What causes diabetes. Manifestation of diabetes mellitus: first external signs and symptoms in adults

The concept " diabetes» it is customary to denote a group endocrine diseases, which develop as a result of an absolute or relative lack of a hormone in the body insulin . Due to this condition, the patient exhibits hyperglycemia - a significant increase in the amount of glucose in human blood. For diabetes mellitus typical chronic course. During the development of the disease, a metabolic disorder occurs as a whole: the fatty , protein , carbohydrate , mineral And water-salt exchange. According to WHO statistics, approximately 150 million people worldwide suffer from diabetes. By the way, not only humans suffer from diabetes, but also some animals, for example, cats.

The meaning of the word "diabetes" with Greek language- “expiration”. Therefore, the term “diabetes mellitus” means “losing sugar.” IN in this case displayed main feature diseases - excretion of sugar in the urine. Today, there are many studies regarding the causes of of this disease, however, the reasons for the manifestation of the disease and the occurrence of its complications in the future have not yet been definitively established.

Causes of diabetes

The main cause of diabetes is impaired coal water exchange , which manifests itself due to the inability of the pancreas to produce the required amount of the hormone insulin or produce insulin required quality. There are many assumptions regarding the causes of this condition. It is known for certain that diabetes mellitus is non-communicable disease. There is a theory that the disease is caused by genetic defects. It has been proven that a higher risk of developing the disease occurs in those people whose close relatives had diabetes. The risk of developing the disease is especially high in people who have been diagnosed with diabetes in both parents.

Experts identify another significant factor that directly affects the possibility of developing diabetes. . In this case, a person has the opportunity to adjust his own weight, so this issue should be taken seriously.

Another provoking factor is a number of diseases that result in damage beta cells . First of all, we are talking about, diseases of other glands internal secretion , pancreatic cancer .

Viral infections can serve as a kind of trigger for the onset of diabetes. Viral infections do not “trigger” diabetes in every case. However, people who have a hereditary predisposition to diabetes and other predisposing factors have a much higher risk of developing the disease due to infection.

In addition, doctors identify as a predisposing factor to the disease and emotional stress. Older people should be aware of the possibility of developing diabetes: the older a person gets, the greater the likelihood of the disease.

At the same time, the assumption of many that those who constantly eat a lot of sugar and sweet foods are at risk of developing diabetes is confirmed from the point of view of the high likelihood of obesity in such people.

In more rare cases, diabetes mellitus in children and adults occurs as a consequence of certain hormonal disorders in the body, as well as damage to the pancreas due to alcohol abuse or taking certain medications.

Another assumption indicates the viral nature of diabetes mellitus. Thus, type 1 diabetes can manifest itself due to viral damage to the beta cells of the pancreas, which produce insulin. As a response the immune system produces which are called insular .

However, to this day there are many unclear points regarding the determination of the causes of diabetes mellitus.

Types of diabetes

Diabetes mellitus sometimes also occurs in humans as one of the manifestations of the underlying disease. In this case we are talking about symptomatic diabetes , which can occur against the background of a lesion thyroid or pancreas , adrenal glands , . In addition, this form of diabetes also develops as a consequence of treatment with certain drugs. And if the treatment of the underlying disease is successful, then diabetes is cured.

Diabetes mellitus is usually divided into two forms: it is type 1 diabetes mellitus , that is, insulin dependent , and diabetes mellitus type 2 , that is insulin-independent .

Type 1 diabetes mellitus most often occurs in young people: as a rule, most of these patients are under thirty years of age. This form of the disease affects approximately 10-15% of all diabetic patients. Diabetes mellitus in children manifests itself mainly in this form.

Type 1 diabetes is a consequence of damage to the beta cells of the pancreas that produce insulin. Very often, people get this type of diabetes after viral illnesses - viral hepatitis , . Type 1 diabetes often occurs as autoimmune diseaseb due to a defect in the body's immune system. As a rule, a person suffering from type 1 diabetes exhibits unhealthy thinness. The blood sugar level increases significantly. Patients with type 1 diabetes depend on constant insulin injections, which become vital.

Among diabetics, in general, patients with type 2 diabetes mellitus predominate. Moreover, about 15% of patients with this form of the disease have normal weight, and everyone else suffers from excess body weight.

Type 2 diabetes mellitus develops as a consequence of a fundamentally different cause. In this case, beta cells produce enough or too much insulin, but the tissues in the body lose the ability to receive its specific signal. In this case, insulin injections are not required for the patient's survival, but they are sometimes prescribed in order to control the patient's blood sugar levels.

Symptoms of diabetes

Symptoms of diabetes mellitus are primarily manifested by excessive urine production. A person begins to urinate not only often, but also a lot (a phenomenon called polyuria ). Due to this phenomenon, the patient experiences a very serious problem. Excreted along with urine glucose , a person loses calories. Therefore, a sign of diabetes will also be too much appetite due to the constant feeling of hunger.

Other unpleasant phenomena occur as symptoms of diabetes mellitus: severe fatigue, itching in the perineal area. The patient's limbs may freeze, and visual acuity gradually decreases.

The disease progresses, and the following signs of diabetes mellitus appear. The patient notes that his wounds are healing much worse, and gradually the vital functions of the body as a whole are suppressed.

It is important to consider that the main signs of diabetes that every person should pay attention to are loss vitality, constant feeling of thirst, rapid elimination of consumed fluid from the body through urine.

However, at first, symptoms of diabetes may not appear at all, and the disease can only be determined through laboratory tests. If the disease does not manifest itself, but a slightly increased sugar content is detected in the blood and its presence in the urine, then the person is diagnosed prediabetic condition . It is typical for very large quantity people, and within ten to fifteen years they develop type 2 diabetes. In this case, insulin does not perform the splitting function carbohydrates . As a result, too little glucose enters the blood, which is a source of energy.

Complications of diabetes

Of particular danger to human health and life are complications of diabetes, which appear if diabetes treatment is not carried out or is carried out incorrectly. Due to such complications, death often occurs. It is customary to distinguish acute complications diabetes, which develop rapidly in the patient, as well as late complications that arise several years later.

Acute complications of diabetes appear : in this state the patient loses consciousness, the functions of a number of organs are disrupted - the liver, kidneys, heart, nervous system. Reasons for the development of coma - a strong change acidity blood, violation of the ratio of salts and water in the body, the manifestation of lactic acid in the blood in large quantities, sharp drop blood glucose levels.

As a late complication of diabetes, damage to the small vessels of the kidneys and eyes often occurs. If a large vessel is affected, then it may occur, , legs . The human nervous system also suffers.

