Non-insulin dependent diabetes mellitus: symptoms, treatment. Non-insulin dependent diabetes What type of diabetes is non-insulin dependent

Insulin dependent diabetes mellitus

Diabetes- a syndrome, the main diagnostic feature of which is chronic hyperglycemia. Diabetes mellitus occurs in various diseases leading to insufficient secretion of insulin or a violation of its biological action.

Type 1 diabetes- an endocrine disease characterized by absolute insufficiency of insulin caused by the destruction of pancreatic beta cells. Type 1 diabetes can develop at any age, but most often it affects young people (children, adolescents, adults under 40 years of age. The clinical picture is dominated by classic symptoms: thirst, polyuria, weight loss, ketoacidotic states.

Etiology and pathogenesis

The pathogenetic mechanism of the development of type 1 diabetes is based on the insufficiency of insulin production by pancreatic endocrine cells (pancreatic β-cells), caused by their destruction under the influence of certain pathogenic factors (viral infection, stress, autoimmune diseases, etc.). Type 1 diabetes accounts for 10-15% of all cases of diabetes and, in most cases, develops during childhood or adolescence. This type of diabetes is characterized by the appearance of basic symptoms that progress rapidly over time. The main method of treatment is insulin injections, which normalize the metabolism of the patient's body. If left untreated, type 1 diabetes progresses rapidly and leads to severe complications such as ketoacidosis and diabetic coma, resulting in death of the patient.

Classification

1. According to the severity of the flow:
   1. easy current
   2. moderate severity
   3. severe course
2. According to the degree of compensation of carbohydrate metabolism:
   1. compensation phase
   2. subcompensation phase
   3. decompensation phase
3. For complications:
   1. Diabetic micro- and macroangiopathy
   2. Diabetic polyneuropathy
   3. diabetic arthropathy
   4. Diabetic ophthalmopathy, retinopathy
   5. diabetic nephropathy
   6. Diabetic encephalopathy

Pathogenesis and pathohistology

Insulin deficiency in the body develops due to its insufficient secretion by β-cells of the islets of Langerhans of the pancreas.

Due to insulin deficiency, insulin-dependent tissues (liver, adipose and muscle) lose their ability to utilize blood glucose and, as a result, blood glucose levels increase (hyperglycemia) - a cardinal diagnostic sign of diabetes mellitus. Due to insulin deficiency in adipose tissue, the breakdown of fats is stimulated, which leads to an increase in their level in the blood, and in muscle tissue, the breakdown of proteins is stimulated, which leads to an increased intake of amino acids into the blood. Substrates of catabolism of fats and proteins are transformed by the liver into ketone bodies, which are used by insulin-independent tissues (mainly the brain) to maintain energy balance against the background of insulin deficiency.

Glycosuria is an adaptive mechanism for removing elevated glucose from the blood when the glucose level exceeds the threshold value for the kidneys (about 10 mmol / l). Glucose is an osmoactive substance and an increase in its concentration in the urine stimulates increased excretion of water (polyuria), which can eventually lead to dehydration of the body if the loss of water is not compensated by adequate increased fluid intake (polydipsia). Along with the increased loss of water in the urine, mineral salts are also lost - a deficiency of sodium, potassium, calcium and magnesium cations, chloride anions, phosphate and bicarbonate develops.

There are 6 stages in the development of DM1. 1) Genetic predisposition to DM1 associated with the HLA system. 2) Hypothetical starting torque. Damage to β-cells by various diabetogenic factors and triggering of immune processes. In patients, the above listed antibodies are already detected in a small titer, but insulin secretion is not yet affected. 3) Active autoimmune insulinitis. The antibody titer is high, the number of β-cells decreases, insulin secretion decreases. 4) Decrease in glucose-stimulated secretion of I. In stressful situations, the patient can detect transient IGT (impaired glucose tolerance) and NGPN (impaired fasting plasma glucose). 5) Clinical manifestation of DM, including with a possible episode of "honeymoon". Insulin secretion is sharply reduced, as more than 90% of β-cells have died. 6) Complete destruction of β-cells, complete cessation of insulin secretion.

Clinic

• hyperglycemia. Symptoms due to high blood sugar levels: polyuria, polydipsia, weight loss with decreased appetite, dry mouth, weakness
• microangiopathy (diabetic retinopathy, neuropathy, nephropathy),
• macroangiopathy (atherosclerosis of the coronary arteries, aorta, GM vessels, lower extremities), diabetic foot syndrome
• concomitant pathology (furunculosis, colpitis, vaginitis, urinary tract infection)

Mild DM - compensated by diet, no complications (only with DM 2) Moderate DM - compensated by SSSP or insulin, diabetic vascular complications of 1-2 severity are detected. Severe DM - labile course, complications of the 3rd degree of severity (nephropathy, retinopathy, neuropathy).

Diagnostics

In clinical practice, sufficient criteria for the diagnosis of type 1 diabetes mellitus are the presence of typical symptoms of hyperglycemia (polyuria and polydipsia) and laboratory-confirmed hyperglycemia - glycemia in capillary blood on an empty stomach is more than 7.0 mmol / l and / or at any time of the day more than 11.1 mmol / l;

When establishing a diagnosis, the doctor acts according to the following algorithm.

1. Exclude diseases that are manifested by similar symptoms (thirst, polyuria, weight loss): diabetes insipidus, psychogenic polydipsia, hyperparathyroidism, chronic renal failure, etc. This stage ends with a laboratory statement of hyperglycemia syndrome.


2. The nosological form of DM is specified. First of all, diseases that are included in the group "Other specific types of diabetes" are excluded. And only then the issue of DM1 or DM2 is solved. The level of C-peptide is determined on an empty stomach and after exercise. The level of concentration in the blood of GAD-antibodies is also assessed.

Complications

• Ketoacidosis, hyperosmolar coma
• Hypoglycemic coma (in case of insulin overdose)
• Diabetic micro- and macroangiopathy - a violation of vascular permeability, an increase in their fragility, an increase in the tendency to thrombosis, to the development of vascular atherosclerosis;

• Diabetic polyneuropathy - polyneuritis of peripheral nerves, pain along the nerve trunks, paresis and paralysis;

• Diabetic arthropathy - joint pain, "crunching", limitation of mobility, a decrease in the amount of synovial fluid and an increase in its viscosity;

• Diabetic ophthalmopathy - early development of cataracts (clouding of the lens), retinopathy (retinal lesions);

• Diabetic nephropathy - kidney damage with the appearance of protein and blood cells in the urine, and in severe cases with the development of glomerulonephritis and renal failure;

• Diabetic encephalopathy - mental and mood changes, emotional lability or depression, symptoms of CNS intoxication.

Treatment

The main goals of treatment:

• Elimination of all clinical symptoms of diabetes
• Achieve optimal metabolic control for a long time.
• Prevention of acute and chronic complications of diabetes
• Ensuring a high quality of life for patients.

