Diabetes mellitus is a chronic metabolic disease resulting from impaired secretion or action of insulin, a hormone produced by the pancreas. What are the causes and types of diabetes? How do you recognize the symptoms of diabetes? What tests detect high blood sugar? And how is diabetes treated? Are the complications of diabetes dangerous?

Diabetes - disease definition

The namediabetes-diabetes mellitus- comes from the Latin words meaning "draining water through the body" and "sweet as honey". Both terms refer to important symptoms of diabetes: increased thirst, frequent urination and high blood sugar levels.

Why is it important for everyone to know what the symptoms of diabetes are? Because more and more people develop diabetes, especially type II diabetes, also known as non-insulin dependent diabetes.

Data from the World He alth Organization (WHO) indicate that, according to estimates, in 2014, there were 422 million adults with diabetes in the world (for comparison - in 1980 there were 108 million of them). According to the International Diabetes Federation, by 2040 there are already 642 million people with diabetes. In Poland, the number of people suffering from diabetes is estimated at over 2 million, but you should probably add another million Poles who do not know that they have diabetes.

Causes of diabetes

There are many reasons for this increase. The most important causes of diabetes include:

  • bad eating habits
  • overweight and obesity
  • hypertension
  • stress
  • Cushing's syndrome
  • little sleep

If there were cases of sickness in the family, the risk that we will increase the army of people with "too sweet blood" automatically increases. If someone in your family has been diagnosed with diabetes, you need to be especially vigilant as you may be prone to the disease.

Gender and age are also a risk factor- the risk of diabetes increases with age in both women and men, while women are more likely to develop type 2 diabetes.

Types of diabetes

  • Type 1 diabetes (insulin-dependent diabetes)

Affects 15-20 percent of people with diabetes, it is caused by the destruction of beta cells in the pancreas, responsible for the production and secretion of insulin; type 1 diabetes is most common in children and young people, and in children; it cannot be prevented, and the only treatments for diabetes are insulin administration, diet, and an active lifestyle (exercise).

  • LADA type diabetes (Latent Autoimmune Diabetes in Adults)

This is type 1 diabetes, late-onset autoimmune diabetes in adults; LADA type diabetes affects 5-10% of people with diabetes diagnosed after the age of 35; in order to diagnose it, it is necessary to confirm the presence of autoantibodies typical for type 1 diabetes, especially anti-GAD.

  • Monogenic diabetes

Monogenic diabetes accounts for 1-2 percent of all diabetes cases; it arises as a result of a single mutation, therefore its final diagnosis depends on genetic testing; the most common forms of monogenic diabetes areMODY diabetes(Maturity Onset Diabetes of the Young), mitochondrial diabetes andneonatal diabetes , most of them associated with a secretory defect insulin.

  • Type 2 diabetes (non-insulin dependent diabetes)

It is diabetes that most often affects the elderly, and the reason for the increased level of glucose in the blood is not a lack of insulin, but its malfunction in the body (insulin resistance). The most common type of diabetes mellitus is obesity - about 80-85 percent of all patients suffer from it, as well as arterial hypertension. Treatment of type 2 diabetes is based on the use of an appropriate diet, exercise and oral antidiabetic drugs, although some patients switch to insulin over time.

  • Gestational diabetes

This is diabetes, which is diagnosed in the course of pregnancy, and resolves after the birth of a child. Women with gestational diabetes have a higher risk of developing diabetes in the future compared to women without this complication.Diabetes in pregnancy can cause troublesome symptoms.These include polyuria, sudden hunger pangs, severe thirst, tiredness and sleepiness, blurred vision, and recurring skin infections. Treatment of this form of diabetes should be carried out only in specialized gynecological and diabetic centers.

  • Secondary diabetes mellitus (type 3 diabetes)

This is a group of diabetics, which together account for approx2-3% of all forms of diabetes in Europe and North America. Characteristic for this form are other disorders or syndromes coexisting with diabetes. The most common causes of secondary diabetes include:

  • some medications used in cardiovascular diseases (thiazides or other diuretics, especially in combination with beta blockers, steroids and others)
  • certain endocrine diseases (endocrinopathies) - Cushing's disease and Cushing's syndrome, acromegaly, hyperthyroidism, pheochromocytoma, glucagon secreting tumor
  • genetically determined metabolic diseases - hemochromatosis
  • pancreatic diseases - chronic pancreatitis, pancreatic cancer, condition after pancreatectomy (surgical removal of the pancreas)

Secondary diabetes also includes diabetes due to insufficient and faulty nutrition - it occurs mainly among the indigenous population of the tropics in Asia, Africa and South America, where malnutrition and hunger are common.

Diabetes - general symptoms

Type II diabetes (80-90% of patients have it) may not cause any discomfort at the beginning. Sometimes they appear only after a few years, so it is worth watching the body's reactions to notice any suspicious symptoms as soon as possible.

The most important symptom of diabetes is high blood glucose, but unfortunately it is not visible to the naked eye.

If you are not in the habit of doing this test regularly, it remains to be vigilant and watch out for the following symptoms. Regardless of the type of diabetes (the types of diabetes are discussed below), the symptoms are quite similar and are usually grouped according to whether or not insulin-dependent diabetes is present.

Symptoms of type 1 (insulin-dependent) diabetes

  • thirst
  • frequent urination
  • good appetite and weight loss
  • general weakness
  • sleepiness
  • blurred or double vision

If you notice such symptoms in yourself or a loved one, know that you need a medical consultation as soon as possible, and above all a blood sugar check.

