Currently, metabolic diseases are a huge problem ( metabolic diseases), including diabetes mellitus. Diabetes is very serious pathology which can lead to disability. Because of this, diagnostics, including early diagnosis, and control over the course of this severe and formidable disease are invaluable.
What is diabetes mellitus?
In general, under the term diabetes Currently, they mean a whole group of metabolic diseases (metabolic diseases), which are characterized by a common feature - an increased level of glucose in the blood, which is caused by impaired insulin secretion, insulin action, or both of these factors in combination. Elevated blood glucose ( hyperglycemia) is the value of this indicator, exceeding 6 mmol / l. Normally, the concentration of blood glucose should be in the range of 3.5 - 5.5 mmol / l. When a patient with diabetes mellitus is admitted to the hospital, it is necessary to determine the concentration of glucose in the blood and urine. In severe diabetes mellitus, the level of ketone bodies in the urine is also determined.When does pathological and physiological hyperglycemia occur?
However, hyperglycemia does not necessarily mean the presence of diabetes. Distinguish physiological hyperglycemia and pathological. Physiological hyperglycemia includes:
- alimentary, that is, developing after eating
- neurogenic, that is, developing as a result of stressful influences
Insulin - what does it consist of and where is it formed, what are the functions of insulin?
The concept of proinsulin and C-peptide. Where and how is insulin formed?
Let's get back to the issue of diabetes. So, the main syndrome of diabetes mellitus - hyperglycemia, is caused by disturbances in the action of insulin. What is insulin? Insulin is a protein consisting of 51 amino acids, which is synthesized in the pancreas. The pancreas synthesizes it as proinsulin, which consists of 74 amino acids. The 23 amino acid portion of proinsulin is called C-peptide.After the formation of proinsulin in the pancreas, the C-peptide is cleaved and the insulin molecule is formed, consisting of two chains - A and B. Further, insulin and C-peptide in equal amounts enter the portal vein of the liver. In the liver, about 50-60% of the incoming insulin undergoes utilization. And the liver secretes insulin into the blood, depending on the needs of the body (from the level of glucose in the blood).
In the blood, insulin and its precursors are bound to plasma proteins. A significant amount of insulin is also adsorbed on the surface of erythrocytes. At the same time, it is not known whether insulin binds to receptors on the surface of erythrocytes or simply sorbs to the cell surface. With the introduction of insulin into the body from the outside, the number of antibodies circulating in the blood - immunoglobulins - decreases. This fact is due to the fact that insulin binds to antibodies and disables them.
Functions of insulin in the human body
Why is insulin so important? What functions does it perform in the human body? So, consider the effect of insulin on metabolism in the body:
- the only one a hormone that lowers blood sugar levels
- affects protein and fat metabolism, nucleic acid metabolism, that is, it affects adipose tissue, liver and muscles
- stimulates the synthesis of glycogen (a storage form of glucose) and fatty acids in the liver
- stimulates the synthesis of glycerol in adipose tissue
- stimulates the absorption of amino acids and, as a result, the synthesis of protein and glycogen in muscles
- inhibits the breakdown of glycogen and the synthesis of glucose from the internal reserves of the body
- inhibits the formation of ketone bodies
- inhibits the breakdown of lipids
- inhibits the breakdown of proteins in muscles
Since insulin is the only hormone that lowers blood glucose levels, its activity and quantity are very important for the normal functioning of the body. Insulin lowers blood glucose levels by redistributing glucose into cells from the bloodstream. And in cells, glucose is used for the needs of the cell itself.
Types of Diabetes
So, based on the above, main cause of diabetes Relative or absolute deficiency of insulin. Consider what types of diabetes can occur. We present the classification of diabetes mellitus by the World Health Organization, which was adopted in 1999.| type of diabetes | Characteristics of the type of diabetes |
| Type 1 diabetes | Destruction of pancreatic cells, which usually results in absolute insulin deficiency |
| Type 2 diabetes | The presence of predominant resistance (insensitivity) to insulin and, as a result, relative insulin deficiency. There may also be defects in insulin production. |
| Gestational | This type of diabetes occurs during pregnancy. |
| Endocrinopathy (diseases of the glands internal secretion) | |
| Diabetes mellitus caused by exposure to various medicines or chemicals | |
| Diabetes caused by infectious diseases | |
| Unusual forms of immune-mediated diabetes mellitus | |
| Other genetic syndromes associated with diabetes | |
The most common type of diabetes mellitus in the population is type 1 or type 2. These types of diabetes are common features - high level blood glucose, as well as the same clinical symptoms.
Symptoms of diabetes, comparison of different types of diabetes, complications of diabetes
Clinical symptoms of diabetes
So, consider the same type of manifestations of all types of diabetes: - polydipsia (intense thirst)
- polyuria (frequent and profuse urination)
- weight loss
- visual impairment
Comparative characteristics of diabetes mellitus types 1 and 2.
Due to the fact that type 1 and type 2 diabetes are the most common among the population, we believe it is logical to compare the clinical symptoms of these two types of diabetes mellitus. So let's consider comparative characteristic clinical signs of diabetes mellitus types 1 and 2.
| Clinical signs | Type 1 diabetes | Type 2 diabetes |
| Prevalence | 10-20% | 80-90% |
| age of onset | up to 25 years (youth) | over 35 years old |
| onset of illness | acute | slow |
| body mass | reduced or normal | increased in 80% of patients |
| sensitivity to insulin preparations | high | Low |
| insulin content | ||
| C-peptide content | lowered or not determined | normal or slightly enlarged |
| proinsulin content | increases | does not change |
As we can see from the data in the table, type 1 diabetes is caused by absolute insufficiency insulin, that is, its content in the blood is reduced or absent altogether. In type 2 diabetes, on the other hand, relative lack of insulin, since the amount of this hormone in the blood is normal or even increased. However, insulin, which is present in the blood in enough does not perform its functions. Such a phenomenon is called insulin resistance i.e. insulin insensitivity.
A complication of diabetes is the metabolic syndrome. What does the metabolic syndrome include and the cause of its development?
