Diabetes mellitus: symptoms and treatment
Diabetes mellitus is a chronic disease in which the endocrine system is affected. Diabetes mellitus, the symptoms of which are based on a prolonged increase in the concentration of glucose in the blood and the processes accompanying the altered state of metabolism, develops in particular because insulin is deficient, as a hormone produced by the pancreas, through which the body regulates the processing of glucose in the tissues of the body And in its cells.
In diabetes mellitus, a chronic increase in blood sugar levels develops, which determines a condition such as hyperglycemia, which occurs because insulin secretion is deficient or because the sensitivity of the body cells to it decreases. On average, this disease is relevant for 3% of the population, while it is known that diabetes mellitus in children is less common, determining average values within 0.3%. Meanwhile, there is a trend in which the annual number of patients with diabetes mellitus only increases, with an annual growth of about 6-10%.
Thus, it can be argued that approximately every 15 years the number of patients with diabetes mellitus is doubled. As part of the global indicators on the number of cases, the figure was estimated at more than 120 million in 2000, but now the total number of people with diabetes is more than 200 million people.
Let us dwell in more detail on those processes that are directly related to the development of diabetes mellitus, and start with the most important thing — with insulin.
Insulin, as we have already noted, is a hormone produced by the pancreas and controlling the concentration of glucose (ie, sugar) in the blood. In our body, there is a splitting of food in the intestines, due to which a number of different substances are released, which the body needs for full-fledged work. One of these substances is glucose. Absorbed from the intestine into the blood, it spreads, therefore, through the body. After eating, high levels of sugar have a stimulating effect on the secretion of insulin by the pancreas, which ensures that glucose enters the body through the bloodstream, thus, it helps to reduce the concentration of glucose in the blood. Let’s add that certain cells without insulin simply are not capable of assimilating the blood glucose coming in from the blood.
As for glucose, it either accumulates in the cells of the body, or immediately converted into energy, which, in turn, is consumed by the body for one or another of its needs. Throughout the day there is a variation in the glucose level in the blood, in addition, its parameters change, depending on the food intake (that is, food intake has a direct effect on these parameters). Accordingly, after the meal, there is an increase in glucose levels, after which their normalization occurs gradually, lasting for two hours following the ingestion of food. Normalization of blood glucose levels, as a rule, is accompanied by a decrease in the production of insulin, which, as is already clear, is realized by the pancreas. In the event that insulin is produced in insufficient quantities, cells cease to properly absorb glucose, due to which its accumulation takes place in the blood. Because of the increased level of glucose in it (that is, with increased sugar), there are, respectively, symptoms of diabetes, as well as complications associated with this disease.
Features of the mechanism of development of diabetes in children
Diabetes in children develops in accordance with the same principles as diabetes in adults. Nevertheless, it is characterized by the presence of certain specific features. So, the pancreas in the child, due to which, as we found out, insulin is produced, has small dimensions. By the age of ten, it doubles in size, thus reaching 12 cm, and its weight is about 50 grams. The process of insulin production is finally formed to reach a child of 5 years, it is from this age and up to the age of 11 that children are especially affected by the development of their diabetes mellitus.
In general, metabolic processes occur in children much faster than in adults, and the assimilation of sugar (and this is carbohydrate metabolism) in such processes is also no exception. In a day per kilogram of a child’s weight, carbohydrates are needed in the amount of 10 grams, which, in principle, explains the children’s love for sweets, which is dictated by quite natural needs on the part of their body. The metabolic processes of carbohydrates are significantly influenced by the nervous system, which, in turn, is also not completely formed, due to which various kinds of failures in it are tolerated, which also affect the level of sugar in the blood.
It should be noted that although there is a belief that consumption of sweet is the cause of diabetes, especially if it is a significant amount. Specifically, the love for sweets does not lead to the development of diabetes, this factor can only be considered as a predisposing factor — provoking obesity, and with it the risk of developing this disease.