To achieve these goals, apply:

• diet
• dosed individual physical activity (DIFN)
• teaching patients self-control and the simplest methods of treatment (management of their disease)
• constant self-control

insulin therapy

Insulin therapy is based on the imitation of physiological insulin secretion, which includes:

• basal secretion (BS) of insulin
• stimulated (food) secretion of insulin

Basal secretion provides an optimal level of glycemia during the interdigestive period and during sleep, promotes the utilization of glucose that enters the body outside meals (gluconeogenesis, glycolysis). Its speed is 0.5-1 units / hour or 0.16-0.2-0.45 units per kg of actual body weight, that is, 12-24 units per day. With physical activity and hunger, BS decreases to 0.5 units / hour. Secretion of stimulated - food insulin corresponds to the level of postprandial glycemia. The level of CC depends on the level of carbohydrates eaten. Approximately 1-1.5 units are produced per 1 bread unit (XE). insulin. Insulin secretion is subject to diurnal fluctuations. In the early morning hours (4-5 o'clock) it is the highest. Depending on the time of day, 1 XE is secreted:

• for breakfast - 1.5-2.5 units. insulin
• for lunch 1.0-1.2 units. insulin
• for dinner 1.1-1.3 units. insulin

1 unit of insulin reduces blood sugar by 2.0 mmol / unit, and 1 XE increases it by 2.2 mmol / l. From the average daily dose (SSD) of insulin, the value of dietary insulin is approximately 50-60% (20-30 units), and basal insulin accounts for 40-50%.

Principles of insulin therapy (IT):

• the mean daily dose (MAD) of insulin should be close to physiological secretion
• when distributing insulin during the day, 2/3 of the SDS should be administered in the morning, afternoon and early evening and 1/3 in the late evening and at night
• using a combination of short-acting insulin (SDI) and long-acting insulin. Only this allows us to approximately simulate the daily secretion of I.

During the day, the ICD is distributed as follows: before breakfast - 35%, before lunch - 25%, before dinner - 30%, at night - 10% of the SDS insulin. If necessary, at 5-6 o'clock in the morning 4-6 units. ICD. It should not be administered in one injection> 14-16 units. In case it is necessary to administer a large dose, it is better to increase the number of injections by reducing the intervals of administration.

Correction of insulin doses according to the level of glycemia To correct the doses of the administered ICD, Forsh recommended that for every 0.28 mmol / l of blood sugar exceeding 8.25 mmol / l, an additional 1 unit of insulin should be administered. I. Therefore, for each "extra" 1 mmol / l of glucose, an additional 2-3 units are required. And

Correction of insulin doses for glucosuria The patient must be able to carry it out. During the day, between insulin injections, collect 4 portions of urine: 1 portion - between breakfast and lunch (previously, before breakfast, the patient must empty the bladder), 2 - between lunch and dinner, 2 - between dinner and 22 hours, 4 - from 22 hours until breakfast. Diuresis is taken into account in each serving, the % glucose content is determined and the amount of glucose in grams is calculated. If glucosuria is detected, to eliminate it, 1 unit is additionally administered for every 4-5 g of glucose. insulin. The next day after urine collection, the dose of insulin administered is increased. After achieving compensation or approaching it, the patient should be transferred to a combination of ICD and ISD.

Traditional insulin therapy (IT). Allows you to reduce the number of insulin injections to 1-2 times a day. With TIT, ISD and ICD are simultaneously administered 1 or 2 times a day. At the same time, the share of the ISD accounts for 2/3 of the SS, and the ICD - 1/3 of the SS. Advantages:

• ease of administration
• ease of understanding the essence of treatment by patients, their relatives, medical personnel
• no need for frequent glycemic control. It is enough to control glycemia 2-3 times a week, and if self-control is impossible - 1 time per week
• treatment can be carried out under the control of glucosuric profile

Flaws

• the need for strict adherence to a diet in accordance with the selected dose AND
• the need for strict adherence to the daily routine, sleep, rest, physical activity
• obligatory 5-6 meals a day, at a strictly defined time, tied to the introduction of AND
• inability to maintain glycemia within physiological fluctuations
• persistent hyperinsulinemia accompanying TIT increases the risk of developing hypokalemia, arterial hypertension, and atherosclerosis.

TIT shown

• older people if they cannot master the requirements of IIT
• persons with mental disorders, low educational level
• sick people in need of care
• unruly patients

Calculation of insulin doses for TIT 1. Pre-determine insulin SDS 2. Distribute insulin SDS by time of day: 2/3 before breakfast and 1/3 before dinner. Of these, the ICD should account for 30-40%, ISD - 60-70% of the SDS.

IIT (intensive IT) Basic principles of IIT:

• the need for basal insulin is provided by 2 injections of ISD, which is administered in the morning and evening (the same drugs are used as for TIT). The total dose of the ISD is not > 40-50% of the SDS, 2/3 of the total dose of the ISD is administered before breakfast, 1/3 before dinner.
• food - bolus secretion of insulin is simulated by the introduction of ICD. The necessary doses of ICD are calculated taking into account the amount of XE planned for breakfast, lunch and dinner and the level of glycemia before meals. IIT provides for mandatory glycemic control before each meal, 2 hours after meals and at night. That is, the patient should carry out glycemic control 7 times a day.

Advantages

• imitation of physiological secretion of I (basal stimulated)
• the possibility of a more free mode of life and daily routine for the patient
• the patient can use a "liberalized" diet by changing the time of meals, a set of products at will
• higher quality of life for the patient
• effective control of metabolic disorders, preventing the development of late complications
• the need to educate patients on the problem of diabetes, the issues of its compensation, the calculation of XE, the ability to select doses and develops motivation, understanding the need for good compensation, prevention of complications of diabetes.

Flaws

• the need for constant self-monitoring of glycemia, up to 7 times a day
• the need to educate patients in schools for patients with diabetes, change their lifestyle.
• additional costs for training and self-control tools
• tendency to hypoglycemia, especially in the first months of IIT

Mandatory conditions for the possibility of using IIT are:

• sufficient intelligence of the patient
• ability to learn and implement acquired skills in practice
• the possibility of acquiring self-control equipment

IIT is shown:

• with DM1 it is desirable for almost all patients, and for newly diagnosed DM it is mandatory
• during pregnancy - transfer to IIT for the entire period of pregnancy, if the patient was treated for TIT before pregnancy
• with gestational diabetes, in case of ineffective diet and DIF

Scheme of patient management when using IIT

• Daily calorie calculator
• Calculation of the amount of carbohydrates planned for consumption per day in XE, proteins and fats - in grams. Although the patient is on a “liberalized” diet, he should not eat more carbohydrates per day than the calculated dose in XE. Not recommended for 1 reception more than 8 XE
• Calculation of SDS I

The calculation of the total dose of basal I is carried out by any of the above methods - the calculation of the total food (stimulated) I is carried out based on the amount of XE that the patient plans to consume during the day

• Distribution of doses of administered And during the day.
• Self-monitoring of glycemia, correction of doses of food I.

