Diabetes mellitus type 1 and 2

Diabetes mellitus is one of the most common diseases faced by people from different parts of the world and age doesn't really matter.

According to statistics, there are about 250 million people with one form or another of the disease.The real number of patients exceeds official figures, since many are unaware of the existing violations.

Most children suffer from a disease, the manifestations of which cannot always be detected in time due to mild symptoms.

Due to negligence, patients do not go to an endocrinologist who can identify the problem and make a diagnosis.

To avoid an unpleasant situation, it is necessary to study in detail what is meant by diabetes mellitus, what are the factors predisposing to its development, symptoms and treatment methods.

What is diabetes mellitus?

This pathology is characterized by insufficient levels of insulin in the body, which is a peptide hormone that is concentrated in the cells of the pancreas.Diabetes mellitus occurs in the form of a large number of diseases associated with damage to the endocrine system.There is an active production of glucose in the blood, which also increases in the urine, and a destabilization of metabolic processes also occurs.

If we consider the deviations that occur in the body, we find:

• The internal organs are fed by glucose and if it is not supplied in sufficient quantities, starvation will occur.This happens due to a low amount or absence of insulin, which is produced by pancreatic cells.When the movement of accumulated sugar in the blood stops, subsequent metabolic development does not occur;
• The cells responsible for transporting the hormone and assimilating glucose at some point become immune and do not react in any way to a substance that has managed to remain unchanged;
• sugar is not converted into nutrients, which causes the body to starve, while a lot of glucose enters the blood, which negatively affects the cells;
• the degree of damage to the endocrine system depends on the severity of the disease and timely treatment;
• It is easier to treat the problem at an early stage, but many patients come to the clinic much later, which worsens the implementation of therapeutic measures.

Many doctors talk about diabetes not as a disease, they agree that the cause of the problem lies in an incorrect lifestyle.

You can protect yourself from negative consequences by adjusting your work and rest schedule, following your doctor's recommendations, and monitoring your well-being and blood sugar levels.

If no action is taken, there is a risk of damage to all organs.In advanced cases, the patient is exposed to the threat of falling into a coma due to serious complications.It is important, even if there are small deviations, to make an appointment with the doctor on time.

Diabetes types 1 and 2

There is a classification of the disease that allows us to distinguish between types, each of which has specific characteristics.

We are talking about varieties such as:

• first type, called juvenile, detected in patients of adolescence and advanced age.It is mainly transmitted to children of close relatives.Beta cells undergo changes that negatively affect their structure.Insulin is produced in minute quantities, insufficient for the victim's normal life.About 10% face a problem that is largely autoimmune in origin.Sometimes the cause of the pathology is an attack of pancreatitis or pancreatic necrosis, while the person survives, but the pancreas eventually loses its original properties.The situation does not change over time, it remains until the end of life;
• second type– due to a deterioration in metabolism, the hormone stops being produced in the necessary volumes, which causes a relative lack of insulin.Beta cells stop functioning stably;Due to pathological processes, they cannot perform the functions specified by the body: produce the necessary substance and reduce blood glucose.

Gestational diabetes in women occurs in pregnant women with serum glucose levels that exceed normal levels.The detected deviations cannot be ignored, since inaction has a negative impact on the fetus.It is possible to get rid of the disease after childbirth, but disturbances in the absorption of this organic compound can also be found in women who do not initially complain of poor health.

There are other types when the situation develops negatively due to the use of medications, destabilization of the endocrine system, pancreatic dysfunction and the like.

Symptoms of type 1 and 2 diabetes

The first type has a chronic form, is transient and quickly passes from the initial stage to a more severe one, which occurs against the background of the adverse effects of various factors.

Distinctive features include:

• sudden weight loss;
• nocturnal urinary incontinence, which is more common in children;
• deterioration of the visual apparatus;
• the skin and mucous membranes dry out;
• lack of moisture in the oral cavity even if water balance is maintained;
• thirst causes drinking water in large quantities, exceeding 10 liters;
• itching and purulent formations on the skin;
• frequency of urination, large amounts of urine;
• uncontrolled contraction of the muscles of the lower extremities;
• vomiting and nausea: the relief that occurs after emptying the stomach is temporary;
• irritability;
• loss of strength, inability to work for a long time;
• increased appetite;
• an incessant desire to eat after a short period of time.

