How to get tested for diabetes in the modern world should know every person. IN this moment about 500 million people suffer from this disease.

But this is not the final figure, as the current generation is increasingly exposed to obesity associated with diabetes. This is due to a sedentary lifestyle, malnutrition and hereditary predisposition.

This article will help you find out which diagnostic methods diabetes exist and which of them are more reliable.

What is diabetes mellitus and its types?

The disease is associated with disruption of the endocrine system. In diabetes, the production of insulin completely stops or decreases, as a result, hyperglycemia develops - a rapid increase in the concentration of glucose in the blood. There are currently three types of diabetes mellitus.

The first type of the disease is insulin-dependent. In this case, there is a violation of the function of pancreatic beta cells, as a result, they cannot produce an important hormone for the body - insulin, which helps glucose be absorbed into peripheral cells and tissues. Therefore, it remains and accumulates in the blood, and the starving body begins to break down fats and proteins, the by-products of which are ketone bodies. They negatively affect the functioning of organs, especially the brain. This type of diabetes is called juvenile diabetes because it is common in people under 30 years of age.

The second type of pathology does not depend on the production of insulin. The reason for the appearance of this type of diabetes is a violation of the sensitivity of peripheral cells and tissues to insulin. That is, the pancreas produces the hormone in the right amount, but the body reacts to it incorrectly. The second type of the disease develops in people over 40 who lead an inactive lifestyle and/or are obese. It is the most common type of the disease, as 90% of all diabetics suffer from it.

Gestational diabetes is a disease that occurs in expectant mothers during the period of bearing a child. This is due to hormonal changes in the body of a pregnant woman. Such a pathology can occur at 14-26 weeks of gestation and manifest itself as an increase in blood sugar levels.

Often the disease goes away on its own after the baby is born, but sometimes it can progress to type 2 diabetes.

When should sugar be checked?

Sugar level

Diabetes mellitus has many symptomatic manifestations. Therefore, noticing suspicious signals from the body, you need to urgently go to a doctor who can prescribe an immediate diagnosis.

In addition to the symptoms listed below, women and men may have signs of diabetes associated with the reproductive system. In women, the menstrual cycle is disturbed, there is a burning sensation and itching in the genital area, with complications, infertility develops.

Men have problems with ejaculation, with potency, itching occurs in the groin and perineum. In both cases, there is a hormonal imbalance: in the female, testosterone increases, and in the male, it decreases.

So, the main symptoms of diabetes are:

1. Dry mouth, intense thirst and frequent need to go to the toilet. Since there is an increase in the load on the kidneys, which must remove sugar from the body, they need more fluid. They begin to take water from cells and tissues, as a result, a person constantly wants to drink and relieve himself.
2. Dizziness, drowsiness and irritability. Glucose is the source of energy for the entire body. But since it does not enter the tissues and cells in the right amount, the body loses energy and becomes depleted. The breakdown products of fats and proteins, ketone bodies, begin to affect the functioning of the brain, and as a result, the patient complains of frequent dizziness.
3. Numbness and tingling of the legs and arms. With the progression of diabetes mellitus, it negatively affects the nerve endings, primarily of the limbs. As a result, the patient feels such signs.
4. Visual impairment. The development of pathology over time leads to damage to small vessels located in the retina of the eyeballs. A person can see a blurry picture, black dots and other defects.
5. Disruption of the digestive tract. As a rule, there is nausea, vomiting, diarrhea, excessive gas formation (flatulence), a change in taste.
6. Other signs: constant hunger, increased blood pressure, skin infections, rapid weight loss.

Methods for diagnosing diabetes

There are a sufficient number of different tests that can be used to find out if a patient has diabetes.

Among them, the specialist must choose the most suitable option. Blood sugar test. It is taken in the morning on an empty stomach.

At the same time, it is forbidden to drink tea or coffee before taking the analysis. Normal values ​​for an adult range from 3.9 to 5.5 mmol / l.

The main methods for testing blood for glucose are:

1. Analysis of urine. The study is carried out using special test strips. True, their cost is quite expensive - at least 500 rubles. This method diagnostics is not very effective due to the fact that it shows only a high level of glucose - at least 180 mg / l.
2. Analysis for glycated hemoglobin. The survey is carried out for three months to determine the average level of sugar in the blood. It is not the most convenient method, since it is carried out long time.
3. Glucose tolerance test. Two hours before the study, the patient drinks sweetened water. Then blood is taken from a vein. The result obtained above 11.1 mmol/l indicates the development of diabetes.

Based on the above, we can conclude that the best diagnostic methods are those that can determine the level of sugar in the blood for a short time and show the most accurate results. In addition, in order for the test to be truly reliable, it is necessary to pass the test several times. Since the distortion of the results of the analysis is influenced by such factors:

1. Neglect of the rules for passing the analysis (for example, the patient drank coffee or ate sweets).
2. Stressful state during blood sampling (release of adrenaline).
3. Fatigue in patients working night shifts.
4. Chronic diseases.
5. Pregnancy.

If the patient has been diagnosed with hyperglycemia (high sugar content), then the doctor prescribes an additional analysis to determine the type of diabetes. Often this is an analysis of the level of C-peptide and GAD antibodies, which should be carried out on an empty stomach or after certain physical exertion.

In addition, people over 40 and at risk are recommended to be tested for diabetes 2 times a year.

Self-checking sugar levels

A person who is aware of their diagnosis and is undergoing therapy knows how sugar levels can be checked at home. To do this, there is a special device - a glucometer, for example, which measures the content of glucose in the blood in a matter of seconds.

Patients dependent on insulin should check the sugar level before each injection of the hormone, that is, 3-4 times a day. And diabetics suffering from the second type of pathology check at least three times a day. Be sure to check the sugar in the morning after sleep, then 2 hours after breakfast and in the evening.

To test for diabetes at home, you need to buy a glucometer and carefully read the instructions for use. In order to find out the level of sugar in the blood, you need to perform the following steps:

1. Wash your hands with soap and stretch the finger that will be punctured.
2. Treat it with an antiseptic.
3. With a scarifier, make a puncture on the side of the finger.
4. The first drop is wiped off with a sterile napkin.
5. The second is squeezed onto the test strip.
6. It is placed in the glucometer, and after a couple of seconds the result is displayed on the display.

There are a lot of different devices on the market of medical devices for determining the level of sugar in the blood.