When the tests ordered by your doctor show that you have excess blood sugar, the next step should be a visit to a diabetes clinic.

Diabetes is a disease that cannot be cured, but can be very effectively controlled to avoid serious complications.

The condition is, however, regular glycemic control (i.e. blood sugar content) and following the instructionsdoctor and dietitian.

Symptoms of type 2 diabetes (non-insulin dependent)

  • high thirst and frequent urination ( although not as severe as in type I diabetes)
  • lose weight despite normal appetite and diet
  • blurred vision
  • irritability, apathy
  • fatigue and sleepiness
  • easy bruising and slower wound healing
  • recurrent dermatitis, gingivitis or cystitis
  • dry skin
  • itchy skin
  • tingling or temporary loss of sensation in feet
  • in men - erectile dysfunction
  • in women - chronic vaginitis

Where do these symptoms come from? Our body's cells need glucose, which they turn into energy.

Glucose can get into them if insulin helps. Sometimes, however, the pancreas produces too little of this hormone or cells do not want to open to glucose with it and begin to "starve".

Then the body, by defending itself against malnutrition, activates mechanisms that increase the appetite.

Unfortunately, even if we eat a lot and often, glucose from food will not penetrate into the cells. They will continue to starve.

In this situation, firstly, the body will start to use up fat reserves and we will lose weight despite the wolf's appetite, secondly, the body will try to excrete excess glucose with urine as soon as possible.

But first he has to dissolve it and hence the increased thirst. And the more we drink, the more we go to the toilet. We get rid of fluids, so the body requires them to be replenished. And the circle closes.

Diabetes diagnosis - tests

Diabetes diagnosis is possible due to the presence of symptoms of hyperglycaemia in combination with random glycaemia (which does not occur in the morning and on an empty stomach) not lower than 200 mg / dl (11.1 mmol / l) or fasting glucose measured twice, at least 126 mg / dL (7 mmol / L) or blood glucose in the second hour of the glucose load test minimum 200 mg / dL (11.1 mmol / L).

  • Oral glucose load test (sugar curve) - what is it?

Determining glycosylated hemoglobin is not a diabetes diagnosis test, but it can be used as a screening test for double fasting blood glucose measurements.

Performing a glycosylated hemoglobin test allows you to determine the average glucose levels (sugar levels) over the last 100 days.

The results show not only whether the implemented treatment is effective, but also whether the patient complied with the medical recommendations.

  • HbA1c glycated hemoglobin: normal hemoglobin result

Diabetes treatment

Treating diabetes is not only about normalizing blood sugar levels, but also about preventing complications.

In type 1 diabetes, insulin is the mainstay of treatment.- human insulin with intermediate-acting insulin or long-acting insulin analogues are used. The key to maintaining proper glycemia is the patient's self-control - multiple blood sugar measurements, regular insulin intake, the right dose of exercise and a he althy, balanced diet.

Treatment of type 2 diabetesshould be multifaceted, with patient education and involvement in the treatment process of great importance - specialists emphasize the huge responsibility that rests on the shoulders of diabetes educators.

  • Diabetes educator at the National He alth Fund

It is because it is impossible to control glycemia satisfactorily without changing the lifestyle - the diet should be in line with the principles of he althy eating and the dose of exercise should be adjusted to the patient's abilities.

The first-line treatment for type 2 diabetes is metformin , which reduces insulin resistance. If its application does not bring the expected results, then:

  • sulfonylurea derivatives - in Poland there are three drugs available in the composition: gliclazide, glimepiride and glipizide
  • acarbose
  • incretin drugs
  • SGLT2 inhibitors - the so-called floosin or gliflozin; dapagliflozin, canagliflozin
  • thiazolidinedione derivatives - the so-called glitazones - pioglitazone is the only available drug from the group of thiazolidinedione derivatives

If they also do not lower blood glucose, insulin is introduced.

Important

Sometimes the concentration of glucose in the blood and in the urine is very high. If we do not know about it and do not react in time, the so-called ketone bodies (beta-hydroxybutyric acid, acetoacetic acid and acetone) that acidify the body.

This leads to ketoacidosis, which can cause a life-threatening coma. The acidosis is evidenced, among others, by smell of the air exhaled by diabetics - it resembles sour apples.

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Diabetes complications

Proper diabetes management is also important and thereforethat decompensated diabetes carries a risk of many complications, which can be either early (acute) from blood sugar fluctuations or late (chronic) caused by high sugar levels for many years.

Early (acute) complications of diabetes:

  • ketoacidosis
  • lactic acidosis
  • hypoglycemia
  • hyperglycemia
  • hyperglycemic-hyperosmolar syndrome

The acute complications of diabetes, if treated properly and promptly, do not cause permanent damage, but if not addressed in a timely manner, they can lead to diabetic coma and even death.

Late (chronic) complications of diabetes:

  • diabetic retinopathy (eye damage)
  • diabetic neuropathy (nerve damage)
  • Diabetic nephropathy (kidney disease)
  • heart disease
  • stroke
  • diabetic foot

Late or chronic complications of diabetes are the result of persistently elevated blood sugar levels.

It results in damage to blood vessels - both small (microangiopathy) and large (macroangiopathy).

It happens that chronic complications of diabetes show up more quickly than the disease itself - this is because most of us rarely do basic blood sugar tests.

Category:

Diabetes