Diabetes mellitus symptoms and signs
Diabetes mellitus is an insidious disease in which an increased level of glucose in the blood is observed. When digesting food carbohydrates and proteins decompose to simple sugars and amino acids. The liver converts all the sugar and some of the amino acids into glucose, which is used as a source of energy by every cell in the body. Glucose gets from the blood into the cells with the help of insulin, a hormone produced by the pancreas( a pear-shaped organ located under the stomach).Attaching to the receptors on the surface of the cell membrane, insulin promotes the progress of proteins transporting glucose from the depth of the cell to its surface, where they combine with glucose and carry it into the cell. In diabetes mellitus, this process causes several disturbances: the production of insulin by the pancreas can be partially or completely impaired or the cells of the body may not be able to respond effectively to the normal amount of insulin.
Diabetes mellitus is a heterogeneous disease and occurs in two forms: type 1 diabetes mellitus or "insulin-dependent", and type 2 diabetes mellitus or "insulin-independent".In the first type of diabetes mellitus, also known as juvenile diabetes, the pancreas produces little or no insulin. How to treat this ailment with folk remedies, look here.
This type of diabetes develops abruptly and is most common in people under the age of 30;the average age of the beginning of its development is between 12 and 14 years. However, type 1 diabetes accounts for only about 5 percent of all cases of diabetes mellitus. Much more common is type 2 diabetes, also known as adult diabetes. In this type of diabetes, the production of insulin by the pancreas is only slightly reduced, but cells are not able to respond effectively to insulin, so this disease is considered as insulin resistance. Diabetes of the second type usually begins in a sedate manner and affects people aged 40 years and especially full people, one of the risk factors is age over 50 years. Occasionally, adults may have type 1 diabetes.
The main causes of diabetes are hereditary predisposition, pancreas diseases, overeating( read - overload of the same pancreas, liver and GI tract), excessive intake of simple carbohydrates( sugar, candy, jam, cakes, chocolate, etc.), animal fats, alcohol. In a number of cases, diabetes mellitus may occur due to mental trauma, poisoning or intoxication( including and medication).
In both types of diabetes, hyperglycemia leads to the release of glucose into the urine, which is accompanied by an increase in the production of urine. If a patient with type 1 diabetes is prescribed an incorrect amount of insulin, excessive release of fatty acids from fatty tissue will lead to an overproduction of ketone bodies in the liver. The accumulation of ketone bodies can cause a life-threatening condition, known as diabetic ketoacytosis. Diabetic ketoacytosis can sometimes occur in patients with type 2 diabetes at times when the body experiences severe stress, for example, during a severe infectious disease.
People with type 2 diabetes are susceptible to another life-threatening disease, known as a hyperosmotic non-ketone state, characterized by extremely high blood sugar levels. This disease usually occurs in the elderly with some other serious illness. An attack of diabetic ketoacytosis or a hyperosmotic condition may be the first sign of diabetes.
People with diabetes can also suffer from low blood sugar( hypoglycemia) if too much insulin is injected into their treatment.
After 10-20 years of diabetes, complications can occur in patients, for example, visual impairment, kidney damage and degeneration of the peripheral nervous system( neuropathy).Strict monitoring of blood glucose levels may delay or prevent the onset of these complications. Loss of touch in the legs can lead to the fact that the damage will be ignored, and infection will occur.
What signs can say that you have diabetes, or testify that there is a danger of its occurrence?
• Excessive and frequent urination( approximately every hour).Wake up at night to urinate. The body, to get rid of excess sugar, secrete it through the kidneys with urine.
• Strong thirst or increased need to drink plenty of fluids. It is caused by the increase in blood glucose level, which "takes" the liquid from the tissues, the tissues are dehydrated. Therefore, patients are forced to drink a lot: 2-3-5 liters a day or more.
• Itching of the skin and genitals.
• Dry mouth.
• Poor wound healing.
• First a lot of weight, then decrease it due to a violation of the assimilation of food, especially carbohydrates.
• Decreased immunity - frequent infections from commonplace flu and colds to pneumonia.
• Sometimes the disease is preceded by "strange" conditions: as a result of short-term forced starvation or after intense physical exertion, headache, blanching, swelling, general weakness appears. Once a person ate, drank at least a cup of sweet tea, all the symptoms quickly pass. Indirectly, this may indicate a malfunction in the pancreas: the blood received insulin more than usual, and the sugar level fell below the permissible level of 3-3.5 units.
• Increased appetite.
• Unintentional weight loss.
• Poor vision.
• Fatigue and weakness.
• Frequent or persistent infections of the bladder, skin or gums.
• Numbness and tingling in the legs and hands.
• Signs of hypoglycemia.