For the majority of the population, the most the best option is a domestic glucometer Satellite, which is inexpensive, but accurately determines the concentration of glucose.

Why is early diagnosis important?

The difference between the first and second type of diabetes is manifested in the course of the disease. The first type can develop quite quickly - within a few weeks.

The second type passes secretly for several years, and then becomes apparent when a person feels serious consequences development of pathology.

Such a simple procedure can save a person from complications, and diabetes has a lot of them, for example:

1. Diabetic coma: ketoacidotic (type 1), hypermolar (type 2). With the onset of such a severe case, urgent hospitalization of the patient is necessary.
2. Hypoglycemia is a sudden decrease in sugar levels below normal.
3. Nephropathy is a pathology associated with impaired functioning of the kidneys.
4. Increase in blood pressure.
5. The development of retinopathy - inflammation of the retina associated with damage to the vessels of the eyeballs.
6. Reduced immunity, as a result, the presence of a cold or flu.
7. Stroke and heart attack.

To prevent such pathologies, you need to take care of your health. Do not be lazy and check once every six months in medical institution. Also, to reduce the risk of developing diabetes, you need to adhere to such preventive measures:

1. To live an active lifestyle. Get up off the couch more often and exercise. It can be anything from visiting the pool to taking part in team games.
2. Observe, that is, to prevent the development of the disease, you need to eat less fatty and fried foods, fast food, easily digestible carbohydrates, sweet fruits. On the contrary, it is necessary to enrich your diet with unsweetened fruits, vegetables, foods containing fiber and complex carbohydrates.
3. Protect yourself from emotional shocks. To do this, you need to pay less attention to all sorts of little things. As people say, various diseases appear from nerves. So in traditional medicine this opinion is correct.
4. Combine leisure and work. You can not load yourself with overwork and not get enough sleep. Poor and insufficient sleep reduces the body's defenses.

If you feel certain symptoms that may indicate diabetes, you need to have your blood sugar tested. If you find this pathology, do not lose heart! This is not a sentence, thanks to modern methods of treatment, diabetics live full life like the rest of the people.

The video in this article explains how to diagnose diabetes.

Diabetes mellitus is a disease of the endocrine system that occurs due to a lack of insulin and is characterized by metabolic disorders and, in particular, carbohydrate metabolism. In diabetes, the pancreas loses its ability to secrete the required amount of insulin or to produce insulin of the desired quality.

The name "diabetes mellitus", according to the decision of the World Health Organization in 1985, is the name of a whole list of diseases that have common features: due to various factors, the level of sugar (glucose) in the blood rises in the owner of any of these diseases.

Diabetes is a rarely diagnosed disease.

There are a number factors that predispose to diabetes. In the first place is hereditary predisposition; the second leading cause of diabetes is obesity; the third reason is some diseases that result in damage to beta cells that produce insulin (these are diseases of the pancreas - pancreatitis, pancreatic cancer, diseases of other endocrine glands). The fourth reason is a variety of viral infections (rubella, chicken pox, epidemic hepatitis and some other diseases, including influenza); in fifth place is nervous stress as a predisposing factor; in sixth place among the risk factors is age. The older a person is, the more reason he has to be afraid of diabetes. It is believed that every ten years the age increases, the risk of developing diabetes doubles.

In rare cases, some hormonal disorders lead to diabetes, sometimes diabetes is caused by damage to the pancreas that occurs after the use of certain drugs or as a result of long-term alcohol abuse.

Depending on the reasons for the rise in blood glucose, diabetes mellitus is divided into two main groups: type 1 diabetes mellitus and type 2 diabetes mellitus.

Type 1 diabetes- insulin dependent. It is associated with damage to the pancreas, absolute insufficiency of its own insulin, and requires the introduction of insulin. Type 1 diabetes usually occurs at a young age (this form of diabetes mostly affects young people under the age of 30).

The second type of diabetes- insulin-independent, occurs due to the relative insufficiency of insulin. In the early stages of the disease, the introduction of insulin, as a rule, is not required. Type 2 diabetes is a disease middle age(they mostly affect the elderly). In such patients, insulin is produced, and by following a diet, leading an active lifestyle, these people can achieve that for quite a long time the sugar level will correspond to the norm, and complications can be safely avoided. Treatment of this type of diabetes may be limited to taking tablets only, however, in some patients, over time, it becomes necessary to additionally prescribe insulin. This is not a mild form of diabetes, as previously thought, since type 2 diabetes is one of the main risk factors for the development of coronary heart disease (angina pectoris, myocardial infarction), hypertension and other cardiovascular diseases.

Symptoms

There is a complex of symptoms characteristic of both types of diabetes: frequent urination and a feeling of unquenchable thirst; rapid weight loss, often with a good appetite; feeling weak or tired; fast fatiguability; blurred vision ("white veil" before the eyes); decreased sexual activity, potency; numbness and tingling in the limbs; feeling of heaviness in the legs; dizziness; protracted course of infectious diseases; slow wound healing; drop in body temperature below the average; spasms of the calf muscles.

There are times when a chronic increase in blood sugar for some time may not have such manifestations typical of diabetes, such as thirst or a significant increase in the daily amount of urine. And only over time, patients pay attention to general weakness, constantly bad mood, itching, more frequent pustular skin lesions, progressive weight loss.

The onset of type 1 diabetes is characterized by a rapid deterioration in well-being and more pronounced symptoms of dehydration. Such patients need urgent prescription of insulin preparations. Without appropriate treatment, a life-threatening condition, a diabetic coma, can occur. With type 2 diabetes, in almost all cases, weight loss and significant physical activity can prevent the progression of diabetes and normalize blood sugar levels.

In order to install diagnosis diabetes, it is necessary to determine the level of sugar in the blood. If the blood sugar level on an empty stomach is less than 7.0 mmol/l, but more than 5.6 mmol/l, a glucose tolerance test is necessary to clarify the state of carbohydrate metabolism. The procedure for this test is as follows: after determining the fasting blood sugar (fasting period of at least 10 hours), you must take 75 g of glucose. The next measurement of blood sugar levels is made after 2 hours. If the blood sugar level is more than 11.1, we can talk about the presence of diabetes. If the blood sugar level is less than 11.1 mmol / l, but more than 7.8 mmol / l, they speak of a violation of carbohydrate tolerance. At lower blood sugar levels, the test should be repeated after 3-6 months.

