Diabetes sugar: what is it in simple language and words, causes, symptoms, signs and treatment

What is diabetes? In simple words and language, we can say that this is a violation of the metabolism of carbohydrates and water in the body.

The fact that the pancreas produces a hormone - insulin, which takes a direct part in the process of sugar processing. Without it, the body can not turn sugar into glucose. Therefore, sugar, accumulating in the blood, is excreted through the urine.

At the same time, water exchange is violated. Tissues can not hold water, as a result of a large number of inferior water is excreted through the kidneys.

The main sign of diabetes is high sugar( glucose) in the blood - higher than normal. Remember that in a healthy person who does not suffer from diabetes, the blood sugar content is 3.3 - 5.5 mmol / l on an empty stomach.

What happens in the body with diabetes? When the body produces insufficient amounts of insulin, while the sugar and glucose content in the blood becomes high, but the tissue cells begin to suffer from a lack of glucose.

This metabolic disease can be hereditary or acquired. From lack of insulin, pustular and other skin lesions develop, teeth suffer, atherosclerosis, angina pectoris, hypertension, kidneys, nervous system, vision impairment.

Causes of hyperglycemia

There are two types of diabetes mellitus, which are fundamentally different from each other. Although modern endocrinologists call the separation of diabetes mellitus very conditional, but still the type of disease is important in determining therapeutic tactics. Therefore, it is advisable to dwell on each of them separately.

Diabetes mellitus refers to those diseases, in essence which is a violation of metabolic processes. Carbohydrate metabolism is most affected here, which is manifested by a persistent and constant increase in glucose in the blood. This indicator is called hyperglycaemia .

The most important basis of the problem is the distortion of the interaction of insulin with tissues. It is this hormone that is unique in the body contributing to a drop in glucose, by carrying it into all cells, as the main energy substrate for supporting life processes.

If a failure occurs in the system of interaction of insulin with tissues, glucose can not enter into normal metabolism, which contributes to its constant accumulation in the blood. These cause-effect relationships are called diabetes mellitus.

It is important to understand that is not all hyperglycemia a true diabetes mellitus , but only one that is caused by a primary insulin violation!

Immediately indicate when hyperglycemia can still occur:

1. Pheochromocytome is a tumor of the adrenal glands that produces hormones with the action of the opposite insulin;
2. Glucagon and somatostatinome - tumor growth from cells synthesizing insulin competitors;
3. Hyperfunctions of the adrenal glands( hypercortisy);
4. Hyperthyroidism;
5. Cirrhosis of the liver;
6. Disturbed susceptibility( tolerance) to carbohydrates - poor digestion after eating with relatively normal fasting content;
7. Transient hyperglycemia is a short-term increase in the level of glycemia.

The expediency of isolating all these states is due to the fact that the hyperglycemia that occurs during them is secondary. It is a symptom of these diseases. Therefore, eliminating the main reason, will go away and diabetes, which is temporary.

Naturally, if such hyperglycemia persists for a long time, then it causes typical signs of diabetes, which gives the right to state the fact of the true form of this disease against the background of this or that pathology of the organism.

Why are type 1 and type 2 diabetes mellitus isolated?

This need is mandatory, since it completely determines the treatment of the patient, which in the initial stages of the disease is fundamentally different. The longer and more severe the diabetes mellitus, the more its division into types is of a formal nature. After all, in such cases the treatment practically coincides with any form and origin of the disease.

Type 1 diabetes mellitus: insulin-dependent

This type is called insulin-dependent diabetes. Most often this type of diabetes affects young people, under the age of 40, who are thin. The disease is severe, and insulin is required for treatment.

Cause: the body produces antibodies that exterminate the pancreas cells that produce the hormone insulin.

It is almost impossible to completely recover from type 1 diabetes, although there are cases of restoration of pancreatic functions, but this is possible only under special conditions and natural raw nutrition.

To maintain the body it is required to inject insulin into the body using a syringe. Since insulin is destroyed in the gastrointestinal tract, insulin administration in the form of tablets is not possible. Insulin is administered along with a meal. It is very important to follow a strict diet, completely easily digestible carbohydrates( sugar, sweets, fruit juices, sugar-containing lemonades) are excluded from the diet.

Diabetes mellitus type 2: non-insulin dependent

This type of diabetes is insulin-independent. More often type 2 diabetes affects elderly people, after 40 years, obese.

