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The concept "diabetes mellitus" it is accepted to designate group of endocrine diseases which develop as a result of absolute or relative shortage in a hormone organism insulin. In view of such state at the patient the hyperglycemia — considerable increase of amount of glucose in human blood is shown. The chronic current is characteristic of a diabetes mellitus. In development of an illness there is disbolism in general: also the water salt metabolism is broken fatty, proteinaceous, carbohydrate, mineral. According to the statistics WHO, in the world about 150 million people are ill a diabetes mellitus. By the way, a diabetes mellitus not only the person, but also some animals, for example, of a cat is ill.
Word meaning "diabetes" from Greek — "expiration". Therefore, the concept "diabetes mellitus" designates "the losing sugar". In this case the main symptom of an illness – removal of sugar with urine is displayed. Today there are many researches concerning origins of this illness, however the reasons of display of an illness and emergence of its complications are still not finalized further.
Diabetes mellitus reasons
The broken carbohydrate metabolism which is shown in view of impossibility of a pancreas to make the necessary amount of hormone insulin or to produce insulin of necessary quality becomes the main reason of display of diabetes. There are many assumptions concerning origins of a similar state. It is for certain known that the diabetes mellitus is a noncontagious illness. There is a theory that defects of genetic character become a cause of illness. It is proved that higher risk of developing of a disease takes place at those people whose close relatives were ill a diabetes mellitus. The probability of a disease at people at whom diabetes was diagnosed for both parents is especially high.
As one more powerful factor directly influencing a possibility of a disease of diabetes, specialists define obesity. In this case an opportunity to adjust a body weight therefore it is necessary to take this question seriously is available to the person.
One more provocative factor – a number of diseases which consequence defeat of beta cells turns out to be. First of all, it is about pancreatitis, diseases of other hemadens, a pancreatic cancer.
Viral infections can serve as a peculiar releaser to start diabetes. Viral infections "start" diabetes not in each case. However people at whom predisposition of hereditary character to a diabetes mellitus and other having factors takes place have much higher risk to ache owing to an infection.
Besides, as the factor contributing to a disease doctors define a stress and an emotional overstrain. To elderly people it is necessary to remember an opportunity to ache with diabetes: the person, the high probability of a disease becomes more senior.
At the same time the assumption of many that those who like to eat constantly a lot of sugar and sweet products, are confirmed from the point of view of high probability of obesity at such people risk to get sick with diabetes.
In more exceptional cases the diabetes mellitus at children and adults arises as an effect of certain hormonal disturbances in an organism, and also damages of a pancreas because of an alcohol abuse or reception of some drugs.
One more of assumptions testifies to virus character of a diabetes mellitus. So, diabetes of 1 type can be shown because of virus defeat of beta cells of the pancreas producing insulin. As response the immune system produces antibodies which are called insulyarny.
However till today there are many not clear moments in a question of definition of the reasons of manifestation of a diabetes mellitus.
Diabetes mellitus types
The diabetes mellitus sometimes also arises at the person as one of displays of the main illness. In this case we speak about symptomatic diabetes which can arise against defeat thyroid or a pancreas, adrenal glands, a hypophysis. Besides, this form of diabetes develops and as treatment effects some drugs. And if treatment of the main illness takes place successfully, then and the diabetes mellitus recovers.
The diabetes mellitus can be subdivided into two forms: it is a diabetes mellitus of 1 type, that is, insulin-dependent, and also a diabetes mellitus 2 types, that is insulino-independent.
The diabetes mellitus of 1 type is most often shown at young people: as a rule, most of such patients is not thirty years old. About 10-15% of all number of patients with diabetes suffer from this form of an illness. The diabetes mellitus at children is shown generally in this form.
Diabetes of the first type is a consequence of defeat of the beta cells of a pancreas making insulin. People get sick with very often this type of diabetes after viral illnesses – parotitis, a viral hepatitis, a rubella. Often diabetes of the first type arises as an autoimmune illness owing to defect in immune system of an organism. As a rule, at the person who is ill the first type of diabetes unhealthy leanness is shown. Sugar level noticeably increases in blood. Patients with the first type of diabetes depend on constant injections of insulin which become vital.
Among diabetics in general patients with a diabetes mellitus 2 types prevail. At the same time about 15% of patients with this form of an illness have normal weight, and all others suffer from excess body weight.
The diabetes mellitus 2 types develops, as a result of essentially other reason. In this case beta cells produce enough or too much insulin, however fabrics in an organism lose property to accept its specific signal. In this case insulin injections for a survival are not required for the patient, however sometimes appoint them to exercise control over the content of sugar in the patient's blood.
