Diabetes mellitus type 1 and 2

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

According to statistics, there are about 250 million people with one form or another of the disease.The real number of patients exceeds the official figures, since many are unaware of the existing violations.

Mostly children suffer from a disease whose manifestations cannot always be detected in a timely manner due to mild symptoms.

Due to negligence, patients do not turn to an endocrinologist who can identify the problem and make a diagnosis.

To avoid an unpleasant situation, you need to study in detail what is meant by diabetes mellitus, what are the predisposing development factors, symptoms and methods of treatment.

What is diabetes mellitus?

This pathology is characterized by insufficient levels of insulin in the body, which is a peptide hormone that is concentrated in the cells of the pancreas.Diabetes mellitus is presented 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, and destabilization of metabolic processes also occurs.

If we consider the deviations that occur in the body, we find:

• Internal organs are fed with glucose, and if it is not supplied in sufficient quantities, starvation will occur.This happens due to a low amount or absence of insulin, which is produced by pancreatic cells.When the movement of sugar accumulated in the blood stops, subsequent metabolic development does not occur;
• the cells responsible for transporting the hormone and assimilating 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 causes the body to starve, while a lot of glucose enters the blood, which negatively affects 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 agree on the cause of the problem, and it lies in an incorrect 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 no measures are taken, then there is a risk of harm to all organs.In advanced cases, the patient exposes himself to the threat of falling into a coma due to serious complications.It is important, even if there are minor deviations, to make an appointment with a doctor on time.

Types of diabetes 1 and 2

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

We are talking about such varieties as:

• first type, called juvenile, detected in patients of adolescence and older age.It is mainly transmitted to children from close relatives.Beta cells undergo changes that negatively affect their structure.Insulin is produced in minute quantities, insufficient for the normal life of the victim.About 10% face a problem that is largely of autoimmune 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 over time, it remains until the end of life;
• second type– due to a deterioration in metabolism, the hormone ceases to be produced in the required volumes, which causes a relative lack of insulin.Beta cells stop working stably; due to pathological processes, they are unable to perform the functions specified 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, since inaction leads to a negative impact on the fetus.It is possible to get rid of the disease after childbirth, but disturbances regarding the absorption 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 medications, destabilization of the endocrine system, pancreatic dysfunction, and the like.

Symptoms of type 1 and 2 diabetes

The first type has a chronic form, is transient and quickly passes from the initial stage to a more severe one, which occurs against the background of the adverse effects 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 out;
• 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;
• frequency of urination, copious amounts of urine;
• uncontrolled contraction of the muscles of the lower extremities;
• vomiting and nausea - the relief that comes after emptying the stomach is temporary;
• irritability;
• loss of strength, inability to engage in work for a long time;
• increased appetite;
• an incessant desire to eat after a short period of time.

A complication is hyperglycemia - an increase in glucose levels, which can be fatal.A deterioration of the condition, manifested in a minimal amount or absence of hair on the legs, cannot be ruled out.

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

Diabetes mellitus symptoms of the second type have some similarities, however, there are manifestations that make it possible to determine which type you are dealing with.The following signs are identified:

• wounds take a long time to heal;
• infection of the epidermis;
• feeling of thirst;
• frequent urination, forcing you to go to the toilet both day and night;
• exhaustion, slow reaction, sleep disturbances;
• mucous membranes are dry;
• numbness, tingling in the limbs;
• increased appetite resulting from pathology of leptin synthesis;
• dry mouth, you have to drink about 3-5 liters a day;
• itching of the groin area - confusion occurs, prompting you to contact a gynecologist or dermatologist instead of an endocrinologist;
• hunger after 1-2 hours of eating;
• swelling on the face and lower legs;
• childhood enuresis, manifested at night;
• high blood pressure;
• headaches and dizziness.

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

Pathogenesis of the disease

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

• heredity – the risk of the first type of disease appearing in a child increases if the parents have the same diagnosis;
• excess weight – 80-90% of patients suffer from excess body weight, since adipose tissue is unable to use insulin as intended.Newborns should weigh 2.5-3.5 kg; if the indicators increase, the endocrinologist needs to conduct an examination;
• viruses - cause abnormalities of the pancreas, therefore, due to rubella, measles, chickenpox, previously suffered by a child, they can lead to the death of cells in the digestive system;
• age-related changes;
• regular stressful situations;
• an unhealthy lifestyle and poor diet - a body mass index of more than 30 complicates the situation leading to insulin resistance, the likelihood of this increases by 2 times.Indicators of 35 or more indicate a 100% probability of diabetes;
• fat deposits around the abdomen;
• disruption of the pancreas for various reasons, including injury to the organ;
• pathological processes in the endocrine system that occurred due to acromegaly, Itsenko-Cushing syndrome, and so on.

The primary factors causing deterioration of the condition are listed; they can have a one-time impact, thereby increasing the threat.Absolutely healthy people are at risk and it is recommended to visit a doctor.

Sugar levels after and before meals

On an empty stomach, there is a low level of glucose, which is normally in the range of 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, 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 assimilate it.In practice, the examination is not carried out when the stomach is full.The most accurate information will be that obtained 1-3 hours after the meal.

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

• up to 11;
• up to 10-10.3;
• up 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 phases of diabetes?

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

• compensation– managed to achieve the 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 implement.

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

• light– improvement of the condition occurs 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 double benefit.The likelihood of transition from one stage to another is minimized;
• average– You can’t do without medications that lower your sugar levels.They are used on an ongoing basis, but are not able to protect against vascular pathologies;
• heavy– the use of hypoglycemic agents and insulin, which is sometimes used without combination with other medications, should not be interrupted.There is a threat of developing encephalopathy, neuropathy, and vascular angiopathy.