There are certain risks in terms of individual characteristics, predisposing to the development of this disease. So, the least developed and premature babies, and also adolescents (in this case we are talking about the period of puberty) are most prone to diabetes mellitus. Excessive / significant physical exertion, for example, caused by visits to sports sections, also determine high risks in the issue of predisposition to diabetes.
Diabetes mellitus: causes
Diabetes mellitus can develop for a number of reasons, in particular, the following can be distinguished.
The impact of viral infections. Viral infections contribute to the destruction of pancreatic cells, through which insulin production is provided. Of these viral infections, viral parotitis (also called mumps), rubella, viral hepatitis, chickenpox, etc., can be isolated. Some of these viral infections have a significant affinity for the gastric gland, more specifically to its cells. By affinity in the general plan of consideration is meant the ability, which has one object in relation to another, due to what, accordingly, the possibility of creating a new complex object is determined. In the case of the affinity of infections and cells of the gland, the development of a complication in the form of diabetes is stipulated. Remarkably, among the patients who had rubella, there is an increase in the incidence of diabetes on average by 20% and even higher. It is also important to emphasize that the impact of a viral infection is reinforced by the presence of a hereditary predisposition to the development of diabetes mellitus. It is the viral infection that in most cases becomes the cause of the development of diabetes, especially in children and adolescents.
Heredity. Often, diabetes develops several times more often in those patients who have relatives with the disease we are considering. With diabetes mellitus in both parents, the risk of developing diabetes in a child throughout life is 100%. In the same case, if diabetes is relevant only for one of the parents, the risk, respectively, is 50%, and if the sister / brother has this disease, this risk is 25%. Below we will dwell in more detail on the classification of diabetes mellitus, for the present we only note the features of type 1 diabetes mellitus for this predisposing factor. They are concerned with the fact that for a given type of diabetes even the relevance of the hereditary predisposition does not stipulate the obligatory and unconditional fact of the further development of this disease in the patient. For example, it is known that the probability of transferring a defective gene from a parent to a child in the presence of type 1 diabetes is low enough — it is about 4%. In addition, there are known cases of morbidity, when only one of the twin pairs showed diabetes, respectively, the second remained healthy. Thus, even predisposing factors are not the final statement that the patient will have type 1 diabetes, unless he is infected with a certain viral disease.
Autoimmune diseases. These include those types of diseases in which the body’s immune system begins to «fight» with its own tissues and cells. Among such diseases, autoimmune thyroiditis, systemic lupus erythematosus, hepatitis, glomerulonephritis, etc. can be distinguished. Diabetes mellitus, respectively, in such cases acts as a complication, it develops because the cells of the pancreas begin to degenerate, due to which the production of insulin is made, and the destruction is caused by the influence of the immune system.
Increased appetite (overeating). This cause becomes a predisposing factor to obesity, obesity, in turn, is seen as one of the factors leading to the development of diabetes mellitus 2 types. For example, those who are not overweight are diagnosed with diabetes mellitus in 7.8% of cases, while those who are overweight above the norm by 20% are diabetic in 25% of cases, but Excess weight exceeding the norm by 50%, increases the incidence of diabetes by 60%. At the same time, if patients achieve weight loss by an average of 10% due to the appropriate physical activity and diet, then it is possible for them to significantly reduce the risk of developing the disease we are considering.
Stresses. Stresses are considered in the context of treating diabetes as an equally serious aggravating factor that provokes its development. Especially it is necessary to try to exclude stresses and emotional overstrain for those patients who have a compliance with these or other factors of predisposition (obesity, heredity, etc.).
Age. Age also refers to predisposing factors for the development of diabetes. So, the older the patient, the more likely it is that he can develop diabetes. It should be noted that with age, heredity as a predisposing factor, loses its relevance for this disease. But obesity, on the contrary, acts as a practically decisive threat for this, especially in combination with weakened immunity against the background of previous diseases. Most often this pattern contributes to the development of type 2 diabetes.