With all types of diabetes develops, the so-called metabolic syndrome This syndrome develops as a result of the harmful effects of excess glucose in the blood. Glucose damages the walls of blood vessels, blood cells, blood proteins, etc. As a result, all these physiological structures and biologically active substances cannot perform their functions normally, which leads to the development various pathologies. The combination of such pathological changes is called the metabolic syndrome. Metabolic syndrome includes the following pathologies - arterial hypertension ( hypertension), coronary heart disease (CHD), violation of the concentration of blood protein and protein fractions (dysproteinemia), as well as obesity.In the presence of type 1 diabetes mellitus, metabolic complications develop during the first 5 years from the onset of the disease, after 10-15 years, as a rule, chronic renal failure develops. With a duration of type 1 diabetes mellitus for more than 20 years, various cardiovascular disorders develop ( trophic ulcers, gangrene, etc.). For type 2 diabetes ischemic disease heart disease (IHD) is observed in 50% of patients, stroke - in 15%, and chronic renal failure - in 8% of patients.
Diagnosis of diabetes mellitus - glucose concentration and glucose tolerance test
Determination of the concentration of glucose in the blood
How can diabetes be diagnosed? What criteria allow you to accurately recognize this formidable disease? Let's move on to the consideration of diagnostic criteria for diabetes mellitus. The most important and accurate among the criteria for diabetes mellitus is the determination of the concentration of glucose in the blood ( glycemia). A glucose tolerance test (GTT) is also performed. The determination of the concentration of glucose in the blood is carried out in the morning, on an empty stomach, after fasting for 8-10 hours. Do not drink tea or other sugary drinks before taking the test. Blood is taken from a vein or from a finger.
Carrying out a glucose tolerance test - how is it done? Norms of glucose tolerance test
A glucose tolerance test is performed in case of doubtful glycemia values to clarify the diagnosis. The glucose tolerance test is a determination of the concentration of glucose in the blood on an empty stomach and two hours after a glucose load. A glucose tolerance test is not performed if the fasting blood glucose level is above 6.1 mmol/L. The glucose load for children and adults is different. For adults, 75 g of glucose is dissolved in 300 ml of water, and drink this solution for 3-5 minutes. For children, 1.75 g of glucose per 1 kg of the child's weight (but not more than 75 g) is dissolved in 300 ml of water. The solution must also be drunk within 3-5 minutes. When conducting a glucose tolerance test, the following steps are performed:- on an empty stomach, blood is taken from a finger or a vein and the level of blood glucose is determined
- give glucose solution to drink
- 2 hours after taking the glucose solution, blood is again taken from a finger or vein and the concentration of blood glucose is determined
When not to test the concentration of glucose
The study of glycemia is not carried out against the background acute diseases, myocardial infarction, trauma or surgery, and cirrhosis of the liver. Also, the level of blood glucose is not determined against the background of short-term use of drugs that increase blood glucose levels. These drugs include glucocorticoids, thyroid hormones, adrenoblockers.
Levels of impaired carbohydrate metabolism - impaired fasting glucose, impaired glucose tolerance and diabetes mellitus.
Classification of carbohydrate metabolism disorders depending on fasting glucose concentration and glucose tolerance testFurther, depending on the values of the concentration of glucose in the blood and the glucose tolerance test, the level of disturbance of carbohydrate metabolism is determined. To date, there are three such levels of carbohydrate metabolism disorders:
- fasting glucose disorder (FGD)
- impaired glucose tolerance (IGT)
- diabetes mellitus (DM)
What characterizes impaired fasting glucose (what are the concentrations of glucose and glucose tolerance test)?
In this way, fasting glucose disorder detects an increased concentration of glucose in the blood on an empty stomach. However, insulin still has sufficient activity to cope with the incoming glucose and, two hours after the load of glucose, bring the concentration of sugar in the blood to normal values.
What characterizes impaired glucose tolerance (what are the concentrations of glucose and glucose tolerance test)?
The next and more serious level of carbohydrate metabolism disorder is impaired glucose tolerance. With this pathology, the fasting glucose level can be normal or slightly increased - up to 7.0 mmol / l. However, two hours after the glucose load, the blood sugar concentration is elevated. This means that the insulin present in the blood cannot cope with the incoming glucose. That is, insulin cannot perform its function at a normal rate, as a result of which the rate of glucose uptake decreases, and the high concentration of glucose in the blood lasts for a long time. The low "performance" of insulin may be due to an insufficient amount of it in the blood or insulin resistance with a sufficient amount of the hormone.
What characterizes diabetes mellitus (what are the concentrations of glucose and glucose tolerance test)?
Finally, carbohydrate metabolism disorders can reach the very last level. - diabetes. Diabetes mellitus is deep violation carbohydrate metabolism, in which both fasting glucose and glucose tolerance are impaired. The fasting glucose concentration exceeds 7.0 mmol/l, and the blood sugar concentration two hours after the glucose load is more than 11 mmol/l.
Early diagnosis of diabetes mellitus (prediabetes) and differential diagnosis of type 1 and type 2 diabetes.
Diagnosis of prediabetes - determination of antibodies to pancreatic β-cells. How early can prediabetes be diagnosed?
In connection with this complexity and severity of the disease, the question arises: is it possible to detect diabetes as early as possible? To date, there are a number of tests that can detect a tendency to develop diabetes. So, the early diagnosis of diabetes mellitus is based on the detection of antibodies to pancreatic β-cells. What does it mean? It is in the β-cells of the pancreas that insulin is produced. And the presence of antibodies to these pancreatic β-cells means that the antibodies are slowly destroying the pancreatic β-cells. Eventually, there are very few or no pancreatic β-cells left, and no insulin is produced in the body. Unfortunately, by the time the clinical signs of diabetes appear - increased concentration blood glucose, in 80% of patients, pancreatic β-cells have already died. This factor makes treatment very difficult. Antibodies to pancreatic β-cells are detected 8-10 years before the onset of clinical signs of the disease. If such antibodies are detected, then a diagnosis is made. prediabetes. During this period, treatment is carried out aimed at the destruction of antibodies to pancreatic β-cells, which is successful. In this case, diabetes does not develop. By the time the clinical symptoms of diabetes mellitus manifest, antibodies to pancreatic β-cells disappear. Determination of C-peptide and proinsulin concentrations to distinguish between type 1 and type 2 diabetes mellitus. What indicators are increased or decreased in type 1 or 2 diabetes
To distinguish between type 1 and type 2 diabetes, the determination of the concentration of C-peptide and proinsulin is used. Determination of the concentration of these substances is carried out using enzyme immunoassay. In type 1 diabetes, the concentration of proinsulin in the blood is increased. The definition of this indicator in obese people is especially informative. And the concentration of C-peptide in type 1 diabetes, on the contrary, is reduced. In type 2 diabetes, on the contrary, the concentration of C-peptide is normal or slightly increased. In general, the concentration of C-peptide makes it possible to assess the potential of the pancreas.