One complication is hyperglycemia, an increase in glucose levels that can be fatal.A deterioration of the condition cannot be ruled out, which manifests itself in a minimal amount or absence of hair on the legs.

The appearance of benign yellowish formations is observed on the tendons, on the mucous membranes of internal organs and on the skin.Inflammation can be observed on the surfaces of the genital organs in both men and women.The bones become brittle and are easily susceptible to negative influences from the outside.As for immunity, it practically loses its protective properties.

The symptoms of diabetes mellitus of the second type have some similarities, however, there are manifestations that allow us to determine which type it is.The following signs are identified:

• wounds take a long time to heal;
• infection of the epidermis;
• feeling of thirst;
• frequent urination, which forces you to go to the bathroom both day and night;
• exhaustion, slow reaction, sleep disturbances;
• mucous membranes are dry;
• numbness, tingling in the extremities;
• increased appetite resulting from pathology of leptin synthesis;
• dry mouth, you should drink about 3-5 liters a day;
• itching in the groin area - confusion occurs, leading you to contact a gynecologist or dermatologist instead of an endocrinologist;
• hunger after 1-2 hours of eating;
• swelling in the face and lower legs;
• infantile enuresis, which manifests itself at night;
• hypertension;
• headaches and dizziness.

Symptoms occur when glucose levels exceed levels, which can be easily determined by the appearance of sugar in the urine.

Pathogenesis of the disease.

Factors that cause the appearance of diabetes mellitus have been identified.Among them are:

• heredity: the risk of the child having the first type of disease increases if the parents have the same diagnosis;
• excess weight: 80 to 90% of patients suffer from excess body weight, since adipose tissue cannot use insulin as intended.Newborns should weigh between 2.5 and 3.5 kg;if the indicators increase, the endocrinologist should conduct an examination;
• viruses - cause abnormalities of the pancreas, so due to rubella, measles and chickenpox, which a child previously suffered, can lead to the death of cells in the digestive system;
• age-related changes;
• usual stressful situations;
• an unhealthy lifestyle and poor diet: a body mass index above 30 complicates the situation that leads to insulin resistance;the probability of this occurring increases by 2 times.Indicators of 35 or more indicate a 100% probability of diabetes;
• fat deposits around the abdomen;
• disruption of the pancreas for various reasons, including injury to the organ;
• pathological processes in the endocrine system that occurred due to acromegaly, Itsenko-Cushing syndrome, etc.

The main factors causing the deterioration of the condition are listed;they can have a unique impact, thus increasing the threat.Absolutely healthy people are at risk and it is recommended to visit a doctor.

Sugar levels before and after meals.

Fasting produces a low glucose level, which is normally between 3.4 and 5.5 mmol/l.In diabetics, the indicators exceed the specified value and are calculated as follows:

• first type – up to 9.3 mmol/l;
• second type: 8.5 mmol/l.

After eating, the metabolism is activated, as a result of which glucose is released.How much the level of an organic compound will increase depends on the ability to assimilate it.In practice, the exam is not performed on a full stomach.The most accurate information will be that obtained 1-3 hours after the meal.

The normal blood sugar level for diabetes in women, men and children over 12 years of age is:

• after 1 hour – up to 8.6-8.9;
• after 2 hours – up to 7.0-7.2;
• after 3 hours – up to 5.8-5.9.

For type 1 diabetics with the same period of time:

• up to 11;
• up to 10-10.3;
• up to 7.5.

If you have type 2 diabetes:

• 9.0;
• 8.7;
• 7.5.

After three or more hours, the glucose level continues to decrease until it returns to normal.

What are the phases of diabetes?

The classification is based on the degree of development of carbohydrate metabolism pathologies, hence the distribution into the following phases:

• compensation– managed to achieve the glucose content in accordance with natural indicators;
• undercompensation– sometimes the volume of the substance increases;
• decompensation– lack of response to insulin, therapy is difficult to implement.

The disease is classified according to the severity of its course;Three forms are known.Among them are:

• light– improvement of the condition occurs due to the choice of the right diet and regimen.The positive effect is evident when following a diet, while the use of a hypoglycemic agent will provide a double benefit.The probability of transition from one stage to another is minimized;
• average– You cannot do without medications that reduce your sugar levels.They are used continuously, but they cannot protect against vascular pathologies;
• heavy– The use of hypoglycemic agents and insulin, which is sometimes used without combination with other medications, should not be interrupted.There is a threat of developing encephalopathy, neuropathy and vascular angiopathy.

