Diabetes mellitus type 1 and 2

Diabetes mellitus is one of the most common diseases faced by people from different parts of the world, age does not really matter.

According to statistics, there are about 250 million people with one or another form of the disease.The actual number of those affected exceeds the official data, as many of them do not know about the existing violations.

Mostly 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 turn to an endocrinologist who can identify the problem and make a diagnosis.

In order to avoid an unpleasant situation, you should study in detail what is meant by diabetes mellitus, what are the predisposing factors for its development, symptoms and methods of treatment.

What is diabetes mellitus?

This pathology is characterized by an insufficient level of insulin in the body, which is a peptide hormone that is concentrated in the cells of the pancreas.Diabetes mellitus presents itself 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, as well as destabilization of metabolic processes.

If we look at the deviations that occur in the body, we find:

• The internal organs are powered by glucose, and if it is not supplied in sufficient quantity, starvation will occur.This happens due to a low amount or lack of insulin, which is produced by the cells of the pancreas.When the movement of sugar accumulated in the blood stops, the subsequent metabolic development does not occur;
• the cells responsible for the transport of the hormone and the absorption of glucose at some point become immune and do not react in any way to a substance that has managed not to undergo changes;
• sugar is not converted into nutrients, which makes the body 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 deal with the problem at an early stage, but many patients come to the clinic much later, which affects the implementation of therapeutic measures for the worse.

Many doctors talk about diabetes not as a disease, they are unanimous about the cause of the problem and it lies in the wrong lifestyle.

You will be able to protect yourself from negative consequences if you adjust your work and rest schedule, follow your doctor's recommendations and monitor your well-being and blood sugar levels.

When measures are not taken, then 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 a doctor on time.

Diabetes types 1 and 2

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

We are talking about such varieties as:

• first type, called juvenile, found in patients in adolescence and older age.It is mainly passed on to children from close relatives.Beta cells undergo changes that negatively affect their structure.Insulin is produced in minimal amounts, insufficient for the normal life of the victim.About 10% experience 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 finally loses its original properties.The situation does not change with time, it remains until the end of life;
• second type– due to deterioration of metabolism, the hormone ceases to be produced in the necessary quantities, which causes a relative lack of insulin.Beta cells stop working stably;due to pathological processes, they are unable to perform the functions determined by the body - to produce the necessary substance and reduce glucose in the blood.

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

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

Symptoms of diabetes type 1 and 2

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

Distinctive features include:

• sudden weight loss;
• urinary incontinence at night, which is more common in children;
• deterioration of the visual apparatus;
• the skin and mucous membranes dry;
• lack of moisture in the oral cavity, even if the water balance is maintained;
• thirst provokes drinking water in large quantities, exceeding 10 liters;
• itching and purulent formations on the skin;
• frequent urination, copious urination;
• uncontrolled contraction of the muscles of the lower limbs;
• vomiting and nausea - the relief that comes after emptying the stomach is temporary;
• irritability;
• loss of strength, inability to work for a long time;
• increased appetite;
• constant desire to eat after a short period of time.

A complication is hyperglycemia - an increase in glucose levels that can be fatal.A worsening of the condition, expressed in a minimal amount or absence of hair on the legs, is not excluded.

The appearance of benign yellowish formations is observed in the tendons, on the mucous membranes of the internal organs and the skin.Inflammation can be observed on the surface of the genital organs in both men and women.Bones become fragile and easily succumb to negative external influences.As for immunity, it practically loses its protective properties.

The symptoms of type 2 diabetes have some similarities, but there are manifestations that allow you to determine which type you are dealing with.The following signs have been identified:

• wounds take a long time to heal;
• infection of the epidermis;
• feeling thirsty;
• frequent urination, forcing you to go to the toilet both during the day and at night;
• exhaustion, slow reaction, sleep disorders;
• mucous membranes are dry;
• numbness, tingling in the limbs;
• increased appetite as a result of leptin synthesis pathology;
• dry mouth, you need to drink about 3-5 liters a day;
• itching in the groin area - confusion arises, which makes you contact a gynecologist or dermatologist instead of an endocrinologist;
• hunger after 1-2 hours after eating;
• swelling of the face and lower legs;
• children's enuresis, manifested at night;
• high blood pressure;
• headache and dizziness.