Compensation for diabetes. Determination of glycated hemoglobin and fructosamine concentrations
Criteria for assessing the compensation of diabetes mellitus - fructosamine and glycated hemoglobinIn the treatment of diabetes mellitus, the focus is on the degree of compensation for diabetes mellitus. Because when diabetes is compensated, the development of complications of diabetes, including metabolic syndrome, occurs very slowly. When saving normal concentrations blood glucose in type 1 diabetes mellitus, there are no visual impairment and chronic renal failure. And with type 2 diabetes, the risk of developing myocardial infarction is sharply reduced. The criteria for assessing the degree of compensation for diabetes mellitus are concentrations glycated (glycosylated) hemoglobin and fructosamine in blood.
Diabetes mellitus develops chronic hyperglycemia(high concentration of sugar in the blood), which leads to stimulation of the binding of glucose to various substances circulating in the blood. Such phenomena of the chemical activity of glucose lead to the development of pathologies of the eyes and kidneys.
Formation of glycated hemoglobin
One of the chemical activity products of glucose is glycated hemoglobin. Glycated hemoglobin is formed in red blood cells by the binding of a hemoglobin molecule and glucose. Glycated hemoglobin is associated with hyperglycemia for 4 months. This period - 4 months - is due to the life of the erythrocyte (120 days). That is, if by the end of life hemoglobin turned out to be glycosylated, this means that within 4 months there were high concentrations of glucose in the blood. Determination of the concentration of glycated hemoglobin is used to assess the severity of the disease, the effectiveness of the treatment, as well as the degree of compensation for diabetes.Norms and methods for determining glycated hemoglobin
The concentration of glycosylated hemoglobin is determined by ion exchange chromatography or immunochemical method. At the same time, the content of glycosylated hemoglobin in healthy people using the ion-exchange chromatography method is 4.5-7.5% of the total hemoglobin. And when using the immunochemical method - glycated hemoglobin in healthy people, no more than 4.5-5.7% is found.Stages of compensation, subcompensation and decompensation of diabetes mellitus and levels of glycated hemoglobin at these stages
The level of glycated hemoglobin with normal compensation in patients with diabetes mellitus is 6-9%, the level of glycated hemoglobin over 9% indicates decompensation of diabetes mellitus. What does decompensated diabetes mean? This means that it is not possible to support in any way normal level blood glucose. The development of decompensation is facilitated by errors in the diet, irregular use of antidiabetic drugs (if any are indicated). Let us consider at what values of glycosylated hemoglobin one speaks of compensation or decompensation of diabetes mellitus.
Formation of fructosamine, norm
The second indicator used in determining the degree of compensation for diabetes mellitus is fructosamine. Fructosamine is formed as a result of the binding of glucose to plasma proteins. An increase in the concentration of fructosamine in the blood plasma indicates that in the last 2-3 weeks there was an increased level of glucose in the blood. The definition of fructosamine is used to control the condition of a patient with diabetes mellitus. Normally, the concentration of fructosamine in the blood does not exceed 285 µmol/l.Dependence of the risk of developing cardiovascular complications in patients with diabetes mellitus on the concentration of glycated hemoglobin and fructosamine
The concentrations of fructosamine and glycated hemoglobin reflect the risk of developing pathology of the cardiovascular system. A low risk of developing the above pathologies is observed in compensated diabetes mellitus, an average risk in subcompensated diabetes, and high risk- at the stage of decompensation of diabetes mellitus.
Lipidogram parameters (cholesterol, triglycerides, HDL and LDL) depending on the stage (compensation, subcompensation and decompensation) of type 2 diabetes mellitus
To determine the stage of compensation in type 2 diabetes, it is very important to determine the parameters of lipid metabolism. Let us consider the dependence of the degree of compensation of type 2 diabetes mellitus on the concentration of various blood lipids.| Lipidogram index | Stage of diabetes compensation | Stage of subcompensation of diabetes mellitus | Stage of decompensation of diabetes mellitus |
| total cholesterol | Less than 4.8 mmol/l | 4.8-6.0 mmol/l | More than 6.0 mmol/l |
| Low density lipoproteins (LDL) | Less than 3.0 mmol/l | 3.0-4.0 mmol/l | More than 4.0 mmol/l |
| High density lipoproteins (HDL) | More than 1.2 mmol / l | 1.0-1.2 mmol/l | Less than 1.0 mmol/l |
| Triacylglycerides (TAG, TG) | Less than 1.7 mmol/l | 1.7-2.2 mmol/l | More than 2.2 mmol / l |
Late complication of diabetes - diabetic nephropathy
What is diabetic nephropathy?long-term course of diabetes mellitus, a late complication occurs - diabetic nephropathy. That is, kidney pathology develops due to the prolonged course of diabetes mellitus. Diabetic nephropathy is one of the main causes of disability and mortality in diabetic patients. Development frequency diabetic nephropathy in patients with type 1 diabetes is 40-50%, and in patients with type 2 diabetes - 15-30%.
Determination of microalbuminuria - a way to control the development of diabetic nephropathy
To control the development of diabetic nephropathy, the definition of the following indicator is used - microalbuminuria. Microalbuminuria is the appearance of proteins in the urine, in concentrations above normal, but below pathological. The norm of microalbuminuria is less than 30 mg per day, albuminuria is said to be when the protein content in the urine is 30-300 mg per day. And proteinuria is diagnosed when the concentration of protein in the urine is more than 300 mg per day. The stage of microalbuminuria develops 5-15 years after the onset of diabetes mellitus. It is important not to skip this stage in order to start timely treatment of kidney pathology.
We reviewed the main diagnostic criteria for the development and compensation of diabetes mellitus. However, you should not try to self-medicate. If you find any suspicious signs, you should consult a doctor for highly qualified and professional help.
The clinical course of diabetes mellitus depends on the type of disease. Acute onset is typical for patients with type 1 diabetes mellitus, especially for young people. Such patients report thirst, polyuria, dry mouth, quick loss body weight.
The diagnosis is confirmed by the presence of hyperglycemia, glucosuria, and sometimes ketosis or ketoacidosis. On the clinical course diabetes also affects the level of residual secretion of insulin. Low residual secretion of the hormone creates conditions for a labile course, a tendency to ketosis, ketoacidosis, and hypoglycemia.
