Diabetes mellitus is a disease that affects the endocrine system. It occurs due to insufficient production of insulin by the body. It is characterized by metabolic disorders and a critical increase in glucose levels in the blood and urine.
The classification adopted in modern medicine includes two large groups:
- Diabetes insipidus.
The first is a rare chronic disease. It occurs in both adult men and women, and in children. It develops due to a malfunction of the hypothalamus or pituitary gland, which leads to insufficient production of vasopressin, a hormone responsible for regulating the absorption of fluid by the body. The main symptom of the disease is polyuria. The body can excrete up to 15 liters of urine per day with polyuria. Diabetes mellitus, according to WHO standards, is divided into:
- Type 1 diabetes – accompanied by a deficiency of insulin in the body. With this type of diabetes mellitus, insulin administration is required, therefore this type is otherwise called insulin-dependent. It develops due to the fact that the damaged pancreas is not able to produce hormones in sufficient quantities. Most often, the disease occurs in slender people under 30 years of age. Symptoms come on suddenly.
- Type 2 diabetes – insulin is produced in sufficient quantities, but the body is not able to absorb it, since the cells have lost their sensitivity to the hormone. The disease affects obese people over 30 years of age.
- Diabetes mellitus in pregnancy ( gestational ) – occurs during the period of gestation and, in most cases, disappears after childbirth. Symptoms appear due to hormonal changes in the body.
This classification does not include types of diabetes mellitus that develop due to chronic diseases of the pancreas, drug intake, endocrine system pathologies, as well as phosphate-diabetes.
Diabetes mellitus can exist in a latent form for a long time. The appearance of symptoms depends on the level of insulin secretion, the individual characteristics of the body and the duration of the disease. Diabetes types 1 and 2 have similar symptoms, but they appear to varying degrees. In the second case, the symptoms are less pronounced. Most often, patients complain about:
- dry mouth;
- frequent urination;
- rapid fatigue;
- feeling weak;
- numbness and tingling in the limbs;
- decreased libido;
- problems with potency;
- feeling of heaviness in the legs;
- itchy skin;
- painful sensations in the region of the heart;
- sleep disturbance;
People with type 1 diabetes often experience dramatic weight loss. On the other hand, type 2 diabetes patients gain extra pounds quickly.
When the first symptoms of the disease appear, it is necessary to undergo a comprehensive diagnosis of diabetes.
Tests Required to Detect Diabetes
Diagnosis for suspected development of type 1 or 2 diabetes begins with laboratory blood and urine tests. They help the patient to make the correct diagnosis and find an effective treatment.
Analysis of urine
This test is used to determine the level of sugar in the urine. In a healthy person, this indicator does not exceed 0.8 mmol / l. Higher numbers indicate the onset of type 1 or type 2 diabetes. For the study to be accurate, it is recommended to collect urine in the morning, after hygiene procedures. It must be delivered to the clinic within 1-2 hours to avoid distortion of the results. If the general analysis showed an excess of the permissible sugar norm, a daily urine test may be prescribed. Then the liquid is collected in a large container throughout the day. You need to store it in the refrigerator. Daily analysis helps to determine how critical an increase in urine sugar levels is in type 1 or type 2 diabetes.
For biochemical analysis, blood is taken from a vein. You need to come to the procedure on an empty stomach. On the eve, you can not drink strong coffee, tea, alcoholic beverages, eat fatty foods. It is not recommended to visit the bathhouse and sauna. It is forbidden to brush your teeth before the tests, as the sugar contained in the paste can distort the results. A blood test can help detect type 1 and type 2 diabetes at an early stage of development, which will greatly increase the chances of successful treatment. It provides information about glucose, cholesterol, glycated hemoglobin, insulin, and total body protein. The norms for these indicators are shown in the table. Their excess is one of the symptoms of the development of diabetes mellitus.
For preventive purposes, a biochemical blood test is performed at least once a year, as it gives a complete picture of the state of all organs. In type 1 and type 2 diabetes, the study should be carried out more often, since patients need constant monitoring.
If the disease is latent, the ophthalmologist may become the first specialist to suspect the development of type 1 or 2 diabetes in a patient. Lack of insulin in the body leads to changes in the fundus. They occur in three stages:
- The retinal venous vessels expand, become heterogeneous in shape and size.
- Changes take place in the structure of the retina. There are punctate hemorrhages. The retina has pale yellow opacities.
- The above changes are amplified. There are extensive and multiple hemorrhages. Retinal detachment and rupture are possible.
The clinical picture worsens over time. The speed depends on the location and depth of the pathological changes in the eyeball caused by diabetes. At the last stage, there is a high risk of losing sight almost completely.
The examination takes place using an ophthalmoscope. The doctor directs a beam of light to the eyeball at a distance of 15 cm. The device is gradually brought closer to expand the field of view. The procedure does not require any special preparation.