More simple modified IIT techniques:

• 25% SDA I administered before dinner or at 22:00 in the form of IDD. The ADI (comprising 75% of the DS) is distributed as follows: 40% before breakfast, 30% before lunch, and 30% before dinner
• 30% SDS And administered in the form of IDD. Of these: 2/3 doses before breakfast, 1/3 before dinner. 70% SSc is administered as an ICD. Of these: 40% of the dose before breakfast, 30% before lunch, 30% before dinner or at night.

In the future - dose adjustment I.

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Features of type 2 diabetes mellitus insulin-dependent

Unlike other varieties of the disease, thirst does not torment. Often referred to as the effects of aging. Therefore, even weight loss is accepted as a positive result of diets. Endocrinologists note that the treatment of type 2 diabetes begins with diets. The therapist or gastroenterologist draws up a list of allowed foods, a nutrition schedule. For the first time there is a consultation on the preparation of the menu for each day. (See also: Insulin-dependent diabetes mellitus - useful information on the disease)

In insulin-dependent type 2 diabetes, you always lose weight. At the same time getting rid of fat deposits. This leads to an increase in insulin sensitivity. Insulin, produced by the pancreas, begins to process sugar. The latter rushes to the cells. As a result, there is a decrease in blood sucrose levels.

It is not always possible to regulate glucose levels with diet in type 2 diabetes. Therefore, during the consultation, the endocrinologist prescribes medication. It can be tablets, injections.

Insulin therapy for type 2 diabetes is seen in those who are obese. Even with such a strictly limited diet, it is not always possible to lose weight. This is due to the fact that the normalization of sugar indicators did not occur, and the insulin produced is simply not enough to reduce glucose. In such situations, it is important to ensure a decrease in blood levels and insulin injections are prescribed.

Developing, diabetes requires constant injections of a drug that lowers blood sucrose. In this case, the endocrinologist is obliged to indicate on the outpatient card - "Type 2 diabetes mellitus insulin-dependent." A distinctive feature of diabetics of this type from the first is the dosage for injection. There is nothing critical in this. After all, the pancreas continues to secrete a certain amount of insulin.

How to choose a doctor?

Life expectancy in insulin-dependent diabetes mellitus is difficult to determine. There is a situation when a diabetic ceases to trust the endocrinologist. He believes that insulin therapy was prescribed incorrectly and begins to rush around the clinics.

In other words, you decide to spend finances on obtaining the results of surveys, consulting services. And treatment options may vary. This race forgets the fact that insulin therapy for type 2 diabetes requires instant decisions. After all, with an uncontrolled disease, harm is done quickly and irreversibly. Therefore, before throwing around the offices of endocrinologists, one should decide on the qualifications of a doctor.

This type of diabetes occurs at the age of 40 years and older. In some cases, the development of insulin therapy is not required, because the pancreas secretes the required amount of insulin. These situations do not cause diabetic ketoacytosis. However, almost every diabetic has a second enemy, in addition to the disease - obesity.

Genetic predisposition to the disease

In insulin-dependent diabetes mellitus, life expectancy plays a big role. Genetics have a certain chance
cause of diabetes. After all, if a family has a risk of developing an insulin-independent disease, then the chances of children to stay healthy are reduced by 50% (if the father is ill) and only 35% if the mother is ill. Naturally, this reduces life spans.

Endocrinologists say that genes for non-insulin-dependent diabetes mellitus can be found. And at the same time to determine the causes of metabolic disorders. In other words, in medical practice, there are 2 types of genetic defects.

• Insulin resistance has a second, more common name, obesity.
• decrease in the secretory activity of beta cells / their insensitivity.

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The main types of diabetes

Diabetes mellitus (DM) is an autoimmune disease characterized by a complete or partial cessation of the production of a sugar-lowering hormone called insulin. Such a pathogenic process leads to the accumulation of glucose in the blood, which is considered an "energy material" for cellular and tissue structures. In turn, tissues and cells do not receive the necessary energy and begin to break down fats and proteins.

Insulin is the only hormone in our body that can regulate blood sugar levels. It is produced by beta cells located on the islets of Langerhans in the pancreas. However, in the human body there are a large number of other hormones that increase the concentration of glucose. These are, for example, adrenaline and norepinephrine, "command" hormones, glucocorticoids and others.

The development of DM is influenced by many factors, which will be discussed below. It is believed that the current lifestyle has a great influence on this pathology, since modern people are more likely to be obese and do not play sports.

The most common types of the disease are:

• type 1 insulin-dependent diabetes mellitus (IDDM);
• non-insulin-dependent diabetes mellitus type 2 (NIDDM);
• gestational diabetes.

Insulin-dependent type 1 diabetes mellitus (IDDM) is a pathology in which insulin production stops completely. Many scientists and doctors believe that the main reason for the development of type 1 IDDM is heredity. This disease requires constant monitoring and patience, since today there are no drugs that could completely cure the patient. Insulin injections are an integral part of the treatment of insulin-dependent diabetes mellitus.

Non-insulin-dependent type 2 diabetes mellitus (NIDDM) is characterized by impaired perception of target cells to sugar-lowering hormone. Unlike the first type, the pancreas continues to produce insulin, but the cells begin to react incorrectly to it. This type of disease usually affects people older than 40-45 years. Early diagnosis, diet therapy and physical activity can avoid drug treatment and insulin therapy.

Gestational diabetes develops during pregnancy. In the body of the expectant mother, hormonal changes occur, as a result of which glucose levels may increase.

With the right approach to therapy, the disease goes away after childbirth.

Causes of diabetes

Despite the colossal amount of research done, doctors and scientists cannot give an exact answer to the question of the cause of diabetes.

Exactly what makes the immune system work against the body itself remains a mystery.

However, the research and experiments carried out were not in vain.

With the help of research and experiments, it was possible to determine the main factors that increase the likelihood of developing insulin-dependent and non-insulin-dependent diabetes mellitus. These include:

1. Hormonal imbalance in adolescence associated with the action of growth hormone.
2. The gender of the person. It has been scientifically proven that the beautiful half of humanity is twice as likely to have diabetes.
3. Overweight. Extra pounds lead to the deposition of cholesterol on the vascular walls and to an increase in the concentration of sugar in the blood.
4. Genetics. If insulin-dependent or non-insulin-dependent diabetes mellitus is diagnosed in the mother and father, then the child will also manifest it in 60-70% of cases. Statistics show that twins simultaneously suffer from this pathology with a probability of 58-65%, and twins - 16-30%.
5. The color of a person's skin also affects the development of the disease, since diabetes is 30% more common in blacks.
6. Violation of the pancreas and liver (cirrhosis, hemochromatosis, etc.).
7. Inactive lifestyle, bad habits and malnutrition.
8. Pregnancy, during which there is a violation of the hormonal background.
9. Drug therapy with glucocorticoids, atypical antipsychotics, beta-blockers, thiazides and other drugs.