• Severe symptoms of a hyperosmotic non-ketosis state: extreme thirst, lethargy, weakness, confusion, coma.
• Severe symptoms of diabetic ketoacidosis: nausea and vomiting, shortness of breath, confusion, coma.
The described symptoms are observed in 40-90% of patients with diabetes mellitus long before the diagnosis. But there are also "nondiabetic" symptoms, to which the increased blood sugar level leads:
1. The appearance and progression of vascular disorders - the development of atherosclerosis, hypertension, angina, memory decreases( cerebral vessels suffer);
2. Diabetic changes in the vessels of the fundus( retinopathy), decreased vision;
3. Decreased kidney function( nephropathy, pyelonephritis);
4. Diabetic foot( "feet in the cold are burning, but in the heat they are cold" - violation of the blood supply of the lower extremities);
5. Sometimes the character changes( mental disorders);
6. The skin gradually becomes dry, wrinkled, palms and soles coarse, flake off, the nails thicken, the hair is dry and brittle, on the limbs thins and disappears completely, on the skin, due to lower overall immunity, pustular abscesses, furuncles, carbuncles, relapseswhich often push the doctor to check the blood sugar in the patient. Often the skin is affected by fungi, eczema, and lichen.
7. One of the signs of diabetes is the defeat of gums - periodontitis, bleeding, gums turn blue, and teeth begin to loosen, sometimes painlessly leaving their rightful places.
8. Diabetes mellitus also affects the endocrine glands. Men lose interest in women, they not only lose libido, but also the potency. In women, the menstrual cycle "gets lost", it happens that the monthly disappear completely.
That's why diabetes is called an endocrine-metabolic disease with pancreatic damage, characterized by a rise in blood sugar and a violation of all kinds of metabolism in the body.
Diabetes mellitus is distinguished: prediabetes, latent diabetes mellitus and actual diabetes mellitus( obvious).The latter is manifested in mild, moderate and severe severity.
With pre-diabetes, latent diabetes and mild diabetes, nutrition is the only curative factor. And with moderate and severe forms - a necessary condition for successful treatment and maintaining an acceptable quality of life.
In addition, people with diabetes are more prone to narrowing the coronary arteries and narrowing the vessels supplying the brain and legs. The combination of infectious diseases of the legs and a reduction in the supply of blood can lead to gangrene( tissue death), which requires amputation.
Treatment of type 1 diabetes requires one to four daily injections of insulin.(Insulin can not be taken orally, as digestive juices destroy it.) In addition, you must follow a diet and do exercises so that blood glucose levels are not too high or too low. A combination of diet, exercise and weight loss can be used for type 2 diabetes, although medications( including insulin) are also usually needed. Treatment largely depends on self-control. Although there is no way to cure diabetes, almost all patients are able to control the symptoms and lead a full life.
• Type 1 diabetes is an autoimmune disease that occurs as a result of an erroneous attack of the immune system on pancreatic cells that produce insulin.
• In case of diabetes of the second type, genetic factors are important.
• Excessive completeness makes people predisposed to developing type 2 diabetes.
• Some drugs, such as corticosteroids or diuretics, may increase the risk of developing type 2 diabetes.
• Other diseases, eg hemochromatosis, chronic pancreatitis, Cushing's syndrome or acromegaly, can lead to diabetes. Surgical removal of the pancreas can also trigger diabetes.
• Pregnant women may develop diabetes, which usually disappears after childbirth. These women are at increased risk of developing type 2 diabetes in the future.
• Contrary to popular belief, consuming a large amount of sweet does not contribute to the development of diabetes.
General principles of diabetic nutrition are reduced to simple rules.
The caloric content of the diet should be reduced to 2000-2200 kcal by reducing the intake of simple carbohydrates: sugar, cakes, ice cream, chocolate, sweets, jams, pasta, rice, honey and similar products. Black bread, legumes, vegetables, fruits are complex carbohydrates( except bananas, grapes, watermelon), and their consumption is permissible within the usual limits. Seafood is useful because of the highly digestible high-quality protein and minerals contained in them, in particular zinc, which is an essential component for the production of insulin. Beans in the content of zinc, so necessary for people with diabetes, and copper is the champion among vegetables. The consumption of beans reduces thirst, and in the presence of concomitant atherosclerosis with violation of the heart rhythm - restores a normal rhythm!
It is recommended to eat 3-4 times a day. Between meals to drink water. It should limit daily intake of table salt to 10 g, animal and vegetable fats - up to 50 g, and also reduce the consumption of dairy products with high fat content( cheeses, ice cream, cream, sour cream), meat, sausages, smoked products, sprats, chocolate, cakes, halva, caviar, brains, egg yolks, giblets and poultry skin.