Again, again, for the myth of diabetes mellitus in sweet tooth. There is only a part of the truth in it, and it consists that excessive consumption of sweet leads to the fact that there is a problem of excess weight, it, in turn, is considered as a factor that we identified above as predisposing.
Diabetes mellitus develops more rarely on the background of hormonal disorders, due to pancreatic damage by some medications, and also because of alcohol abuse over a long period of time. In addition, among the predisposing factors, high blood pressure (arterial hypertension) and elevated cholesterol are distinguished.
Diabetes mellitus: risk factors for the development of the disease in children
The risk factors that contribute to the development of this disease in children, by some points are similar to the above factors, but there are some special features here. Let us single out the main of such factors:
- the birth of a child in parents with diabetes (in the presence of this disease in one of them or both)
- frequent occurrence of viral diseases in the child
- the presence of those or other disorders in metabolism (obesity, hypothyroidism, etc.)
- the weight of the child at birth of 4.5 kg or more;
- reduced immunity.
Diabetes can actually manifest itself in several varieties of forms, we will discuss them below.
Diabetes insipidus. This disease develops because of the relative or absolute lack of vasopressin — antidiuretic hormone. Among the features characteristic of the disease, you can identify increased urination and a constant unquenchable thirst. More information on diabetes insipidus can be found in our article on it: symptoms and treatment of diabetes insipidus.
Diabetes mellitus. Actually, this is the very form of the disease in which our article is devoted. As the reader has already been able to understand, this is a chronic disease, accompanied by a disturbance in the metabolism of glucose (primarily), fats and, to a lesser extent, proteins. There are two main types of this diabetes, these are type 1 and type 2.
- 1 type of diabetes mellitus, or insulin-dependent diabetes (IDDM). With this form of the disease, insulin deficiency is actual, because of what it is defined as insulin-dependent diabetes. The pancreas in this case does not cope with its functions, because of which insulin or is produced in a minimum volume, due to which it becomes impossible to later process glucose entering the body, or insulin is not produced at all. The level of blood glucose in this case increases. Taking into account the peculiarities of the manifestation of the disease, patients with it need to ensure the possibility of additional insulin administration, which will ensure the prevention of the development of ketoacidosis in them — a condition accompanied by a high content of ketone in the urine, in other words it is hypoglycemia. Hypoglycemia is accompanied by a number of specific symptoms, in addition to changes in the composition of the urine, and this is the appearance of the odor of acetone from the mouth, drowsiness and severe fatigue, nausea and vomiting, muscle weakness. The introduction of insulin in this type of diabetes in general can support the life of patients. The age of the patients can be anything, but mostly it ranges within not exceeding 30 years. There are other types of features. Thus, patients in this case, as a rule, are lean, the symptoms and signs of type 1 diabetes mellitus appear suddenly.
- type 2 diabetes mellitus, or non-insulin-dependent diabetes (NIDDM). This type of disease is insulin-independent, that is, the production of insulin occurs in a normal amount, and sometimes even in an amount exceeding the norm. Nevertheless, the benefits of insulin in this case is practically none, which is caused by the loss of tissue sensitivity to it. The age group in most cases — patients after 30 years, mostly obese, have relatively few symptoms (classical variants in particular). In the treatment of drugs used in the form of tablets, due to their effects, it is possible to reduce the resistance to insulin cells, in addition, drugs can be used, due to which the stimulation of the pancreas to produce insulin is provided. This type of disease can be divided by the type of occurrence, that is, when it appears in obese patients (obese individuals) and when it appears in individuals with normal weight. Based on studies conducted by some specialists, a slightly different condition, called prediabetes, can be isolated. It is characterized by an increased level of sugar in the patient’s blood, but on the verge of practically reaching the markers at which diabetes is diagnosed (glucose corresponds to a value within 101-126 mg / dl, which is slightly higher than the 5 mmol / l level). Prediabet (and he also — latent diabetes) without the implementation of adequate therapies, oriented to its correction, is subsequently transformed into diabetes.