After analyzing the above, we can identify a risk factor in which a certain group of people are more susceptible to developing diabetes. It includes:

• overweight people;
• people with a genetic predisposition;
• patients suffering from acromegaly and Itsenko-Cushing's syndrome;
• patients with atherosclerosis, hypertension or angina pectoris;
• people suffering from cataracts;
• people prone to allergies (eczema, neurodermatitis);
• patients taking glucocorticoids;
• people who have had a heart attack, infectious diseases and stroke;
• women with pathological pregnancy;

The risk group also includes women who have given birth to a child weighing more than 4 kg.

How to recognize hyperglycemia?

The rapid increase in glucose concentration is a consequence of the development of "sweet disease". Insulin-dependent diabetes can not make itself felt for a long time, slowly destroying the vascular walls and nerve endings of almost all organs of the human body.

However, with insulin-dependent diabetes mellitus, a lot of signs are manifested. A person who is attentive to his health will be able to recognize the signals of the body, indicating hyperglycemia.

So, what are the symptoms of insulin-dependent diabetes mellitus? Among the two main ones, polyuria (frequent urination), as well as constant thirst, are distinguished. They are associated with the work of the kidneys, which filter our blood, ridding the body of harmful substances. Excess sugar is also a toxin, so it is excreted from the body with urine. The increased load on the kidneys leads to the fact that the paired organ begins to draw the missing fluid from the muscle tissue, causing such symptoms of insulin-dependent diabetes.

Frequent dizziness, migraines, fatigue and poor sleep are other signs that are characteristic of this disease. As mentioned earlier, with a lack of glucose, cells begin to break down fats and proteins to obtain the necessary energy supply. As a result of decomposition, toxic substances are formed, which are called ketone bodies. Cellular “starvation”, in addition to the toxic effects of ketones, affects the functioning of the brain. Thus, a diabetic patient does not sleep well at night, does not get enough sleep, cannot concentrate, as a result, he complains of dizziness and pain.

It is known that DM (forms 1 and 2) negatively affects nerves and vessel walls. As a result, nerve cells are destroyed, and the vascular walls become thinner. This entails a lot of consequences. The patient may complain of a deterioration in visual acuity, which is a consequence of inflammation of the retina of the eyeball, which is covered with vascular networks. In addition, numbness or tingling in the legs and arms are also signs of diabetes.

Among the symptoms of the “sweet disease”, disorders of the reproductive system, both men and women, deserve special attention. In the strong half, problems with erectile function begin, and in the weak, the menstrual cycle is disturbed.

Less common are symptoms such as delayed wound healing, skin rashes, high blood pressure, unreasonable hunger, and weight loss.

Consequences of the progression of diabetes

Undoubtedly, insulin-dependent and non-insulin-dependent diabetes, progressing, disables almost all systems of internal organs in the human body. This outcome can be avoided through early diagnosis and effective supportive treatment.

The most dangerous complication of non-insulin-dependent and insulin-dependent diabetes mellitus is diabetic coma. The condition is characterized by symptoms such as dizziness, bouts of vomiting and nausea, clouding of consciousness, fainting. In this case, urgent hospitalization is necessary for resuscitation.

Insulin-dependent or non-insulin-dependent diabetes mellitus with multiple complications is a consequence of a careless attitude to one's health. Manifestations of concomitant pathologies are associated with smoking, alcohol, a sedentary lifestyle, non-compliance with proper nutrition, late diagnosis and ineffective therapy. What are the complications associated with the progression of the disease?

The main complications of diabetes include:

1. Diabetic retinopathy is a condition in which the retina of the eyes is damaged. As a result, visual acuity decreases, a person cannot see a complete picture in front of him due to the appearance of various dark spots and other defects.
2. Periodontal disease is a pathology associated with inflammation of the gums due to impaired carbohydrate metabolism and blood circulation.
3. Diabetic foot is a group of diseases covering various pathologies of the lower extremities. Since the legs are the most distant part of the body during blood circulation, type 1 diabetes mellitus (insulin-dependent) causes the appearance of trophic ulcers. Over time, with the wrong response, gangrene develops. The only treatment is amputation of the lower limb.
4. Polyneuropathy is another disease associated with the sensitivity of the hands and feet. Insulin-dependent and non-insulin-dependent diabetes mellitus with neurological complications presents a lot of inconvenience to patients.
5. Erectile dysfunction that begins 15 years earlier in men than their non-diabetic peers. The chances of developing impotence are 20-85%, in addition, there is a high probability of childlessness among diabetics.

Additionally, diabetics have a decrease in the body's defenses and the frequent occurrence of colds.

Diagnosis of diabetes

Knowing that there are plenty of complications in this disease, patients seek help from their doctor. After examining the patient, the endocrinologist, suspecting an insulin-independent or insulin-dependent type of pathology, directs him for an analysis.

At the present time, there are many methods for diagnosing diabetes. The simplest and fastest is a blood test from a finger. The fence is carried out on an empty stomach in the morning. The day before the analysis, doctors do not recommend eating a lot of sweets, but you should not deny yourself food either. The normal value of sugar concentration in healthy people is the range from 3.9 to 5.5 mmol / l.

Another popular method is the glucose tolerance test. This analysis is carried out for two hours. Before the study, you can not eat anything. First, blood is taken from a vein, then the patient is offered to drink water diluted with sugar in a ratio of 3:1. Next, the health worker begins to take venous blood every half hour. The result obtained above 11.1 mmol / l indicates the development of insulin-dependent or non-insulin-dependent type of diabetes mellitus.

In rare cases, a glycated hemoglobin test is done. The essence of this study is to measure blood sugar levels for two to three months. Then the average results are displayed. Due to its long duration, the analysis has not gained much popularity, however, it provides an accurate picture for specialists.

Sometimes a urine test for sugar is prescribed in combination. A healthy person should not have glucose in urine, so its presence indicates diabetes mellitus of an insulin-independent or insulin-dependent form.

Based on the results of the tests, the doctor will decide on therapy.

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Insulin-independent diabetes mellitus

Type 2 disease is associated mainly with the inability of the body to adequately dispose of insulin. The content of glucose in the blood increases significantly, which negatively affects the condition and functioning of blood vessels and organs. Less often, the problem is associated with insufficient production of pancreatic hormone. Non-insulin-dependent type 2 diabetes is diagnosed in middle-aged and older patients. The disease is confirmed by the results of blood and urine tests, in which the glucose content is high. About 80% of patients are overweight.

Symptoms

Non-insulin-dependent type 2 diabetes develops sequentially, usually over several years. In this case, the patient may not notice the manifestations at all. More severe symptoms include:

Thirst can be both pronounced and barely perceptible. The same goes for frequent urination. Unfortunately, type 2 diabetes is often discovered incidentally. However, early diagnosis is essential for this disease. To do this, you need to regularly take a blood test for sugar levels.