Treatment depends on the type of diabetes. Type I diabetes should always be treated with insulin to compensate for its lack in the body. Type II diabetes can first be treated with diet, and if this treatment is not enough, tablets (oral anti-diabetic drugs, i.e. taken by mouth) are added; as the disease progresses, the person switches to insulin therapy. In most countries modern world patients' need for insulin is fully covered by genetically engineered human insulin preparations. This is biosynthetic or recombinant human insulin and all dosage forms derived from it. According to International Federation diabetes, at the end of 2004, more than 65% of the world's countries used only genetically engineered human insulins to treat patients with diabetes mellitus.

There are short-acting drugs, intermediate-acting drugs and long-acting drugs. Along with them, insulin analogs with additional properties are also used. These include ultrashort-acting and long-acting insulins. As a rule, such drugs are administered subcutaneously, but if necessary, intramuscularly or intravenously.

It is firmly established that diabetes cannot be contracted, as one can become infected with the flu or tuberculosis. Diabetes is rightly attributed to the diseases of civilization, that is, the cause of diabetes in many cases is excess, rich in easily digestible carbohydrates, "civilized" food.

Diabetes mellitus is the most common endocrine disease worldwide. According to the World Health Organization (WHO), diabetes is the fourth leading cause of premature death and diabetes deaths are predicted to increase by more than 50% over the next 10 years unless urgent action is taken.

Despite all the efforts of health organizations and taken in many countries around the world national programs to combat this disease, the number of patients with this diagnosis is constantly growing. The incidence of diabetes is increasing not only within the age group over 40 years, but more and more children and adolescents are among the sick. According to the International Diabetes Federation and WHO, there are currently more than 200 million people with diabetes in all countries of the world.

According to experts, by 2010 this figure will increase to 239.4 million, and by 2030 - up to 380 million. More than 90% of cases in this case are type 2 diabetes.

These values ​​may be greatly underestimated, since up to 50% of patients with diabetes today remain undiagnosed. These people do not receive any hypoglycemic therapy and maintain stable hyperglycemia, which creates favorable conditions for the development of vascular and other complications.

Every 10-15 years total number patients are doubled. On average, 4-5% of the world's population suffer from diabetes, in Russia - from 3 to 6%, in the USA - from 10 to 20%.

The incidence of diabetes in Russia today has come close to the epidemiological threshold. More than 2.3 million diabetics are registered in Russia (unofficial statistics give figures from 8.4 to 11.2 million people), of which more than 750 thousand need daily insulin intake.

The material was prepared on the basis of information from open sources

Diabetes mellitus is a disease associated with a malfunction in the endocrine system. Origin and development this disease provokes the absence of the hormone insulin in the human body. Due to the lack of insulin, the blood sugar rises, and the primary signs of the development of a disease such as hyperglycemia appear.

Diabetes mellitus: glucose-insulin imbalance.

Hyperglycemia or diabetes (sugar) is a disease that is chronic. With hyperglycemia, there is a malfunction in the activity of the pancreas. The functionality of the gland is the production of this hormone. With hyperglycemia, the functionality of the metabolism is disturbed.

Classification of hyperglycemia

Diabetes can develop into several types:

• Type 1 diabetes. This is insulin-dependent diabetes. The initial stage of insulin deficiency and the initial level of development of hyperglycemia. The reason for this type is a deviation from the norm of the pancreas;
• Debit type #2. This is not insulin dependent diabetes. The amount of the hormone is within the normal range, and sometimes exceeds the prescribed norm. But adipocytes become insensitive to this hormone. For this reason, the blood glucose index rises rapidly.

Comparison scheme for type 1 and type 2 diabetes mellitus.

Diabetes mellitus in women at the time of pregnancy (gestational) and diabetes, which is the result of genetic diseases, or a deviation from the norm of the endocrine sphere, are classified separately.

Hyperglycemia is divided according to the degree of development of the disease:

• Diabetes degree No. 1 (mild)- sugar index on an empty stomach does not exceed 6 - 8 mmol / l. Glucosuria index for one day - not higher than 18 - 20 mmol / l. Therapy of this degree consists in the correct diet and taking medications;
• Diabetes degree No. 2 (medium)- the index on an empty stomach does not exceed 8 - 10 mmol / l. The index of glucosuria for one day is not higher than 35 - 40 mmol / l. Therapy is a diet and drugs that lower the glucose index. In this degree of diabetes, the first signs of the disease are already manifesting: eye diseases, pathologies in the activity of the heart, kidney disease, nervous disorders, problems with the vessels of the legs;
• Diabetes degree No. 3 (severe)- the index on an empty stomach does not exceed 12 - 14 mmol / l. Glucosuria index for one day - not less than 40 mmol / l. Diagnosed with protein in urine. Symptoms: progressive eye disease, nervous system is in a state of overexcitation, failures in the activity of the kidneys and the cardiac system. Increased pain in the lower extremities. The blood pressure coefficient is above normal. Therapy at this stage is a special diet and hormone injections;
• Diabetes degree No. 3 (super severe)- the sugar index on an empty stomach does not exceed 20 - 25 mmol / l. Glucosuria index one day - at least 40 - 50 mmol / l. Signs of the disease: all internal vital organs are affected. The body constantly loses its protein index by excreting it in the urine. The patient at this degree is subject to frequent diabetic coma. The work of the body is supported only by injections of the hormone insulin and in a sufficiently large dosage - at least 60 OD.

Type I diabetes mellitus: symptoms and signs of the disease

Signs of type 1 diabetes mellitus:

• High appetite and a constant feeling of an empty stomach. Man uses a large number of food, and there is no increase in body weight, and the person loses weight for no reason. The reason for this weight loss is that glucose is not absorbed by the body;
• Frequent urination and increased body fluid output. Polyuria occurs due to the strong filtration of glucose into the urine, which increases the pressure of the urine;
• Increased fluid intake due to extreme thirst. The volume of fluid intake is more than 5 liters per day. Thirst develops due to polyuria to make up for water deficiency, and thirst also develops due to irritation of the hypothalamus receptors;
• Signs of the development of acetonemia in a patient. Acetone is diagnosed in urine, the patient has the smell of acetone from the oral cavity. Acetonemia is caused by ketones in the blood and urine, which are toxins. The consequence of their influence on the body is poisoning with toxins: nausea, turning into vomiting, stomach cramps and spasms in the intestines;
• Eye dysfunction and vision loss. Objects in the field of view become indistinct, with blurry contours. Constant process of inflammation in the eyes, conjunctivitis. Feeling of clogging of the eyeball;
• Itching of the skin, rashes on the skin. Which turn into small sores and erosion and do not heal for a long period of time. The mucosa is also affected by sores;
• Intensive hair loss on the head.