Type 2 diabetes is more often discovered incidentally during examinations for other diseases. It is characterized by a slow onset, a stable course, the presence non-specific symptoms, to which patients do not pay attention, therefore they turn to specialists of a different profile. Thirst and polyuria are slightly expressed, and can only be detected with a thorough and active questioning of patients. One of common symptoms is itching of the genital organs and skin, epidermophytosis, periodontal disease, general weakness.
Below are the main clinical symptoms of diabetes mellitus.
Hyperglycemia in diabetes mellitus - a sign of diabetes mellitus
This symptom is a cardinal manifestation this disease. WHO experts define diabetes mellitus as a syndrome of chronic hyperglycemia. The development of the latter is facilitated by two independent factors: a sharp decline transport of glucose from the blood to tissues and an increase in gluconeogenesis, which is due to progressive absolute or relative insulin deficiency.
At the first stages of diabetes mellitus, hyperglycemia has a protective adaptive character, because it provides not only the transition of glucose to the tissues due to "glucose" pressure, but also its utilization. In the future, "Glucose intoxication" contributes to non-enzymatic glycation of proteins that cause damage to blood vessels and nervous system.
Glucosuria in diabetes mellitus
There is no glucose in the urine of a healthy person, so it is reabsorbed in the tubules of the kidneys. Complete reabsorption is possible up to a glycemic level of 8.8 mmol/L, which is called the renal threshold. Higher glycemia predicts glucosuria in healthy people with overuse sweets.
In diabetes mellitus, due to the fact that 3-7 times more glucose is filtered by the glomeruli of the kidneys than in a healthy person, the amount of glucose excreted in the urine depends on the intensity of reabsorption and the osmotic pressure of the primary urine. In diabetes mellitus, the concentration of glucose in the urine reaches 8-10%.
In some diabetic patients, glucosuria is absent, despite the fact that the level of glycemia significantly exceeds the renal threshold. Glycosuria may appear against the background of normal glycemia if glucose reabsorption in the kidneys is reduced. The size of glucosuria often coincides with the size of hyperglycemia.
Long-term reabsorption of a large amount of glucose leads to the formation of glycogen in the epithelium of the tubules of the kidneys and to the depletion of their enzymatic activity. As a result, glucose reabsorption may decrease, and then, under conditions of unchanged glycemia, glucosuria increases. Filtration of glucose in the kidneys depends on the condition of the vessels. Glomerulosclerosis significantly reduces glucose filtration.
Polyuria and polydipsia in diabetes mellitus
The diuresis of a healthy person averages 1.4 liters (0.9 - 1. l). In diabetes mellitus, the daily secretion of urine depends on the compensation of the disease and can increase to 3-5 liters or more, the amount of urine depends on the severity of glucosuria and polyuria.
Significant polyuria dehydrates the patient, leads to thirst. Polydipsia also cause dryness of the oral mucosa, depression salivary glands, increase in blood osmolarity, decrease in circulating blood volume.
Weight loss in diabetes
As endocrinologists note, the predominance of catabolic processes in decompensated diabetes mellitus leads to progressive weight loss. Weight loss is also determined by dehydration, lipolysis, and gluconeogenesis.
An increase in appetite in diabetes mellitus is associated with impaired glucose utilization, activation of gluconeogenesis, and a significant loss of glucose by the body, where it is needed for energy needs.
Hyperketonemia in diabetes mellitus
Ketogenesis in the liver increases due to increased intake of free fatty acids. They are esterified and intensively oxidized to acetyl-CoA, and ketone bodies are formed from it, the accumulation of which leads to hyperketonemia.
Diabetes mellitus is one of the most common diseases today. Let us consider in more detail the signs of diabetes and the causes of its occurrence.
Diabetes mellitus has been known since the time of medicine BC. The ancient Egyptians described this disease as an independent pathology. The ancient Greek scholar Celsus argued that main reason Diabetes mellitus is not the correct functioning of the stomach, and Hippocrates made a diagnosis by tasting the patient's urine. The doctors of ancient China came up with their own original way of diagnosing diabetes: the patient's urine was poured into a saucer and exposed to the street. If wasps and bees sat on the edge of the saucer, then the doctors knew that sugar was present in the patient's urine.
Diabetes is a disease endocrine system and is characterized by an increase in blood sugar levels as a result of a violation of the production of the hormone insulin by the pancreas. The progression of diabetes mellitus leads to disruption of metabolic processes in the body, damage to the nervous system, blood vessels and other organs and systems.
Types and types of diabetes
Depending on the form of the course of the disease, there are:
- Insulin-dependent diabetes mellitus (type 1 diabetes) - most often occurs in children and young people;
- Non-insulin-dependent diabetes (type 2 diabetes) - most often occurs in people over 40 years of age who are overweight. This form of diabetes is observed in 80% of cases;
- Secondary diabetes mellitus - symptomatic;
- Diabetes in pregnant women - blood sugar levels are elevated during pregnancy, and after childbirth everything returns to normal;
- Diabetes resulting from malnutrition and malnutrition.
Diabetes mellitus of the insulin-dependent type is characterized by an absolute deficiency of insulin, which occurs against the background of insufficient production of it by the pancreas.
Diabetes can be caused by lack of insulin
When diagnosing the second type of diabetes mellitus, we are talking about relative insulin deficiency.
Causes of Type 1 Diabetes
Type 1 diabetes begins to manifest itself clinically after the destruction of more than half of the cells of the islets of Langerhans of the pancreas (responsible for the production of insulin). In children and patients adolescence the progression of the disease is observed much faster, as a result of which the general condition of the patient deteriorates sharply.
Type 1 diabetes is characterized by inadequate production of insulin by the cells of the pancreas. Insulin is either not produced at all, or its quantity is very small. The main function of this hormone is to ensure the delivery of glucose into cells. Glucose is the main source of energy for all tissues and cells of the body. If glucose, for some reason, does not enter the cell, then it begins to accumulate in the blood in high concentrations, and, accordingly, the cells and tissues of the body experience an energy deficit (that is, hunger). To compensate for the deficiency nutrients and carbohydrates, the body begins to intensively break down fats and proteins. It is this fact that contributes to the sudden and sharp weight loss of the patient.
Glucose molecules have the property of attracting water to themselves. If the level of sugar in the body rises significantly, then glucose with liquid is intensively excreted from the body along with urine. Thus, a diabetic patient experiences intense thirst and marked dehydration.