Diabetes mellitus symptoms
Diabetes mellitus symptoms, first of all, are shown by too intensive producing urine. The person begins to urinate not only often, but also it is a lot of (the phenomenon which is called a polyuria). In view of the similar phenomenon the patient has very strong thirst. Together with urine glucose is emitted, the person loses also calories. Therefore also too strong appetite in view of constant feeling of hunger will be a sign of a diabetes mellitus.
As symptoms of a diabetes mellitus there are other unpleasant phenomena: strong fatigue, constant drowsiness, existence of an itch in a crotch. At the patient extremities can freeze, visual acuity gradually decreases.
The illness progresses, and the following signs of a diabetes mellitus are shown. The patient notes that wounds at him heal much worse, gradually life activity of an organism is oppressed in general.
It is important to consider that the main signs of a diabetes mellitus to which each person has to pay attention it is loss of vital forces, constant feeling of thirst, fast removal from an organism with urine of the consumed liquid.
However, at first diabetes mellitus symptoms in general can not be shown, and the disease can be defined only by laboratory analyses. If the illness is not shown, and in blood a little increased content of sugar is found and its presence at urine takes place, then the prediabetic state is diagnosed for the person. It is characteristic of very large number of people, and in ten-fifteen years they develop a diabetes mellitus 2 types. Insulin in this case does not carry out function of splitting of carbohydrates. As a result, not enough glucose which is an energy source comes to blood.
Complications of a diabetes mellitus
Special health hazard and human lives are represented by complications of diabetes which are shown if treatment of a diabetes mellitus is not carried out, or it is carried out incorrectly. Owing to similar complications often there is a lethal outcome. It is accepted to distinguish acute complications of diabetes which develop at the patient promptly, and also complications late which arise a several flying later.
Acute complications of diabetes are shown by a coma: in such condition of the patient faints, it breaks functions of a number of bodies – a liver, kidneys, heart, a nervous system. The reasons of development of a coma – strong change of acidity of blood, ratio distortion of salts and water in an organism, manifestation in blood of lactic acid in a large number, sharp falling in glucose level blood.
As late complications of diabetes often there is a defeat of small vessels of kidneys and eyes. If the large vessel is surprised, then developing of a stroke, myocardial infarction, gangrene of legs is possible. The nervous system of the person also suffers.
Diagnosis of a diabetes mellitus
The diabetes mellitus is shown at the person gradually, therefore, doctors allocate three periods of his development. At people who are inclined to an illness in view of existence of some risk factors the so-called period of prediabetes is shown. If glucose is already acquired with disturbances, however symptoms of a disease do not arise yet, then the period of the hidden diabetes mellitus is diagnosed for the patient. The third period — directly a course of a disease.
For diagnosis of a diabetes mellitus at children and adults special importance is represented by laboratory analyses. At research of urine in it find acetone and sugar. By the fastest method of establishment of the diagnosis, blood test at which determine the content of glucose is considered. It, besides, the most reliable diagnostic method.
Higher precision of researches is guaranteed by carrying out peroral glucose loading. It is initially necessary to define what level of glucose is present at blood of the patient on an empty stomach. After that the person has to drink a glass of water in which previously dissolve 75 grams of glucose. Two hours later repeated measurement is taken. If the result of content of glucose made from 3,3 to 7,0 mmol/l, so tolerance to glucose is broken, at result more than 11,1 mmol/l diabetes is diagnosed for the patient.
Besides, during diagnosis of a diabetes mellitus carry out blood test on glycohaemo globins with the purpose to define the average level of sugar in blood for the long period (about 3 months). Also use this method for definition of that, treatment of a diabetes mellitus in three last months was how effective.
Treatment of a diabetes mellitus
Doctors appoint complex treatment of a diabetes mellitus with the purpose to provide support of normal content of glucose in blood. In this case it is important to consider that it is impossible to allow a hyperglycemia, that is increase of level of sugar, a hypoglycemia, that is its falling.
During the whole day the content of glucose has to stay approximately at the same level. Such support allows not to allow manifestations of complications of diabetes which are life-threatening. Therefore, it is very important that the person carefully controlled own state and it is most disciplined treated therapy of an illness. Glyukometr is the specially developed device which gives the chance independently to measure glucose level in blood. To make the analysis, it is necessary to take a drop of blood from a finger and to apply it on a test strip.
It is important that treatment of a diabetes mellitus at children and adults began at once after the corresponding diagnosis is made to the person. The doctor defines ways of treatment of a diabetes mellitus, considering what type of diabetes takes place at the patient.
For treatment of a diabetes mellitus of 1 type it is important to provide lifelong replacement hormonal therapy. For this purpose every day the patient for whom the first type of diabetes is diagnosed has to give insulin injections. Other options of treatment in this case do not exist. Before in 1921 scientists defined an insulin role, the diabetes mellitus did not respond to treatment.
There is a special classification of insulin which is based on that from where there is a drug, and what duration of its action. Distinguish bull, pork and human insulin. In view of detection of a number of by-effects bull insulin is used less often today. The closest on structure to human is pork insulin. Distinction consists in one amino acid. Duration of influence of insulin happens short, average, long.
