diabetes

Diabetes is a chronic endocrine disease in which glucose (sugar) levels in the blood are significantly elevated.Glucose is the body's main source of energy; it comes from food and is required for the normal functioning of tissues and organs. Insulin is a hormone produced by the pancreas that helps glucose enter cells and acts as a "key" that opens the cell's "doors. "Diabetes develops when the pancreas doesn't produce enough hormone, or the body doesn't use it efficiently.There is no cure for this disease, but it can be controlled with medication. Uncontrolled or poorly controlled diabetes can have serious health consequences—complications: damage to tissues and organs, including the heart, kidneys (nephropathy), eyes (retinopathy), ears (hearing loss), and nerves (diabetic neuropathy)lesions); amputation (diabetic foot), Alzheimer's disease, depression, dental disease.The diabetes group includes several endocrine diseases (or metabolic disorders): type I diabetes, type II diabetes, and gestational diabetes (occurring only during pregnancy). Prediabetes is an early-stage disorder of carbohydrate metabolism (blood sugar levels that are higher than normal, but not high enough to be classified as diabetes) that, if left unchecked, may eventually transform into type II diabetes. Prediabetes and gestational diabetes are considered potentially reversible conditions.Less common types of diabetes include:

• Monogenic diabetes (MODY, Maturity-Onset Diabetes of the Young, adult-onset diabetes of the young) is a genetically determined type of diabetes caused by mutations in multiple genes. MODY accounts for 4% of all diabetes cases;
• Diabetes related to cystic fibrosis (cystic fibrosis), a type of diabetes that is common in people with this disease;
• Drug or chemical diabetes - occurs after an organ transplant, during HIV/AIDS treatment, or during glucocorticoid therapy.

Diabetes insipidus is a rare (treatable) disorder in which people produce large amounts of urine (polyuria). It is caused by insufficient secretion of antidiuretic hormone (ADH) or insufficient kidney sensitivity to it.As of 2019, the global prevalence of diabetes is estimated at 463 million cases. The number of people affected by this disease is expected to increase to 578 million by 2030 and 700 million by 2045 (increases of 25% and 51%, respectively). Also in 2019, diabetes was the ninth leading cause of death, with 1. 5 million people dying directly from the disease.

reason

Type I diabetes is an autoimmune disease in which the body's immune system attacks and destroys the pancreatic cells that produce insulin, resulting in an absolute lack of insulin. This disease occurs most often in children but can occur at any age. The exact cause is unknown, but a combination of factors: genetic predisposition and environmental factors (not yet fully identified) are thought to play a key role. People with type 1 diabetes need to make up for the lack of insulin every day, so they are called insulin-dependent diabetes.Type II diabetes is the most common "insulin resistant" disease and is associated with impaired glucose absorption: the transport of insulin and glucose into cells is disrupted, resulting in hyperglycemia (elevated blood sugar levels). Strictly speaking, type II diabetes occurs for two interrelated reasons: the pancreas cannot produce normal amounts of insulin to regulate blood sugar levels, and the cells (fat, muscle, liver) become resistant to it and fail to receive enough glucose. Why this occurs is not fully understood, but it is known that genetic predisposition (an individual's own genetic variants, family history of type 2 diabetes), excess body weight, and a sedentary lifestyle play a key role in the development of the disease. However, not all people with type 2 diabetes are overweight). The disease can occur at any age (even in childhood), but is most common in middle-aged and older adults.Gestational diabetes occurs in women (who do not have diabetes) during pregnancy due to insulin resistance or reduced production of this hormone. It is also characterized by hyperglycemia. Symptoms of the disease may be mild, but with HD, mothers are at increased risk of preeclampsia, depression, and caesarean section, and babies are at increased risk of hypoglycemia (low blood sugar), jaundice, and high birth weight. Additionally, children are at a higher risk of being overweight and developing type 2 diabetes in the long term.

risk factors

Factors that increase the risk of developing diabetes vary depending on the type of diabetes.Risk factors for type 1 diabetes include:

• Family history of type 1 diabetes (close relatives with the disease - parents, brothers, sisters);
• Pancreatic injury (infection, tumor, surgical intervention);
• Presence of autoantibodies;
• physical stress (illness, surgery);
• Diseases caused by viruses.