Insulin-dependent diabetes is manifested by problems with the skin and mucous membranes. Usually this:

With a pronounced thirst, the patient can drink up to 3-5 liters per day. There are frequent nightly trips to the toilet.

With the further progression of diabetes, numbness and tingling appear in the limbs, the legs hurt when walking. In women, intractable candidiasis is observed. In the later stages of the disease develop:

The above severe symptoms in 20-30% of patients are the first obvious signs of diabetes. Therefore, it is extremely important to take tests annually to avoid such conditions.

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• 1. Target fasting and postprandial blood glucose levels and try to maintain them. These levels are planned strictly individually. a. For patients who recognize the approach of hypoglycemia well and in whom it quickly passes on its own or after taking glucose, it is possible to outline a fasting glucose level close to the level in healthy people (3.9-7.2 mmol / l). This category includes adult patients with a short duration of insulin-dependent diabetes mellitus and adolescents. b. Pregnant women should aim for even lower fasting glucose levels. in. Planned fasting glucose levels should be higher in those patients who do not feel the approach of hypoglycemia, as well as in cases where hypoglycemia requires medical treatment or is of particular danger (for example, in patients with coronary artery disease). G. Disciplined patients who frequently measure blood glucose levels and adjust insulin doses manage to maintain target glucose levels for 70-80% of the time of day.
• 2. It is necessary to imitate the physiological fluctuations in insulin levels as best as possible. In healthy people, beta cells continuously secrete small amounts of insulin and thus provide its basal level. After eating, the secretion of insulin increases. To create a basal insulin level close to normal in the patient's blood and simulate physiological fluctuations in insulin secretion, one of the following insulin therapy regimens is selected: a. Before each meal, short-acting insulin is administered, and to create a basal level of the hormone, medium-acting insulin is injected 1 time per day (before bedtime) or 2 times a day (before breakfast and at bedtime). b. Before each meal, short-acting insulin is administered; to create a basal level of the hormone, long-acting insulin is administered 1 or 2 times a day. in. Twice a day, short-acting and intermediate-acting insulin or a combined insulin preparation is administered simultaneously. d. Short-acting insulin and intermediate-acting insulin or a combined insulin preparation are administered simultaneously before breakfast. Short-acting insulin is given before dinner and intermediate-acting insulin is given at bedtime. e. A patient with a wearable insulin dispenser should increase the hormone supply before meals. Modern dispenser models equipped with blood glucose meters not only maintain basal insulin levels, but also automatically increase the hormone supply when glucose levels rise after a meal.
• 3. Maintain a balance between insulin doses, nutrition and physical activity. Patients or their relatives are given dietary tables developed by the American Diabetes Association. These tables list the carbohydrate content of different foods, their energy value and interchangeability. The doctor, together with the patient, develops an individual nutrition plan. In addition, the doctor explains how physical activity affects blood glucose levels.
• 4. Self-monitoring of blood glucose levels a. Every day, 4-5 times a day (before each meal and at bedtime), the patient measures the concentration of glucose in capillary blood from a finger using test strips or a glucometer. b. Once every 1-2 weeks, and whenever the dose of insulin administered at bedtime is changed, the patient measures the concentration of glucose between 2:00 and 4:00. With the same frequency determine the level of glucose after meals. in. Always measure the concentration of glucose when the precursors of hypoglycemia appear. d. The results of all measurements, all doses of insulin and subjective sensations (for example, signs of hypoglycemia) are recorded in a diary.
• 5. Self-correction of the insulin therapy regimen and diet, depending on the level of blood glucose and lifestyle. The doctor should give the patient a detailed plan of action, providing for as many situations as possible in which correction of the insulin regimen and diet may be required. a. Correction of the insulin therapy regimen includes changes in insulin doses, changes in the ratio of drugs of different duration of action, and changes in the time of injections. Reasons for adjusting insulin doses and insulin therapy regimens:
• 1) Steady changes in blood glucose levels at certain times of the day, identified by entries in the diary. For example, if your blood glucose levels tend to increase after breakfast, you can slightly increase the dose of short-acting insulin given before breakfast. Conversely, if glucose levels decrease between breakfast and lunch, and especially if signs of hypoglycemia appear at this time, the morning dose of short-acting insulin or the dose of intermediate-acting insulin should be reduced.
• 2) Increase or decrease in the average daily blood glucose level (accordingly, you can increase or decrease the total daily dose of insulin).
• 3) An upcoming additional meal (for example, if the patient goes to visit).
• 4) upcoming physical activity. 5) Long trip, strong feelings (going to school, divorce of parents, etc.).
• 6) Accompanying illnesses.
• 6. Education of patients. The doctor must teach the patient to act independently in any situation. The main questions that the doctor should discuss with the patient: a. Self-monitoring of blood glucose levels. b. Correction of the scheme of insulin therapy. in. Meal planning. G. Permissible physical activity. d. Recognition, prevention and treatment of hypoglycemia. e. Correction of treatment for concomitant diseases.
• 7. Close contact of the patient with the doctor or with the diabetic team. First, the doctor should as often as possible inquire about the patient's condition. Secondly, the patient should be able to contact a doctor or nurse at any time of the day and get advice on any issue related to his condition.
• 8. Motivation of the patient. The success of intensive insulin therapy largely depends on the discipline of the patient and his desire to fight the disease. Maintaining motivation requires a lot of effort from relatives and friends of the patient and medical staff. Often this task is the most difficult.
• 9. Psychological support. Patients with recently onset insulin-dependent diabetes mellitus and their relatives need psychological support. The patient and his relatives must get used to the thought of the disease and realize the inevitability and necessity of dealing with it. In the United States, special self-help groups are organized for this purpose.

ex-diabetic.com

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Description:

Type 2 diabetes mellitus is a chronic disease manifested by impaired carbohydrate metabolism with development due to insulin resistance and secretory dysfunction of beta cells, as well as lipid metabolism with development. Since complications of systemic atherosclerosis are the main cause of death and disability in patients, type 2 is sometimes called cardiovascular disease.

Symptoms:

In most cases, there are no significant clinical manifestations, and the diagnosis is established by routine determination of the level of glycemia. The disease usually manifests itself over the age of 40, while the vast majority of patients also have other components. Patients do not complain about a decrease in performance, if there are no other reasons for this. Complaints of thirst and polyuria rarely reach significant severity. Quite often, patients are concerned about skin and vaginal itching, and therefore they turn to dermatologists and gynecologists. Since it often takes many years from the actual manifestation of type 2 diabetes to the diagnosis (about 7 years on average), in many patients at the time of detection of the disease, the symptoms and manifestations of late complications of diabetes mellitus dominate in the clinical picture. Moreover, the first visit of a patient with type 2 diabetes to medical care is very often due to late complications. So, patients can be hospitalized in surgical hospitals with ulcerative lesions of the legs ( syndrome), contact ophthalmologists due to a progressive decrease in vision ( diabetic), be hospitalized with heart attacks, strokes, obliterating lesions of the vessels of the legs in institutions where hyperglycemia is first detected in them.