Differences between type 1 and 2 diabetes

In addition to the fact that type 2 diabetes mellitus has an ICD-10 code E11 and type 1 diabetes mellitus has E10, it is important to familiarize yourself with the rest of the distinctive characteristics of these varieties to have an idea of each of them and be able to determine the type of disease based on its characteristics.

Characteristics	first type	Second type
Period	Autumn, winter, spring.	Not noted
Cases (%)	10-20%	80-90%
Gender	More often men	More often women
age	Up to 40 years	Children, adults over 40 years old.
Weight	Standard or reduced	extra kilos
Development	transient	Slow, does not appear bright.
vascular abnormalities	Mostly small	Mostly big
Cellular sensitivity to insulin.	Yeah	Low
Antibodies against insulin and beta cells.	Yeah	No
Therapy	insulin	Diet, glucose-lowering medications, insulin (at a later stage)

Diagnosis of the disease.

Before knowing how to treat diabetes, a blood sugar test is performed, which is the main way to calculate current and daily glucose levels.

Additional diagnostic measures include polyuria, polygraphy, excess body weight, or significant weight loss.The following also applies:

• Ultrasound;
• determination of pathological insulin;
• electrocardiography – study of the electrical fields of the heart;
• Rehberg test - assessment of the condition of the kidneys;
• biochemical blood test;
• fundus study.

From the information received, a clinical picture emerges, after which a therapeutic technique is proposed.

Type 1 medications.

The main remedy is insulin, but the doctor also prescribes tablets that help to cope with glucose metabolism disorders, which are combined with obesity, which aggravates the situation.

These are drugs from the biguanide group, which reduce the acute need for insulin and also alleviate the patient's condition.

insulin lispro

An analogue of insulin produced in the human body has a rapid action - 15 minutes after injection.Glucose metabolism is controlled and anticatabolic and anabolic effects appear in the tissues.

The drug turned out to be the best in the list of similar drugs;per day, the sugar concentration decreases by 22% and glycemic data improves.

insulin glulisine

A substitute for human insulin, which has a faster effect, but the result does not last long.

Used on an empty stomach or after a meal, the substance enters the body by injection.The duration of the course and dosage are established taking into account the individual characteristics of the patient.

insulin aspart

Latest generation hypoglycemic agent, whose action is aimed at correcting glucose levels.There are slight differences compared to the human hormone, which allows results to appear faster.After use, you are allowed to start eating.my, since it is not necessary to pause.

At night, hypoglycemia is much easier and glucose levels return to normal.Due to the strong effect, increasing the dose can be avoided.

Medications for the second type

The species is not as rare as the first type, which is why many more drugs have been developed to eliminate the problem.

biguanide

It has a hypoglycemic effect, reduces blood glucose concentration and does not cause insulin production.

Weight loss, cholesterol, lipoprotein and triglyceride levels decrease.In the early stages of therapy, 2-3 tablets are prescribed per day, intended for 2-3 doses, otherwise indigestion will occur.

The maximum amount is 6 tablets divided into three doses.The dose is increased gradually if there are no complications.Children over 10 years of age and adolescents will need 1 tablet per day, after two weeks the dose changes.It is not allowed to exceed the course, which involves the daily use of 4 tablets, distributed three times.

Exenatide-based GLP-1 receptor agonist

It is administered using a syringe designed for performing procedures at home.

There is a hormone similar to the one produced in the digestive tract, which releases a substance when food enters.

Insulin begins to be actively produced, as it has a beneficial effect on the pancreas, which is responsible for the creation of this substance.

Liraglutide-based GLP-1 receptor agonist

A formula has been invented to prolong the effect.

Course – 1 time a day 1 hour before a meal.

It is necessary to carry out the procedure at the same time, this will ensure the activity of the pancreas and the gastrointestinal tract.

Sitagliptin-based DPP-4 inhibitor 

The tablets are used before or after meals, you just have to respect a certain period of time.

You will need 100 mg for 1 daily dose.

It is possible to use both a drug separately and in combination with other drugs.

Saxagliptin-based DPP-4 inhibitor

Included in the category of DPP-4 inhibitors, suitable for combination therapy and monotherapy.

Type 1 diabetes becomes a complication that requires insulin administration after meals.

Vildagliptin-based DPP-4 inhibitor

It is needed once a day, the required dose is 50 mg, no matter the time of meal.