Diagnosis of diabetes mellitus

Diabetes mellitus manifests itself gradually in a person, therefore, doctors distinguish three periods of its development. In people who are prone to the disease due to the presence of certain risk factors, a so-called period appears prediabetes . If glucose is already absorbed with disturbances, but signs of the disease have not yet appeared, then the patient is diagnosed with a period hidden diabetes mellitus . The third period is the immediate development of the disease.

Laboratory tests are of particular importance for diagnosing diabetes mellitus in children and adults. When examining urine, it is found acetone And sugar . Most quick method To establish a diagnosis, a blood test is considered to measure glucose levels. This is also the most reliable diagnostic method.

Higher accuracy of research is guaranteed by an oral glucose tolerance test. Initially, it is necessary to determine what level of glucose is present in the patient’s blood on an empty stomach. After this, the person should drink a glass of water in which 75 grams of glucose are previously dissolved. Two hours later, the measurement is repeated. If the glucose result is from 3.3 to 7.0 mmol/l, then glucose tolerance is impaired; if the result is more than 11.1 mmol/l, the patient is diagnosed with diabetes.

In addition, during the diagnosis of diabetes mellitus, a blood test is performed to glycohemoglobins in order to determine average level blood sugar over a long period (about 3 months). This method is also used to determine how effective diabetes treatment was over the last three months.

Treatment of diabetes

Doctors prescribe complex treatment diabetes mellitus in order to maintain normal blood glucose levels. In this case, it is important to take into account that neither hyperglycemia , that is, an increase in sugar levels, nor hypoglycemia , that is, his fall.

Throughout the whole day, glucose levels should remain at approximately the same level. This support helps prevent life-threatening complications of diabetes. Therefore, it is very important that the person himself carefully monitors his own condition and is as disciplined as possible in treating the disease. Glucometer is a specially designed device that makes it possible to independently measure blood glucose levels. To perform the test, take a drop of blood from your finger and apply it to the test strip.

It is important that treatment for diabetes in children and adults begins as soon as the person is diagnosed. The doctor determines methods of treating diabetes mellitus, taking into account what type of diabetes the patient has.

To treat type 1 diabetes, it is important to provide lifelong replacement therapy. hormone therapy. To do this, every day a patient diagnosed with type 1 diabetes must take insulin injections. There are no other treatment options in this case. Before scientists identified the role of insulin in 1921, diabetes mellitus had no cure.

There is a special classification of insulin that is based on where the drug comes from and how long it lasts. Distinguish bullish , pork And human insulin. Due to the discovery of a number of side effects, bovine insulin is used less frequently today. Porcine insulin is the closest in structure to human insulin. The difference is one . The duration of action of insulins varies short , average , long-term .

As a rule, the patient injects insulin approximately 20-30 minutes before eating. It is injected into the thigh, shoulder or abdomen subcutaneously, and the injection site should be alternated with each injection.

When insulin enters the blood, it stimulates the process of glucose moving from the blood into the tissues. If there has been an overdose, this is fraught with hypoglycemia. The symptoms of this condition are as follows: the patient experiences trembling, increased sweating, increased heart rate, and the person feels severe weakness. In this state, a person should quickly increase their glucose level by consuming a few spoons of sugar or a glass of sweet water.

An insulin regimen for each patient should be selected exclusively by a specialist, taking into account all the characteristics of the body, as well as its lifestyle. The daily dose of insulin is selected so that it corresponds physiological norm. Two-thirds of the hormone dose is taken in the morning and afternoon, one-third in the afternoon and at night. There are several different injection schemes, the appropriateness of which is determined by the doctor. Correction of insulin doses is possible depending on a number of factors ( , physical loads, features of carbohydrate metabolism). Self-measurement of glucose levels and keeping self-monitoring records play an important role in determining the optimal insulin dosing regimen.

In this case, an appropriate diet for diabetes is very necessary. It is important that the patient eats according to a special scheme: three main meals and three additional ones. Nutrition for diabetes mellitus takes into account the fact that carbohydrates increase blood glucose levels most strongly. However, severe restrictions on their use are not required. Assuming a person is of normal body weight, it is important to take into account the amount of carbohydrates in order to choose the correct dose of insulin.

If a person is diagnosed with type 2 diabetes mellitus, then at the beginning of the disease one may not take medications at all. In this case, a diet for diabetes is important, which involves minimizing the consumption of simple carbohydrates and a competent approach to physical activity. If diabetes progresses, drug therapy is required. The doctor prescribes treatment with glucose-lowering drugs. He selects suitable drugs from derivatives sulfonylureas , prandial glycemic regulators . Helps increase tissue sensitivity to insulin biguanides (the drugs also reduce the absorption of glucose in the intestine) and thiazolidinediones . If there is no effect from treatment with these drugs, patients are prescribed insulin therapy.

Also used for diabetes folk recipes, which stimulate a decrease in blood sugar levels. For this purpose, decoctions of herbs that have such properties are used. These are blueberry leaves, bean leaves, bay leaves, juniper and rose hips, burdock root, stinging nettle leaves, etc. Herbal decoctions are taken several times a day before meals.

Diet for diabetes

A diet for diabetes mellitus must be followed without fail. Nutritional features for diabetes mellitus in this case imply the normalization of carbohydrate metabolism in the human body and at the same time facilitating the functioning of the pancreas. The diet excludes easily digestible carbohydrates and limits consumption . People with diabetes need to eat plenty of vegetables, but also limit cholesterol-containing foods and salt. Food should be baked and boiled.

A patient with diabetes is advised to eat a lot of cabbage, tomatoes, zucchini, greens, cucumbers, and beets. Instead of sugar, diabetic patients can eat xylitol, sorbitol, and fructose. At the same time, it is necessary to limit the amount of potatoes, bread, cereals, carrots, fats, and honey.

It is forbidden to eat confectionery sweets, chocolate, sweets, jam, bananas, spicy, smoked, lamb and pork fat, mustard, alcohol, grapes, raisins.

You should always eat at the same time and should not skip meals. Food should contain a lot of fiber. To do this, you should periodically include legumes, rice, oats, and buckwheat in your diet. A person with diabetes should drink plenty of fluids every day.

Prevention of diabetes

Prevention of diabetes mellitus involves maintaining as much healthy image life. You should prevent the appearance of extra pounds, constantly do exercises and exercise. Everyone should reduce their intake of fat and sweets to some extent. If a person is already forty years old or has a history of diabetes in his family, then the prevention of diabetes involves regular checking of blood sugar levels.

You should try to eat a lot of fruits and vegetables every day, include them in your diet more products With high content complex carbohydrates. It is equally important to monitor how much salt and sugar is included in your daily diet - in this case, abuse is not allowed. The diet should contain a lot of vitamin-containing foods.

