Why Diabetes Mellitus Will Make You Question Everything?
Insulin secretion is impaired in diabetes mellitus. Too little insulin in the body causes impaired use of glucose by the body’s cells, which causes an increase in blood glucose levels (hyperglycemia) and the excretion of glucose with the urine. Diabetes – what is it? How is it treated? Is it curable? Below you will find all the information.
Table of Contents
Diabetes Mellitus – definition
Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from impaired insulin secretion and action. Insufficient insulin secretion and decreased tissue response to insulin impair the complex action of insulin in the target tissues, resulting in disturbance of carbohydrate, lipid, and protein metabolism. Therefore, the patient may have impaired insulin secretion and function.
Types of diabetes
According to the World Health Organization (WHO), diabetes is classified into four types:
- type 1 diabetes (primary diabetes, adolescent diabetes, insulin-dependent diabetes),
- type 2 diabetes (diabetes of mature age, non-insulin-dependent diabetes, acquired diabetes),
- gestational diabetes,
- other specific types of diabetes.
Type II diabetes is the most common form of this disease and accounts for approximately 80–90% of all diabetes cases. It is mainly affected by adults, usually after the age of 40, and it is conducive to chronic, difficult to heal, recurrent inflammation
Diabetes Mellitus – Causes of its occurrence
Unfortunately, the causes of diabetes are not fully understood yet. Genetic and environmental factors play a key role in its creation. Disorders of carbohydrate metabolism in diabetes result from a low amount of insulin in the body and, therefore, a deficiency of the hormone produced by the beta cells of the pancreatic islets.
The lack of insulin causes the glucose metabolism in the body to be impaired. First of all, there is too much penetration of glucose through cell membranes into the interior of cells, activation of its various intracellular transformations, as well as erroneous participation in protein synthesis and inhibition of fat breakdown processes. Glucose is a substance that is essential in the body; it is the main, readily available source of energy. Hence, disturbances in its transformations have systemic consequences.
Type 1 diabetes is an autoimmune disease. As a result of the destruction by autoantibodies, the insulin-secreting beta cells of the pancreas are damaged. Consequently, this leads to a situation where the pancreas does not deliver insulin or transfers it too little. Then the body cannot absorb the glucose from the blood, and the cells starve, even though the blood sugar level is constantly too high. Unfortunately, the root cause of this phenomenon is still unknown. However, it is known that in this type of diabetes, the predisposition to develop it is inherited, not the disease itself. Type 1 diabetes is also caused by acquired immune mechanisms (caused by viral infections) that target the destruction of insulin-producing beta cells in the pancreas.
Type 1 diabetes has a certain subtype – LADA diabetes. It is also called young adult diabetes, late-onset type 1 diabetes, and immunologically positive insulin-dependent diabetes. This type of diabetes very often develops only after 30, which is why it is referred to as latent diabetes. The disease arises due to a failure of the immune system, and thus – as an autoimmune disease.
Type 2 diabetes is acquired diabetes and may have two causes:
- It may be due to insulin resistance (cells have a reduced sensitivity to insulin, which reduces their use of insulin) of cells and tissues.
- It may result from insufficient insulin production by the pancreas. As a result, the blood sugar concentration is too high in this form of the disease because the pancreas does not release insulin as needed by the sick body.
- Unlike type 1 diabetes, diabetes is more closely related to heredity.
Risk factors for developing type 2 diabetes also include:
Age and Gender – Women are slightly more prone to type 2 diabetes, and the risk increases with age in both genders,
- overweight and obesity,
- too little sleep
- pancreatic cancer,
- overactive thyroid gland
- Cushing’s syndrome,
- professional overload,
- incorrect diet,
- gestational diabetes,
- taking certain medications (β-blockers, antipsychotics, statins, glucocorticoids, thiazide),
- Exposure to chemicals.
Type 1 and type 2 diabetes are known as overt diabetes.
Diabetes mellitus in pregnancy may present as pre-pregnancy diabetes (when a woman had diabetes before pregnancy) or as hyperglycemia first diagnosed during pregnancy in previously healthy women. It can occur in any pregnant woman, but the most vulnerable are overweight women and those with a family history of type 2 diabetes. The risk also increases with age and subsequent pregnancies (especially if the previous one had elevated blood sugar levels).
Other specific types of diabetes – are caused by genetic defects in β-cell function or insulin action (e.g., monogenic diabetes), diseases of the exocrine pancreas, endocrinopathies, certain drugs or chemicals, infections, rare immune processes, and genetic syndromes accompanying diabetes.
Due to the lack of insulin in the body, it is difficult for glucose to pass from the blood to the cells. Therefore, one of its main symptoms is a very high blood glucose level. It also accumulates in excess in other fluids and the intercellular space as unused. The effect of a more significant increase in blood glucose is the penetration of glucose into the urine, which is not found in physiological conditions, i.e., glucosuria. This phenomenon is also called glycosuria.
Glucose metabolism disorders cause problems in the metabolism of lipids, i.e., lipids. In the case of insulin deficiency and the inability to use glucose as an energy source, fats are excessively broken down, and the concentration of their transformation products in the form of harmful chemical compounds called ketone bodies increases. The excess mentioned above of ketone bodies causes acidification (the so-called diabetic acidosis) and has a negative (toxic) effect on the central nervous system. During the urine analysis, the presence of acetone in it is then found as a sign of acidosis and an excess of ketone bodies in the body.