Type 1 diabetes occurs abruptly and with clear signs. In diabetes, ketoacidosis manifests itself in a severe form and it can go into a diabetic coma. According to these signs, hyperglycemia of the first type is diagnosed.

Type 2 diabetes mellitus: symptoms and signs of the disease

Diabetes mellitus symptoms in the second type:

• The first sign is increased thirst. The volume of fluid intake is more than 5 liters per day. In older people, intense thirst develops due to loss of sensitivity to thirst;
• Nocturnal polyuria. Polyuria occurs due to the strong filtration of glucose into the urine, which increases the pressure of the urine. The volume of excreting biological fluid is equivalent to the volume of fluid entering the body;
• A sign is an increase in body weight;
• Constant feeling of hunger and increased appetite. Great desire to eat foods high in sugar;
• Fatigue of the body and weakness of the whole body. Increased fatigue and drowsiness after eating. This fatigue occurs due to a malfunction of metabolic processes and the accumulation of toxins;
• Itching on the mucous membranes and on the genitals. After itching, microtraumas and erosions appear, which are very difficult to heal and the healing process takes a long time;
• Neuropathy appears. Signs of neuropathy: numbness of the palms and feet, paresthesia of the lower extremities;
• Cold hands and feet, rapid fatigue of the legs while walking;
• Skin lesions, skin candidiasis, wounds that do not heal for a long time;
• Periodontal disease, stomatitis with relapses of the disease;
• Partial loss of vision, cataract. These signs arise from the high accumulation of glucose in the body;
• Relapses of the chronic form of pyelonephritis, infectious diseases of the urinary system and genital area.

Signs of diabetes

Initial symptoms of type II diabetes

Type 2 diabetes develops predominantly in older age and with increased body weight. With the accumulation of fat in the body, the cells increase in size and the perception of insulin on them changes. Such fat cells become insensitive to the hormone insulin, and therefore glucose is not absorbed into the cells.

At the early stage of type 2 hyperglycemia, the pancreas intensively synthesizes the hormone, but with the intensive development of the disease, the hormone reserve decreases and insulin deficiency develops.

It is almost impossible to recognize hyperglycemia of the second type at an early stage. A sick person associates poor health with age-related changes in the body, severe overwork. The untimely appeal to the doctor is explained by the fact that the symptoms are not pronounced than in type 1 diabetes.

You can find out that you have diabetes mellitus by chance during a preventive examination.

What are the signs of diabetes during pregnancy and during breastfeeding?

Gestational diabetes during childbearing is often asymptomatic.

But in most cases, symptoms appear:

• Constant feeling of hunger;
• Increased appetite;
• Frequent urge to urinate;
• Large volume of biological fluid exit from the body;
• Dizziness when changing the position of the head;
• Headache;
• Sudden change of mood;
• Increased irritability;
• increased heart rate;
• blurred vision;
• Fatigue;
• Drowsiness.

As soon as there are signs of incipient gestational diabetes, you should immediately consult a doctor to conduct an examination.

How does diabetes begin in children?

Reveal on early stages type 1 diabetes in children is possible with the development of ketoacidosis in a child. At the first attacks of cyclic vomiting, it is necessary to conduct an examination of the child. Such attacks develop in children whose body is prone to children's acetonymic syndrome.

An exacerbation occurs at the time of colds, viral diseases, infectious diseases. This syndrome provokes dehydration due to frequent vomiting. With age, acetonymic syndrome in a child disappears.

If ketoacidosis occurs in a child under the age of 12 months and its signs do not disappear until the age of 9, then an endocrinologist should be consulted.

With the manifestation of acetonymic syndrome, the pediatrician recommends taking an analysis for blood sugar levels.

Initial signs of high blood sugar in children:

• Frequent urination - nocturnal polyuria;
• polydipsia;
• A sharp decrease in body weight.

If it was not possible to establish the diagnosis of diabetes in a timely manner, then the child develops ketoacidosis.

The characteristic features are:

• Pain in the stomach and intestines;
• Nausea turning into vomiting;
• Dryness of the skin of the body;
• Rapid breathing;
• head spinning;
• Drowsiness;
• The presence of acetone in urine;
• Fainting.

At the first symptoms of ketoacidosis, it is necessary to call an ambulance.

How does diabetes manifest itself in men?

The manifestation of hyperglycemia in the male reproductive system occurs due to neuropathy and disruption of the normal flow of blood to the genitals.

Sign of failure in the reproductive system:

• Decreased libido;
• Weak erection;
• Itching in the genitals and perineum;
• Sedentary spermatozoa;

Due to the high accumulation of glucose in the body, most of the spermatozoa die and these are the main causes of male infertility in diabetes.

How does hyperglycemia manifest itself in women?

Manifestations of hyperglycemia in women affect reproductive function and the state of the genital area:

• Weak sex drive;
• Failure of the menstrual cycle;
• Itching in genital external organs and perineum;
• Candidiasis of the genital external organs, as well as the vagina;
• Abortion;
• female infertility.

Causes of Diabetes

The main causes of the onset and development of diabetes mellitus in adults, as well as in children:

• Heredity;
• Age-related changes in the hormonal background;
• Increased body weight;
• Constant tension of the nervous system;
• Pathology in the work of the pancreas;
• infectious hepatitis;
• Viral diseases;
• Increased sensitivity of the adrenal glands;
• Neoplasms in the organs of the gastrointestinal tract;
• Cirrhosis of the liver;
• Hyperthyroidism disease;
• A small percentage of digestibility of carbohydrates by the body;
• Short-term, but frequent increase in glucose.

Also, the cause of high glucose levels can be malnutrition, with a predominance of foods high in sugar.

Disease diagnosis

Hyperglycemia is very difficult to detect at an early stage.