Risk factors for type 2 diabetes (and prediabetes) include:

• Family history of type 2 diabetes;
• race (African Americans, Hispanics, and other ethnic groups are at higher risk);
• overweight;
• hypertension;
• Low HDL and high triglycerides;
• sedentary lifestyle;
• gestational diabetes;
• polycystic ovary syndrome;
• History of heart disease and stroke;
• Smoking.

Risk factors for gestational diabetes include:

• Family history of prediabetes or type 2 diabetes;
• overweight;
• race (African Americans, Hispanics, and other ethnic groups are at higher risk);
• GD’s personal history;
• Aged over 25 years old.

symptom

Symptoms of type I diabetes:

• intense thirst;
• Frequent urination;
• blurred vision;
• fatigue;
• Unexplained weight loss.

Symptoms appear fairly quickly - within days/weeks of illness onset. Sometimes they talk about a life-threatening condition—diabetic ketoacidosis—that requires emergency care. Symptoms: acetone smell in the mouth, dry skin, flushing, nausea, vomiting, abdominal pain, difficulty breathing, and difficulty concentrating.Symptoms of type II diabetes:

• intense thirst;
• Frequent urination;
• fatigue;
• blurred vision;
• Numbness in parts of the body, tingling in the arms or legs;
• Slow-healing or non-healing ulcers;
• Frequent infections (gum, skin, vagina);
• Unexplained weight loss.

Symptoms develop slowly, taking years, and may be mild so people don't notice them. Many people do not have the classic symptoms of diabetes and do not seek medical attention promptly.With gestational diabetes, there are usually no signs and symptoms specific to diabetes. Of note are increased thirst and frequent urination.

diagnosis

The main way to diagnose type I and type II diabetes is to measure blood sugar levels. Your doctor may recommend one of the following tests:

• Analyze fasting blood glucose levels - after fasting for 8-12 hours;
• Glycated hemoglobin analysis - displays average blood sugar levels over the past two to three months at any time, measuring the percentage of blood sugar relative to hemoglobin;
• Random blood glucose test - Any time, regardless of food intake, a blood glucose level of 200 mg/dL - 11. 1 mmol/L or higher indicates diabetes;
• Oral Glucose Tolerance Test - The measurement is taken on an empty stomach and then you are asked to drink a glass of water with glucose dissolved in it. The measurement is repeated 1 hour and 2 hours later.

If type I diabetes is suspected, the blood will be additionally tested for the presence of autoantibodies. To diagnose gestational diabetes, a fasting blood glucose test is performed and an oral glucose tolerance test is performed to confirm the diagnosis.Patients diagnosed with diabetes may need to consult with doctors in related specialties: ophthalmologists, cardiologists, urologists, nephrologists, psychotherapists, etc.

diabetes treatment

Treatment—monitoring of blood sugar levels, insulin therapy, blood sugar-lowering medications—depends on the type of diabetes. This is supplemented by proper nutrition, maintaining a normal weight and regular physical activity.Treatment of type 1 diabetes includes insulin therapy (insulin injections or use of an insulin pump), frequent blood glucose testing, and carbohydrate counting; type 2 diabetes - primarily lifestyle changes (weight loss, physical activity, healthy eating), control of blood sugar, cholesterol, andBlood pressure, blood sugar-lowering drugs, insulin therapy.Treatment of gestational diabetes mainly involves adjusting your diet, ensuring regular physical activity, and closely monitoring blood sugar levels; insulin therapy is only given in certain circumstances.If prediabetes is diagnosed, it is important to adhere to a healthy lifestyle, eat right, and normalize your weight. Exercise (at least 150 minutes per week) and losing 7% of your body weight can help prevent or at least delay the development of type 2 diabetes. If you are still at high risk of converting from prediabetes to diabetes, have a chronic disease (cardiovascular, non-alcoholic fatty liver disease, polycystic ovary syndrome), your doctor may prescribe blood sugar-lowering medications, medications to control cholesterol levelsand antihypertensive medications.