These biochemical changes result in a high thirst (drinking even a dozen liters of beverages a day) and a significant increase in the daily volume of urine excreted. In addition, the body has to dissolve the amount of unused glucose in something and then excrete it outside in the form of polyuria. Thus, when the supply of fluids is restricted in diabetes, the body’s tissues become dehydrated, losing body weight.
Diabetes can therefore be suspected in people who have increased thirst and a large amount of urine daily.
Another negative effect of the disorders is a bad effect on the endothelium of blood vessels, favoring the faster development of atherosclerotic lesions and disturbances in the blood supply to various tissues and organs.
Further symptoms that suggest diabetes include progressive weight loss and dehydration, progressive weakness, decreased immunity in the form of recurrent infections and purulent skin lesions, rapidly progressive visual impairment, nagging itching at the urethral orifice (sometimes also in men and labia in women ), etc.
The main symptoms of type 1 diabetes are:
- high thirst and very frequent urination
- weight loss, despite a good appetite,
- drowsiness, general body weakness,
- double vision or blurred vision.
The main symptoms of type 2 diabetes are:
- high thirst and frequent urination,
- weight loss, despite a good appetite,
- irritability, apathy,
- blurred vision
- drowsiness and general fatigue,
- easy and quick bruising,
- difficulty healing wounds,
- recurrent inflammation of the skin, gums, bladder,
- dry and itchy skin.
In the case of type 2 diabetes, it should also be noted that the patient may develop excess insulin (hyperinsulinemia). The body then produces too much insulin in the blood. Hyperinsulinemia is closely related to the concept of insulin resistance, i.e., the insensitivity of cells to insulin. Usually, patients with hyperinsulinemia also have insulin resistance. It isn’t easy to estimate which of these conditions develops first. Excess insulin symptoms:
- increased sleepiness,
- general breakdown and fatigue,
- increased levels of triglycerides,
- high blood pressure
- elevated cholesterol,
- problems with concentration,
- Increased levels of uric acid in the blood.
Diabetes mellitus is a disease that can be asymptomatic for many years, especially type 2 diabetes. Diabetes is diagnosed only once, usually at follow-up. Only a doctor can diagnose diabetes.
Screening for diabetes should be performed every 3 years in anyone over 45 years of age and, regardless of age, annually in the following risk groups:
- overweight or obese [BMI ≥25 kg / m2 and / or waist circumference> 80 cm (women); > 94 cm (men)],
- with diabetes in the family (parents or siblings),
- not physically active,
- from an environmental or ethnic group more likely to develop diabetes,
- who in the previous test was diagnosed with pre-diabetes,
- in women with a history of gestational diabetes,
- in women who gave birth to a child weighing> 4 kg,
- with hypertension (≥ 140/90 mm Hg),
- with dyslipidemia [concentration of HDL cholesterol <40 mg / dl (<1.0 mmol / l) and / or triglycerides> 150 mg / dl (> 1.7 mmol / l)],
- in women with polycystic ovary syndrome,
- Symptoms suggesting the possibility of diabetes mellitus with significant hyperglycemia:
- severe diuresis (polyuria)
- increased thirst,
- Weight loss unexplained by deliberate weight loss.
Diabetes Mellitus – Treatment
Treatment of diabetes as a chronic disease takes time. Therefore, close and informed cooperation between the patient and the doctor is necessary to achieve successful results.
Treatment of diabetes mellitus is still symptomatic.
The goals of long-term treatment of diabetes mellitus are:
- the patient’s well-being,
- obtaining the so-called normoglycemia – physiological blood glucose level,
- help in achieving the patient’s personal goals and intentions,
- Obtaining the possibility of realizing the social aspirations of a person with diabetes.
Type 1 diabetes mellitus treatment:
Treatment of type 1 diabetes is based on blood sugar control and insulin injection. Diabetes must also follow a proper diet and exercise.
Type 2 diabetes mellitus treatment:
In the first phase of the disease, it is required to take appropriate oral antidiabetic drugs, and in the later phases of treatment, insulin is required. In addition, it is required to change the diet, introduce physical activity and reduce body weight.
Diabetes Mellitus – Prognosis
The prognosis of diabetes depends on its type, age of onset, duration, and systematic adherence to the recommended rules, lifestyle, treatment, and diet. Outpatient treatment facilities for people who have diabetes promote proper diagnosis and systematic treatment monitoring. They should register, carry out systematic checks, and periodically adjust the treatment if necessary. In case of complications of diabetes, patients require hospitalization.
How to prevent diabetes, especially in the presence of genetic and family predisposition? It is not easy, but it is also not impossible. Above all, you should:
- eliminate a large number of carbohydrates from the diet, especially in middle age (over 40) and in the elderly,
- in patients with a genetic predisposition to diabetes, avoid circumstances that may cause it (e.g., obesity, alcohol intoxication, mechanical injuries, especially of the abdomen, liver diseases),
- counteract psychological trauma,
- avoid excessive use of corticosteroid therapy, diphenylhydantoin, and thiazide diuretics, which may accelerate the disclosure of previously latent diabetes,
- Do physical activity, preferably systematically – it also prevents obesity.