Causes of occurrence:

Type 2 diabetes mellitus is a multifactorial disease with a hereditary predisposition. Most patients with type 2 diabetes indicate the presence of type 2 diabetes in the next of kin; in the presence of type 2 diabetes in one of the parents, the probability of its development in the offspring throughout life is 40%. No one gene, the polymorphism of which determines the predisposition to type 2 diabetes mellitus, has been found. Of great importance in the implementation of a hereditary predisposition to type 2 diabetes is played by environmental factors, primarily lifestyle habits. Risk factors for developing type 2 diabetes are:

   1.obesity, especially visceral;
   2. ethnicity (especially when changing the traditional way of life to the western one);
   3. type 2 diabetes mellitus in the next of kin;
   4. sedentary lifestyle;
   5.features of the diet (high consumption of refined carbohydrates and low fiber content);
   6. arterial hypertension.

Treatment:

For treatment appoint:

The main components of the treatment of type 2 diabetes are: diet therapy, increased physical activity, hypoglycemic therapy, prevention and treatment of late complications of diabetes. Since most patients with type 2 diabetes are obese, the diet should be aimed at weight loss (hypocaloric) and the prevention of late complications, primarily macroangiopathy (atherosclerosis). A hypocaloric diet is necessary for all patients with excess body weight (BMI 25-29 kg/m2) or obesity (BMI> 30 kg/m2). In most cases, it should be recommended to reduce the daily caloric intake of food to 1000-1200 kcal for women and to 1200-1600 kcal for men. The recommended ratio of the main food components for type 2 diabetes is similar to that for type 1 diabetes (carbohydrates - 65%, proteins 10-35%, fats up to 25-35%). Alcohol consumption should be limited due to the fact that it is a significant source of additional calories, in addition, alcohol intake during therapy with sulfonylurea drugs and insulin can provoke the development.

Recommendations for increasing physical activity should be individualized. At the beginning, aerobic exercise (walking, swimming) of moderate intensity is recommended for 30-45 minutes 3-5 times a day (about 150 minutes a week). In the future, a gradual increase in physical activity is necessary, which significantly contributes to the reduction and normalization of body weight. In addition, physical activity helps to reduce insulin resistance and has a hypoglycemic effect.

Drugs for hypoglycemic therapy in type 2 diabetes mellitus can be divided into four main groups.

I. Drugs that help reduce insulin resistance (sensitizers)

This group includes metformin and thiazolidinediones. Metformin is the only biguanide drug currently in use. The main components of its mechanism of action are:

   1. Suppression of gluconeogenesis in the liver (decrease in glucose production by the liver), which leads to a decrease in fasting glycemia.
   2. Decreased insulin resistance (increased utilization of glucose by peripheral tissues, primarily muscles).
   3.Activation of anaerobic glycolysis and reduction of glucose absorption in the small intestine.
II. Drugs that act on the beta cell and increase insulin secretion.
III. Drugs that reduce the absorption of glucose in the intestine.
IV. Insulins and insulin analogues.

Despite the fact that patients with type II diabetes mellitus are prescribed insulin preparations, insulin-dependent diabetes is still considered to be type I disease. This is due to the fact that with this disease, the body stops producing its own insulin.

The pancreas of people diagnosed with insulin-dependent diabetes is practically devoid of cells that produce this protein hormone.

In type II diabetes, the pancreas produces too little insulin and the cells of the body do not have enough of this hormone to function normally. Often, proper exercise and a well-designed diet can normalize insulin production and tidy up the metabolism in type II diabetes.

If this is the case, these patients will not need insulin. For this reason, type I diabetes is also commonly referred to as insulin-dependent diabetes mellitus.

When a patient with type II diabetes has to be prescribed insulin, the disease is said to have entered an insulin-dependent phase. But, fortunately, this does not happen very often.

Type I diabetes mellitus develops very rapidly and usually occurs in childhood and adolescence. This is where another name for this type of diabetes comes from – “juvenile”. Full recovery is possible only with a pancreas transplant. But such an operation entails a lifelong intake of medications that suppress the immune system. This is necessary in order to prevent rejection of the pancreas.

Injection of insulin does not have such a strong negative effect on the body, and with proper insulin therapy, the life of a patient with type 1 diabetes is no different from the life of healthy people.

How to notice the first symptoms

When type 1 diabetes is just beginning to develop in a child or teenager, it can be difficult to identify right away.

1. If a child constantly asks for a drink in the summer heat, then most likely the parents will consider this natural.
2. Visual impairments and high fatigue of primary school students are often attributed to high school loads and the body's unaccustomed to them.
3. There is also an excuse for weight loss, they say, hormonal changes take place in the body of a teenager, fatigue again affects.

But all these signs can be the beginning of developing type I diabetes. And if the first symptoms went unnoticed, then the child may suddenly develop ketoacidosis. By its nature, ketoacidosis resembles poisoning: abdominal pain, nausea, and vomiting occur.

But with ketoacidosis, consciousness is confused and sleepy all the time, which is not the case with food poisoning. The smell of acetone from the mouth is the first sign of illness.

Ketoacidosis can also occur with type II diabetes, but in this case, the patient's relatives already know what it is and how to behave. But the ketoacidosis that appeared for the first time is always unexpected, and this is why it is very dangerous.

Meaning and principles of insulin treatment

The principles of insulin therapy are very simple. After a healthy person has taken food, his pancreas releases the required dose of insulin into the blood, glucose is absorbed by the cells, and its level decreases.

In people with type I and type II diabetes, for various reasons, this mechanism is impaired, so it has to be mimicked manually. To correctly calculate the required dose of insulin, you need to know how much and with what products the body receives carbohydrates and how much insulin is required for their processing.

The amount of carbohydrates in food does not affect its calorie content, so it makes sense to count calories, unless type I and II diabetes is accompanied by overweight.

Type 1 diabetes does not always require a diet, which is not the case with insulin-dependent type 2 diabetes. That's why every type I diabetic needs to measure their blood sugar levels and correctly calculate their insulin doses.

People with type II diabetes who do not use insulin injections should also keep a self-monitoring diary. The longer and more accurate the record is kept, the easier it is for the patient to take into account all the details of his disease.

The diary will provide invaluable assistance in controlling nutrition and lifestyle. In this case, the patient will not miss the moment when type II diabetes turns into an insulin-dependent form of type I.

"Bread unit" - what is it

Diabetes I and II require constant counting of the amount of carbohydrates consumed by the patient with food.

In type I diabetes, this is necessary in order to correctly calculate the dose of insulin. And in type II diabetes - in order to control medical and dietary nutrition. When calculating, only those carbohydrates are taken into account that affect the level of glucose and the presence of which forces the administration of insulin.

