Diabetes Mellito is a disease of the endocrine system associated with pathological changes in the hormonal background and malnutrition of metabolic processes.
To date, the disease is not susceptible to eradication (complete liquidation).It is possible to slow down the destructive process in the body through medicines and diet 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 nature of the course of the disease differ, therefore it is divided into different types.
The types of diabetes (DS) are determined by the World Health Organization and have no fundamental differences throughout the medical world.Diabetes of any type does not apply to contagious diseases.
Typical of pathology
There are different types of diseases combined with a main sign: a greater concentration of glucose in the blood.The typing of diabetes is due to the causes of its occurrence.The patient's therapy, sex and age methods are also being verified.
Types of diabetes accepted in medicine:
- The first type is dependent on insulin (ISD 1) or youth;
- The second is dependent on insulin (Inzsd 2) or insulin resistant;
- Gestational Mellito Diabetes (HSD) in the perinatal period in women;
- Other specific types of diabetes, including:
- Damage to the β cells of the genetic pancreas (Mode-diabetes variety);
- pathologies of the pancreas extension function;
- Hereditary and acquired pathologies of the glands of the external secretion and their functions (endocrinopathy);
- pharmacologically caused by diabetes;
- diabetes following congenital infections;
- DS related to genomic pathologies and hereditary defects;
- Violation of blood sugar (blood sugar) on an empty stomach and violation of glucose tolerance.
The pre -dibet is a borderline of the body, when the level of blood sugar is changed towards an increase (glucose tolerance is disturbed), however, the blood sugar indicators "do not reach" the digital values generally accepted corresponding to the real diabetes.According to the World Health Organization (WHO 2014), over 90% of endocrinologists suffer from the second type of illness.
According to medical statistics, the tendency to increase the number of sick people is clearly tracked all over the world.Over the past 20 years, the number of type 2 diabetics has doubled.GSD represents about 5% of pregnancies.Specific types of diabetes are extremely rare and occupy a small percentage of medical statistics.
In terms of affiliation of Inzsd 2 genre, it is more common in women in the preliminated period and during menopause.This is due to a change in the hormonal state and a series of extra kilos.In men, the factor of the development of type 2 diabetes is often the chronic inflammation of the pancreas, due to the toxic effects of the Aanolol.
Diabetes dependent on insulin (1 type)
Type 1 diabetes is characterized by the inability of pancreatic cells.The organ does not perform its endocrine function (intra -regional) for the production of insulin, a hormone responsible for the supply of glucose to the body.As a result of the blood glucose accumulation, organs do not receive complete nutrition, including 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) and diet therapy.The classification of the first type diabetes is dictated by various etiology of the disease.The type of illness dependent on insulin has two causes: genetic and autoimmune.
Genetic reason
The formation of the pathology is associated with the biological characteristic of the human body to transmit its characteristics and its pathological deviations to subsequent generations.As for diabetes, the child inherits a predisposition to the disease from close parents or relatives suffering from diabetes.
Important!A predisposition is inherited, but not the disease itself.A 100% guarantee on diabetes development does not have a child.
Autoimmune motif
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 that destroy body cells.The triggers (impetus) are used to start autoimmune processes:
- Malse -combined food behavior with hypodynamia;
- metabolic insufficiency (carbohydrates, lipids and proteins);
- Critical deficiency in the body of Cholegalciferol and Ergocalciferol (group of vitamins);
- chronic pancreatic pathology;
- The presence in the anamnesis of epidemic paroti (pigs), measles, herpes koksaki viruses, epstein-bar viruses, cytomegalovirus, viral hepatitis A, B, C;
- anguish (prolonged stay in a state of neuropsychological stress);
- Chronic alcoholism;
- Wrong treatment with medical drugs containing hormones.
ISSD is formed in children, adolescents and adults who have not reached thirty years.The version for children of the development of diabetes Forma 1a is associated with complicated viral infections.Module 1b occurs in young people and children against the background of autoimmune processes and hereditary predisposition.The disease, as a rule, develops 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 insulin sensitivity -insulin resistance.Up to a certain point, the treatment is carried out through hypoglycaemic medicines (which use sugar) and diet therapy.
To compensate the imbalance in the body, the pancreas activates the production of the hormone.Working in emergency mode, the organ is consumed over time and loses the intra -regional function.Type 2 diabetes passes in an dependent form of insulin.The decrease or loss of the susceptibility of cells to the endogenous hormone is mainly associated with obesity in which fat and carbohydrate metabolism is disturbed.
This is particularly true for visceral obesity (deposition of fats around the internal organs).In addition, with excess of body weight, blood flow is difficult due to numerous cholesterol plaques inside the vessels, which are formed with hypercolystesterinemia, which always accompanies obesity.The cells of the body therefore experience a lack of nutrition and energy resources.Other factors that influence the development of Inzsd include:
- alcohol abuse;
- gastronomic dependence on sweet dishes;
- chronic pancreatic diseases;
- pathologies of the heart and the vascular system;
- immodesty in food against the background of a sedentary lifestyle;
- Errated hormonal therapy;
- complicated pregnancy;
- dysfunctional heredity (diabetes in parents);
- Anguish.