Gestational diabetes. This form of diabetes develops during pregnancy, and after birth it can also disappear.
Diabetes mellitus: symptoms
Until a certain period, diabetes can not manifest itself for a long time. Symptoms of type 1 and type 2 diabetes differ from each other, at the same time, there may be no signs at all (again, up to a certain time). The severity of the main manifestations associated with diabetes of both types is determined by the degree of decrease in insulin production, the individual characteristics of the patient’s organism and the duration of the course of the disease. Let us single out the main complex of symptoms characteristic for both types of diabetes:
- insatiable thirst, increased urination, against which general dehydration develops;
- Rapid weight loss, regardless of appetite
- frequent dizziness;
- weakness, reduced performance, fatigue
- heaviness in the legs
- tingling, numbness of limbs
- pain in the heart area
- calf muscle cramps;
- low temperature (below average indicators)
- the appearance of itching in the perineal region
- skin itching
- slow healing of skin lesions, wounds
- Violations of sexual activity
- long-term cure for infectious diseases
- visual impairment (general visual impairment, the appearance of «shrouds» before the eyes).
There are also some «special» signs that allow you to suspect diabetes. For example, diabetes mellitus in children — the symptoms of a special type in this case are the lack of growth and weight gain. In addition, diabetes in infants is manifested as white traces on diapers after the previous drying of urine on them.
Diabetes mellitus in men also manifests itself as a characteristic symptom, impotence is considered as such.
And, finally, signs of diabetes in women . Here, too, the symptomatology is quite pronounced, it consists in manifestations in the area of the external genitalia, and this is their itching, as well as the persistent and prolonged manifestation of thrush. In addition, women with the actual latent form of type 2 diabetes mellitus for a long period can be treated for infertility and polycystic ovaries. In addition to these manifestations of symptomatology, it remains to add the redundancy of growth on the body and on the face of the hair in women.
Diabetes mellitus type 1: symptoms
This type of diabetes is a disease accompanied by a chronic increase in blood sugar levels. This form of diabetes develops due to insufficient secretion of the pancreas of insulin. Type 1 diabetes mellitus accounts for about 10% of cases in general.
The typical form of the disease manifestation, especially in children and young people, is accompanied by a debut in the form of a fairly vivid picture, and its development is noted within the period from several weeks to several months. To provoke the development of this type of diabetes may be infectious diseases or other types of diseases that accompany the violation of the patient’s general health. The earlier the debut of the disease occurs, the more bright it is. The manifestation of symptoms is sudden, the deterioration of the condition occurs abruptly.
The symptomatology manifested here is typical for all forms of diabetes caused by hyperglycemia, and this is: increased frequency of urination, accompanied by a possible increase in the volume of urine production (when this volume exceeds 2-3 l / day), constant thirst, weakness and weight loss (For a month the patient can lose weight by 15 kilograms). Dwelling on weight loss, it can be noted that the patient may even eat a lot, but loses about 10% of its total weight.
As one of the signs of this disease may appear the appearance of the odor of acetone from the mouth, the same odor appears in urine, in some cases vision may be impaired. Also, a companion of patients with this type of diabetes is frequent dizziness, heaviness in the legs. The following are considered as indirect signs of the disease:
- wounds last longer;
- the cure for infectious diseases is also significantly longer;
- the gastrocnemius area is prone to seizures
- Itching appears in the genital area
Thirst with this type of diabetes is particularly pronounced — patients can drink (respectively, allocating) a liquid in a volume of about 5 and even 10 liters. The onset of the disease in many cases is accompanied by an increase in appetite in patients, but further anorexia develops against the background of parallel development of ketoacidosis.