Cause: loss of cell sensitivity to insulin due to overabundance of nutrients in them. The use of insulin for treatment is not necessary for every patient. Only a qualified technician can prescribe treatment and dose.

To begin with, such patients are prescribed a diet. It is very important to follow the doctor's recommendations completely. It is recommended to reduce weight slowly( 2-3 kg per month), to achieve a normal weight, which must be maintained throughout life. In cases where diets are not enough, sugar is used to lower tablets, and only in a very extreme case, prescribe insulin.

High blood glucose levels than harmful?

The higher and more prolonged is hyperglycemia in diabetes mellitus, the more severe the disease is. This is due to such pathological mechanisms that are triggered by the body for the release of glucose:

1. Transformation of glucose into fatty deposits, which leads to obesity.
2. Glycosylation( peculiar sugaring) of cell membrane proteins. This underlies the violation of the normal structure of all internal organs: the brain, heart, lungs, liver, stomach and intestines, muscles and skin.
3. Activation of sorbitol glucose release pathway. This creates toxic compounds that cause a specific damage to nerve cells, which is the basis of diabetic neuropathy.
4. The defeat of small and large vessels. This is caused by glycosylation of proteins and the progression of cholesterol deposits. As a consequence - diabetic microangiopathy of the internal organs and eyes( nephropathy, retinopathy), as well as angiopathy of the lower extremities.

Thus, hyperglycemia gradually causes damage to almost all organs and tissues with a predominant spread to one of the body systems!

Diabetes mellitus: signs and symptoms

Clinical signs of the disease in most cases are characterized by a gradual course. Rarely, diabetes manifests as a fulminant form with a rise in the glycemic index( glucose content) to critical figures with the development of various diabetic comas.

With the onset of the disease in patients appear:

1. Constant dryness in the mouth.
2. Feeling of thirst with an inability to quench it. Sick people drink up to several liters of daily liquid.
3. An increase in diuresis is a marked increase in the amount of daily urine and the total urine output.
4. Decrease or sharp increase in weight and body fat.
5. Severe itching of the skin and its dryness.
6. Increased predisposition to pustular processes on the skin and soft tissues.
7. Muscle weakness and increased sweating.
8. Poor healing of any wounds.

The appearance of the above signs and symptoms should become a mandatory reason for immediate blood testing for glycemia( glucose content).

As the disease progresses, there may appear symptoms of complications of diabetes, which affect almost all organs. In critical cases, life-threatening states with impaired consciousness, severe intoxication, and multiple organ failure may occur.

The main manifestations of complicated diabetes include:

1. Visual impairment. Headaches and neurologic abnormalities.
2. Heart pain, enlargement of the liver, if not noted before the onset of diabetes.
3. Pains and numbness of the lower limbs with impaired walking function.
4. Reduces the sensitivity of the skin, especially the feet.
5. The appearance of wounds that do not heal for a long time.
6. Progressive increase in arterial( systolic and diastolic) pressure.
7. Swelling of the face and lower legs.
8. Appearance of the odor of acetone from the patient.
9. Confusion of consciousness.

The emergence of characteristic signs of diabetes or the development of its complications is an alarm signal that indicates the progression of the disease or insufficient medication correction.

Diabetes mellitus: causes of

The most significant causes of diabetes are:

1. Heredity. We need other factors that affect the development of diabetes mellitus.
2. Obesity. Actively fight overweight.
3. A number of diseases that contribute to the defeat of beta cells responsible for the production of insulin. Such diseases include pancreas diseases - pancreatitis, pancreatic cancer, diseases of other endocrine glands.
4. Viral infections( rubella, chickenpox, epidemic hepatitis and other diseases, this includes influenza).These infections are the starting points for the development of diabetes mellitus. Especially for people who are at risk.
5. Nervous Stress. People who are at risk should avoid nervous and emotional stress.

Age. With age for every ten years, the risk of developing diabetes is doubled.

This list does not include those diseases in which diabetes mellitus or hyperglycemia is secondary, being only their symptom. In addition, such hyperglycemia can not be considered true diabetes until developed clinical manifestations or diabetic complications develop.

The diseases that cause hyperglycemia( increased sugar) include tumors and adrenal hyperfunction, chronic pancreatitis, an increase in the level of contrinsular hormones.

