Diabetes mellitus is a progressive chronic disease characterized by a violation of carbohydrate metabolism. This is manifested by high blood glucose levels and the development of lesions of blood vessels and internal organs over time. The number of people with diabetes is steadily increasing worldwide. For what reasons this disease occurs and what obvious symptoms should be paid attention to, we analyze in the material.
Causes of diabetes mellitus
Type 2 diabetes mellitus can develop for several reasons. Significant prerequisites for its occurrence are excessive nutrition and low physical activity, which leads to obesity. Due to the constant accumulation of glucose and lipids, the sensitivity of adipose tissue to insulin decreases. As a result, insulin production compensatorily increases, its level in the blood increases. This in turn slows down the breakdown of fats, and obesity progresses. Gradually, the reserves of beta cells of the pancreas are depleted, there is a shortage of insulin.
In addition, there is a hereditary predisposition to type 2 diabetes mellitus. In old age, there is a decrease in muscle and skeletal mass, fat accumulation, in addition, insulin secretion by beta cells worsens, which causes a violation of glucose tolerance.
Types of diabetes mellitus
Diabetes mellitus of the first and second type is isolated.
Diabetes mellitus of the first type may appear due to unexplained circumstances or be caused by autoimmune causes when, under certain conditions, their own immune cells begin to destroy the pancreatic tissue responsible for insulin synthesis. In type 1, the cells that secrete insulin (beta cells) gradually die off, against this background, the amount of synthesized insulin decreases.
In type 2 diabetes, the very number of insulin-secreting cells does not change, but tissue insensitivity to the action of insulin and/or its production may develop.
There are also specific types of diseases that occur for a specific reason: genetic defects in beta cells and the insulin molecule, acquired pancreatic diseases, toxic effects of chemicals, drugs, infections, etc.
Separately, women have diabetes mellitus that occurs during pregnancy — gestational.
Signs and symptoms of diabetes mellitus in adults
The classic symptoms of diabetes mellitus (DM) are listed here. Read carefully and listen to your body.
- Constant fatigue. Constant fatigue reduces the activity and efficiency of a person, worsening his well-being. If you don’t feel cheerful even after sleeping, it’s worth thinking about.
- Persistent hunger. How to distinguish hunger caused by any disease from the usual, unrelated to the disease? Find out more about it.
- Numbness and pain in the legs. One of the main and most common complications of diabetes is diabetic polyneuropathy. Therefore, when there is a loss of sensitivity or numbness of the limbs, it is important to understand that this may be a symptom of DM.
- Intense thirst. A symptom that cannot be ignored. With the development of diabetes mellitus, a thirsty person drinks from 2 to 6 liters (10-30 glasses) of liquid per day.
- Frequent urination. With diabetes, the volume of urine can reach 10 liters per day. If you notice the appearance of frequent and copious urination, this is a reason to consult a doctor for diagnosis.
- Blurry vision. Symptoms of visual impairment in diabetes mellitus may be: gradual deterioration of vision, spots, threads or other darkening, “floating” in the field of vision, etc. Find out more about it.
- Unexplained weight loss. If you notice that for several months you inexplicably began to lose weight without a special program, then such weight loss is a reason to consult a doctor, because it may be a symptom of diabetes.
- Long-term wound healing. There may be several reasons, and one of them is the manifestations of diabetes mellitus. If you begin to notice wounds that do not heal for a long time, scratches, ulcers, do not ignore it.
Severity of the disease
According to the severity of the disease, it can be mild, moderate and severe.
A mild course is spoken of in the case when no vascular complications are detected. With a moderate course, there are circulatory disorders and associated signs of organ changes (retina, kidneys, nerve fibers) that are at an early stage. Severe diabetes mellitus is characterized by chronic pathology of organs and systems with significant impairment of their functions and the formation of clinical diabetic syndromes: heart and kidney failure, condition after stroke and heart attack, loss of vision due to retinal vascular pathology, etc.
Currently, the concept of the severity of diabetes mellitus is excluded from the diagnosis, because the severity of the condition is determined not by diabetes itself or the level of sugar/ glucose in the blood, but by the presence of complications (early and late) and their severity.
For the diagnosis of “diabetes mellitus”, the doctor may recommend an assessment of several glucose readings. This is fasting glucose, then 2 hours after the oral glucose tolerance test (when the patient drinks a standard glucose solution in water after a certain preparation, and after that it is estimated how much the blood glucose content has increased). Also, to detect diabetes, the glycated hemoglobin index is analyzed by taking blood from a vein or finger.
Consequences and complications
Against the background of the use of an excessive dose of hypoglycemic drugs, excessive physical exertion, during prolonged fasting, a state of hypoglycemia develops — a low blood glucose level. Symptoms: palpitations, trembling, severe hunger, sweating, dizziness and loss of consciousness. It is necessary to urgently increase the level of glucose, because with its long-term deficiency, loss of consciousness or even hypoglycemic coma may develop.
The increased glucose level for a long time disrupts the structure of small and large vessels. Lesions of small vessels are most often found in the kidneys and retina of the eye. Pathological changes in large vessels can cause heart attacks, strokes, the formation of long-term non-healing ulcers, which can lead to the loss of limbs.
Treatment of diabetes mellitus
The basis of treatment is to maintain blood glucose levels in the target values, taking into account nutrition and physical activity. It is also important to give up smoking and alcohol abuse.
For effective treatment, it is necessary to follow the regimen of drug therapy, as well as monitor blood glucose. The treatment of type 2 diabetes can be carried out both with the use of tablet drugs and with the help of insulin.
In addition to assessing glucose levels, it is recommended to regularly monitor blood pressure.
It is important to take proper care of your feet: observe hygiene, choose comfortable, suitable shoes, and regularly examine your feet with specialists. If skin lesions and ulcers appear in this area, you should immediately seek professional help.
In case of type 2 disease with excess weight, it is recommended to reduce the caloric content of the diet in order to reduce body weight. We are not talking about strict restrictions (on the contrary, strict diets and fasting are contraindicated), but about the gradual formation of a healthy eating style. To lose weight, you need to limit animal fats and sugars, reduce starchy foods and proteins in the menu. Vegetables rich in fiber can be eaten in unlimited quantities.
It is recommended to supplement the menu with polyunsaturated fatty acids: fish, vegetable oils 7. Dishes are cooked in boiled, stewed, baked, steamed. If possible, you should divide the food into 3-6 meals. Daily salt intake should be reduced to 5-8 g. When using insulin, it is important to calculate the amount of carbohydrates.
Alcohol consumption is harmful to health. In diabetes mellitus, alcoholic beverages can also complicate the control of the disease. In the absence of complications of diabetes and digestive pathology, the maximum permissible dose for men is 2 conventional units per day, for women — 1 conventional unit per day, without daily use (1 conventional unit = 15 g of ethanol or 40 g of spirits, or 140 g of wine, or 300 ml of beer).
The dosed use of sweeteners is acceptable.
The importance of self-control
Self—monitoring is a regular independent measurement of blood glucose and maintaining this level as close as possible to the indicators that the doctor has determined. Regular self-monitoring reduces the risk of complications. Glucose level tests are divided into urgent (carried out at any time with changes in well-being) and routine (performed daily at a certain time).
Self-monitoring is recommended to be carried out at different hours: on an empty stomach, before eating and 1.5 hours after it, before going to bed, before and after physical activity, in acute diseases and suspected low glucose levels. In order to self – monitor glucose , it is recommended to use individual glucose meters with the setting of the target range . The frequency of self-monitoring helps to determine the attending physician.