In addition, to prevent diabetes mellitus, it is important to constantly be in a state of peace of mind, avoid stressful situations. In addition, carbohydrate metabolism disorder manifests itself as a consequence high blood pressure, so it is very important to prevent this condition in advance.

What causes it? The basis of the disease is a violation of the metabolism of carbohydrates and water. As a result, pancreatic function is reduced. It is this organ that is responsible for producing a hormone called insulin.

Many people are interested in what insulin is? After all, it is used to treat diabetes mellitus.

The hormone insulin takes part in the production of sugar. In its absence, the body is unable to process sugar into glucose. As a result, the content of It is excreted from the body in large quantities in the urine.

In parallel with this process, a violation of water metabolism is observed. Fabrics are unable to retain water. As a result, its excess is excreted by the kidneys.

If a person has a high rate, this is the main sign that the body is affected by a disease such as diabetes.

Insulin response to blood sugar

What is insulin and what is the pattern of its interaction with sugar? In the human body, pancreatic beta proteins are responsible for the production of the hormone. Insulin supplies the body's cells with sugar in the required quantity.

What malfunction occurs in the body with high sugar levels? In this case, insulin is produced insufficiently in the body, sugar levels are increased, but the cells suffer from a lack of glucose supply.

So, diabetes. What it is in simple language? The basis of the disease is a violation of metabolic processes in the body. The disease can be either hereditary or acquired.

From a lack of insulin, the skin is affected by small pustules, the condition of the gums and teeth worsens, atherosclerotic plaques and angina pectoris develop, blood pressure rises, kidney function is inhibited, functional disorders of the nervous system are noted, and vision declines.

Etiology of the disease

What causes diabetes mellitus, what provokes it? The pathogenesis of this disease depends on the type of disease. There are two main types, which have large differences. Although in modern endocrinology this division is arbitrary, the type of disease still matters when choosing therapy. Therefore, it is advisable to consider the features of each type separately and highlight their key characteristics.

In any case, diabetes mellitus, the causes of which lie in impaired carbohydrate metabolism and a constant increase in blood glucose, is a serious disease. Elevated levels are called hyperglycemia in medicine.

The hormone insulin does not interact fully with tissues. It is he who lowers the glucose content in the body by transporting it to all cells of the body. Glucose is an energy substrate that helps maintain the life of the body.

If the system is disrupted, then glucose does not take part in the normal metabolic process and accumulates in excess in the blood. These are cause-and-effect mechanisms that are the start of the development of diabetes mellitus.

It should be noted that not every increase in blood sugar levels is true diabetes. The disease is caused by a primary disruption of the action of insulin.

Under what conditions is hyperglycemia observed?

Hyperglycemia can occur under the following conditions:

• Pheochromocytoma. It is a benign tumor in the adrenal glands that promotes the production of insulin antagonist hormones.
• Glucagonoma and somatostatinoma are the proliferation of cells that synthesize insulin competitors.
• Increased adrenal function.
• Enhanced function thyroid gland(hyperthyroidism).
• Cirrhosis of the liver.
• Impaired tolerance to carbohydrates (their reduced absorption after eating with normal indicator on an empty stomach).
• Transient hyperglycemia.

The expediency of distinguishing such conditions is due to the fact that the hyperglycemia that occurs with them is secondary in nature. It acts as a symptom. Therefore, by eliminating the underlying disease, it is possible to normalize blood glucose levels.

If a disorder is observed in the body for a long time, then this gives grounds to diagnose a disease such as diabetes. In this case, it occurs against the background of pathological processes in the body.

Symptoms of the disease

The clinical manifestation of the disease is characterized by a gradual increase in leading signs. Diabetes rarely debuts at lightning speed; it develops gradually.

The onset of the disease is characterized by the following symptoms:

• feeling of dry mouth;
• constant thirst that cannot be quenched;
• increased number of urinations;
• sudden weight loss or obesity;
• itching and dry skin;
• the formation of small pustules on the skin;
• poor wound healing;
• muscle weakness;
• fast fatiguability;
• increased sweat production.

Usually these complaints are the first sign of the onset of diabetes. If such symptoms appear, it is recommended to immediately consult an endocrinologist.

As the disease progresses, conditions that negatively affect work may become apparent. internal organs. At critical development The disease may even result in impaired consciousness with severe poisoning and multiple organ failure.

Factors provoking the disease

What causes diabetes mellitus? The reasons for the development of the disease are varied.

The triggering factors for diabetes are as follows:

• Unfavorable genetic background. At the same time, other factors are reduced to nothing.
• Weight gain.
• A number of pathological processes in the body that contribute to the damage of beta proteins. As a result, the production of insulin in the body is disrupted.
• The development of the disease can be provoked by a pancreatic tumor, pancreatitis, or pathological disorders of the endocrine glands.
• Infectious diseases, for example, damage to the body by rubella, chicken pox, hepatitis and even common flu. These diseases can serve as a trigger for the development of the disease, especially in people at risk.
• Nervous stress. Emotional stress has a detrimental effect on the functionality of the pancreas.

Does age play a role?

Does age play a role in the development of a disease such as diabetes? Paradoxically, the answer is yes. Scientists have found that every 10 years the risk of the body being affected by the disease doubles. Moreover, diabetes mellitus can be diagnosed even in infants.

Why are there two types of disease?

This distinction is important, since for one type or another, different therapy is selected.

The longer diabetes mellitus lasts, the less clear-cut the division into subtypes is. If the course is prolonged, the same treatment will be carried out regardless of the causes of the disease.

Diabetes mellitus type 1

This type causes a lack of insulin. Most often, people under the age of 40 with severe diabetes mellitus are susceptible to this type of disease. Insulin is required to control the disease. The reason is that the body produces antibodies that destroy pancreatic cells.

If you have type 1 diabetes complete cure impossible, although very rare cases occur full recovery pancreatic functions. But such a state can only be achieved by including a certain diet with the consumption of natural raw foods.

To maintain the body, a synthetic analogue of the hormone insulin is used, which is administered intramuscularly. Since insulin is susceptible to destruction in the gastrointestinal tract, taking it in tablet form is impractical. The hormone is administered with food. In this case, it is important to adhere to a certain diet. Foods containing sugar and carbohydrates are completely excluded from the diet.

Diabetes mellitus type 2

Why does this diabetes occur? The causes are not due to a lack of insulin. Most often, people over 40 who tend to be overweight suffer from this disease. The cause of the disease lies in the loss of cell sensitivity to insulin due to increased levels of nutrients in organism.