Diagnosis of diabetes

In the presence of suspected diabetes mellitus, this diagnosis must necessarily be either confirmed or disproved. There are a number of laboratory and instrumental methods for this. They include:

1. Study of blood glucose - the definition of fasting glycemia.
2. Glucose tolerance test - the determination of the ratio of muscle glycemia to this indicator after two hours after taking carbohydrate components( glucose).
3. Glycemic profile - the study of glycemic numbers several times throughout the day. It is performed to evaluate the effectiveness of treatment.
4. General urine analysis with determination of glucose level in urine( glucosuria), protein( proteinuria), leukocytes.
5. Urine test for acetone - if there is a suspicion of ketoacidosis.
6. A blood test for the concentration of glycosylated hemoglobin - indicates the extent of the disorders that are caused by diabetes.
7. Biochemical blood test - examination of hepatic-renal samples, which indicates the adequacy of the functioning of these organs against the background of diabetes.
8. Investigation of electrolyte blood composition - is indicated in the development of severe forms of diabetes.
9. Reberg's test - shows the degree of kidney damage in diabetes.
10. Determination of the level of endogenous insulin in the blood.
11. Investigation of the fundus.
12. Ultrasound examination of abdominal organs, heart and kidneys.
13. ECG - for evaluation of the degree of diabetic myocardial damage.
14. Ultrasonic dopplerography, capillaroscopy, rheovasography of the vessels of the lower extremities - assesses the degree of vascular disorders in diabetes.

All patients with diabetes must necessarily be consulted by such specialists:

1. Endocrinologist.
2. Cardiologist.
3. Neuropathologist.
4. Ophthalmologist.
5. by the surgeon( vascular).

The implementation of the whole complex of these diagnostic measures can help to clearly determine the severity of the disease, its degree and the correctness of the tactics regarding the therapeutic process. It is very important to carry out these studies more than once, and to repeat in dynamics as many times as the specific situation requires.

What is the level of blood sugar in diabetes mellitus

The first and informative method of primary diagnosis of diabetes mellitus and its dynamic evaluation during treatment is the study of blood glucose( sugar) level. This is a clear indicator, from which all subsequent diagnostics and treatment measures should be based.

Regular determination of blood sugar level at home will help to carry out the glucometer. Let's consider the indicators of the level of glucose in the body:

Blood sugar:

• on an empty stomach - 3,3 - 5,5 mmol / l;
• 2 hours after the carbohydrate load - & lt; 7.8 mmol / l.

Impaired glucose tolerance:

• on an empty stomach - 5,5 - 6,7 mmol / l;
• 2 hours after the carbohydrate load - 7.8 - 11.1 mmol / l.

Diabetes mellitus:

• on an empty stomach - & gt; 6.7 mmol / l;
• 2 hours after the carbohydrate load - & gt; 11.1 mmol / l.

As can be seen from the table, the diagnostic confirmation of diabetes is extremely simple and can be carried out in the walls of any dispensary or even at home with a personal electronic glucometer( a device for determining the glucose in the blood).

Likewise, criteria for assessing the sufficiency of diabetes therapy by these or other methods have been developed. The main one is the same level of sugar( glycemia).

According to international standards, a good indicator of the treatment of diabetes is a blood glucose level below 7.0 mmol / l. Unfortunately, in practice this is not always feasible, despite real efforts and a strong desire of doctors and patients.

Diabetes mellitus: Degrees - 1, 2, 3, 4

A very important rubric in the classification of diabetes mellitus is its division in terms of severity. The basis for this distinction is the level of glycemia. Another element with the correct formulation of the diagnosis of diabetes mellitus is the indication of process compensation. The basis of this indicator is the presence of complications.

But for a simple understanding of what happens to a diabetic patient, looking at the records in the medical records, you can combine the severity of the stage of the process into one heading. After all, it is natural that the higher the blood sugar level, the heavier the diabetes and the higher the number of its menacing complications.

Diabetes mellitus of the 1st degree

Characterizes the most favorable course of the disease, to which any treatment should strive. At this stage of the process, it is completely compensated, the glucose level does not exceed 6-7 mmol / l, there is no glucosuria( glucose release in the urine), the glycosylated hemoglobin and proteinuria values ​​do not go beyond the normal range.

