochemistry of the blood.The indicators for the hepatic enzymes of aspartate teaminotransferase (AST), alaninine or grass (old), alpha-amylase, alkaline phosphatase (SCF), bilirubin (gallpigment) and cholesterol 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 | From 6 to 6.4% |
| diabetes | >7.1 | >11.1 | More than 6.5% |
In addition to blood microscopy, a general urine analysis is examined for the presence of glucose in urine (glycosuria).In healthy people there is no sugar in the urine (for diabetics 0.061 - 0.083 mmol/l is regarded as a permissible standard).The referee sample is also carried out to identify albumin protein in the urine and an exchange of protein from creatinine.In addition, the hardware diagnosis is prescribed, including an EKG (electrocardiogram) and ultrasound of the abdominal cavity (with kidneys).
Results
Modern medicine classifies diabetes according to four basic types, depending on the pathogenesis (origin and development) of the disease: insulin -dependent (ISD 1), insulin -dependent (inzsd 2 -type), gestation (GSD of pregnant women), specific (diabetes includes different types of diseases or chronic pathologies) orChronic pathologies).Healing is formed in the perinatal period formed.The condition of the pre -Thethe diabetes (violation of glucose tolerance) is regarded as reversible, which is subject to early diagnosis.