The administration of the hormone insulin is not applicable to every patient. Only a doctor will be able to select the right treatment regimen and, if necessary, determine daily dose hormone.

First of all, such patients are asked to reconsider their diet and adhere to a diet. It is very important to strictly follow the doctor's recommendations. It is advised to gradually lose weight (3 kg per month). Weight should be monitored throughout life, preventing its gain.

If the diet does not help, they are prescribed special drugs to reduce sugar levels, and only in very extreme cases resort to the use of insulin.

What pathological processes are triggered in the body when insulin increases?

The higher the blood sugar level and the longer the disease itself, the more severe its manifestations. The consequences of diabetes can be very serious.

To release excess glucose, the body triggers the following pathological mechanisms:

• Glucose is transformed into fat, which leads to obesity.
• Protein glycolysis occurs cell membranes, which causes a disruption in the functionality of all systems in the human body.
• The sorbitol pathway for resetting glucose levels is activated. The process causes the appearance of toxic compounds that damage nerve cells. It is the basis of diabetic neuropathy.
• Small and large vessels are affected, which is caused by increased levels of cholesterol in the blood during protein glycosylation. As a consequence, this process causes diabetic microangiopathy of internal organs and eyes, as well as angiopathy of the lower extremities.

Based on the above, it can be stated that an increase in blood glucose levels contributes to damage to internal organs with a predominant lesion of one system.

Symptoms of complicated diabetes

• sudden deterioration of vision;
• migraines and other functional disorders of the nervous system;
• pain in the heart area;
• liver enlargement;
• pain and numbness in lower limbs;
• decreased sensitivity of the skin in the foot area;
• arterial hypertension;
• the appearance of the smell of acetone from the patient;
• loss of consciousness.

The appearance of clear symptoms of diabetes should be a signal of alarm. Such manifestations indicate the deep development of the disease and its insufficient correction through medications.

Complications caused by diabetes mellitus

The disease itself does not pose a threat to human life. Its complications are more dangerous. It is impossible not to mention some of them. These consequences of diabetes are quite common.

The most severe condition is loss of consciousness or a high degree of inhibition of the patient. Such a patient should be hospitalized immediately.

The most common diabetic coma is ketoacidotic. It is caused by the accumulation toxic substances at metabolic processes which have a detrimental effect on nerve cells. The main indicator of coma is the smell of acetone on the breath. Consciousness in this state is clouded, the patient becomes covered in profuse sweat. In this case, there is a sharp drop in blood sugar, which can be caused by an overdose of insulin. Other types of coma are extremely rare.

Swelling can be either local or widespread. This symptom is an indicator of kidney dysfunction. If the edema is asymmetrical and spreads to one leg or foot, then this process is evidence of diabetic microangiopathy of the lower extremities caused by neuropathy.

Systolic and diastolic blood pressure are also indicators of the severity of diabetes. The condition can be assessed in two ways. In the first case, attention is paid to the total pressure indicator. An increase indicates a progressive course of diabetic nephropathy. With this complication, the kidneys release substances that increase blood pressure.

On the other hand, there is often a drop in pressure in the vessels and lower extremities. The process is determined by sound Doppler sonography. It indicates the presence of angiopathy of the lower extremities.

Pain in the legs is an indicator of the development of diabetic angio- or neuropathy. Microangiopathy is characterized by pain during exercise and walking.

Appearance pain at night indicates the presence of diabetic neuropathy. As a rule, this condition is characterized by numbness with decreased sensitivity. Some patients experience a local burning sensation in certain areas of the leg or foot.

Trophic ulcers are the next stage of diabetic angio- and neuropathy after pain. The type of wounds varies among different forms. For each individual case Individual treatment methods are provided. In a difficult situation, the smallest symptoms should be taken into account, since this determines whether the patient’s limb will be saved.

Neuropathic ulcers are caused by decreased sensitivity of the feet due to neuropathy with foot deformity. At the main points of friction in the areas of bony protrusions, calluses are formed, which are not felt by patients. Hematomas appear under them, in which pus subsequently collects. The foot begins to seriously bother a person only when it swells and an ulcer appears on it.

Gangrene is usually caused by diabetic angiopathy. In this case, small and large vessels are affected. Usually the process is localized in the area of ​​one toe. If blood flow is disrupted, a sharp pain appears in the foot, followed by redness. Over time, the skin acquires a bluish tint, becomes cold and swollen, then becomes covered with blisters with cloudy contents and black skin necrosis.

Such changes cannot be treated. In this case, amputation is indicated. Its optimal level is the lower leg area.

How to prevent complications from developing

Prevention of complications is based on early detection of the disease and its proper treatment. The doctor should outline correct treatment and the patient strictly follows the instructions.

Lower extremities with diabetes mellitus require daily proper care. If damage is detected, you should immediately contact a surgeon.

Prevention of diabetes

Unfortunately, it is not always possible to prevent the development of the disease. After all, often the trigger is genetics and viruses that affect every person.

The condition is assessed completely differently in the presence of type 2 diabetes. It is often associated with an unhealthy lifestyle.

TO preventive measures In this case, the following activities can be considered:

• weight normalization;
• control blood pressure;
• consumption of foods low in carbohydrates and fats;
• moderate physical exercise.

Conclusion

So, what causes diabetes? The disease is a violation of the mechanism of glucose absorption by the body.

A complete cure is impossible. The exception is type 2 diabetes. To relieve it, a certain diet is used in combination with moderate physical activity. It should be remembered that the risk of recurrence of the disease if the regime is violated is extremely high.

Good day, dear friends! In the conditions of our medicine and the availability of the Internet, you have to figure out many issues yourself. So that you do not get confused in the abundance of information, I offer you a reliable and accurate source from a specialist.

Let's talk about initial symptoms and signs of diabetes mellitus in adults, what are the first manifestations on the skin and in other organs of the onset of the disease. I really hope that after reading the article you will receive comprehensive answers to your questions.

How to recognize the first symptoms of diabetes

Early signs of diabetes can appear at any age. It is possible to recognize and begin treatment in time only by knowing the initial manifestations of the disease. I'm sure you know about the existence different types diabetes mellitus, for example diabetes of young people and diabetes of adults or elderly people. In medicine, they are more often divided into: diabetes mellitus type 1 or 2. But there are many more types than you think.

And although the causes of these types of diabetes are different, the primary manifestations are the same and are associated with the action higher level blood glucose. There is a difference in the speed of appearance of type 1 or 2 diabetes mellitus, the degree of severity, but the main symptoms will be the same.

