Diabetes mellitus is a disease of the endocrine system, caused by absolute or relative insufficiency in the body of the pancreatic hormone – insulin and which is manifested by profound disorders of carbohydrate, fat and protein metabolism. Diabetes mellitus is one of the most common, but rarely diagnosed diseases. The prevalence of diabetes in the population is currently around 10%. Every 10-15 years, the total number of patients doubles. In addition to the above, in 30-35% of patients “latent”, previously undetected diabetes is detected.
Types of diabetes.
There are two main forms of diabetes:
• 1st type (insulin-dependent), • 2nd type (non-insulin-dependent).
People with type 1 diabetes have little or little insulin . In the occurrence of this form of diabetes with a genetic predisposition to it, viral infections, environmental factors, and nutritional errors play an important role. In type 2 diabetes mellitus, the pancreas continues to produce insulin , but the body reacts poorly to the influence of the hormone, which leads to a relative insulin deficiency. The reasons for the development of type 2 diabetes mellitus ( non-insulin-dependent ) are: genetic predisposition; obesity, often associated with overeating (80 to 90% of people with this disease are overweight), as well as diseases of the endocrine system: pathology of the pituitary gland, thyroid gland ( hypo – and hyperfunction), adrenal cortex. Diabetes mellitus can occur as a complication in viral diseases (influenza, viral hepatitis, herpes virus, etc.), pancreatitis, pancreatic tumors. Clinical symptoms of diabetes. The first symptoms of diabetes are a consequence of high blood sugar and are manifested in increased urine formation, the patient urinates a lot and often (polyuria) , excessive urination causes excessive thirst (polydipsia) .
Since a person loses a lot of calories in the form of glucose with urine, an increased feeling of hunger is observed, and a “wolf” appetite appears . In addition, with diabetes mellitus, drowsiness, fatigue, itching in the perineal region, decreased visual acuity, chilliness of the limbs, etc. can disturb.
Complications of diabetes.
Increased blood sugar in diabetes, over time, leads to damage to the blood vessels of the heart, brain, eyes, kidneys, lower extremities and the development of serious complications ( heart attacks, strokes, retinal detachment with the development of blindness, renal failure, gangrene of the lower extremities). Complications of diabetes can be prevented by maintaining normal blood sugar.
TREATMENT OF DIABETES.
Comprehensive diabetes care includes the following activities.
- Diet (restriction of sugar and other carbohydrates, as well as fats in the diet): sometimes one diet is enough to compensate for the disorder (this is the so-called mild diabetes);
- Physical exercise.
- Acceptance of sugar – lowering drugs : these drugs can increase the sensitivity of the body’s cells to insulin, and also contribute to the penetration of sugar into the cells, thereby reducing the amount of sugar in the blood.
Medicines used for diabetes.
- Derivatives of sulfonylureas ( glibenclamide , glimepiride , tolbutamide , chlorpropamide , etc.). These antidiabetic pills lower blood sugar by stimulating the pancreas to release more insulin. Well tolerated, but in some cases can cause hypoglycemia.
- Biguanides . These antidiabetic pills improve the ability of insulin to transport sugar into cells, especially muscle cells. They also prevent the liver from releasing sugar stores.
- Thiazolidinone derivatives ( troglitazone , rosiglitazone ). By increasing the activity of insulin receptors, they reduce glucose levels and normalize the lipid profile.
- Alpha- glucosidase inhibitors ( acarbose and miglitol ). Medications that affect intestinal glucose absorption.
- Inhibitors dipeptidildipeptidiazy 4 (DPP-IV) ( sitagliptin , vildagliptin ). With a normal or elevated level of blood glucose, the hormones of the incretin family contribute to an increase in insulin synthesis, as well as its secretion by pancreatic β-cells.
- Meglithinids ( Novonorm and Starlix ). These antidiabetic medicines lower blood sugar by stimulating the pancreas to release more insulin.
In Combined treatment, 2 or more sugar – lowering drugs are used at the same time. As a rule, this type of treatment causes fewer complications than monotherapy with high doses of any one drug.
- Insulin preparations ;
- Various remedies for the correction of diabetes complications.
Treating diabetes with insulin and certain hypoglycemic agents requires strict control of blood sugar levels. The main danger with such a correction is an overdose of these drugs, as a result of which the blood sugar can drop sharply and lead to the so-called hypoglycemic coma and even the death of the patient.
It is quite difficult to choose insulin preparations and their optimal dosages, since many factors must be taken into account: how much the patient’s physical activity changes during the day, how much blood sugar level is controlled, how stable the patient’s sugar content is, taking into account the diet, calorie intake, and much more.
For the purpose of monitoring, individual glucometers are used – devices with which patients themselves measure the level of glucose in the blood. Based on the readings of the glucometer , a person himself can dose insulin.