Ketoacidosis, as we noted above, is accompanied by the appearance of a smell of acetone from the mouth (fruit smell), and also nausea and vomiting. Often the condition is supplemented with abdominal pain, defined as a pseudo-peritonitis and a severe form of dehydration. The listed complex of symptoms subsequently concludes with the development of coma in patients. In a number of cases, type 1 diabetes mellitus in children is accompanied by a progressive form of impairment of consciousness, which can reach the state of coma, and this occurs against the background of existing concomitant diseases, mainly infectious diseases, or conditions caused by acute surgical pathology.
Rare cases of this type of diabetes are accompanied by a less pronounced form of the disease. In particular, it is a question of such a form as latent autoimmune diabetes in adults. It is manifested in patients aged 35-40 years, accompanied by a moderate manifestation of the actual disorders associated with urination (increased frequency of urination, increased urine output), and the absence of weight changes (i.e., without weight loss).
In some cases, and at all, the detection of the disease occurs randomly, as part of a standard blood test. Because of this, initially an erroneous diagnosis can be made, type 2 diabetes mellitus, which in turn causes the patient to prescribe sugar-lowering drugs in the form of tablets — at their expense for a certain time, it is possible to achieve an acceptable level of compensation for the actual condition caused by sugar Diabetes. Meanwhile, with such a picture for a year or a maximum of several years, there are symptoms that arise against the background of increasing absolute indices of insulin deficiency. Such symptoms include weight loss, ketoacidosis and inability to achieve adequate glycemic parameters by using prescribed tablets to reduce sugar.
Diabetes mellitus type 2: symptoms
Diabetes mellitus is one of the most common diseases in the field of endocrinology, and in 90% of cases of diagnosing type 2 diabetes. Most patients of this group are individuals after 45 years, in the overwhelming majority of cases, with obesity that is relevant to them. A moderate degree of obesity causes an average increase in the risk of developing diabetes by 4 times, a pronounced form of obesity — up to 30 times. Diabetes mellitus in women develops more often than in men.
Early signs of type 2 diabetes mellitus (insulin-independent diabetes) consist in a periodic sharp decrease in blood sugar, that is, in the development of hypoglycemia. She is accompanied by a strong hunger, the appearance of cold sweat, palpitation, trembling in the fingers and the body. Episodes of sugar reduction can be manifested as after eating, and on an empty stomach, in particular, often their occurrence after eating sweet.
Assuming the relevance of diabetes is possible in patients with signs of tissue insensitivity to insulin. As such, you can call excess fat in the waist, high cholesterol, uric acid and triglycerides in the blood, high blood pressure. As a characteristic skin sign of the disease, black acanthosis is considered, in which dark rough spots appear on the skin, they are concentrated in particular where the skin is most exposed to friction.
Thus, the following are the main symptoms associated with this type of disease:
- increased frequency of urination, increased volume of excreted urine
- weight change (rapid weight gain, weight loss).
Other symptoms include susceptibility to infectious diseases, progressive vision impairment, the formation of ulcers that are difficult to heal, numbness or tingling of limbs (arms, legs).
For this type of disease, you can add that his symptoms are not manifested in a pronounced version, there are no complaints of reduced performance. Thirst and symptoms associated with urination (increased and increased urine output), also manifested mainly in an insignificant degree of self-expression. Meanwhile, there are frequent complaints about the occurrence of vaginal and skin itching, because of which patients turn to the gynecologist and the dermatologist respectively.
Given that on average, since the onset of the disease of this type is about 7 years, many patients at the time of seeking medical help face symptoms of complications of diabetes. It is also common practice that patients seek medical help for the first time when they have serious late complications.
For example, patients in the surgical hospital are hospitalized in such a picture of the course of the disease when they develop ulcerative lesions of the lower limbs (which determines such complication as the diabetic foot syndrome). Due to the progressive reduction in vision, consultation with an ophthalmologist is required, in which case diabetic retinopathy is diagnosed. In addition, hospitalizations against this background are subject to patients with the development of heart attacks and strokes, as well as for obliterating lesions of the vessels of the lower extremities (hospitalization is performed in an institution in which hyperglycemia was initially identified).