Therefore, to establish a diagnosis, it is necessary to conduct a number of diagnostic studies:

• Determination of the degree of glycemia by the method of analysis for sugar;
• Glycemic profile - fluctuation of the glucose ratio within 24 hours;
• Test for measuring the hormone insulin;
• Hormone testing for glucose sensitivity;
• A study on the density in the blood of hemoglobin (glycosylated);
• Biochemical analysis;
• Checking urine for the concentration of leukocytes in it;
• Urine for glucose content;
• Examination of urine for the presence of protein;
• Reberg's test;
• Ultrasound examination of the ruffled cavity;
• Examination of urine for the presence of acetone in it;
• Diagnosis of blood composition;
• Examination of the eyeball;

At home, you can identify deviations from the normative indicators of glucose on your own, using a sugar measuring device - a glucometer.

Can diabetes be completely cured?

Treatment of diabetes mellitus depends mainly on the type and stage of development of the disease. To date, it is impossible to completely cure this disease. Pharmaceutical companies didn't invent medications for the complex treatment of this disease.

Today used in therapy medical preparations are aimed at preventing the transition of the disease to a more severe stage and preventing complications of this disease. Diabetes mellitus is a very insidious disease and it is dangerous for its complications on the organs and systems of the body's vital functions.

The use of insulin therapy is intended to slow down the destruction processes.

A doctor-adjusted diet helps in the treatment of type 2 diabetes. Quite often, the use of traditional medicine methods in the treatment of hyperglycemia ends up in a diabetic coma for a patient.

Diabetes due to relative or absolute insufficiency of insulin in the human body. With this disease, the metabolism of carbohydrates is disturbed, and the amount of glucose in the blood and urine increases. Diabetes mellitus also causes other metabolic disorders in the body.

Cause Diabetes mellitus is a deficiency of insulin, a pancreatic hormone that controls the processing of glucose at the level of tissues and cells of the body.

Risk factors for developing diabetes

Risk factors for the development of diabetes, that is, conditions or diseases that predispose to its occurrence, are:
hereditary predisposition;
overweight - obesity;
arterial hypertension;
elevated level.

If a person has several facts at the same time, the risk of developing diabetes for him increases up to 30 times.

Causes of diabetes

Destruction of insulin-producing cells in the pancreas as a result of viral infections. A number of viral infections are often complicated by diabetes, as they have a high affinity for pancreatic cells. Mumps (viral mumps), rubella, viral hepatitis, chickenpox, etc. cause the greatest risk of developing diabetes. So, for example, in people who have had rubella, diabetes mellitus develops in 20 % cases. But especially often a viral infection is complicated by diabetes in those who also have a hereditary predisposition to this disease. This is especially true for children and teenagers.
hereditary factor. In relatives of people with diabetes, as a rule, diabetes occurs several times more often. If both parents have diabetes, the disease manifests itself in children in 100 % cases, if only one of the parents is sick - in 50 % cases, in case of diabetes mellitus in a sister or brother - at 25%.

But when it comes to diabetes 1 type, the disease may not appear, even with hereditary predisposition. In this type of diabetes, the likelihood that a parent will pass on to a child defective gene, is approximately 4 %. Science also knows cases when only one of the twins fell ill with diabetes. The risk that type 1 diabetes will still develop increases if, in addition to the hereditary factor, there is also a predisposition resulting from a viral infection.
Autoimmune diseases, in other words, those diseases when the body's immune system "attacks" its own tissues. These diseases include autoimmune thyroiditis, glomerulonephritis, lupus, hepatitis, etc. In these diseases, diabetes develops due to the fact that cells of the immune system destroy pancreatic tissue, responsible for insulin production.
Overeating, or increased appetite leading to obesity. In people with normal body weight, diabetes mellitus occurs in 7,8 % cases, when the normal body weight is exceeded by 20 % the incidence of diabetes is 25 %, with an excess of mass 50 % - diabetes appears in 60 % cases. Obesity leads to the development of diabetes 2 type.

You can even reduce the risk of this disease reduced through diet and exercise total body weight 10 %.

Classification of diabetes

In classification World Organization Health (WHO) diabetes mellitus is classified into 2 type:
insulin-dependent - type 1;
insulin-independent - type 2.

non-insulin dependent diabetes also divided into two varieties: 1) diabetes in persons with normal body weight; 2) diabetes in obese individuals.

In the studies of some scientists, a condition called prediabetes (hidden diabetes). With it, the level of sugar in the blood is already above the norm, but not yet high enough to make a diagnosis of diabetes. For example, the glucose level between 101 mg/dl to 126 mg/dL (slightly higher 5 mmol/l). When there is no right treatment Prediabetes turns into diabetes itself. However, if prediabetes is detected on time and measures are taken to correct this condition, the risk of developing diabetes is reduced.

A form of diabetes mellitus has also been described gestational diabetes. It develops in women during pregnancy, and may disappear after childbirth.

Diabetes mellitus type 1. In insulin-dependent diabetes mellitus ( 1 type) are destroyed more 90 % insulin-secreting pancreatic cells. The reasons for this process can be different: autoimmune or viral diseases, etc.

In patients with diabetes 1 type, the pancreas secretes less insulin than necessary, or does not secrete this hormone at all. Of those people who suffer from diabetes, diabetes 1 type suffer only in 10 % sick. Usually diabetes 1 type manifests itself in people before 30 years. Experts believe that the start to the development of diabetes 1 type gives a viral infection.

Destructive role infectious disease It is also expressed in the fact that it not only destroys the pancreas, but also causes the immune system of a sick person to destroy their own pancreatic cells that produce insulin. So, in the blood of people suffering from insulin-dependent diabetes mellitus, contains antibodies against insulin-producing b-cells.

Normal absorption of glucose without insulin is impossible, that is, the normal functioning of the organism is also impossible. Those with diabetes 1 type, are constantly dependent on insulin, which they need to receive from the outside, since their own body of these people does not produce it.

Diabetes mellitus type 2. In non-insulin dependent diabetes mellitus ( 2 type) the pancreas secretes insulin in some cases even in larger quantities than necessary. However, the cells of the patient's body as a result of the action of any factors become resistant - their sensitivity to insulin decreases. Because of this, even with a large amount of insulin in the blood, glucose does not enter the cell in the right amount.

diabetes mellitus 2 kind of get sick too 30 years. The risk factors for its occurrence are obesity and heredity. Diabetes 2 type can also result from the misuse of certain drugs, in particular, corticosteroids for Cushing's syndrome, acromegaly, etc.