The result remains throughout the day, while the negative impact of the drug decreases.

How to control your glucose levels

The patient must independently monitor the sugar concentration.For these purposes, it is advisable to keep a diary where it is necessary to make important notes.You will need to periodically monitor your glucose level with a glucometer;you should not eat before observations;You should measure it in the morning before and after meals.Based on the data obtained, the diet and lifestyle are adjusted so that the indicators return to normal.However, you will still have to take tests in an outpatient clinic, where more reliable information is provided.

Documents to prescribe medications.

A system has been developed that allows those who need it to receive insulin for free.The doctor writes a prescription to the patient, before receiving it, the following list of documents must be presented:

• ID card;
• health insurance;
• individual insurance policy;
• document indicating disability;
• a document proving that the patient does not reject the social package.

Diabetes diet

An approximate diet for a week has been drawn up that will alleviate the patient's condition.

Diabetes mellitus type 2, what you can eat is shown in the table where the diet for the week is described.

	Breakfast	Second breakfast	Lunch	snack	dinner
1 day	Buckwheat, cottage cheese, milk 1% fat	glass of milk	Cabbage soup, boiled meat, fruit jelly.	two apples	Cabbage schnitzel, boiled fish, tea
Day 2	Barley porridge, soft-boiled egg, coleslaw	glass of milk	Mashed potatoes, pickled cucumbers, boiled beef liver, dried fruit compote	fruit jelly	A piece of boiled chicken, stewed cabbage, tea.Kefir before bed
Day 3	Cottage cheese with milk, oatmeal, coffee.	Kissel	Meatless borscht, boiled chicken, buckwheat porridge	two pears	Vinaigrette, egg, tea.Yogurt before bed
4 day	Buckwheat, cottage cheese, coffee.	kefir	Cabbage soup, lean boiled beef, compote	1-2 pears	Schnitzel, boiled fish, tea
5 days	Vinaigrette without potatoes with 1 tsp.vegetable oil, egg, coffee, slice of buttered rye bread	two apples	Sauerkraut with stewed meat, pea soup	fresh fruit	Boiled chicken, vegetable pudding, tea.Yogurt before bed
Day 6	Stewed meat, millet porridge, coffee.	Wheat bran decoction	Boiled meat, fish soup, lean mashed potatoes.	kefir	Oatmeal, cottage cheese, milk, apple.
Day 7	Buckwheat, boiled egg	two apples	Veal cutlet, pearl barley, vegetable soup	milk	Boiled fish, steamed potatoes, vegetable salad, tea.Kefir before bed.

natural medicine

Treatment with home remedies for diabetes is considered a way to eliminate the disease, which is why some of the most effective recipes are considered.

Namely:

• Fill the container with 1 liter of boiled water, add 100 g of cinnamon powder, stir, add 200 g of honey.Let it sit for 3 hours in a cool place.Course – 3 times a day;
• linden flower 1 tbsp.l.pour 1 glass of boiling water, the decoction can replace black tea;
• Put 300 g of peeled garlic and the same amount of parsley roots, 100 g of lemon zest in a meat grinder.Place the ground ingredients in a jar, cover with a lid and set aside in a dark, dry place for 2 weeks.Drink 1 tsp.2 times a day;
• grind dried walnut leaves, select 1 tbsp.l., pour ½ l of filtered water.Cook for 15 minutes, then remove from heat and set aside in a dry place for 1 hour.Strain, take ½ cup 3 times a day.

Before use, it is advisable to consult a doctor to avoid complications.

Sports and physical education.

Through physical activity, a lot of glucose is burned, the metabolism and the functioning of the cardiovascular system are also stabilized, so it is important to perform at least simple exercises daily.

Overvoltage should not be allowed, as there will be negative consequences.Increased appetite forces us to consume large amounts of food, so the efforts made previously lose meaning.

When fatigue occurs, stress occurs, adrenal hormones are released, after which glucose levels increase.

The best options to achieve excellent results are morning exercises, exercises with dumbbells, walking, jogging, cycling, swimming.

Prognosis of type 1 and 2 diabetes

If you allow the disease to enter the decompensation phase, then it will not be possible to eliminate the problem, since the body's resources are significantly reduced.

In the initial stage it is always easier to combat the disease than in advanced cases.By choosing the most effective therapy, the patient's condition is alleviated and life is thus prolonged.It is possible to improve the situation through a healthy lifestyle and physical activity.