Diabetes mellitus type 2, which is often caused by insulin insensitivity, may long time be practically asymptomatic. When in this type, as a result of depletion of pancreatic reserves, a lack of the hormone insulin develops, the manifestations of diabetes become more pronounced, which forces one to seek medical help.

But by this time, unfortunately, the main vascular complications, sometimes irreversible. Find out to prevent complications in a timely manner.

Initial signs of diabetes

Let's consider the most common and main manifestations of diabetes mellitus in an adult.

Thirst and frequent urination

People begin to complain of dryness and a metallic taste in the mouth, as well as thirst. They can drink 3-5 liters of liquid per day. One of the first signs of diabetes is considered frequent urination, which may intensify at night.

What are these signs of diabetes associated with? The fact is that when the blood sugar level exceeds an average of 10 mmol/l, it (sugar) begins to pass into urine, taking water with it. Therefore, the patient urinates a lot and often, the body becomes dehydrated, and dry mucous membranes and thirst appear. A separate article - I recommend reading it.

Sweet cravings as a symptom

Some people experience increased appetite and most often you want more carbohydrates. This may be due to two reasons.

• The first reason is excess insulin (type 2 diabetes), which directly affects appetite, increasing it.
• The second reason is “starvation” of cells. Since glucose is the main source of energy for the body, if it does not enter the cell, which is possible both with deficiency and with insensitivity to insulin, hunger occurs at the cellular level.

Signs of diabetes on the skin (photo)

The next sign of diabetes, which is one of the first to appear, is itching of the skin, especially the perineum. A person with diabetes is often susceptible to infectious skin diseases: furunculosis, fungal diseases.

Doctors have described more than 30 types of dermatoses that can occur with diabetes. They can be divided into three groups:

• Primary - resulting from metabolic disorders (xanthomatosis, necrobiosis, diabetic blisters and dermatopathies, etc.)
• Secondary - when attached to a bacterial or fungal infection
• Skin problems during drug treatment, i.e. allergic and adverse reactions

Diabetic dermatopathy - most common cutaneous manifestation with diabetes mellitus, which manifests itself as papules on the front surface of the lower leg, brownish in color and 5-12 mm in size. Over time, they turn into pigmented atrophic spots that can disappear without a trace. There is no treatment. In the photo below there are signs of diabetes on the skin in the form of dermopathy.

Diabetic bubble or pemphigus occurs quite rarely, as a manifestation of diabetes mellitus on the skin. It occurs spontaneously and without redness on the fingers, hands and feet. There are bubbles different sizes, the liquid is clear, not infected. They usually heal without scarring in 2-4 weeks. The photo shows an example of a diabetic bladder.

Xanthoma occurs when lipid metabolism is disrupted, which often accompanies diabetes. By the way, the main role is played by elevated triglycerides, and not cholesterol, as some believe. Yellowish plaques develop on the flexor surfaces of the limbs; in addition, these plaques can form on the face, neck and chest skin.

Necrobiosis lipoidica rarely occurs as a symptom of diabetes mellitus on the skin. It is characterized by focal lipid degeneration of collagen. Occurs more often in type 1 diabetes long before the onset obvious signs. The disease can occur at any age, but most often between the ages of 15 and 40 years and mainly in women.

Large lesions are observed on the skin of the legs. It begins with bluish-pink spots, which then grow into oval, clearly defined indurative-atrophic plaques. the central part is slightly sunken, and the edge rises above the healthy skin. The surface is smooth, but may peel at the edges. Sometimes there is an ulceration in the center, which can be painful.

There is currently no treatment. Use ointments that improve microcirculation and lipid metabolism. Injecting corticosteroids, insulin, or heparin into the affected area often helps. Sometimes laser therapy is used.

Itchy skin, and also neurodermatitis can occur long before the onset of diabetes. Research shows that it can take anywhere from 2 months to 7 years. Many people believe that skin itching is common in overt diabetes, but it turns out that it is most intense and persistent in latent diabetes.

Most often, the abdominal folds, groin areas, elbow pits and intergluteal cavity itch. It usually only itches on one side.

Fungal skin lesions in diabetes

Candidiasis, commonly known as thrush, is a very common problem in diabetology, one might say a threatening sign. Basically, the skin is affected by fungi of the genus Candidaalbicans It occurs mostly in older people and very obese patients. It is localized in large folds of skin, between the fingers and toes, on the mucous membranes of the mouth and genitals.

First, a white stripe of exfoliating stratum corneum appears in the fold, then cracks and erosions appear. The erosions are smooth in the center, bluish-red in color, and have a white rim around the perimeter. Soon, so-called “dropouts” appear in the form of pustules and vesicles near the main focus. They embed themselves and also turn into erosions, prone to merging the process.

Confirmation of the diagnosis is simple - a positive culture for candidiasis, as well as visual identification of fungi during microscopic examination. Treatment consists of treating the affected areas with alcohol or aqueous solutions methylene blue, brilliant green, Castellani liquid and ointments containing boric acid.

Antimycotic ointments and oral medications are also prescribed. Treatment continues until the changed areas disappear completely and for another week to consolidate the result.

Dental problems

One of the obvious symptoms of incipient diabetes may be problems with teeth, as well as frequent stomatitis and periodontal disease. These problems arise against the background of contamination with yeast fungi of the genus Candida, as well as an increase in the population pathogenic flora in the mouth due to a decrease in the protective properties of saliva.

Diabetes symptoms and vision

Change in body weight

Signs of diabetes can include either weight loss or, conversely, weight gain. A sharp and inexplicable weight loss occurs with an absolute deficiency of insulin, which occurs in type 1 diabetes.

With type 2 diabetes, your own insulin is more than enough and the person only gains weight over time, because insulin plays the role of an anabolic hormone that stimulates fat storage.

Chronic fatigue syndrome in diabetes

Due to impaired carbohydrate metabolism, a person experiences a feeling of constant fatigue. The decrease in performance is associated with both cell starvation and the toxic effects of excess sugar on the body.

These are the initial signs of diabetes, and sometimes it doesn’t matter what type of diabetes it is. The difference will only be in the rate of increase of these symptoms and the degree of severity. How to treat and, read the following articles, stay tuned.

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

Diabetes mellitus (diabetes mellitus, diabetes mellitus) is a disease endocrine system, in which carbohydrate metabolism and water in the body are disrupted.

Carbohydrates supplied with food are not sufficiently absorbed by the body due to impaired pancreatic function. Due to insufficient production of the required amount of the hormone insulin by the gland, carbohydrates that are processed by the body into glucose are not absorbed, but accumulate in large volumes in the blood and are excreted through the kidneys into the urine. At the same time, water metabolism is also disrupted; as a result, the tissues cannot retain water and dry out, and unabsorbed water is excreted in significant quantities by the kidneys.