Very often, the disease develops in women and men in the age of 40+ of age.In this case, the second type diabetes is of a latent nature and may not show symptoms pronounced for several years.Timetable tests for blood sugar can detect pre -antiabet.With adequate therapy, the antiabetic state is reversible.If the weather is lost, progresses and subsequently diagnosed the Inzsd.
Diabetes of Lada
In medicine, the term "diabetes 1.5" or the name of diabetes lada is found.This is an autoimmune violation of the production of hormones and a malfunction of the metabolism processes that occur in adults (at the age of 25+).The disease combines the first and second variety of diabetes.The development mechanism corresponds to ISD, the latent course and the manifestation of symptoms are similar to Inzsd.
The triggering factors for 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 disease);
- chronic inflammation of the thyroid gland (hashimoto thyroiditis);
- Youth and rheumatoid arthritis;
- color change (pigment loss) of the skin (vitiligo);
- inflammatory pathology of the colon mucosa (ulcerative colitis);
- Chronic damage to the connective tissue and the external secretion glands (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 to antigens -iif (analysis of immuno function).Therapy is carried out through regular insulin injections and 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 often detected during a second planned screening, when the waiting mother undergoes a complete examination.The main feature of GSD coincides with type 2 diabetes: this 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 renovation.During the gestation period, the synthesis of progesterone (steroid sexual hormone) that blocks insulin production increases.In addition, the endocrine hormones of the placenta are gaining strength, which have the property of inhibiting the production of insulin.
- Load doubled on the female body.To ensure full nutrition of the unborn child, the body requires a greater quantity 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, which enters abundantly into the body, is accumulated in the blood, since the cells refuse to perceive insulin due to obesity and hypodynamia.The mother and fruit waiting in such a situation are lacking in nutrients and hunger for energy.
Unlike the first and second type, gestational diabetes is a reversible process, since the insulin molecules and the functional skills of the pancreas are preserved.
The correctly selected therapeutic tactics guarantee the elimination of the pathology after childbirth in 85% of cases.The main method of treatment of the GDC is a diet for diabetics "Table n. 9".In difficult cases, injections of medical insulin are used.Sahabro winning drugs are not used due to their teratogenic effects on the fetus.
Furthermore
The specific types of diabetes are genetically determined (mody-diabetes, some types of endocrinopathy) or caused by other chronic pathologies:
- Pancreatic diseases: pancreatitis, emocromatosis, tumor, cystic fibrosis, mechanical injuries and glands surgery;
- Functional failure of the front lobe of the pituitary gland (acromegalia);
- increase in the synthesis of thyroid hormones (thyrotoxicosis);
- Adulteur hypothalamic-pituitary (ieco-cushing syndrome);
- adrenal cortex tumors (aldosterore, feocromocytoma, etc.).
Separate diabetic pathology - Shagal Diabetes Non Shagal is characterized by a decrease in the production of the hormone of the hormone of vasopressin, which regulates the balance of fluid in the body.
Diagnostic measures
The diagnosis of diabetes (any type) is possible only on the basis of the results of blood laboratory microscopy.The diagnosis consists of several studies constantly conducted:
- A general clinical blood test to identify the inflammatory processes hidden in the body.
- A blood test (widespread or venous) for the glucose content.It is rigorously produced on an empty stomach.
- GTT (glucosotolerant test).It is performed to determine the body's ability to absorb glucose.A tolerance test is a two -stroke blood fence: on an empty stomach and two hours after the "load of glucostostrol", whose role is an aqueous solution of glucose prepared in a relationship of 200 ml of water for 75 grams.Substances.
- HBA1C analysis at the level of glycosylated hemoglobin (Glicete).Based on the results of the study, a retrospective of blood sugar is assessed in the last three months.
- Blood biochemistry.The indicators of the hepatic enzymes of aspartateaminotransferase (AST), Alaninein-Organo (alt), alpha-melasi, phosphatase alkaline (scf), bilirubin (pigment), cholesterol levels are evaluated.
- A blood test for the concentration of antibodies in glutamatdecarbossilasi (antibodies gad) determines the type of diabetes.
Reference values of blood sugar indicators and disease
| Analyses | For sugar | Gluczotolerant test | Glyted hemoglobin |
|---|---|---|---|
| rule | 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 studied due to the presence of glucose in the urine (glycosuria).In healthy people, there is no sugar in the urine (for diabetics, 0.061 - 0.083 mmol/l is considered the admissible rule).The referega sample is also performed to identify the albumin protein in the urine and an exchange of creatinine proteins.In addition, hardware diagnostics is prescribed, including an ECG (electrocardiogram) and the ultrasound of the abdominal cavity (with a kidneys).
Results
Modern medicine classifies diabetes based on four basic types, depending on the pathogenesis (origin and development) of the disease: insulin -dependent (type ISSD 1), insulin -dependent (type inzsd 2), gestational (GSD of pregnant women), specifications (diabetes include different types due to genetic defects or chronic patiologies).The hasty diabetes formed in the perinatal period is cure.The state of pre -diabetes (violation of glucose tolerance) is considered reversible subject to early diagnosis.