Diabetes mellitus is a chronic disease of the human endocrine system that occurs with a prolonged increase in the concentration of glucose in the blood (hyperglycemia). It develops due to an absolute or relative deficiency in the body of the hormone pancreatic hormone insulin, as well as due to a decrease in the sensitivity of cells to this substance. The disease disrupts carbohydrate, fat, protein, mineral and water-salt metabolism, resulting in accelerated atherogenesis (a constant, periodically worsening process of vascular damage resulting from changes in the vascular wall, impaired cholesterol metabolism and connective tissue) and increases the risk of cardiovascular diseases.
According to some reports, the term “diabetes” was first used by the Greek physician Demetrios of Apamania (II century BC. E.). In those days, pathology was considered as the inability of the body to retain fluid. Later, ancient Indians noticed that the urine of patients with diabetes attracts ants, and called this disease “sweet urine disease”. If urine was “tasteless” with increased excretion of fluid, then they talked about “diabetes insipidus” associated with damage to the kidneys or pituitary gland.
The hormone insulin secrete the pancreas, or rather: beta cells of the islets of Langerhans. It enables the cells of the body to absorb blood sugar (glucose). In diabetes mellitus, the substance is either absent altogether (type I diabetes, or insulin-dependent diabetes, IDDM), or the body cells do not sufficiently respond to it (type II diabetes, or non-insulin-dependent diabetes, NIDDM). About 10% of patients suffer from insulin-dependent diabetes mellitus, the rest – non-insulin-dependent. As a rule, IDDM , indicating the patient’s lifelong need for insulin, affects children, adolescents, and young people (hence its former name: juvenile diabetes), but, in fact, it can begin at any age. The main problem in this situation is the destruction of beta cells. This process is quite slow and has, most often, an autoimmune nature. Mass death of pancreatic endocrine cells can also be caused by viral infections, cancer, pancreatitis, toxic lesions and stressful conditions. When 80-95% of beta cells die, absolute insulin deficiency occurs, severe metabolic disorders develop and the disease manifests itself in all its glory. As for NIDDM , on the contrary, it is more likely to affect people over 40 years old. The function of beta cells in them is partially or fully preserved, so most patients do not need insulin therapy. As noted above, this type of diabetes accounts for 85-90% of all cases of the occurrence of such disorders. The main factors provoking the development of NIDDM are two: obesity and a hereditary predisposition.
In general, risk factors for diabetes:
- Obesity (in the presence of I degree obesity, the risk of developing diabetes increases by 2 times, with II degree – 5 times, with III degree – more than 10 times)
- High cholesterol
- Arterial hypertension
- Hereditary predisposition (in the presence of diabetes in parents or immediate relatives, the risk of developing the disease increases by 2-6 times).
According to various sources, the prevalence of diabetes in human populations is 1-8.6%, and the incidence among children and adolescents is approximately 0.1-0.3%. Some experts argue that each year the number of patients with diabetes increases by 6-10%, which leads to a doubling of the number of susceptible diseases every 10-15 years.
For diabetes, a classic triad of symptoms is characteristic :
- Polyuria (more than 2 liters of urine per day)
- Polydipsia (feeling of thirst)
- Polyphagia (increased appetite)
Most often, a number of secondary manifestations can be added to them:
- dry mouth
- general and muscle weakness;
- itching of the skin and mucous membranes (especially vaginal in women);
- poor wound healing;
- visual impairment;
- sharp weight loss in patients with type 1 diabetes mellitus (IDDM);
- obesity in patients with type 2 diabetes mellitus (NIDDM);
- the presence of acetone in the urine with type 1 diabetes (it is the result of burning fat reserves).
The most common complications of diabetes are:
- diabetic ketoacidosis (a serious condition leading to loss of consciousness and a violation of the vital functions of the body, developing as a result of the accumulation of products of intermediate fat metabolism in the blood);
- cardiovascular diseases (vascular atherosclerosis, coronary heart disease, myocardial infarction);
- atherosclerosis of peripheral arteries, including arteries of the lower extremities;
- microangiopathy (damage to small vessels) of the lower extremities;
- diabetic retinopathy (decreased vision due to damage to the retina in the form of microaneurysms, spot and spotted hemorrhages, edema, the formation of new vessels);
- diabetic neuropathy (decreased sensitivity, dryness and peeling of the skin, pain and cramps in the limbs);
- diabetic nephropathy (excretion of urine protein, impaired renal function);
- diabetic foot (ulcers, purulent-necrotic processes) against the background of damage to peripheral nerves, blood vessels, skin, soft tissues;
- various infectious complications (frequent pustular skin lesions, nail fungi, etc.);
- coma (diabetic, hyperosmolar, hypoglycemic).
Today, treatment of diabetes is not completely effective, which is why in the vast majority of cases it is symptomatic and is aimed at eliminating the existing symptoms without eliminating the cause of the disease. All patients with diabetes mellitus, along with medical treatment and regular physical activity, need diet therapy that excludes sugar, alcohol, syrups, cakes, cookies, and sweet fruits from the diet. Physical activity increases the sensitivity of body tissues to insulin and helps maintain optimal weight.