Diabetics often suffer from impaired fat and protein metabolism. As a result, toxic substances accumulate in the body, which are the cause of one of the dangerous complications - diabetic coma, the so-called self-poisoning of the body. Treatment of a patient with diabetes must be carried out under the supervision of a doctor. First of all, a diet is prescribed taking into account the characteristics of metabolic disorders in the body, and insulin is taken when it is already necessary.

Causes of the disease In a person, diabetes mellitus can be due to poor nutrition (overeating sweets), hereditary predisposition, neuropsychic experiences, stress, difficult working and living conditions, a consequence of a serious illness (stroke, hypertensive crisis, etc.), poisoning and disruption of normal liver function, etc. d.

Most people diagnosed with diabetes are over 40 years of age, but the disease can occur at a younger age. Diabetes often does not show any signs until a certain time. Sometimes, the presence of diabetes is determined when a doctor is treating another disease. The signs of diabetes differ between type I diabetes and type II diabetes. But there are a number of symptoms inherent in both types of diabetes, the severity of which depends on the duration of the disease, the degree of insulin production by the gland and the personal characteristics of the person.

Symptoms and signs of diabetes

The main common symptoms of diabetes most often are:

* insatiable (“wolfish”) appetite;

*constant dry mouth;

*painful thirst;

*frequent urination at night;

*excretion of large amounts of sugar-containing urine;

*increased blood glucose levels;

*sometimes weakness, general malaise, fatigue;

*obesity or causeless weight loss;

*taste of iron in the mouth;

*deterioration of vision, blurred vision;

*poor healing of wounds, cuts, ulcers;

*itchy skin especially in the groin area, genitals and frequent skin diseases;

* persistent vaginal infections in women;

*fungal infections in both women and men;

*nausea, or even vomiting;

*dry skin;

*convulsions in calf muscles;

*numbness of legs, arms.

Signs of type 1 diabetes include thirst, dry mouth, frequent urination, rapid weight loss, even with good nutrition, fatigue, weakness, irritability, nausea and even vomiting, constant hunger, blurred vision, weight loss.

A secondary sign of type 1 diabetes mellitus may be: heart pain, cramps or pain in the calf muscles, itching, furunculosis, poor sleep, headache, irritability.

Children show signs of type 1 diabetes such as urinary incontinence while sleeping at night, especially when this has not happened before. As a rule, type 1 diabetes develops rapidly, which leads to a rapid deterioration in health. Therefore, the patient can accurately determine the onset of type 1 diabetes.

With type I diabetes, there are situations when the blood sugar level either becomes too high or too low. Each condition requires urgent medical attention.

Distinctive signs of type 2 diabetes mellitus are numbness and paresthesia of the legs, cramps, pain in the legs, numbness of the arms, constant thirst, blurred vision, itching, skin infections, poor wound healing, drowsiness, fatigue, decreased pain sensitivity, gradual weight gain, frequent infectious diseases, deterioration of potency in men, etc. Also, with type 2 diabetes, hair falls out on the legs, hair growth on the face increases, and small yellow growths called xanthomas appear on the body. Balanoposthitis or inflammation foreskin can also be one of the first signs of diabetes, which is associated with frequent urination.

Symptoms of type 2 diabetes mellitus, on the contrary, do not appear immediately and are not very pronounced. There are cases when the disease progresses sluggishly and this greatly complicates the diagnosis. In such cases, diabetes mellitus is detected by chance, after a urine test and a blood sugar test. This disease manifests itself in adulthood and most often as a result of poor nutrition.

You should immediately consult a doctor if you have the following symptoms:

- feeling weak, nausea and severe thirst, frequent urination, abdominal pain, breathing deeper and faster than usual, exhaled air smells like acetone (may be dangerous complications);

- Weakness or episodes of loss of consciousness, a feeling of rapid heartbeat, excessive sweating, trembling, irritability, hunger or sudden drowsiness are present. In this case, you urgently need to eat a light carbohydrate snack to avoid serious complications.

To determine the correct type of diabetes, you need to undergo tests:

The norm for fasting blood glucose is 6.5 mmol/l, excess is more than 6.5 mmol/l, after eating the norm is 7.5 mmol/l, and more than 7.5 mmol/l is excess.

Sugar in urine is not normally detected, since the kidneys filter and retain all glucose. And when there is excess sugar in the blood (8.8-9.9 mmol/l), the filter in the kidneys allows sugar to pass into the urine, i.e. the so-called “renal threshold” has been exceeded.

Since the limit values ​​of the norm from various sources fluctuate, the following can be carried out: test for precise definition presence of illness:

1 — Determine fasting blood glucose levels.

2 — Dilute 75 g of grape sugar in 300 ml of boiled water and drink.

3 — After 60 minutes, measure the blood glucose level.

4 - And after 120 minutes have passed, measure your glucose level again.

The test results are considered negative, i.e. an unconfirmed diagnosis of diabetes, if the fasting blood sugar level is less than 6.5 mmol/l, and after 120 minutes it is less than 7.7 mmol/l. If on an empty stomach the sugar level exceeds 6.6 mmol/l, and after 2 hours it exceeds 11.1 mmol/l, then the result confirms diabetes mellitus. And that means you urgently need to see a doctor!

This is a disease caused by an absolute or relative deficiency of insulin and characterized by impaired carbohydrate metabolism with an increase in the amount of glucose in the blood and urine, as well as other metabolic disorders.

History of diabetes

A lot has been written about diabetes, opinions various authors They differ and it is quite difficult to name some dates exactly. The first information about the disease appeared in the 3rd century BC. The doctors of Ancient Egypt, and, of course, the doctors of Greece were apparently familiar with it. Rome, medieval Europe And eastern countries. People could identify the symptoms of diabetes, but the causes of the disease were unknown, they tried to find any treatment for diabetes, but the results were unsuccessful and those who were diagnosed with diabetes were doomed to death.

The term “diabetes” was first introduced by the Roman physician Aretius, who lived in the second century AD. He described the disease as follows: “Diabetes is a terrible suffering, not very common among men, dissolving flesh and limbs into urine. Patients continuously release water in a continuous stream, as if through open water pipes. Life is short, unpleasant and painful, thirst is insatiable, fluid intake is excessive and not commensurate with the huge amount of urine due to even greater diabetes. Nothing can stop them from drinking fluids and passing urine. If they refuse to drink fluids for a short time, their mouth becomes dry, their skin and mucous membranes become dry. Patients become nauseated, agitated, and die within a short period of time."

