Diabetes mellitus – a condition in which a significantly increased blood glucose levels. There are several types of the disease. In the case of early diagnosis and correctly selected therapy, some types of diabetes can be cured, while others are successfully monitored throughout life.
Types of diabetes
There are two main types of the disease – diabetes mellitus type 1 and 2.
Other types include:
- LADA – autoimmune diabetes in adults;
- rare, genetically determined, types of diabetes mellitus – MODY;
- Gestational diabetes – can develop only during pregnancy.
Causes and Risk Factors of Diabetes
Type 1 diabetes
Diabetes mellitus of the first type is characterized by an absolute deficiency of its own insulin. The reason is autoimmune destruction of the beta cells of the pancreas, which produce insulin. Most often, the disease occurs in childhood (4-6 years old and 10-14 years old), but it can appear at any time in life.
At the moment, the reasons for the development of diabetes in each individual person are not fully known. At the same time, vaccinations, stress, viral and bacterial diseases are never the cause of type 1 diabetes, they only occasionally coincide with the time of detection of diabetes. The predisposition to autoimmune processes may be associated with genetics, but not 100% determined by it.
Type 2 diabetes
Type 2 diabetes is a prime example of metabolic disorders, namely – violation of the assimilation of carbohydrates (glucose). In type 2 diabetes mellitus, insulin production remains normal for a long time, but the ability of tissues to transport insulin and glucose into cells is disrupted, which causes hyperglycemia, an increase in blood glucose concentration.
Unlike diabetes mellitus type 1, where the primary deficiency of insulin production, with the second type of diabetes, insulin in the blood is sufficient. Sometimes insulin can be synthesized excessively, due to an attempt by the body to solve the problem of the breakdown of the “transport mechanism”, increasing the production of glucose conductor.
The reasons:
Overweight combined with a genetic predisposition. As a rule, a combination of these two conditions is necessary. In this case, the excess weight may be quite small, but be located mainly around the waist. Genetic predisposition for each person is calculated individually, based on his own variants of genes and the presence of close relatives with diabetes.
In 2017, the concept of remission and recovery from type 2 diabetes was first introduced in the USA, Europe and Russia. Previously it was thought that this is impossible. Now, medical researchers around the world have recognized that in some cases a complete cure for type 2 diabetes is possible. The path to this is the normalization of body weight.
The EMC clinic has developed an individual approach to patients with diabetes and obesity. Against the background of drug normalization of blood sugar, classes are held, aimed at correcting the eating habits together with nutritionists and psychologists.
As a result of an integrated approach, we manage to achieve a stable result – normalize patient weight and sugar level.
A genetic study on susceptibility to type 2 diabetes is being conducted at the Center for Genomic Medicine EMC. Often the disease develops due to genetically programmed insufficient insulin synthesis in response to the use of high carbohydrate products. Knowing your risk allows you to start prevention even before the first deviations in blood tests appear.
For patients with obesity, it is important to know their own biological mechanisms that may affect eating behavior. In most cases, genetic research provides an answer to the cause of the failure of many diets and techniques, which allows you to personalize the approach for each of our patients.
LADA – autoimmune diabetes
This type of diabetes is characterized by a cumulative clinical picture of type 1 and 2 diabetes. The disease proceeds in a slower form and at the initial stages may manifest symptoms of type 2 diabetes. Patients with suspected LADA need clarifying diagnostics and individual treatment, which is different from the treatment of type 2 diabetes.
MODY – diabetes “young”
This monogenic, hereditary form of diabetes, which usually occurs during adolescence or at the age of 20-40 years. Patients with MODY usually have a family history of diabetes in virtually every generation, that is, in such families diabetes was at a young age with grandfather, mother and brothers and sisters.
Diagnosis of diabetes
The main method for the diagnosis of diabetes are laboratory tests. The most commonly determined glucose in venous blood. In some cases, to clarify the diagnosis, the doctor may order additional tests, such as the oral glucose tolerance test, continuous daily monitoring of blood glucose (CGMS sensor).
If a hereditary form of diabetes mellitus is suspected, the Center for Genomic Medicine EMC conducts molecular genetic diagnostics, which makes it possible to establish an accurate diagnosis and evaluate the prognosis for future children regarding this disease. Also, patients can always undergo a comprehensive screening genetic test to understand their genetic predisposition, both to diabetes itself and its complications (for example, diabetic cataracts).
For people with established diabetes mellitus, especially It is important to know what genetic risks exist for other diseases, such as kidney or heart disease, because diabetes can trigger many of the increased risks. Thanks to genetic diagnostics, it is possible to plan in time the volume of regular examinations and get individual recommendations on lifestyle and nutrition.
Diagnosis of diabetes in EMC clinics is carried out as soon as possible, according to international protocols and under the supervision of an endocrinologist.
EMC Diabetes Treatment
The EMC is a comprehensive treatment of diabetes, where doctors of various specialties are always involved in the management of patients. After the diagnosis, the patient may be assigned to consult the following specialists: endocrinologist , ophthalmologist, cardiologist . This is necessary because of the different rate of development of the disease and its complications. First of all, vascular complications in the kidneys and eyes. In addition, additional consultations of related specialists are the international standard for providing medical care in diagnosed diabetes.
Modern diabetes treatment is never complete without correction of lifestyle, which is often the most difficult for overweight patients. It is necessary to adjust the type of nutrition, start sports training recommended by a specialist. A very important role at this stage is played by the support of doctors: an endocrinologist and a therapist, if necessary a dietician, a cardiologist, a psychotherapist and other specialists. Without lifestyle correction, the effectiveness of therapy can be reduced.
Treatment always involves insulin therapy and constant monitoring of blood glucose levels. According to indications, the doctor may prescribe monitoring with a glucometer or continuous daily monitoring of glucose levels over several days. In the latter case, it is possible to find out and analyze the causes of deviations of the glucose level for various factors. This is especially important for patients with unstable glucose levels or frequent hypoglycemia, for pregnant women with diabetes. A portable (small-sized) device measures glucose level every five minutes for 7 days, its wearing does not affect the patient’s habitual activity (you can swim and play sports with it). The detailed data allows the doctor to get the result of the reaction to therapy and, if necessary, adjust the treatment.
Drug treatment
Treatment also involves medication with antihyperglycemic drugs, which should always be under the supervision of a physician.
Insulin in type 2 diabetes mellitus is prescribed when the beta cells of the pancreas are depleted . This is a necessary measure to prevent various complications. In some cases, insulin therapy is prescribed temporarily, for short periods. For example, before surgery or during periods of decompensation, when glucose levels for some reason become high. After passing the “peak”, the person returns to the previous regular drug therapy.
Treatment of gestational diabetes mainly consists of the correction of the diet and lifestyle of the expectant mother, as well as strict control of glucose levels. Only in some cases can insulin therapy be prescribed. EMC doctors and nurses provide training and provide round-the-clock support for insulin therapy patients.
Pumps and modern methods for measuring blood glucose
Insulin pumps give you more control over diabetes. Therapy with the help of pumps allows you to enter insulin in doses and mode as close as possible to the natural work of a healthy pancreas. Glucose control is still needed, but its frequency is decreasing.
Pumps allow you to reduce insulin doses, the number of injections and reduce the dosing step, which is extremely important for children and patients with high insulin sensitivity. Insulin pumps are a small device with a tank filled insulin, which is fixed on the patient’s body. The drug from the pump is injected painlessly: insulin is fed through a special micro-catheter. A prerequisite is to teach the patient or parents the rules for counting doses of insulin, self-monitoring of blood glucose levels. It is very important the patient’s willingness to learn to manage the pump and analyze the results.