Symptoms and signs of diabetes

The symptoms of both types of diabetes are very similar. As a rule, the first symptoms of diabetes are caused by high blood glucose levels. When its concentration reaches 160-180 mg/dl (above 6 mmol/l), glucose enters the urine. Over time, when the disease begins to progress, the concentration of glucose in the urine becomes very high. At this point, the first symptom of diabetes appears, which is called polyuria- allocate more 1,5-2 l of urine per day.

Frequent urination leads to polydipsia - constant feeling of thirst to satisfy which you need to consume a large amount of fluid daily.

Calories are also excreted with glucose through the urine, therefore the patient begins to lose weight. Patients with diabetes have an increased appetite.

So there is a classic triad of symptoms characteristic of diabetes mellitus:
polyuria - allocation of more 1,5-2 l of urine per day;
polydipsia - constant feeling of thirst;
polyphagy - increased appetite.

Each type of diabetes has its own characteristics. The first symptoms of diabetes 1 types usually come on suddenly or develop over a very short period of time. Even diabetic ketoacidosis this type of diabetes can develop in a short time.

In patients with diabetes mellitus 2 type, long course of the disease time is running asymptomatic. If certain complaints appear, then the manifestation of symptoms is still not pronounced. Blood glucose levels at the onset of diabetes 2 type can even be downgraded. This condition is called "hypoglycemia".

In the body of such patients, a certain amount of insulin is secreted, therefore, in the early stages of diabetes mellitus 2 type of ketoacidosis, as a rule, does not occur.

There are also less characteristic non-specific signs of diabetes mellitus [b]2 type:
frequent occurrence of colds;
weakness and fatigue;
abscesses on the skin, furunculosis, hard-healing ulcers;
severe itching in the groin area.

Patients suffering from diabetes 2 type, often find out that they are sick, by chance, sometimes after several years from the moment the disease appeared. In such cases, the diagnosis is established on the basis of a detected increase in blood glucose levels or when diabetes is already causing complications.

Diagnosis of type 1 diabetes

Diagnosis of diabetes mellitus 1 type is put by the doctor on the basis of an analysis of the symptoms identified in the patient and the analysis data. To diagnose diabetes, you need to perform the following laboratory tests:
a blood test for glucose to detect its elevated content (see table below);
urinalysis for glucose;
glucose tolerance test;
determination of the content of glycosylated hemoglobin in the blood;
determination of C-peptide and insulin in the blood.

Treatment of type 1 diabetes

For the treatment of diabetes 1 type apply the following methods: drugs, diet, exercise.

The insulin treatment regimen for each diabetic patient is individually compiled by the attending physician. In this case, the doctor takes into account the patient's condition, and his age, and weight, and the characteristics of the course of his illness, and the body's sensitivity to insulin, as well as other factors. For this reason, there is no single treatment regimen for insulin-dependent diabetes. Self-medication for diabetes 1 type (both insulin preparations and any folk remedies) strictly prohibited and extremely dangerous to life!

Diagnosis of type 2 diabetes

If there is a suspicion that the patient has diabetes mellitus 2 Type, you need to determine the level of sugar in the blood and urine.

Usually diabetes 2 type, unfortunately, is detected at a time when the patient has already developed complications of the disease, usually this happens through 5-7 years since the onset of the disease.

Type 2 Diabetes Treatment

For the treatment of diabetes 2 type, you need to follow a diet, exercise, take drugs prescribed by a doctor that reduce blood glucose levels.

For those suffering from diabetes 2 type, oral antidiabetic drugs are usually prescribed. Most often they need to be taken once a day. However, in some cases, more frequent medication is required. To increase the effectiveness of therapy helps to combine medicines.

In a significant number of cases of diabetes mellitus 2 type drugs gradually lose their effectiveness in the process of application. These patients are treated with insulin. In addition, at certain periods, for example, if a patient with diabetes mellitus 2 such as seriously ill with another disease, most often it is required to temporarily change the treatment with tablets to treatment with insulin.

Only the attending physician can determine when taking pills should be replaced with insulin. Purpose of insulin therapy in the treatment of diabetes mellitus 2 type - compensation of the level of glucose in the blood, and consequently, the prevention of complications of the disease. It is worth considering the use of insulin in diabetes mellitus 2 type if:
the patient quickly loses weight;
symptoms of complications of diabetes are revealed;
other methods of treatment do not provide the necessary compensation for the level of glucose in the patient's blood.

People with diabetes have to strictly follow the diet, limiting yourself in many products. Food products for such patients are divided into three categories:
1) products for which there are no restrictions in use in diabetes: cucumbers, tomatoes, cabbage, radish, radish, green beans, green pea(no more than three tablespoons), fresh or pickled mushrooms, zucchini, eggplant, carrots, herbs, spinach, sorrel; allowed drinks: mineral water, tea and coffee without sugar and cream (you can add a sugar substitute), drinks with a sweetener;
2) foods that can only be consumed in limited quantities: lean chicken and beef, eggs, lean boiled sausage, low-fat fish, fruits (except those included in the third category, see below), berries, pasta, potatoes, cereals, cottage cheese with a fat content of not more than 4 % (preferably without additives), kefir and milk with a fat content of not more than 2 %, cheese low-fat varieties(less 30 % fat), beans, peas, lentils, bread.
3) Foods to be excluded from the diet: fatty meat (even poultry), fish, lard, sausages, smoked meats, mayonnaise, margarine, cream; fatty varieties of cottage cheese and cheese; canned food in oil, seeds, nuts, sugar, honey, all confectionery, chocolate, jam, ice cream, grapes, bananas, persimmons, dates. It is strictly forbidden to drink sugary drinks, juices, alcoholic drinks.

- a chronic metabolic disorder, which is based on a deficiency in the formation of one's own insulin and an increase in blood glucose levels. It is manifested by a feeling of thirst, an increase in the amount of urine excreted, increased appetite, weakness, dizziness, slow healing of wounds, etc. The disease is chronic, often with a progressive course. There is a high risk of developing stroke, kidney failure, myocardial infarction, gangrene of the extremities, and blindness. Sharp fluctuations in blood sugar cause life-threatening conditions: hypo- and hyperglycemic coma.