In those days, the disease was diagnosed by its external signs. Treatment depended on the severity of the disease and the age of the patient. If the patient was a child or young person with (insulin-dependent diabetes mellitus or type 1) IDDM. Then he was doomed to quick death from a diabetic coma. If the disease developed in an adult aged 40-45 years or older (according to the modern classification, it is non-insulin-dependent diabetes mellitus (NIDDM) or type 2 diabetes), then such a patient was treated. Or rather, they kept him alive through diet, physical exercise and herbal medicine.

Diabetes comes from the Greek "diabaino" meaning "to pass through."

In 1776 English doctor Dobson (1731-1784) found that the sweetish taste of patients' urine was due to the presence of sugar in it, and from that date diabetes, in fact, began to be called diabetes mellitus.

Since 1796 Doctors began to talk about the need for a special diet for diabetics. A special diet for patients was proposed, in which some carbohydrates were replaced with fats. Physical activity began to be used as a treatment for diabetes.
In 1841 A method for determining sugar in urine was first developed. Then we learned to determine blood sugar levels.
In 1921 managed to obtain the first insulin.
In 1922 insulin was used to treat a patient with diabetes mellitus.
In 1956 The properties of some sulfonylurea drugs that can stimulate insulin secretion have been studied.
In 1960 The chemical structure of human insulin was determined.
In 1979 The complete synthesis of human insulin was carried out using genetic engineering.

Diabetes classification

Diabetes insipidus. The disease is caused by an absolute or relative deficiency of the antidiuretic hormone (vasopressin) and is characterized by increased urination (polyuria) and thirst (polydipsia).

Diabetes mellitus is chronic illness, which is characterized by a metabolic disorder primarily of carbohydrates (namely glucose), as well as fats. To a lesser extent proteins.

• Type 1 (IDDM):

This type of diabetes is associated with a deficiency of insulin, which is why it is called insulin-dependent diabetes (IDDM). A damaged pancreas cannot cope with its responsibilities: it either does not produce insulin at all, or produces it in such meager quantities that it cannot process even the minimum amount of incoming glucose, resulting in an increase in blood glucose levels. Patients can be of any age, but most often they are under 30 years old, they are usually thin and, as a rule, note sudden appearance signs and symptoms. People with this type of diabetes need to take extra insulin to prevent hyperglycemia, ketoacidosis (increased levels of ketone bodies in the urine) and to maintain life.

• Type 2 (INSD):

This type of diabetes is called non-insulin-dependent (NIDDM) because it produces enough insulin, sometimes even in large quantities, but it can be completely useless because the tissues lose sensitivity to it.

This diagnosis is usually made to patients over 30 years of age. They are obese and with relatively few classic symptoms. They are not prone to ketoacidosis, except during periods of stress. They are not dependent on exogenous insulin. For treatment, tablet drugs are used that reduce the resistance (stability) of cells to insulin or drugs that stimulate the pancreas to secrete insulin.

• Gestational diabetes mellitus:

Glucose intolerance occurs or is discovered during pregnancy.

• Other types of diabetes and impaired glucose tolerance:

Secondary, after:

• diseases of the pancreas (chronic pancreatitis, cystic fibrosis, hemochromatosis, pancreatectomy);
• endocrinopathies (acromegaly, Cushing's syndrome, primary aldosteronism, glucagonoma, pheochromocytoma);
• applications medicines And chemical substances(some antihypertensive drugs, thiazide-containing diuretics, glucocorticoids. Estrogen-containing drugs. Psychotropic drugs, catecholamines).

Connected with:

• abnormality of insulin receptors;
• genetic syndromes (hyperlipidemia, muscular dystrophies, Huntington's chorea);
• mixed conditions (malnutrition - “tropical diabetes”.

Symptoms of diabetes

Causes of diabetes

It has been established that diabetes is caused by genetic defects, and it is also firmly established that diabetes cannot be contracted!!! The causes of IDDM are that insulin production decreases or stops altogether due to the death of beta cells under the influence of a number of factors (for example, an autoimmune process, which is when antibodies are produced to one’s own normal cells and begin to destroy them). In NIDDM, which is 4 times more common, beta cells typically produce insulin with reduced activity. Due to excess adipose tissue, the receptors of which have reduced sensitivity to insulin.

1. Hereditary predisposition is of primary importance! It is believed that if your father or mother had diabetes, then the likelihood that you will also get sick is about 30%. If both parents were sick, then – 60%.
2. The next most important cause of diabetes is obesity, which is most common in patients with NIDDM (type 2). If a person knows about his hereditary predisposition to this disease. Then he needs to strictly monitor his body weight in order to reduce the risk of developing the disease. At the same time, it is obvious that not everyone who is obese, even in severe form, develops diabetes.
3. Some diseases of the pancreas that result in damage to beta cells. The provoking factor in this case may be injury.
4. Nervous stress, which is an aggravating factor. It is especially necessary to avoid emotional stress and stress for people with a hereditary predisposition and excess body weight.
5. Viral infections (rubella, chicken pox, epidemic hepatitis and other diseases, including influenza), which play a trigger role in the development of the disease for persons with aggravated heredity.
6. Age may also be considered risk factors. The older the person, the more reason to fear diabetes mellitus. Hereditary factor With age, it ceases to be decisive. The greatest threat is posed by obesity, which, in combination with old age and previous diseases, which usually weakens the immune system, leads to the development of predominantly type 2 diabetes.

Many people believe that diabetes occurs in people with a sweet tooth. This is largely a myth, but there is also some truth, if only because excess consumption produces sweetness. excess weight, and subsequently obesity, which can be an impetus for type 2 diabetes.

In rare cases, some may lead to diabetes hormonal disorders, sometimes diabetes is caused by damage to the pancreas that occurs after the use of certain medications or due to prolonged alcohol abuse. Many experts believe that type 1 diabetes can occur due to a viral infection of the beta cells of the pancreas, which produces insulin. In response, the immune system produces antibodies called insulin antibodies. Even those reasons that are precisely defined are not absolute.

An accurate diagnosis can be made based on a blood glucose test.

Diagnosis of diabetes mellitus

The diagnosis is based on:

• the presence of classic symptoms of diabetes: increased intake and excretion of fluid in the urine, excretion of ketone bodies in the urine, weight loss, increased blood glucose levels;
• increased fasting glucose levels with repeated determinations (normally 3.3-5.5 mmol/l).

There is a certain algorithm for examining a patient with suspected diabetes mellitus. Healthy people with normal body weight and no heredity check the level of glucose in the blood and urine (on an empty stomach). Upon receipt normal values Additionally, a test for glycated hemoglobin (GG) is required. The percentage of glycated hemoglobin reflects the average level of glucose concentration in the patient’s blood over the 2-3 months before the study. When monitoring diabetes treatment, it is recommended to maintain glycated hemoglobin levels below 7% and review therapy when the GG level is 8%.