Due to the active breakdown of fats, blood begins to accumulate fatty acid. The liver makes heavy use of these acids to provide the body with energy. As a result, the concentration of ketone bodies in the blood increases sharply. Ketone bodies are products of the breakdown of fats, and their accumulation in the blood leads to the development of ketosis and severe dehydration. If at this stage the patient does not start rehydration (replenishment of fluid deficiency in the body) and insulin therapy, then soon a coma develops and the subsequent shutdown of vital organs.
Predisposing factors provoking the development of this disease are:
- Postponed parotitis, rubella virus, chickenpox and hepatitis;
- hereditary predisposition;
- Regular intake of selenium-based supplements.
Causes of Type 2 Diabetes
The main predisposing factors for the development of type 2 diabetes are heredity and overweight.
Obesity
If a person is obese 1 degree, then the risk of developing diseases of the endocrine system is doubled. With obesity of the 2nd degree - 5 times, with obesity of the 3rd degree - more than 10 times!
hereditary factor
If at least one of the parents had and has diabetes, then there is a very high probability that the children will also inherit this disease. Type 2 diabetes mellitus develops gradually with mild clinical symptoms.
Diabetes is hereditary
secondary diabetes mellitus
The secondary form of the disease can develop in humans against the background of such factors:
- Prolonged and uncontrolled intake of certain drugs;
- Changes in cell receptors responsible for delivering insulin to tissues;
- Concomitant diseases of the pancreas (pancreatitis, tumor neoplasms on the gland, partial removal of the pancreas);
- Hormonal diseases (Itsenko-Cushing's disease, acromegaly, thyrotoxicosis, toxic goiter and pheochromocytoma).
How to recognize diabetes? First clinical symptoms
This endocrine disease is characterized by a whole range of clinical symptoms. These include:
- Constant thirst of the patient (a person can drink more than 5 liters of water per day);
- Frequent urination and severe oliguria (up to 10 liters of urine per day);
- Increased appetite, feeling of constant hunger;
- Rapid weight loss, sudden weight loss;
- Rapid fatigue and a feeling of general weakness;
- Sudden deterioration of vision - the appearance of the so-called "white veil" before the eyes;
- convulsions calf muscles disturbing the patient more often at night;
- Dizziness and headaches;
- Decreased libido in women and erectile dysfunction in men;
- Decreased immunity;
- Slow wound healing.
Fatigue is one of the symptoms of diabetes.
There have been cases in medicine when constant increase The level of glucose in the blood was not accompanied in the patient by typical symptoms of diabetes mellitus - thirst and an increase in daily diuresis. Only as the disease progressed, patients noted the presence of dizziness and constant weakness, deterioration of vision, rapid weight loss and prolonged healing of wounds on the skin. It is these symptoms that often force the patient to consult a doctor.
The onset of the insulin-dependent type of the disease is characterized by the rapid progression of the pathological process and severe dehydration. Such patients should be treated immediately medical care and administer insulin. Without timely medical intervention, the patient rapidly develops ketoacidosis in the blood, and then he falls into a coma.
Complications of diabetes
If people with this disease ignore doctor's prescriptions and are irresponsible about their state of health, then against the background of the progression of diabetes mellitus, serious complications will soon develop. First of all, the disease affects the cardiovascular system, organs of vision, kidneys and nervous system.
Damage to the heart and blood vessels
With the progression of diabetes in the first place complications affect the cardiovascular system. Approximately 70% of people with diabetes die as a result of a stroke or heart attack. This is due to the fact that diabetes causes severe damage to the large arteries responsible for the blood supply to the heart muscle and great vessels.
In addition, the progression of diabetes and elevated blood sugar levels lead to diseases of the feet, microcracks of the limbs, resulting in gangrene. With the development of gangrene, surgeons carry out amputation of the affected limb to prevent further necrosis of healthy tissues.
Doctors say that timely diagnosis of the disease and the responsible implementation of all medical recommendations can prevent the development of complications.
The effect of diabetes on the organs of vision
Diabetes mellitus, in the absence timely treatment, leads to complete loss of vision of the patient. As the disease progresses, the patient may develop other eye conditions such as increased intraocular pressure, cataracts, and diabetic retinopathy. The last disease is the most frequent complication visual system in diabetes. A timely visit to the ophthalmologist in 90% of cases prevents the development of blindness in diabetics.
Disorders of the excretory system and kidneys
Endocrine disease of the pancreas is one of the main causes of kidney failure. To prevent development this complication it is necessary to take drugs that promote the outflow of urine and normalize blood pressure (diuretics).
Pathologies of the nervous system
Especially often in diabetes mellitus, the nervous system, or rather, the nerve endings of the limbs, is at risk of developing complications. This pathology leads to a decrease in the sensitivity of the limbs and the appearance of numbness and burning of the hands and feet.
In addition, damage to the central nervous system in diabetes can provoke violations of the digestive function and the functioning of the organs of the reproductive system.
How to prevent the development of complications?
If the complications of this disease were diagnosed in a patient at an early stage of their appearance, then they can be easily eliminated with the help of medications. Thus, the patient's lifestyle changes somewhat: for example, with developing nephropathy (damage to the renal tubules), the patient must take daily drugs that will help prevent further progression of the pathology.
Diagnosis of diabetes
To diagnose diabetes in a patient, it is enough to examine a blood test, which determines the level of glucose. If a fasting blood glucose level of less than 7 mmol / l, but more than 5.6 mmol / l is detected in a patient, a glucose tolerance test is additionally prescribed. The test is as follows: the patient donates blood on an empty stomach, doctors determine the level of glucose in the blood, after which the person is offered a piece of sugar. Another blood test is taken from this patient after 2 hours. If the blood glucose levels increased to 11.1 mmol / l, then diabetes mellitus can be diagnosed with confidence. If the blood glucose is less than 11.1 mmol / l, but more than 7.8 mmol / l, then we are talking about a violation of the body's tolerance to carbohydrates. At low glucose levels, but at the same time above the norm, the study is repeated after 3 months, and the patient is registered with an endocrinologist.
Blood glucose levels are used to make a diagnosis
Treatment of diabetes
The method of treatment for diabetes largely depends on the type of disease. When diagnosing type 1 diabetes mellitus (insulin-dependent), the patient is prescribed insulin preparations to compensate for the deficiency of the hormone in the body.
When non-insulin dependent diabetes (type 2 diabetes) is detected, treatment begins with dietary adjustments and antidiabetic medications.
As diabetes progresses, the patient is prescribed insulin therapy. Most often, the body's need for insulin is fully satisfied by preparations of the human hormone. These drugs include recombinant human insulin.