Some of them, such as sugar, are absorbed quickly, others - potatoes and cereals, are absorbed much more slowly. To facilitate their calculation, a conditional value, called a "bread unit" (XE), was adopted, and a peculiar one simplifies the life of patients.

One XE is equal to approximately 10-12 grams of carbohydrates. This is exactly as much as is contained in a 1 cm thick piece of white or black “brick” bread. It does not matter which foods are measured, the amount of carbohydrates will be the same:

• in one tablespoon of starch or flour;
• in two tablespoons of ready-made buckwheat porridge;
• in seven tablespoons of lentils or peas;
• in one medium potato.

Those suffering from type I diabetes and severe type II diabetes should always remember that liquid and boiled foods are absorbed faster, which means that they increase blood glucose levels more than solid and thick foods.

Therefore, when going to eat, the patient is recommended to measure sugar. If it is below the norm, then you can eat semolina porridge for breakfast, but if the sugar level is above the norm, then it is better to have scrambled eggs for breakfast.

On average, one XE requires from 1.5 to 4 units of insulin. True, in the morning it needs more, and in the evening - less. In winter, the dosage increases, and with the onset of summer, it decreases. Between two meals, a type I diabetic can eat one apple, which is equal to 1 XE. If a person controls blood sugar levels, then he will not need an additional injection.

Which insulin is best

In diabetes mellitus I and II, 3 types of pancreatic hormones are used:

1. human;
2. pork;
3. bullish.

It is impossible to say exactly which one is better. The effectiveness of insulin treatment does not depend on the origin of the hormone, but on its correct dosage. But there is a group of patients who are prescribed only human insulin:

1. pregnant women;
2. children with type I diabetes for the first time;
3. people with complicated diabetes.

Insulins are divided into short-acting, intermediate-acting and long-acting insulins according to their duration of action.

Short insulins:

• Actropid;
• Insulrap;
• Iletin P Homorap;

Any of them begins to work 15-30 minutes after the injection, and the duration of the injection is 4-6 hours. The drug is administered before each meal and between them if the sugar level rises above normal. People with type 1 diabetes should always have doses of additional injections with them.

Intermediate acting insulins

• Semilente MS and NM;
• Semilong.

They turn on their activity 1.5 - 2 hours after the injection, and the peak of their action occurs after 4-5 hours. They are convenient for those patients who do not have time or do not want to have breakfast at home, but do it at work, but are embarrassed to administer the drug in front of everyone.

You just need to take into account that if you do not take food on time, then the sugar level can drop sharply, and if there are more than carbohydrates in the diet, you will have to use additional injections.

Therefore, this group of insulins is acceptable only for those who, eating out, know exactly what time they will eat and how much carbohydrates will be in it.

Long acting insulins

1. Monotard MS and NM;
2. Protafan;
3. Iletin PN;
4. Homofan;
5. Humulin N;
6. Tape.

Their action begins 3-4 hours after injection. For some time, their level in the blood remains unchanged, and the duration of action is 14-16 hours. In type I diabetes, these insulins are injected twice a day.

Where and when do insulin injections

Compensation for type I diabetes is carried out by combining insulins of various durations. The advantages of such schemes are that with their help you can most closely simulate the work of the pancreas, plus you need to know

Our body consumes a large amount of energy every day, obtained from the glucose contained in food.

To absorb this glucose, we need heparin, which is produced by beta cells in the pancreas.

Heparin is the “key” by which glucose enters the cells as intended.

Diabetes is manifested as a result of improper functioning of the pancreas or with insufficient response of cells to the produced insulin. This results in an increased level of glucose in the blood over a long period of time. The cause of the disease is not fully understood and many experts believe that it has a genetic basis and can be inherited.

Other factors that influence the development of diabetes include:

• viral infections;
• autoimmune diseases;
• liver pathology;
• prolonged depression and stress, bad habits.

The beginning of the development of insulin-dependent and non-insulin-dependent diabetes mellitus has classic symptoms.

These include:

• constant;
• weight loss and muscle mass loss with increased nutrition;
• and large amounts of urine;
• fatigue and weakness;

When observing these symptoms, you should consult a doctor to find out the cause of its occurrence.

Insulin-dependent diabetes mellitus (IDDM) can also be called a disease of the young. The risk group is mainly children and adolescents, although adults can also get sick with it. Their immunity destroys the beta cells, mistaking them for foreign bodies. As a result, insulin production is significantly reduced or completely stopped. Glucose does not enter the cells and remains in the bloodstream.

Insulin-dependent diabetes mellitus differs from non-insulin-dependent diabetes mellitus in its rapid onset and more severe symptoms.

In childhood, bedwetting is often a symptom of insulin-dependent diabetes mellitus. Fatigue and weakness, blurred vision are sometimes confused with study fatigue and signs of hormonal changes in a growing body. Additional signs of insulin-dependent diabetes mellitus are dry skin, rapid breathing, drowsiness, vomiting, and abdominal pain.

Non-insulin-dependent type 2 diabetes is more common in adults and is predominantly influenced by genetics and lifestyle. The risk group includes people who are overweight, leading a sedentary lifestyle, prone to bad habits. They develop insensitivity to insulin, against the background of its reduced secretion.

The onset of non-insulin-dependent diabetes mellitus can proceed almost imperceptibly and be detected at the next appointment with a doctor.

Features of insulin-dependent diabetes

Insulin-dependent diabetes mellitus is observed infrequently and is considered the most complex form of this disease. They suffer from no more than 10% of all diabetic patients.

Because of the unpredictable and sudden spikes in sugar that appear for no particular reason, it is called “brittle diabetes”. It is often accompanied by low blood sugar and ketosis. Ketosis is a state of the body that is characteristic of adaptation to hunger and occurs when cells do not receive glucose and switch to fats as a source of energy.

The treatment of diabetes mellitus is aimed at regulating and maintaining its indicators at a normal level, while not allowing it to decrease significantly. , diet, exercise, a healthy lifestyle give a good lasting result and allow diabetics to live a full life.

In insulin-dependent diabetes, insulin injections are vital, given subcutaneously or with an insulin pump. When calculating the dosage of insulin, you need to take into account the level of glucose in the blood, the amount of food consumed, physical activity.

Sometimes insulin treatment leads to hypoglycemia (low blood sugar). This is the result of a discrepancy between the selected dose of insulin, food and exercise.

In this condition, there is a strong sweating, acute hunger, trembling, fainting. In this case, eating and drinking sugar-containing drinks will help raise the sugar and improve well-being.

An important point in the treatment of insulin-dependent diabetes is diet. It helps to improve the symptoms of the disease and avoid complications. In insulin-dependent type 1 diabetes, it is recommended to follow a low-carbohydrate diet, in which carbohydrate intake is limited to a quarter or less of the total meal.