Differences between types 1 and 2 diabetes

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

Peculiarities	First type	Second type
Period	Autumn, winter, spring	Not noted
Cases (%)	10-20%	80-90%
Floor	More often men	More often women
Age	Up to 40 years old	Children, adults over 40
Weight	Standard or reduced	Extra kg
Development	Transient	Slow, does not appear brightly
Vascular abnormalities	Mostly small	Mostly large
Cell sensitivity to insulin	Eat	Low
Antibodies to insulin and beta cells	Yes	No
Therapy	Insulin	Diet, glucose-lowering drugs, insulin (at a later stage)

Diagnosis of the disease

Before you find out how to treat diabetes, a blood sugar test is performed, which is the main way to calculate the current and daily glucose levels.

Additional diagnostic measures include polyuria, polygraphy, excess body weight or significant weight loss.The following also applies:

• Ultrasound;
• determination of pathological insulin;
• electrocardiography – study of the electric fields of the heart;
• Rehberg test - assessment of kidney condition;
• biochemical blood test;
• study of the fundus.

Based on the information received, a clinical picture emerges, after which a therapeutic technique is proposed.

Medicines from type 1

The main remedy is insulin, but in addition to it, the doctor prescribes tablets that help cope with glucose metabolism disorders, which is combined with obesity, which aggravates the situation.

We are talking about medications from the biguanide group, which reduce the acute need for insulin and also alleviate the patient’s condition.

Insulin lispro

An analogue of insulin produced in the human body is fast-acting – 15 minutes after injection.Glucose metabolism is controlled, and anti-catabolic and anabolic effects on tissue appear.

The drug turned out to be the best in the list of similar medications; per day, the concentration of sugar decreases by 22%, and glycemia data improves.

Insulin glulisine

A substitute for human insulin, which has a faster effect, but the result does not last long.

Used on an empty stomach or after a meal, the substance enters the body through injection.The duration of the course and dose are set taking into account the individual characteristics of the patient.

Insulin aspart

A hypoglycemic agent of the latest generation, whose action is aimed at correcting glucose levels.There are slight differences compared to the human hormone, which allows the results to appear faster.After use, you are allowed to start eatinge, since there is no need to take a break.

At night, hypoglycemia occurs much easier, glucose levels return to normal.Due to the strong effect, it is possible to avoid increasing the dose.

Medicines for the second type

The species is not as rare as the first type, so many more drugs have been developed to eliminate 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 quantity is 6 tablets taken in three doses.The dose is gradually increased if there are no complications.Children over 10 years of age and adolescents will need 1 tablet per day, after two weeks the dosage changes.It is not allowed to exceed the course, which involves the daily use of 4 tablets, distributed three times.

Exenatide-based GLP-1 receptor agonist

It is administered using a syringe designed for carrying out procedures at home.

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

Insulin begins to be actively produced, as it has a beneficial effect on the pancreas, which is responsible for the creation of this substance.

GLP-1 receptor agonist based on liraglutide

A formula has been invented to prolong the effect.

Course – 1 time per day 1 hour before a meal.

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

DPP-4 inhibitor based on sitagliptin 

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

You will need 100 mg for 1 daily dose.

It is possible to use both a separate medicine and in combination with other medicines.

DPP-4 inhibitor based on saxagliptin

Included in the category of DPP-4 inhibitors, suitable for combination therapy and monotherapy.

Type 1 diabetes becomes a complication, which requires insulin to be administered after meals.

DPP-4 inhibitor based on vildagliptin

It is needed 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 sugar concentration.For these purposes, it is advisable to keep a diary where you need to make important notes.You will need to regularly check your glucose level using a glucometer; you should not eat 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 bring the indicators back to normal.However, you will still have to do tests at an outpatient clinic, where more reliable information is provided.

Documents for prescribing medications

A system has been developed that allows those who need it to receive insulin free of charge.The doctor writes a prescription to the patient, before receiving which the following list of documents must be presented:

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

Diet for diabetes

An approximate diet for a week has been compiled, which will alleviate the patient’s condition.

Diabetes mellitus type 2, what you can eat is displayed in the table where the diet for the week is outlined.

	Breakfast	Lunch	Dinner	Afternoon snack	Dinner
1 day	Buckwheat, cottage cheese, milk 1% fat	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	Glass of milk	Mashed potatoes, pickle, 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	Kissel	Meatless borscht, 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, slice 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 porridge, coffee	Wheat bran decoction	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, steamed potatoes, vegetable salad, tea.Kefir before bed.

Natural medicine

Treatment with folk remedies for diabetes is considered as 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, stir, add 200 g of honey.Let it brew for 3 hours in a cool place.Course – 3 times a day;
• linden blossom 1 tbsp.l.pour 1 glass of boiling water, the decoction can replace black tea;
• put 300 g of peeled garlic and the same amount of parsley roots, 100 g of lemon zest into a meat grinder.Place the ground ingredients in a jar, cover with a lid, and set aside 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 stove, set aside 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, 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 there will be 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, after which glucose levels increase.

The best options to achieve excellent results are morning exercises, exercises with dumbbells, walking, jogging, cycling, swimming.

Prognosis for diabetes type 1 and 2

If you allow the disease to enter the decompensation phase, then it will not be possible to eliminate the problem, since the body’s resources are significantly reduced.

At 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.