ICD-10

E10-E14

General information

Diabetes mellitus is the second most common metabolic disorder after obesity. In the world, about 10% of the population suffers from diabetes mellitus, however, if we take into account the hidden forms of the disease, this figure can be 3-4 times higher. Diabetes mellitus develops as a result of chronic insulin deficiency and is accompanied by disorders of carbohydrate, protein and fat metabolism. Insulin is produced in the pancreas by the ß cells of the islets of Langerhans.

Participating in the metabolism of carbohydrates, insulin increases the entry of glucose into cells, promotes the synthesis and accumulation of glycogen in the liver, and inhibits the breakdown of carbohydrate compounds. In the process of protein metabolism, insulin enhances the synthesis of nucleic acids, protein and inhibits its decay. The effect of insulin on fat metabolism is to activate the entry of glucose into fat cells, energy processes in cells, the synthesis of fatty acids and slow down the breakdown of fats. With the participation of insulin, the process of sodium entering the cell is enhanced. Disorders of metabolic processes controlled by insulin can develop with insufficient synthesis of insulin (type I diabetes mellitus) or with tissue resistance to insulin (type II diabetes mellitus).

Causes and mechanism of development

Type I diabetes mellitus is more often detected in young patients under 30 years of age. Violation of insulin synthesis develops as a result of damage to the pancreas of an autoimmune nature and the destruction of insulin-producing ß-cells. In most patients, diabetes mellitus develops after a viral infection (mumps, rubella, viral hepatitis) or toxic effects (nitrosamines, pesticides, drugs, etc.), the immune response to which causes the death of pancreatic cells. Diabetes mellitus develops if more than 80% of insulin-producing cells are affected. Being an autoimmune disease, type I diabetes mellitus is often combined with other processes of autoimmune genesis: thyrotoxicosis, diffuse toxic goiter, etc.

There are three degrees of severity of diabetes mellitus: mild (I), moderate (II) and severe (III) and three states of compensation for carbohydrate metabolism disorders: compensated, subcompensated and decompensated.

Symptoms

The development of type I diabetes is rapid, type II - on the contrary, gradually. Often there is a latent, asymptomatic course of diabetes mellitus, and its detection occurs by chance during the study of the fundus or laboratory determination of sugar in the blood and urine. Clinically, type I and type II diabetes manifest themselves in different ways, but the following symptoms are common to them:

• thirst and dry mouth, accompanied by polydipsia (increased fluid intake) up to 8-10 liters per day;
• polyuria (abundant and frequent urination);
• polyphagia (increased appetite);
• dry skin and mucous membranes, accompanied by itching (including perineum), pustular skin infections;
• sleep disturbance, weakness, decreased performance;
• cramps in the calf muscles;
• visual impairment.

Symptoms of type 1 diabetes are characterized by intense thirst, frequent urination, nausea, weakness, vomiting, increased fatigue, constant feeling of hunger, weight loss (with normal or increased nutrition), irritability. A sign of diabetes in children is the appearance of bedwetting, especially if the child has not previously urinated in bed. In type 1 diabetes, hyperglycemic (critically high blood sugar) and hypoglycemic (critically low blood sugar) conditions are more likely to develop, requiring emergency measures.

In type II diabetes mellitus, pruritus, thirst, blurred vision, severe drowsiness and fatigue, skin infections, slow wound healing, paresthesia and numbness of the legs predominate. Patients with type II diabetes are often obese.

The course of diabetes is often accompanied by hair loss on the lower extremities and increased hair growth on the face, the appearance of xanthomas (small yellowish growths on the body), balanoposthitis in men and vulvovaginitis in women. As diabetes progresses, a violation of all types of metabolism leads to a decrease in immunity and resistance to infections. Long-term diabetes causes damage to the skeletal system, manifested by osteoporosis (bone thinning). There are pains in the lower back, bones, joints, dislocations and subluxations of the vertebrae and joints, fractures and deformation of the bones, leading to disability.

Complications

The course of diabetes mellitus can be complicated by the development of multiple organ disorders:

• diabetic angiopathy - increased vascular permeability, their fragility, thrombosis, atherosclerosis, leading to the development of coronary heart disease, intermittent claudication, diabetic encephalopathy;
• diabetic polyneuropathy - damage to the peripheral nerves in 75% of patients, resulting in a violation of sensitivity, swelling and chilliness of the limbs, a burning sensation and "crawling" goosebumps. Diabetic neuropathy develops years after the onset of diabetes mellitus, and is more common in the non-insulin dependent type;
• diabetic retinopathy - destruction of the retina, arteries, veins and capillaries of the eye, decreased vision, fraught with retinal detachment and complete blindness. In type I diabetes, it manifests itself after 10-15 years, in type II - earlier, it is detected in 80-95% of patients;
• diabetic nephropathy - damage to the renal vessels with impaired renal function and the development of renal failure. It is noted in 40-45% of patients with diabetes mellitus after 15-20 years from the onset of the disease;
• diabetic foot - circulatory disorders of the lower extremities, pain in the calf muscles, trophic ulcers, destruction of the bones and joints of the feet.

Critical, acutely emerging conditions in diabetes mellitus are diabetic (hyperglycemic) and hypoglycemic coma.

Hyperglycemia and coma develop as a result of a sharp and significant increase in blood glucose levels. The harbingers of hyperglycemia are the growing general malaise, weakness, headache, depression, loss of appetite. Then there are pains in the abdomen, Kussmaul's noisy breathing, vomiting with the smell of acetone from the mouth, progressive apathy and drowsiness, and a decrease in blood pressure. This condition is caused by ketoacidosis (accumulation of ketone bodies) in the blood and can lead to loss of consciousness - diabetic coma and death of the patient.

The opposite critical condition in diabetes mellitus - hypoglycemic coma develops with a sharp drop in blood glucose levels, often due to an overdose of insulin. The increase in hypoglycemia is sudden, rapid. There is a sharp feeling of hunger, weakness, trembling in the limbs, shallow breathing, arterial hypertension, the patient's skin is cold, wet, sometimes convulsions develop.

Prevention of complications in diabetes mellitus is possible with constant treatment and careful monitoring of blood glucose levels.

Diagnostics

The presence of diabetes mellitus is evidenced by the content of glucose in capillary blood on an empty stomach, exceeding 6.5 mmol / l. Normally, there is no glucose in the urine, because it is retained in the body by the kidney filter. With an increase in blood glucose levels of more than 8.8-9.9 mmol / l (160-180 mg%), the renal barrier fails and passes glucose into the urine. The presence of sugar in the urine is determined by special test strips. The minimum level of glucose in the blood at which it begins to be determined in the urine is called the “renal threshold”.