For treatment, short-acting insulins, intermediate-acting insulins and prolonged-acting (long-acting) drugs are used. Most often, insulin preparations are administered subcutaneously, but it can also be administered intramuscularly and into a vein.
Diabetes in women
Manifestations of diabetes mellitus in women have some distinguishing feature. Often the patient is unaware of the development of diabetes, and the reason for going to the doctor is severe itching of the external genital organs. This symptom often appears first in the progression of diabetes in women. Patients often mistake itching of the external genitalia for venereal infection and rush to see a venereologist. During the examination, the woman found an increased level of glucose in the blood.
The risk of getting diabetes
Many people are very concerned about the question, is it possible to get diabetes from a patient through contact with him? No, it's just a stupid myth. Diabetes is not the flu or an acute respiratory infection. This disease is caused by severe disorders in the islets of Langerhans of the pancreas, as a result of which insulin stops being produced or is produced in insufficient quantities. Diabetes mellitus is not transmitted through handshakes, the use of personal hygiene items of the patient, or airborne droplets.
Diabetes mellitus is also called the "disease of civilization", as the cause of its occurrence is often the abuse of various fast foods, pastries and carbonated sweet drinks.
Nutrition for diabetes
Naturally, diabetes mellitus makes multiple adjustments to a person's lifestyle, and this primarily concerns the patient's diet. If you ignore the instructions of a specialist regarding certain food restrictions, the disease provokes a sharp deterioration in the patient's health. The first thing that people with diabetes need to give up is sugar.
Diabetic patients should take care of their diet
Indicated for patients with diabetes therapeutic diet No. 9. This diet is characterized by a restriction in the diet of a sick person of easily digestible carbohydrates and a warning possible violations fat metabolism due to the progression of diabetes mellitus.
The patient is recommended to take food 5 times a day in small quantities, preferably at regular intervals. It is absolutely unacceptable for a person with diabetes to skip meals, for whatever reason. This can have a very negative impact on his health.
Diet number 9
The diet of a diabetic patient consists of the following dishes:
First hot meals
Soups and borscht for a diabetic patient are prepared on water, with the addition of boiled meat to the plate low-fat varieties. Great for eating rabbit meat, turkey breast, chicken fillet and beef. It is very useful to eat soup cooked in vegetable broth for lunch. Thus, the patient not only does not load the pancreas with unnecessary work, but also enriches the body with vitamins.
Main courses
As a side dish for boiled meat of low-fat varieties, you can cook porridge on the water. Particularly useful are buckwheat porridge, barley, oatmeal, wheat and barley. It is very useful as a snack for an afternoon snack to eat wheat bran, pre-filled with warm milk.
Dairy products work well digestive system which is very important for diabetes. Preference should be given to kefir, low-fat cottage cheese, not salty and not spicy hard cheese.
You can also serve the sick porridge with the addition of milk, but always boiled in water. You can add a piece of butter to milk porridge.
Vegetables and fruits
People with diabetes can include vegetables and fruits in their diet: tomatoes, cucumbers, lettuce, zucchini, pumpkin, some eggplant, green apples, dates and figs. Bananas, grapes and strawberries should not be consumed or tasted in very limited quantities, since these fruits and berries are especially rich in fructose and carbohydrates, and their abuse can dramatically worsen the patient's condition.
Drinks for diabetes
Patients with diabetes need to give up black tea, cocoa and coffee. You can drink a coffee drink with the addition of milk. It is allowed to use a rosehip decoction, green tea, vegetable and fruit juices (from the list of permitted vegetables and fruits), non-carbonated mineral water.
List of products that are strictly prohibited for people with diabetes:
- Chocolate candies;
- Sausages and smoked sausage;
- Fatty fish (such as mackerel and salmon);
- Red caviar;
- mayonnaise, ketchup, margarine;
- Spices, spices, vinegar;
- Canned food;
- Homemade jam.
How to diversify the menu for diabetes?
People who are diagnosed with diabetes complain that their diet is very monotonous, and the food is all insipid and not tasty. This is an unjustified statement. Possessing desire and culinary skills, you can eat fully, tasty and properly. Below is sample menu for patients with diabetes. You can take this menu as a basis, changing and adding products from the allowed list daily.
Breakfast: rice milk porridge boiled in water (add milk directly to the plate), bread with butter and tea.
Second breakfast: biscuit cookies and a glass of low-fat natural yogurt.
Lunch: boiled beetroot salad with vegetable oil, vegetable soup with a piece of boiled chicken meat.
Snack: steamed cheesecakes, apple, rosehip broth.
Dinner: boiled fish, vegetable salad with sour cream
At night: a glass of kefir or milk.
As you can see, the diet is quite varied. Of course, at first the patient will experience certain difficulties with permitted and prohibited foods, but he will soon get used to it.
Controlling blood sugar at home
A patient with diabetes cannot be constantly under the control of doctors, and, as you know, the level of glucose in the blood must be constantly maintained at approximately the same level. It is important to ensure that there are no sudden changes in blood glucose levels - hyperglycemia and hypoglycemia. As a result of such jumps, the patient's blood vessels, organs of vision and nervous system begin to be rapidly affected.
Without insulin, glucose cannot be broken down into necessary for the body substances. The liver begins to intensively produce glucose, believing that the critical state of the body is due precisely to a lack of energy. From an excess of glucose and its accumulation in the body, the accumulation of ketone bodies begins.
If the glucose levels exceed the levels of ketone bodies in the blood, then the patient develops a hyperglycemic coma.
If ketone bodies exceed the amount of glucose in blood, then the patient develops ketoacidotic coma.
It is important to take into account the fact that the development of a coma is not always caused in a patient due to the accumulation of glucose or ketone bodies in the blood. The patient may fall into a coma due to an overdose of insulin. Thus, we are talking about hypoglycemic coma.
Signs of a coma
The first signs of a developing coma include:
- Increased thirst and urination;
- Nervous excitement, subsequently replaced by lethargy;
- Increasing weakness and lethargy;
- Headache;
- Lack of appetite and nausea;
If the patient has such signs within 12-24 hours, it is necessary to urgently seek medical help. Without timely treatment, the patient develops a true coma. Clinical signs of a true diabetic coma are:
- Growing indifference to what is happening around;
- Violation of consciousness (apathy with periods of nervous excitement);
- Lack of response to stimuli.