• To prevent the development of type 2 diabetes, you need to lose weight if your weight exceeds the norm by more than 20 percent, and maintain a normal weight.
• Exercise regularly.
• There is no known way to prevent type 1 diabetes.
• People with any type of diabetes should regularly undergo eye examinations for early detection and treatment of diabetes-related visual impairment.
• A medical history and physical examination can give grounds for speculation about the presence of the disease.
• Diagnosis can be made if a blood test on an empty stomach shows high glucose levels( 126 mg / dL or higher) at least twice.
• When test results are ambiguous, a sample of glucose tolerance can be made. The patient drinks a drink containing 75 g of glucose, and then the glucose content in the blood is measured every 30 minutes for two hours.
• Urinalysis can be taken to determine the protein content.
• Measure blood glycohemoglobin;it shows the average glucose level in the blood in the last two to three months.
For Type 1 Diabetes:
• Daily insulin injections are needed. It takes from one to four daily injections to monitor blood glucose levels. There are long-acting and quick-acting drugs, and they are often prescribed in combination.
• A strict diet and meal schedule are necessary to maintain the desired level of glucose in the blood. Your doctor can recommend food that is low in fat, salt and cholesterol and can advise you to visit a nutritionist for nutrition planning.
• Because both exercise and insulin lower glucose levels, exercise and insulin administration should be timed so that they do not interfere and cause a dangerous decrease in blood sugar( hypoglycemia).
• A strict schedule for injections, meals and exercises is necessary for proper disease control.
For type 2 diabetes:
• Use of low-fat and low-calorie foods in conjunction with proper exercise is necessary to control weight.
• Orally taken medications such as tolbutamide, chlorpropamide, tolazamide, acetohexamide, glyburide, glipizide, glimepiride, repaglinide or meglitonide can be prescribed to increase insulin production by the pancreas if exercise and diet do not sufficiently lower blood glucose levels.
• Other oral medications may reduce insulin resistance( metformin, pioglitazone and rosiglitazone) or slow the absorption of sugar from the intestine( acarbose and miglitol).
• Insulin injections may be necessary for severe attacks of type 2 diabetes or if a patient with type 2 diabetes has another illness.
For both types of diabetes:
• Blood tests are required to measure glucose levels, one to four times per day( depending on the doctor's recommendation).Your doctor will advise you which device you can use at home to measure blood sugar.
• Special attention should be paid to the possibility of developing atherosclerosis, as it is often combined with diabetes. Diabetics should not smoke, eat low-fat foods, cholesterol and salt and take medicine for high blood pressure or high cholesterol.
• People with diabetes should drink plenty of water when they get sick with another illness, such as flu, to replace lost fluid and prevent diabetic coma. During illness, people with type 1 diabetes should check urine for ketone bodies every four to six hours.
• People with diabetes should take care of their feet and check them every day. Nerve damage in diabetes mellitus reduces the sensitivity of the legs, and small lesions can lead to the development of serious infectious diseases.
• Laser photocoagulation to prevent tearing of tiny blood vessels in the eye can help prevent or cure diabetic retinopathy. Most patients with diabetes need to check their eyes with an ophthalmologist at least once a year to detect the very first manifestations of retinopathy.
• Dialysis, the process of artificial blood filtration, may be necessary for renal failure. In serious cases, kidney transplantation may be required,
• Amitriptyline, desipramine, or nortriptyline commonly used in the treatment of depression, or gabapentin used in convulsions,
may be prescribed to alleviate pain in the extremities • Clear blood glucose control delays orprevents subsequent complications affecting the eyes, kidneys and nervous system.
• Kidney damage can be slowed by controlling blood pressure.
• Consult your doctor if you notice a sudden or gradual increase in hunger, thirst, or urinary output.
• Consult your doctor if you are sick with diabetes and get sick with a cold or flu, which has brought blood sugar levels out of control. Do not use over-the-counter medicines without consulting a doctor.
• Attention! Call an "ambulance" if a diabetic patient loses consciousness. Tell the doctor that a person has diabetes.
• Attention!(In the second type of diabetes.) Immediately call an "ambulance" if you have symptoms of a hyperosmotic non-ketone state;they include strong thirst, lethargy, weakness and confusion.
• Attention!(For the first type of diabetes.) Immediately call an ambulance if you have symptoms of diabetic ketoacytosis;they include dry mouth, dry and red skin, sweet or fruity aroma, smell from the mouth, difficulty breathing, vomiting and abdominal pain, combined with excessive urination and intense thirst( or without them).
• Attention!(For the first type of diabetes.) Immediately consult a doctor if urine is detected in the urine and the measures prescribed by your doctor do not help to cope with the problem.