To effectively treat diabetes at home, experts advise Dialife. This is a unique tool:

• Normalizes blood glucose levels
• Regulates pancreatic function
• Remove puffiness, regulate water exchange
• Improves eyesight
• Suitable for adults and children
• Has no contraindications

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Vegetables are allowed, with the exception of potatoes, which are limited. Many fruits contain sugar, so it is preferable to choose sweet and sour. It is recommended to exclude fried, smoked foods, canned food containing sugar from the diet. It is better to break the meal into 5-6 times in small portions after the same period of time.

Products suitable for :

• porridge - mostly boiled in water;
• low-fat dairy and sour-milk products;
• dietary varieties of poultry and veal meat, low-fat varieties of fish (cod, flounder, pollock);
• light soups on vegetable, fish broth;
• most vegetables (cabbage, tomatoes, cucumbers, peppers) and greens;
• bread with bran, grain, wheat-rye.

In non-insulin dependent diabetes mellitus, with concomitant overweight, the diet will help keep sugar under control and achieve significant weight loss. Non-insulin dependent diabetes mellitus is treated with antidiabetic drugs, sometimes in combination with insulin.

With any form of diabetes, a person is at risk of developing diabetes, no matter what type of diabetes.

They can develop over many years and take a chronic form, as well as become symptoms in as yet undiagnosed diabetics.

The disease is accompanied by damage to blood vessels, which increases the likelihood of cardiovascular disease, peripheral artery disease and stroke. Damage to the small vessels in the retina causes cataracts, glaucoma, and vision loss. Diabetes can lead to chronic kidney disease. Patients often have a weakened immune system and are prone to viral and infectious diseases.

Poorly controlled blood sugar can cause acute complications, some of which are medical emergencies.

Hypoglycemia develops as a result of an extreme decrease in sugar. Incorrectly selected physical activity or food can cause this disease. Characteristic signs for this condition are weakness, increased sweating, dizziness, agitation, in extreme cases, convulsions, coma may appear. You can stop the development of symptoms with the help of sweet drinks and food.

Hyperglycemia is a disease associated with an increase in the amount of glucose in the blood. The increased sugar content leads to the loss of water from the cells. If this loss is not replenished, the patient will become dehydrated. In the presence of this disease, a person needs qualified medical care.

Against the background of diabetes, the patient may develop. In a state of lack of sugar, the cells begin to break down fats. This lowers the acidity of the blood, dehydration, confusion, abdominal pain, acetone breath odor occurs.

It is the result of severe hypoglycemia or hyperglycemia combined with dehydration, shock, and exhaustion. In this condition, a person needs urgent medical attention.

Insulin dependence brings changes in lifestyle and measures must be taken to prevent complications. So far, there is no way to avoid this disease. But it is possible to alleviate the course of the disease.

Prevention requires good nutrition and physical activity to maintain optimal blood glucose levels. Taking into account the high risk of developing cardiovascular complications, it is important to monitor the pressure and give up bad habits, avoid stress.

In the conditions of urbanization, population aging, there is a growing body of evidence on the relationship of the main risk factors (obesity, physical inactivity, fast food, smoking) with an increase in the incidence of non-insulin-dependent diabetes mellitus. It can be delayed or even prevented by maintaining a normal body weight, exercising and eating healthy.

Physical activity for 2 hours a day reduces the risk of developing non-insulin-dependent diabetes by 28%. Active participation of the patient in treatment improves the prognosis of later life. Quitting smoking, lowering cholesterol, controlling weight and blood pressure prolong life for many years.

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Insulin-dependent type 1 diabetes is a dangerous endocrine disease of a chronic nature. It is caused by a deficiency in the synthesis of the pancreatic hormone.

As a result, the presence of glucose in the blood increases. Among all cases of the ailment in question, this type is not so common.

As a rule, it is diagnosed in people of young and young age. At the moment, the exact cause of this disease is unknown. But, at the same time, there are several specific factors that contribute to its development.

These include genetic predisposition, viral infectious diseases, exposure to toxins, and an autoimmune response of cellular immunity. The main pathogenetic link of this dangerous and serious disease of the first type is the death of approximately 91% of pancreatic β-cells.

Subsequently, a disease develops, which is characterized by insufficient production of insulin. So what is insulin-dependent diabetes, and what leads to?

Insulin dependent diabetes mellitus: what is it?

This form of the disease is approximately 9% of the incidence, which is associated with an increase in glucose in the blood plasma.

However, the total number of diabetics is increasing every year. It is this variety that is considered the most difficult to leak and is often diagnosed in people at an early age.

So what should every person know about insulin-dependent diabetes mellitus in order to prevent its development? First you need to understand the terms. Diabetes mellitus is a disease of autoimmune origin, which is characterized by the complete or partial cessation of the production of a pancreatic hormone called insulin.

This dangerous and fatal process subsequently leads to an undesirable accumulation of sugar in the blood, which is considered the so-called “energy raw material” necessary for the smooth operation of many cellular and muscle structures. In turn, they cannot receive the vital energy they need and begin to break down the available reserves of protein and fat for this.

Insulin production

It is insulin that is considered the only hormone of its kind in the human body that has the ability to regulate. It is produced by certain cells located on the islets of Langerhans of the pancreas.

But, unfortunately, in the body of each person there is a huge number of other hormones that have the ability to increase sugar content. For example, they include adrenaline and norepinephrine.

The subsequent appearance of this endocrine disease is influenced by many factors, which can be found later in the article. It is believed that the present lifestyle has a tremendous impact on this disease. This is due to the fact that people of the modern generation are increasingly suffering from the presence and do not want to lead.

The most popular types of the disease are the following:

• type 1 insulin dependent diabetes;
• non-insulin dependent type 2;

The first form of the disease is considered a dangerous pathology, in the presence of which the production of insulin almost completely stops. A large number of modern scientists believe that the hereditary factor is considered the main reason for the development of this type of disease.

The disease requires constant scrupulous control and remarkable patience, because at the moment there are no drugs that could completely cure the patient.

Treatment

As for effective therapy, there are two main tasks: a radical change in the current lifestyle and competent treatment with the help of certain medicines.

It is very important to constantly follow a special diet, which implies.

Don't forget about sufficient physical activity and self-control. An important step is individual selection.

Any additional sports activities and meals must be taken into account when calculating the amount of insulin administered.

There is a simple regimen of insulin therapy, continuous subcutaneous infusion of pancreatic hormone, and multiple subcutaneous injections.

The consequences of the progression of the disease

In the course of subsequent development, the disease has a strong negative impact on all body systems.

This irreversible process can be avoided through timely diagnosis. It is also important to provide special supportive care.

The most devastating complication is.

This condition is characterized by symptoms such as dizziness, bouts of vomiting and nausea, and fainting.

An additional complication in people with diabetes is a decrease in the protective functions of the body. It is for this reason that they often have colds.

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Type 1 diabetes is not a death sentence. The most important thing is to know everything about this disease. This is what will help to be armed and timely detect any changes in the performance of your own body. When the first alarming symptoms appear, you should immediately contact a qualified endocrinologist for examination, examination and appropriate treatment.