When examining a patient, the doctor detects severe dryness of the skin, a weakening of the pulse in large arteries, a noticeable smell of acetone from the mouth (with the development of hyperglycemic and ketoacidotic coma), a fall blood pressure, softening eyeballs. The patient's skin is warm to the touch.
With the development of coma due to an overdose of insulin (hypoglycemic), the clinical signs are completely different. When approaching a coma, the patient feels severe hunger, trembling in the limbs and body, increasing weakness, anxiety and sudden sweating.
If during the sensation of these signs the patient is not allowed to drink sweet tea, eat chocolate candy or another "fast" carbohydrate, then the patient has a loss of consciousness and convulsions. On examination, the doctor notes increased muscle tone, skin moisture and the absence of acetone breath from the mouth.
First aid for the development of coma
As a rule, people with diabetes are well aware of what happens when insulin is administered incorrectly or the level of glucose and ketone bodies in the blood increases. With increasing signs and symptoms of a coma, such patients know what to do. People who are trying to provide first aid to a patient with increasing symptoms of a coma should ask the patient himself what helps him in this case.
It is strictly forbidden to prevent the patient from injecting insulin during the development of a coma (some people regard this as inappropriate behavior), as well as delay calling an ambulance, relying on the patient himself knowing what to do in these situations.
What causes diabetes? The basis of the disease is a violation of the metabolism of carbohydrates and water. As a result, pancreatic function is reduced. This organ is responsible for the production of a hormone called insulin.
Many people wonder what is insulin? After all, it is used to treat diabetes.
The hormone insulin is involved in the production of sugar. In its absence, the body is not able to process sugar into glucose. As a result, the content of He is excreted from the body in large quantities with urine.
In parallel with this process, there is a violation of water metabolism. Fabrics are unable to retain water. As a result, its excess is excreted by the kidneys.
If a person has a high level of glucose in the blood, then this is the main sign that the body is affected by such a disease as diabetes mellitus.
Insulin response to blood sugar
What is insulin and how does it interact with sugar? In the human body, beta-proteins of the pancreas are responsible for the production of the hormone. Insulin supplies the cells of the body with sugar in the right amount.
What failure is observed in the body when elevated content Sahara? Insulin in this case is insufficiently produced in the body, the sugar level is elevated, but the cells suffer from a lack of glucose supply.
So, diabetes. What it is plain language? The basis of the disease is a violation of metabolic processes in the body. The disease can be both hereditary and acquired.
From a lack of insulin, the skin is affected by small pustules, the condition of the gums and teeth worsens, atherosclerotic plaques develop, angina pectoris, pressure rises, kidney function is inhibited, functional disorders nervous system, visual impairment.
Etiology of the disease
What causes diabetes and what causes it? The pathogenesis of this disease depends on the type of disease. There are two main types, which have great differences. Although such a division is arbitrary in modern endocrinology, the type of disease still matters when choosing therapy. Therefore, it is advisable to consider the features of each species separately and highlight their key characteristics.
In any case, the occurrence of which lies in the violation of carbohydrate metabolism and the constant increase in blood glucose, is a serious disease. Elevated blood sugar is medically known as hyperglycemia.
The hormone insulin does not fully interact with tissues. It is he who lowers the content of glucose in the body by carrying it to all cells of the body. Glucose is an energy substrate that helps maintain the life of the body.
If the system is disrupted, then glucose does not take part in the normal metabolic process and is collected in excess in the blood. These are the causal mechanisms that are the start of the development of diabetes.
It should be noted that not every increase in blood sugar is true diabetes. The disease is provoked by a primary violation of the action of insulin.
What are the conditions for hyperglycemia?
Hyperglycemia can occur in the following conditions:
- Pheochromocytoma. It is a benign tumor in the adrenal glands that promotes the production of insulin antagonist hormones.
- Glucagonoma and somatostatinoma - proliferation of cells that synthesize insulin competitors.
- Increased adrenal function.
- Increased thyroid function (hyperthyroidism).
- Cirrhosis of the liver.
- Impaired tolerance to carbohydrates (their reduced absorption after eating with a normal fasting rate).
- Transient hyperglycemia.
The expediency of isolating such conditions is due to the fact that the hyperglycemia that occurs with them is secondary. It acts as a symptom. Therefore, by eliminating the underlying disease, it is possible to achieve normalization of blood glucose levels.
If a violation is observed in the body for a long time, then this gives grounds to diagnose a disease such as diabetes mellitus. In this case, it occurs against the background of pathological processes in the body.
Symptoms of the disease
The clinical manifestation of the disease is characterized by a gradual increase in leading rarely debuts at lightning speed, it develops gradually.
The onset of the disease is characterized by the following symptoms:
- feeling of dryness in the mouth;
- constant thirst that cannot be quenched;
- increased amount of urination;
- sudden weight loss or obesity;
- itching and dry skin;
- the formation of small pustules on the skin;
- poor wound healing;
- muscle weakness;
- fast fatiguability;
- increased perspiration.
Usually these complaints are the first call of the onset of diabetes. When similar symptoms It is recommended to contact an endocrinologist immediately.
As the course of the disease worsens, conditions that adversely affect the work of internal organs can be revealed. With the critical development of the disease, even a violation of consciousness with severe poisoning and multiple organ failure can be observed.
Factors that provoke the disease
What causes diabetes? The reasons for the development of the disease are varied.
The provoking factors of diabetes are as follows:
- Unfavorable genetic background. In this case, other factors are reduced to nothing.
- Weight gain.
- A number of pathological processes in the body that contribute to the defeat of beta proteins. As a result, insulin production in the body is disrupted.
- Provoke the development of the disease can be a tumor of the pancreas, pancreatitis, pathological disorders endocrine glands.
- Diseases of an infectious nature, for example, the defeat of the body with rubella, chickenpox, hepatitis and even the common flu. These diseases can serve as a trigger for the development of the disease, especially in people at risk.
- Nervous stress. Emotional stress adversely affects the functionality of the pancreas.
Does age play a role?
Does age play a role in the development of a disease such as diabetes? Paradoxically, the answer is yes. Scientists have found that every 10 years the risk of damage to the body by the disease doubles. At the same time, diabetes can be diagnosed even in infants.
Why are there two types of disease?
This distinction is important, since different therapy is selected for one form or another.
The longer diabetes mellitus proceeds, the less clear-cut the division into subspecies has. With a protracted course, the same treatment will be carried out, regardless of the causes of the onset of the disease.