As a rule, the prick of insulin of the patient makes approximately in 20-30 minutes before acceptance of food. It is entered into a hip, a shoulder or a stomach subcutaneously, at the same time the place of an injection should be alternated at each prick.
When insulin gets to blood, it stimulates process of transition of glucose of blood to fabrics. If overdose took place, it is fraught with a hypoglycemia. Symptoms of this state following: at the patient trembling, the strengthened department of sweat is observed, heartbeat becomes frequent, the person feels strong weakness. In such condition of people has to increase quickly glucose level, having used several spoons of sugar or a glass of sweet water.
To each patient the specialist taking into account all features of an organism, and also image of his life has to select the scheme of reception of insulin only. Selection daily doses of insulin is made so that it met physiological standard. Two thirds of a dose of hormone are accepted in the morning and in the afternoon, one third – in the second half of day and for the night. There are several different schemes of introduction of injections which expediency of use is defined by the doctor. Correction of doses of insulin is possible depending on a number of factors (a diet, loadings of physical character, feature of carbohydrate metabolism). The important part in definition of the optimum scheme of reception of insulin is assigned to independent measurement of level of glucose and conducting the records concerning introspection.
In this case the corresponding diet at a diabetes mellitus is very necessary. It is important that the patient ate food according to the special scheme: three main receptions of food and three additional. Food at a diabetes mellitus happens taking into account that the content of glucose in blood is most strongly increased by carbohydrates. However severe restriction of their use is not required. On condition of the normal body weight of the person it is important to consider amount of carbohydrates to choose the correct dose of insulin.
If the diabetes mellitus of the second type is diagnosed for the person, then in the beginning the illness cannot take medicine at all. In this case the diet at a diabetes mellitus which provides minimization of the use of simple carbohydrates and competent approach to exercise stresses is important. If diabetes progresses, medicamentous therapy is required. The doctor appoints treatment glucose-lowering drugs. He chooses suitable drugs from derivatives of a sulfonilmochevina, prandialny regulators of a glycemia. Guanyl guanidines (drugs also lower absorption of glucose in intestines) and tiazolidindiona help to increase sensitivity to insulin of fabrics. In case of absence of effect of treatment by the specified drugs by the patient appoint therapy insulin.
At diabetes practice also national recipes which stimulate decrease in level of sugar in blood. Broths of the herbs having such properties are for this purpose used. It is a leaf of bilberry, seeds of flax, a haricot shutter, a leaf of laurels, fruits of a juniper and a dogrose, a burdock root, leaves of a nettle gonochoristic, etc. Broths of collecting herbs accept several times a day before reception of food.
Diet at a diabetes mellitus
It is necessary to keep to a diet at a diabetes mellitus without fail. Feeding habits at a diabetes mellitus in this case mean normalization of an exchange of carbohydrates in a human body and at the same time simplification of functioning of a pancreas. The diet excludes digestible carbohydrates, limits the use of fats. People with a diabetes mellitus need to use many vegetables, but at the same time to limit holesterinosoderzhashchy products and salt. The food should be baked and cooked.
To the patient with a diabetes mellitus recommend to eat a lot of cabbage, tomatoes, vegetable marrows, greens, cucumbers, beet. Instead of sugar it is possible to eat with sick diabetes xylitol, sorbite, fructose. At the same time it is necessary to limit amount of potatoes, bread, grain, carrots, fats, honey.
It is forbidden to eat confectionery sweets, chocolate, candies, jam, bananas, acute, smoked, mutton and pork fat, mustard, alcohol, grapes, raisin.
It is necessary to eat food always at the same time, meal cannot be missed. The food has to contain a lot of cellulose. For this purpose periodically it is necessary to include in a diet bean, rice, oats, buckwheat. Every day the patient with a diabetes mellitus has to drink a lot of liquid.
Prevention of a diabetes mellitus
Prevention of a diabetes mellitus provides maintaining as much as possible a healthy lifestyle. It is necessary not to allow emergence of extra kilos, to constantly do exercises and to play sports. Each person should reduce the use of fat and sweets somewhat. If the person already was forty years old or in his family there were cases of diabetes, then prevention of a diabetes mellitus provides regular verification of the contents of sugar in blood.
It is necessary to try to use every day many fruit and vegetables, to include in a diet more products with the high content of complex carbohydrates. It is not less important to watch that how many salt and sugar is included into an everyday diet – in this case abuse is not allowed. In a diet there have to be many vitamin-containing products.
Besides, for prevention of a diabetes mellitus it is important to stay constantly in a condition of composure, to avoid stressful situations. Besides disturbance of an exchange of carbohydrates is shown as a result of supertension therefore such state is very important to warn in advance.