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

Pathogenesis of the disease

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

• heredity - the risk of the appearance of the first type of disease in a child increases if the parents have the same diagnosis;
• overweight - 80-90% of patients suffer from excess body weight, because fat tissue is not able to use insulin as intended.Newborns should weigh 2.5-3.5 kg;if the indicators increase, the endocrinologist should conduct an examination;
• viruses - cause abnormalities of the pancreas, therefore, due to rubella, measles, chicken pox, previously passed by a child, they can lead to the death of cells in the digestive system;
• age-related changes;
• regular stressful situations;
• unhealthy lifestyle and poor diet - body mass index over 30 complicates the situation leading to insulin resistance, the probability of this increases 2 times.Indicators of 35 or more indicate a 100% probability of diabetes;
• fat deposits around the abdomen;
• disruption of the pancreas due to 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 deterioration of the condition are listed;they can have a one-time effect, thus increasing the threat.Absolutely healthy people are at risk and it is recommended to see a doctor.

Sugar levels after and before meals

A low glucose level is observed on an empty stomach, which is usually within 3.4-5.5 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 absorb it.In practice, the examination is not performed on a full stomach.The most accurate information will be that obtained 1-3 hours after eating.

The normal diabetes blood sugar level for women, men and children over 12 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 time period:

• until 11;
• up to 10-10.3;
• 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 stages of diabetes?

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

• compensation– was able to achieve glucose content in accordance with natural indicators;
• subcompensation– sometimes the volume of the substance increases;
• decompensation- lack of response to insulin, therapy is difficult to apply.

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

• light- the improvement of the condition is due to the choice of the right diet and regimen.The positive effect is obvious when following a diet, while the use of a hypoglycemic agent will bring a double benefit.The probability of transition from one stage to another is minimized;
• average– You can't do without drugs that lower the sugar level.They are used constantly, but they are not able to protect against vascular pathologies;
• heavy- the use of hypoglycemic agents and insulin, which is sometimes used without combination with other drugs, should not be interrupted.There is a threat of developing encephalopathy, neuropathy and vascular angiopathy.

Differences between type 1 and type 2 diabetes

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

Characteristics	First type	Second kind
Point	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	Additional kg
development	Transitional	Slow, does not appear brightly
Vascular abnormalities	Mostly small ones	Mostly big ones
Cell sensitivity to insulin	yes	low
Antibodies against insulin and beta cells	yes	no
Therapy	Insulin	Diet, glucose-lowering drugs, insulin (at a later stage)

Diagnosis of the disease

Before you know 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, polygraph, overweight or significant weight loss.The following also applies:

• ultrasound;
• determination of pathological insulin;
• electrocardiography - examination of the electrical fields of the heart;
• Rehberg's test - assessment of the condition of the kidneys;
• biochemical blood test;
• fundus examination.

Based on the information obtained, a clinical picture is outlined, after which a therapeutic technique is proposed.

Type 1 drugs

The main drug is insulin, but in addition to it, the doctor prescribes tablets that help to deal with disorders of glucose metabolism, which is combined with obesity, which worsens the situation.

We are talking about drugs from the group of biguanides, which reduce the acute need for insulin and also relieve the patient's condition.

Insulin lispro

The insulin analogue produced in the human body acts quickly - 15 minutes after injection.Glucose metabolism is controlled and anti-catabolic and anabolic effects on tissues occur.

The drug turned out to be the best in the list of similar drugs;per day, 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.

It is used on an empty stomach or after a meal, the substance enters the body by injection.The duration of the course and the dose are determined taking into account the individual characteristics of the patient.

Insulin aspart

A hypoglycemic agent of the latest generation, the action of which is aimed at correcting glucose levels.There are slight differences compared to the human hormone, which allows results to appear faster.After use, you can start eatinge, as there is no need for rest.