Type 1 diabetes
This species causes a lack of insulin. Most often, this type of disease affects people under the age of 40 with severe diabetes. Insulin is required to stop the disease. The reason is that the body produces antibodies that destroy pancreatic cells.
In the presence of type 1 diabetes, a complete cure is impossible, although cases of complete restoration of pancreatic function are very rare. But such a state can only be achieved by including a certain diet with the use of natural raw foods.
To maintain the body, a synthetic analogue of the hormone insulin is used, which is administered intramuscularly. Since insulin is susceptible to degradation in gastrointestinal tract, then taking it in the form of tablets is impractical. The hormone is administered with food. In this case, it is important to follow a certain diet. Foods containing sugar and carbohydrates are completely excluded from the diet.
Type 2 diabetes
Why does this diabetes occur? The causes of occurrence are not the lack of insulin. Most often, this disease affects people after 40 years of age, who have a tendency to be overweight. The cause of the disease lies in the loss of sensitivity of cells to insulin due to the increased content of nutrients in the body.
The introduction of the hormone insulin is not applicable to every patient. Only a doctor will be able to choose the right treatment regimen and, if necessary, determine daily dose hormone.
First of all, such patients are encouraged to review the diet and stick to a diet. It is very important to strictly follow the recommendations of the doctor. It is advised to gradually reduce weight (3 kg per month). Weight should be monitored throughout life, avoiding its addition.
If the diet does not help, special drugs are prescribed to reduce sugar levels, and only in very extreme cases resort to the use of insulin.
What pathological processes are triggered in the body with an increase in insulin
The higher the blood sugar and the longer the disease itself, the more severe its manifestations. The consequences of diabetes can be very severe.
To dump excess glucose, the body triggers the following pathological mechanisms:
- Glucose is converted into body fat, which leads to obesity.
- Glycolysis of cell membrane proteins occurs, which causes a violation of the functionality of all systems in the human body.
- The sorbitol pathway for glucose release is activated. The process causes the appearance of toxic compounds that affect nerve cells. It is the basis of diabetic neuropathy.
- Small and large vessels are affected, which is caused by an increased content of cholesterol in the blood during glycosylation of proteins. As a consequence, this process causes diabetic microangiopathy of the internal organs and eyes, as well as angiopathy of the lower extremities.
Based on the foregoing, it can be stated that an increase in the level of glucose in the blood contributes to the damage of internal organs with predominant lesion one system.
Symptoms of Complicated Diabetes
- a sharp deterioration in vision;
- migraines and other functional disorders of the nervous system;
- pain in the region of the heart;
- liver enlargement;
- pain and numbness in lower limbs;
- decreased sensitivity of the skin in the area of the feet;
- arterial hypertension;
- the appearance of the smell of acetone from the patient;
- loss of consciousness.
The appearance of vivid symptoms of diabetes should be a signal for alarm. Such manifestations indicate the deep development of the disease and its insufficient correction through medication.
Complications caused by diabetes
The disease itself does not pose a threat to human life. Its complications are more dangerous. It is impossible not to mention some of them. These consequences of diabetes are quite common.
by the most serious condition is loss of consciousness or high degree patient's inhibition. Such a patient should be hospitalized immediately.
The most common diabetic coma is ketoacidotic. It is caused by the accumulation of toxic substances during metabolic processes, which have a detrimental effect on nerve cells. The main indicator of coma is the smell of acetone on the breath. Consciousness in this state is clouded, the patient is covered with profuse sweat. In this case, there is a sharp decrease in blood sugar, which can be caused by an overdose of insulin. Other types of coma are extremely rare.
Puffiness can be both local and extensive. This symptom is an indicator of kidney dysfunction. If the edema is inherent in asymmetry, and it spreads to one lower leg or foot, then such a process is evidence of diabetic microangiopathy of the lower extremities caused by neuropathy.
Systolic and diastolic pressure It is also an indicator of the severity of diabetes. The condition can be assessed in two ways. In the first case, attention is drawn to the indicator total pressure. An increase indicates a progressive course of diabetic nephropathy. With this complication, the kidneys release substances that increase blood pressure.
On the other hand, there is often a drop in pressure in the vessels and lower extremities. The process is determined during sound dopplerography. It indicates the presence of angiopathy of the lower extremities.
Pain in the legs is an indicator of the development of diabetic angio- or neuropathy. Microangiopathy is characterized by pain during physical exertion and walking.
Appearance pain at night indicates the presence of diabetic neuropathy. As a rule, this condition is characterized by numbness with a decrease in sensitivity. Some patients experience local burning in certain areas of the lower leg or foot.
Trophic ulcers are next stage diabetic angio- and neuropathy after pain. Type of wounds different forms varies. For each individual case, individual methods of treatment are provided. At difficult situation the smallest symptoms should be taken into account, since this determines whether the patient's limb will be saved.
Neuropathic ulcers are caused by a decrease in the sensitivity of the feet against the background of neuropathy with deformity of the foot. In the main points of friction in the areas of bone protrusions, calluses are formed, which are not felt by patients. Under them, hematomas appear, in which pus collects in the future. The foot begins to greatly disturb a person only when it swells and an ulcer occurs on it.
Gangrene is usually caused by diabetic angiopathy. In this case, small and large vessels are affected. Usually the process is localized in the region of one toe. If there is a violation of blood flow in the foot, a sharp pain appears, then redness occurs. Over time, the skin acquires a bluish tint, becomes cold and swollen, then becomes covered with blisters with cloudy contents and black necrosis of the skin.
Such changes are not treatable. In this case, amputation is indicated. Its optimal level is the lower leg area.
How to prevent the development of complications
Prevention of complications is based on early detection of the disease and its correct treatment. The doctor must outline the correct treatment, and the patient strictly follow the instructions.
The lower limbs with diabetes need daily proper care. If damage is found, contact the surgeon immediately.
Prevention of diabetes
Unfortunately, it is not always possible to prevent the development of the disease. After all, often the trigger is genetics and viruses that affect every person.
The condition is assessed in a completely different way in the presence of type 2 diabetes. It is often associated with the wrong way of life.
TO preventive measures In this case, the following activities can be attributed:
- weight normalization;
- blood pressure control;
- food intake from low content carbohydrates and fats;
- moderate physical activity.
Conclusion
So what causes diabetes? The disease is a violation of the mechanism of absorption of glucose by the body.
A complete cure is not possible. The exception is type 2 diabetes. To stop it, a certain diet is used in combination with moderate physical activity. It should be remembered that the risk of recurrence of the disease in violation of the regimen is extremely high.
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