Gestational diabetes: symptoms
Gestational diabetes, which, as we have already indicated, is also defined as the diabetes of pregnant women (or abbr. GDD), is a pathology that manifests itself within the second half of the gestation period, which allows the possibility of the development of certain complications in it. Although the manifestations accompanying this pathology often pass after childbirth, some cases nevertheless determine the prerequisites for the development of diabetes in women in the future, that is, a patient with gestational diabetes is automatically identified as a risk group for diabetes. We also note that after diabetes, pregnant women predominantly develop type 2 diabetes, that is, an insulin-independent type of diabetes, much less often — type 1 diabetes, respectively, insulin-dependent diabetes.
To the greatest extent the development of gestational diabetes mellitus, women are exposed during the third trimester of pregnancy. In general, during pregnancy, as is known, the female body faces serious hormonal changes, due to which it is affected accordingly. And if during the initial stages of pregnancy such changes do not cause special unrest, it is from this period (third trimester) that the risk of developing diabetes in this form increases. The essence of this kind of changes, under which there is increased production of hormones, is simple, and it consists in the need to receive the required amount of nutrients to the fetus. Meanwhile, it is the additional volume of hormones that determines the risk for increasing the sugar for the mother.
The pancreas, which ensures the production of insulin, increases its production, which allows a few to compensate for elevated blood sugar. Nevertheless, the pancreas can not always cope with increased volumes of its production, which leads to the development of gestational diabetes.
Gestational diabetes is a fairly serious disease, because high blood glucose levels can cause serious impact on the further development of the child, thus causing the development of congenital forms of defects. Moreover, gestational diabetes can result in miscarriage due to its specified characteristics. Returning to defects in the background of this disease, we note that most often they develop in the brain and in the heart.
The middle of pregnancy also in this case is associated with risks. So, because of the excess absorption of glucose by the child, food problems begin to develop in combination with rapid growth. In the case of exceeding the standard standards for growth, the child is most prone to further infection during delivery, which is why a caesarean section is indicated. Later, even after birth, there is also a risk of developing various health complications, which, again, is caused by the production of an excessive amount of glucose during the intrauterine development. After birth, the volume of glucose is reduced, although the pancreas produces insulin in the previous volumes, that is, more than necessary. Because of this, hyperinsulinemia develops, which also affects the health and development of the child.
The following factors predispose to gestational diabetes:
- problem pregnancy in the past (polyhydramnios, etc.)
- previous episodes of abortion, miscarriage;
- the birth in the past of a child with some form of developmental malformations, stillbirth
- Development of gestational diabetes during a previous pregnancy
- heredity (the urgency of the disease through blood relatives)
- Increased glucose levels in the blood before pregnancy.
Symptoms of gestational diabetes correspond to common manifestations of diabetes, they are, as a rule, in the following:
- Visual impairment
- increased thirst;
- increased frequency of urination, increased urination
- dry mouth
- fatigue, weakness.
The listed symptoms can often be perceived without anxiety and be written off to the very state of pregnancy, moreover, in some cases, these manifestations may not be at all.
As the main step to combat the manifestations of this form of diabetes, control over the level of sugar is considered, which is provided by a special diet that reduces it to a minimum. Supplement to this are physical exercises.
Complications of diabetes
Lack of appropriate treatment of diabetes mellitus leads to the development of serious complications in patients. Often, as we have already noted, complications for many of them become an indicator that there is such a problem as diabetes. The nervous system and blood vessels in diabetes mellitus are overwhelmingly affected. Because of the negative impact, atherosclerosis develops, the brain, eyes, heart, kidneys, legs are affected.
- Vessels. In diabetes mellitus, the walls of the vessels are subject to damage, which, in turn, causes delivery to the tissues of oxygen to be impaired. As a consequence of such violations, violations in the heart can be identified, which can manifest itself in the form of a heart attack, stroke, etc.