At night, hypoglycemia occurs much more easily, glucose levels normalize.Due to the strong effect, it is possible to avoid increasing the dose.

Medicines for the second type

The type is not as rare as the first type, so many more drugs have been developed to fix the problem.

Biguanide

It has a hypoglycemic effect, reduces the concentration of glucose in the blood and does not provoke the production of insulin.

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

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

An exenatide-based GLP-1 receptor agonist

It is applied with a syringe designed for performing procedures at home.

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

Insulin begins to be actively produced because it has a beneficial effect on the pancreas, which is responsible for creating 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 meals.

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

DPP-4 inhibitor based on sitagliptin 

Tablets are used before or after meals, you just need to stick to a certain time frame.

You will need 100 mg for 1 daily dose.

It is possible to use both a separate drug 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 the administration of insulin after meals.

DPP-4 inhibitor based on vildagliptin

It is necessary once a day, the required dose is 50 mg, the time of the meal does not matter.

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

How to monitor your glucose levels

The patient must independently monitor the concentration of sugar.For these purposes, it is advisable to keep a diary where you need to make important notes.You will need to check your glucose level regularly using a glucometer;should not be eaten before observations;you should measure it in the morning before and after meals.Based on the data obtained, the diet and lifestyle are adjusted to normalize the indicators.However, you will need to do research in an outpatient clinic, where more reliable information is provided.

Medication Prescription Documents

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

• identity card;
• medical insurance;
• individual insurance policy;
• document certifying disability;
• a document confirming that the patient does not refuse the social package.

Diet for diabetes

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

Type 2 diabetes, what you can eat is shown in the table, where the diet for the week is indicated.

	breakfast	Second breakfast	Lunch	Afternoon breakfast	Dinner
1 day	Buckwheat, cottage cheese, milk 1% fat	A glass of milk	Cabbage soup, boiled meat, fruit jelly	Two apples	Cabbage schnitzel, boiled fish, tea
Day 2	Barley porridge, soft boiled egg, cabbage salad	A glass of milk	Mashed potatoes, pickles, 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	Sour	Borscht without meat, 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 day	Vinaigrette without potatoes with 1 tsp.vegetable oil, egg, coffee, a piece of rye bread with butter	Two apples	Sauerkraut with stewed meat, pea soup	Fresh fruit	Boiled chicken, vegetable pudding, tea.Yogurt before bed
Day 6	Stewed meat, millet, coffee	Decoction of wheat bran	Boiled meat, fish soup, lean mashed potatoes	Kefir	Oatmeal, cottage cheese, milk, apple
Day 7	Buckwheat, hard boiled egg	Two apples	Beef cutlet, pearl barley, vegetable soup	milk	Boiled fish, stewed potatoes, vegetable salad, tea.Kefir before bed.

Natural medicine

Treatment of diabetes with folk remedies is considered a way to eliminate the disease, so some of the most effective recipes are considered.

namely:

• Fill the vessel with 1 liter of boiled water, add 100 g of cinnamon powder, mix, add 200 g of honey.Leave to brew for 3 hours in a cool place.Course - 3 times a day;
• linden blossom 1 tbsp.l. pour 1 cup of boiling water, the decoction can replace black tea;
• put in a meat grinder 300 g of peeled garlic and the same amount of parsley roots, 100 g of lemon peel.Place the ground ingredients in a jar, cover with a lid and leave 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 the heat, leave in a dry place for 1 hour.Strain, take ½ cup 3 times a day.

Before use, you should consult a doctor to avoid complications.

Sports and physical education

A lot of glucose is burned through physical activity, 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 it will have negative consequences.Increased appetite forces you to consume large amounts of food, due to which the efforts made earlier lose their meaning.

When fatigue occurs, stress occurs, adrenal hormones are released, then glucose levels rise.

The best options for achieving 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 phase of decompensation, 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 fight the disease than in advanced cases.By choosing the most effective therapy, the patient's condition is alleviated, thereby prolonging life.It is possible to improve the situation through a healthy lifestyle and physical activity.