There are no signs of complications of diabetes in the clinical picture: angiopathy, retinopathy, polyneuropathy, nephropathy, cardiomyopathy. Such results can be achieved with the help of diet therapy and medication.

Diabetes mellitus 2 degrees

This stage of the process indicates partial compensation. There are signs of complications of diabetes and the defeat of typical organs of the targets: eyes, kidneys, heart, vessels, nerves, lower limbs.

The glucose level is increased slightly and is 7-10 mmol / l. Glucosuria is not defined. The parameters of glycosylated hemoglobin are within normal limits or slightly increased. Severe organ failure is absent.

Diabetes mellitus 3 degrees

A similar course of the process indicates its continuous progression and the impossibility of drug control. At the same time, glucose levels range from 13-14 mmol / l, persistent glucosuria( urine glucose release), high proteinuria( presence of protein in the urine), and explicit manifestations of target organ damage in diabetes mellitus.

Progressively reduced visual acuity, persists severe arterial hypertension( increased blood pressure), decreased sensitivity with the appearance of severe pain and numbness of the lower limbs. At a high level, the level of glycosylated hemoglobin is maintained.

Diabetes mellitus 4 degrees

This degree characterizes the absolute decompensation of the process and the development of severe complications. At the same time, the level of glycemia rises to critical figures( 15-25 and more mmol / l), it can not be corrected by any means. Progressive Proteinuria with Protein Loss. The development of renal insufficiency, diabetic ulcers and gangrene of extremities is characteristic.

Another criterion for the 4th degree of diabetes is the propensity to develop frequent diabetic com: hyperglycemic, hyperosmolar, ketoacidotic.

Diabetes mellitus: complications and consequences

Diabetes mellitus itself does not endanger human life. Its complications and their consequences are dangerous. It is impossible not to mention some of them, which either often occur, or bear the immediate danger of the patient's life.

Coma in diabetes

Symptoms of this complication increase at a lightning speed, regardless of the type of diabetic coma. The most important threat is the confusion of consciousness or extreme inhibition of the patient. Such people urgently need to be hospitalized in the nearest medical institution.

The most common diabetic coma is ketoacidotic. It is caused by accumulation of toxic metabolic products, which have a damaging effect on nerve cells. Its main criterion is the persistent smell of acetone in the respiration of the patient. In the case of hypoglycemic coma, the mind is also darkened, the patient is covered with a cold plentiful sweat, but at the same time a critical decrease in the glucose level is fixed, which is possible with an overdose of insulin. Other types of com, fortunately, are less common.

Edema in diabetes

Swelling can be both local and widespread, depending on the degree of concomitant heart failure. In fact, this symptom is an indicator of renal dysfunction. The more pronounced the puffiness, the heavier the diabetic nephropathy.

If edema is characterized by asymmetric spread, capturing only one shin or foot, this indicates a diabetic microangiopathy of the lower limbs, which is supported by neuropathy.

High / low blood pressure for diabetes mellitus

Systolic and diastolic pressure values ​​also serve as a criterion for severity of diabetes mellitus. You can regard it in two planes. In the first case, the level of total arterial pressure on the brachial artery is judged. Its increase suggests progressive diabetic nephropathy( kidney damage), which results in the release of substances that increase blood pressure.

Another side of the medal is the lowering of arterial pressure in the vessels of the lower limbs, which is determined by ultrasonic dopplerography. This indicator indicates the degree of diabetic angiopathy of the lower extremities.

Pain in the legs with diabetes

Pain in the legs may indicate diabetic angiopathy or neuropathy. You can judge this by their nature. Microangiopathy is characterized by the appearance of pain in any physical activity and walking, which causes patients to stop for a short while to reduce their intensity.

The appearance of nocturnal and restless pains speaks of diabetic neuropathy. Usually they are accompanied by numbness and decreased skin sensitivity. Some patients report local burning in certain places of the lower leg or foot.

Trophic ulcers in diabetes mellitus

Trophic ulcers are the next stage of diabetic angiopathy and neuropathy after pain. The appearance of the wound surfaces with different forms of the diabetic foot is radically different, as does the differentiation of their treatment. In this situation, it is extremely important to correctly assess all the smallest symptoms, since the possibility of preserving the limb depends on this.