- Blood. Because of diabetes mellitus, leukocyte function is impaired, which increases the risk of possible infections, while reducing the patient’s immunity.
- Skin. Diabetes disturbs its blood supply, which, in turn, causes trophic ulcers.
- Kidneys. With diabetes, renal vessels are affected, leading to the development of hypertension and kidney failure.
- Eyes. Again, vessels are affected, this time in the retina. Because of this, visual acuity is reduced, and up to the development of blindness.
- The nervous system. In this case, diabetes mellitus is affected by nerves, which occurs against the background of a violation in the exchange of glucose. Because of this, the patients have weakness in the extremities, sensitivity decreases in them, and their paralysis may develop.
The peculiarity of complications of diabetes is that they can develop practically without symptoms — the patient for years can not suspect of «unhealthy», while the pathological process only progresses. In order to avoid such consequences, it is necessary to systematically undergo a check-up aimed at identifying complications of the disease.
Possible complications of diabetes mellitus can be divided into complications acute and chronic. Acute complications develop with rapid decompensation in the metabolic processes of carbohydrate, chronic complications, in turn, are also defined as late complications, because they develop due to the reaction resulting from a constant increase in tissues or organs of the level of glucose. Acute complications include hyperglycemic coma (lactic acid, hyperosomolar, ketoacidotic) and coma hypoglycemic. Chronic complications of diabetes, they are late complications, are the defeat of the nervous system, skin, vessels, kidneys, etc.
Eye damage in diabetes mellitus (diabetic retinopathy)
Diabetic retinopathy is the most common cause of development of blindness against the background of concomitant vascular lesions in the eye fundus. Retinopathy can correspond to 1 and 2 degrees.
Retinopathy of the 1st degree. As we have already pointed out, the retinal vessels in diabetes mellitus are subject to defeat, because of which it itself «suffers» from worsening of blood circulation, while on the walls of the affected vessels, characteristic sack-like thickenings (aneurysms) begin to form. Vascular permeability is subject to deterioration, because of what edema develops. Vision during edema of the retina is not affected in this stage, unless the central part is affected by edema.
Retinopathy of the 2nd degree. Because of the worsening of blood circulation, there is a need to compensate for the general condition of the affected area, which leads to the proliferation of newly formed vessels in it. This stage due to such its features is also defined as the proliferative stage, the proliferation of vessels within its flow does not occur. The newly formed vessels are weak and sufficiently thin, which causes their frequent rupture, against which hemorrhages form. Because of this, detachment of the retina can occur, on the background of which, in turn, causes the development of blindness. With these changes, vision begins to deteriorate, which determines the appropriate complaints from patients.
Kidney damage in diabetes mellitus (diabetic nephropathy)
As the first sign, indicating the violation of the vessels of the kidneys, appears in the appearance of excess urine in the urine, which is defined as microalbuminuria. This is due to a special method of investigation. Within this stage there is no specific symptomatology, pain and swelling are absent, arterial pressure is within the normal range. Actually, as is clear from this list, the symptoms of diabetic nephropathy are in the manifestation of these conditions.
Kidneys as a whole act as a kind of filter, through which unnecessary substances are removed from the body with the help of urine. Diabetes mellitus, in turn, is accompanied by the destruction of small vessels in the kidneys, as well as their clogging. Because of this, the process of such filtering of urine is disrupted, because of this, substances appear in it, usually absent in the urine, these are proteins and glucose. A prolonged course of diabetes mellitus is accompanied by a significant disruption in the functioning of the kidneys, because of this kidney failure develops.
Disturbance of the cardiovascular system against the background of diabetes
The cardiovascular system is also significantly affected by diabetes mellitus, in particular, this disease provokes the development of hypertension in patients, increasing the degree of its manifestation, which, accordingly, may include the development of the aforementioned stroke, as well as coronary heart disease (IHD).