Another way to accidentally diagnose type 1 and 2 diabetes is to have an electrocardiogram (EKG). This examination is included in the list of mandatory preventive diagnostics, as it helps to detect pathologies at an early stage of their development. Diabetes mellitus negatively affects the work of the heart, since the occurrence of the following problems is noted:
- violation of metabolic processes, due to which the endurance of the organ decreases;
- lack of insulin provokes a decrease in the level of fatty acids in the blood;
- in later stages, changes the structure of the myocardium;
- the accumulation of cholesterol in blood vessels creates an unnecessary load.
An electrocardiogram allows you to assess the heart rate, frequency of contractions, and the work of different parts of the organ.
Diagnosing type 1 diabetes
Type 1 diabetes is treated by an endocrinologist. Diagnosis of the disease begins with a survey, during which the doctor finds out what symptoms the patient has. Finds out if he has blood relatives suffering from diabetes. The doctor then conducts an initial examination. It checks the condition of the skin, muscles and bones. Measures temperature. Sets the patient’s body mass index. Physical examination is necessary in order to understand how much type 1 or 2 diabetes has done to the body. Follow-up examination includes:
- blood chemistry;
- hormonal test to determine the level of insulin and C-peptides in the body;
- general urine analysis;
- examination of the fundus.
In the results of a biochemical blood test, a doctor is interested in the indicators of glucose, glycated hemoglobin, protein and lipid metabolism.
Diagnosing type 2 diabetes
The algorithm for diagnosing type 2 diabetes is no different from the examination method for type 1 disease. First, the endocrinologist conducts a survey and an external examination, then prescribes a blood and urine test. If necessary, gives a referral for additional diagnostic procedures. This is due to the fact that the symptoms of the disease are the same in different types of diabetes.
Differential diagnosis of diabetes mellitus
Differential diagnosis of diabetes is carried out based on the results of the survey, external examination, and blood and urine tests. It helps determine what type of disease the patient has developed.
Currently, Russia ranks 4th in the prevalence of diabetes mellitus in the world. The disease affects 6% of the population. Type 2 diabetes is diagnosed in 90% of patients. Scientists explain this phenomenon by people’s passion for fast food, the frequent use of which leads to metabolic disorders. Type 1 diabetes is diagnosed only in 9% of the population, since the main reason for its occurrence is hereditary predisposition. The remaining percentage falls on the incidence during the period of gestation and cases that do not fall into the classical classification.
Instrumental diagnostic methods
In some cases, in order to establish the cause of the development of the disease, it is required to diagnose diabetes using instrumental methods. This includes:
- Ultrasound of the pancreas, kidneys, heart;
- examination of blood vessels of the eyes;
- examination of the arterial current of the lower extremities;
- kidney scan.
These types of diagnostics may also be needed to determine what complications are causing type 1 or 2 diabetes.
What complications can the disease cause?
Diabetes mellitus needs timely diagnosis and quality treatment, as it can lead to serious complications:
- Hypoglycemia – a decrease in blood sugar levels. Causes unreasonable hunger, weakness, headache, palpitations. In the later stages, it leads to fainting.
- Hyperglycemia – increased blood sugar levels. It provokes increased urination, increased sweating, thirst, dry mouth at night. May lead to nausea and vomiting.
- Ketoacidosis is a type of carbohydrate metabolism disorder. It is accompanied by the appearance of the smell of acetone from the mouth, increased fatigue, rapid breathing, abdominal pain, decreased appetite.
- Nephropathy – damage to small vessels in the kidneys. Leads to swelling, discomfort in the back and lower back, general weakness.
- Loss of vision.
- Neuropathies – damage to peripheral nerves. Provokes cramps in the limbs, body numbness, decreased tactile and pain sensitivity.
The disease is often accompanied by changes in the joints and nerve endings in the legs. In advanced stages, this symptom can lead to non-healing ulcers and the development of gangrene. In especially advanced cases, type 1 and type 2 diabetes can cause hypoglycemic or hyperglycemic coma.
The risk of developing diabetes increases with age. The risk group includes people who are overweight, addicted to smoking and alcohol, and abuse fast food. Prevention measures for this disease include:
- balanced diet;
- light physical activity;
- rejection of bad habits;
- healthy sleep;
- compliance with the drinking regime;
- weight normalization;
- regular walks in the fresh air;
- systematic examination;
- control of chronic diseases.
It is not recommended to try to get rid of extra pounds with the help of strict diets and excessive physical activity, as this will weaken the immune system. In the autumn-winter and spring period, it is recommended to introduce more fresh vegetables, fruits and herbs into the daily diet. If necessary, you need to start taking the vitamin complex. Following the recommendations above will help to strengthen the body and reduce the risk of developing diabetes.