Examination for suspected diabetes mellitus includes determining the level of:

• fasting glucose in capillary blood (from a finger);
• glucose and ketone bodies in the urine - their presence indicates diabetes mellitus;
• glycosylated hemoglobin - significantly increased in diabetes mellitus;
• C-peptide and insulin in the blood - in type I diabetes mellitus, both indicators are significantly reduced, in type II they are practically unchanged;
• carrying out a stress test (glucose tolerance test): determination of glucose on an empty stomach and 1 and 2 hours after taking 75 g of sugar dissolved in 1.5 glasses of boiled water. A negative (not confirming diabetes mellitus) test result is considered for tests: on an empty stomach< 6,5 ммоль/л, через 2 часа - < 7,7ммоль/л. Подтверждают наличие сахарного диабета показатели >6.6 mmol/l at the first measurement and >11.1 mmol/l 2 hours after glucose loading.

To diagnose complications of diabetes, additional examinations are carried out: ultrasound of the kidneys, rheovasography of the lower extremities, rheoencephalography, EEG of the brain.

Treatment

Implementation of the recommendations of a diabetologist, self-monitoring and treatment of diabetes mellitus are carried out for life and can significantly slow down or avoid complicated variants of the course of the disease. Treatment of any form of diabetes mellitus is aimed at lowering blood glucose levels, normalizing all types of metabolism and preventing complications.

The basis for the treatment of all forms of diabetes is diet therapy, taking into account the gender, age, body weight, physical activity of the patient. Training is provided on the principles of calculating the calorie content of the diet, taking into account the content of carbohydrates, fats, proteins, vitamins and microelements. In insulin-dependent diabetes mellitus, it is recommended to consume carbohydrates at the same hours to facilitate control and correction of glucose levels with insulin. With IDDM type I, the intake of fatty foods that contribute to ketoacidosis is limited. With non-insulin-dependent diabetes mellitus, all types of sugars are excluded and the total calorie content of food is reduced.

Nutrition should be fractional (at least 4-5 times a day), with a uniform distribution of carbohydrates, contributing to a stable glucose level and maintaining basal metabolism. Special diabetic products based on sweeteners (aspartame, saccharin, xylitol, sorbitol, fructose, etc.) are recommended. Correction of diabetic disorders with only one diet is used in a mild degree of the disease.

Choice drug treatment diabetes mellitus is determined by the type of disease. Patients with type I diabetes are shown insulin therapy, with type II - a diet and hypoglycemic agents (insulin is prescribed for the ineffectiveness of taking tablet forms, the development of ketoazidosis and precoma, tuberculosis, chronic pyelonephritis, liver and kidney failure).

The introduction of insulin is carried out under the systematic control of glucose levels in the blood and urine. There are three main types of insulin according to the mechanism and duration of action: prolonged (prolonged), intermediate and short-acting. Long-acting insulin is administered once a day, regardless of the meal. More often, injections of prolonged insulin are prescribed together with intermediate and short-acting drugs, allowing compensation for diabetes mellitus.

The use of insulin is dangerous because of an overdose, leading to sharp decline sugar, the development of a state of hypoglycemia and coma. The selection of drugs and the dose of insulin is carried out taking into account changes in the patient's physical activity during the day, the stability of blood sugar levels, the calorie content of the diet, the fragmentation of nutrition, insulin tolerance, etc. Local development is possible with insulin therapy (pain, redness, swelling at the injection site) and general (up to anaphylaxis) allergic reactions. Also, insulin therapy can be complicated by lipodystrophy - "failures" in adipose tissue at the site of insulin injection.

Sugar-reducing tablets are prescribed for non-insulin-dependent diabetes mellitus in addition to the diet. According to the mechanism of lowering blood sugar, the following groups of hypoglycemic agents are distinguished:

• sulfonylurea preparations (gliquidone, glibenclamide, chlorpropamide, carbutamide) - stimulate the production of insulin by pancreatic ß-cells and promote the penetration of glucose into tissues. The optimally selected dosage of drugs in this group maintains a glucose level not > 8 mmol / l. In case of an overdose, hypoglycemia and coma may develop.
• biguanides (metformin, buformin, etc.) - reduce the absorption of glucose in the intestine and contribute to the saturation of peripheral tissues with it. Biguanides can increase the level of uric acid in the blood and cause the development of a serious condition - lactic acidosis in patients over 60 years of age, as well as those suffering from liver and kidney failure, chronic infections. Biguanides are more often prescribed for non-insulin dependent diabetes mellitus in young obese patients.
• meglitinides (nateglinide, repaglinide) - cause a decrease in sugar levels by stimulating the pancreas to secrete insulin. The action of these drugs depends on the content of sugar in the blood and does not cause hypoglycemia.
• alpha-glucosidase inhibitors (miglitol, acarbose) - slow down the rise in blood sugar by blocking the enzymes involved in the absorption of starch. Side effects are flatulence and diarrhea.
• thiazolidinediones - reduce the amount of sugar released from the liver, increase the susceptibility of fat cells to insulin. Contraindicated in heart failure.

In diabetes mellitus, it is important to teach the patient and his family members the skills to control the well-being and condition of the patient, first aid measures in the development of precomatous and comatose conditions. Beneficial therapeutic effect in diabetes mellitus has a decrease excess weight and individual moderate physical activity. Due to muscle efforts, there is an increase in the oxidation of glucose and a decrease in its content in the blood. However, exercise should not be started at glucose levels > 15 mmol/l, but must first be allowed to decrease under the influence of drugs. In diabetes mellitus, physical activity should be evenly distributed to all muscle groups.

Forecast and prevention

Patients with diagnosed diabetes mellitus are registered with an endocrinologist. With the organization of the right lifestyle, nutrition, treatment, the patient can feel satisfactory long years. Aggravate the prognosis of diabetes mellitus and reduce the life expectancy of patients with acute and chronically developing complications.

Prevention of type I diabetes mellitus is reduced to increasing the body's resistance to infections and eliminating the toxic effects of various agents on the pancreas. Preventive measures for type II diabetes mellitus include preventing the development of obesity, correcting nutrition, especially in people with a burdened hereditary history. Prevention of decompensation and complicated course of diabetes mellitus consists in its correct, systematic treatment.