Increased blood pressure requires periodic measurement, while the upper pressure should not exceed 140 mm Hg / st, and the lower pressure — 85 mm Hg / st. We also note that in some cases, with a decrease in weight, blood pressure may be normalized in patients, and with it — the level of sugar. It is also important to reduce the amount of salt consumed. Without achieving significant changes in pressure indicators, additional drugs are prescribed to reduce it.
Stop loss in diabetes (diabetic foot)
The diabetic foot is seen as a rather serious complication associated with diabetes mellitus. This pathology causes a violation of feeding the lower limbs in patients with diabetes in the formation of ulcerative lesions and deformation of the foot area. The main reason for this is that in the case of diabetes, the nerves and vessels of the legs are affected. As predisposing factors to this are obesity, smoking, long-term course of diabetes, arterial hypertension (high blood pressure). Trophic ulcers in the diabetic foot can be superficial (with skin lesions), deep (skin damage with the capture of tendons, bones, joints). In addition, their occurrence can be defined as osteomyelitis, which implies the defeat of the bones in combination with the bone marrow, like localized gangrene, accompanied by numbness in the patient’s fingers or gangrene, common in which the foot is completely injured, which requires her amputation.
Neuropathy, namely, it acts as one of the main causes of the formation of trophic ulcerative lesions, is diagnosed in about 25% of patients. It manifests itself in the form of pain in the legs, numbness in them, tingling and burning. In this number of patients, it is relevant for the number of patients whose diabetes occurs within a period of about 10 years, 50% of neuropathy is relevant for the course of the disease in the period of 20 years. With proper treatment, trophic ulcers have a favorable prognosis for cure, treatment is performed at home, averaging 6-14 weeks. With complicated ulcers, hospitalization is shown (from 1 to 2 months), even more severe cases necessitate hospitalization of the leg section that was affected.
Ketoacidosis as a complication of diabetes
We have already dwelt on this state, we note only some provisions on it. In particular, we distinguish the symptoms, which is the appearance of dry mouth, thirst, the appearance of headache, drowsiness and a characteristic smell of acetone from the mouth. The development of this condition leads to loss of consciousness and to the development of coma, which requires a compulsory and immediate call of a doctor.
Hypoglycemia as a complication of diabetes
This condition is accompanied by a sharp decrease in blood glucose, which can occur against the background of a number of specific factors (increased physical stress, insulin overdose, excessive amounts of alcohol, the use of certain medications). The earliest symptoms of hypoglycemia are a sudden rash in the patient’s cold sweat, the appearance of a feeling of severe hunger, pallor of the skin, trembling of hands, weakness, irritability, numbness of lips and dizziness.
Symptoms in the form of inadequate behavior of the patient (passivity, aggressiveness, etc.), rapid heartbeat, disturbances in coordination of movement, confusion and double vision in the eyes are considered as intermediate symptoms of this condition. And, finally, cramps and loss of consciousness act as late manifestations of symptoms. The patient’s condition is corrected by the immediate use of easily assimilated carbohydrates (sweet tea, juice, etc.). Immediate hospitalization is also required. The main principle of treating this condition is the use of glucose (intravenous administration).
The diagnosis of «diabetes mellitus» is established based on the results of the tests. In particular, these are blood and urine tests for the glucose content, glucose tolerance test, glycosylated hemoglobin detection assay, and an analysis for the detection of C-peptide and insulin in the blood.
Treatment of type 1 diabetes is based on the implementation of measures in the following areas: exercise, diet and drug therapy (insulin therapy with the achievement of insulin values within the daily rate of its production, elimination of manifestations of clinical symptoms of diabetes mellitus).
Similar principles are defined for the treatment of type 2 diabetes, that is, exercise, diet and drug therapy. In particular, weight loss is emphasized — as we have already noted, it can contribute to the normalization of carbohydrate metabolism, as well as to the reduction of glucose synthesis.
If you have symptoms that correspond to the manifestations of diabetes, you need to contact the endocrinologist. The development of acute conditions in patients requires immediate call of an ambulance.