Immediately it is worth noting the relative favorability of neuropathic ulcers. They are caused by a decrease in the sensitivity of the feet as a result of the defeat of the nerves( neuropathy) against the background of deformation of the foot( diabetic osteoarthropathy).At typical points of friction of the skin in the places of the bony protuberances, there arises natypeshes, which the patients do not feel. Under them are formed hematomas with their further suppuration. Patients pay attention to the foot only when it is already red, swollen and with a massive trophic ulcer on the surface.

Gangrene with diabetes

Gangrene is most often a consequence of diabetic angiopathy. For this, there must be a combination of lesions of small and large arterial trunks. Usually the process begins in the area of ​​one of the toes. Due to the lack of blood flow to him, there is a strong pain in the foot and its redness. Over time, the skin becomes cyanotic, edematous, cold, and then covered with blisters with cloudy contents and black spots of skin necrosis.

The described changes are irreversible, therefore it is not possible to save the limb under any circumstances, amputation is indicated. Of course, it is desirable to perform it as low as possible, since the operations on the foot do not bring any effect with gangrene, the optimal level of amputation is the shin. After such an intervention, it is possible to restore walking with the help of good functional prostheses.

Prevention of complications of diabetes

Prevention of complications consists in the early detection of the disease and its adequate and proper treatment. This requires doctors to have clear knowledge of all the subtleties of the course of diabetes, and from patients strictly adhering to all dietary and curative recommendations. A separate rubric in the prevention of diabetic complications is to allocate proper daily care for the lower limbs in order to prevent their damage, and in case of their detection, immediately seek help from surgeons.

Diabetes mellitus: prophylaxis

Unfortunately, not all cases can affect the inevitability of the appearance of type 1 diabetes. After all, its main causes are the hereditary factor and small viruses that every person faces. But the disease does not develop at all. And although scientists have found that diabetes is much less likely to occur in children and adults who have been breastfed and have treated respiratory infections with antiviral drugs, this can not be attributed to specific prevention. Therefore, there are really no effective methods.

A completely different situation with the prevention of diabetes of the second type. After all, it is often the result of an incorrect way of life.

Therefore, the full preventive measures include:

1. Normalization of body weight.
2. Control of arterial hypertension and lipid metabolism.
3. Correct fractional diet food with a minimum content of carbohydrates and fats capable of easy digestion.
4. Dosed physical activity. Suppose the struggle with hypodynamia and the rejection of excessive loads.

Is it possible to cure diabetes?

The question of the possibility of a complete cure for diabetes mellitus is very ambiguous today. The difficulty of the situation is that it is very difficult to return what has already been lost. The only exception is those forms of type 2 diabetes that are well controlled under the influence of diet therapy.

In this case, by normalizing the regimes of nutrition and physical activity, you can completely get rid of diabetes. It should be borne in mind that the risk of re-occurrence of the disease in the event of a violation of the regime is extremely high.

According to official medicine - type 1 diabetes mellitus and persistent forms of type 2 diabetes can not be completely cured. But constant medication can prevent or slow the progression of complications of diabetes. After all, they are dangerous for humans.

Therefore, it is extremely important to engage in regular monitoring of blood glucose levels, monitoring the effectiveness of therapeutic measures. It must be remembered that they must be lifelong. It is permissible to change only their volumes and varieties, depending on the patient's condition.

However, there are many former patients who were able to cure this incurable disease with the help of curative fasting. But forget about this method if you can not find a good specialist in your city who could control you and prevent the situation from getting out of control. Because there are many cases when experiments on themselves end in intensive care!

With regard to surgical methods for eliminating diabetes mellitus with the implantation of a kind of artificial pancreas, which is a device that analyzes the level of hyperglycemia and automatically allocates the necessary amount of insulin. The results of such treatment are impressive with their effectiveness, but they are not devoid of significant shortcomings and problems. Therefore, no one has yet succeeded in replacing the natural insulin of a particular person with a synthetic analogue, which not all can suit a diabetic patient.

There continue to be developments in the field of synthesis of those types of insulin, which will consist of identical components specific for each patient. And while this remains a distant reality, every person, exhausted by the course of diabetes, believes that a miracle will happen.

Author of the article: Zubolenko Valentina Ivanovna, endocrinologist - http: //www.ayzdorov.ru/ lechenie_diabeta_chtotakoe.php