If a high level of glycated hemoglobin is obtained (screening in a healthy patient), it is recommended to determine the blood glucose level 2 hours after a glucose load (75 g). This test is especially necessary if your blood glucose levels, although higher than normal, are not high enough to show signs of diabetes. The test is carried out in the morning, after an overnight fast (at least 12 hours). Determine the initial glucose level and 2 hours after taking 75 g of glucose dissolved in 300 ml of water. Normally (immediately after a glucose load), its concentration in the blood increases, which stimulates insulin secretion. This in turn reduces the concentration of glucose in the blood; after 2 hours its level almost returns to its original level. healthy person and does not return to normal, exceeding the initial values ​​twice in patients with diabetes.

Insulin testing is done to confirm the diagnosis in people with borderline impaired glucose tolerance. Normal insulin levels are 15-180 pmol/L (2-25 µC/L).

The doctor may prescribe additional tests - determination of C-peptide, antibodies to beta cells of the islets of Langerhans, antibodies to insulin, antibodies to GAD, leptin. Determination of these markers allows in 97% of cases to differentiate type 1 diabetes mellitus from type 2 diabetes mellitus, when the symptoms of type 1 diabetes mellitus are disguised as type 2 diabetes mellitus.

Complications of diabetes

Diabetic neuropathy

Neuropathy is damage to peripheral nerves. Damage to not only peripheral but also central structures of the nervous system is possible. Patients are concerned about:

• Numbness;
• Feeling of goosebumps;
• Cramps in the limbs;
• Pain in the legs, worse at rest, at night and relieved by walking;
• Decreased or absent knee reflexes;
• Reduced tactile and pain sensitivity.

Diabetic foot

Treatment of complications of diabetes mellitus

Diabetes mellitus is usually incurable. Supporting normal level blood sugar, you can only prevent or reduce the complications of this disease. First of all, you need an appropriate diet.

Treatment procedures for patients with NIDDM

1. The diet is more strict than for IDDM. The diet can be quite free in time, but you must strictly avoid foods containing sugar. Fats and cholesterol.
2. Moderate physical activity.
3. Take glucose-lowering medications daily as prescribed by your doctor.
4. Monitor blood sugar several times a week, preferably once a day.

Priority order in the treatment of NIDDM (type 2 diabetes)

• Monitoring blood glucose levels.
• Minimize the dose of medications.
• Treat hypertension (high blood pressure) and lipid (fat) concentrations with medications that do not impair glucose tolerance.

Treatment procedures for patients with IDDM (type 1 diabetes)

1. Daily insulin injections!!!
2. The diet is more varied than with NIDDM, but with some restrictions on certain types of foods. The amount of food is converted into bread units (XU) and must be strictly defined, and the diet determines the insulin injection schedule (i.e. when and how much to administer). The diet can be strict or more free.
3. Universal physical activity - to maintain muscle tone and lower sugar levels.
4. Monitor blood sugar 3-4 times a day, more often is better.
5. control of sugar and cholesterol in urine.

Once discovered hypoglycemia(low blood sugar level), it can be easily treated independently by the patient himself. IN mild case hypoglycemia, 15g is quite enough. simple carbohydrate such as 120g. unsweetened fruit juice or non-diet soft drink. With more severe symptoms hypoglycemia should be quickly taken 15-20g. simple carbohydrate and later 15-20g. complex, such as thin dry cookies or bread. Patients who are unconscious should never be given fluids! In this situation, more viscous sources of sugar (honey, glucose gels, icing sugar sticks) can be gently placed behind the cheek or under the tongue. Alternatively, 1 mg can be administered intramuscularly. glucagon. Glucagon, through its effect on the liver, indirectly causes an increase in blood glucose. In a hospital setting intravenous administration Dextrose (D-50) is probably more readily available than glucagon and results in a rapid return of consciousness. Patients and family members should be instructed not to overdose when treating hypoglycemia, especially mild hypoglycemia.

Herbal medicine is used to help with prescribed medications.

What to do if hyperglycemia occurs (sugar levels are elevated)

It is necessary to administer an additional dose of insulin or tableted glucose-lowering drugs.

Review of information that a diabetic should know.

This set of skills is necessary primarily for patients receiving insulin.

1. You need to have an understanding of the nature of your illness and its possible consequences.
2. You need to understand various types insulins (for type 1), in hypoglycemic drugs (for type 2), medications that protect against chronic complications, vitamins and minerals.
3. You must strictly adhere to your diet, insulin injections or pills.
4. You must understand the properties of foods, know which ones contain more carbohydrates and which contain more proteins, fiber, and fats. You should know at what rate this or that product increases blood sugar levels.
5. You should plan any physical activity carefully.
6. You will need to learn how to self-monitor your diabetes using a blood glucose meter and visual test strips to measure your blood and urine sugar.
7. You should be aware of the acute and chronic complications that develop with diabetes.

1. Check the bottom of your feet regularly.
2. Treat foot injuries promptly.
3. Wash your feet daily warm water and wipe dry. Use neutral soap, such as “baby” soap.
4. Trim your nails not too short, not in a semicircle, but straight, without cutting or rounding the corners of the nails, so as not to injure the skin with the blades of the scissors. To smooth out any unevenness, use a nail file.
5. Wear loose-fitting shoes and break in new shoes very carefully to avoid scuffs. Wear socks or stockings made of fabric that absorbs sweat well. Instead of synthetic products, use cotton or wool. Do not wear socks with tight elastic, which impede blood circulation.
6. Check your shoes to make sure there are no pebbles, grains of sand, etc.
7. Protect your feet from damage and cuts, do not walk on rocks, and do not walk barefoot.
8. Do not use a heating pad or band-aid; Do not steam your feet, but wash them and soften calluses in warm water.
9. Use foot moisturizer daily. Apply the cream to the lower surface of the foot and apply talc between the toes.
10. Buy shoes in the evening (the foot swells somewhat in the evening), having previously prepared a paper footprint - you need to put it in the purchased shoes and check that the edges of the footprint are not bent.
11. The heel should not exceed 3-4 cm.
12. Do not self-medicate.
13. Visit the diabetic foot office.

As you know, people suffering from diabetes must limit themselves to many foods. Explore detailed lists permitted, recommended and prohibited products. But this issue can be disputed, since more strict adherence to the diet is necessary in NIDDM due to the fact that there is excess body weight, and in IDDM the amount of carbohydrates consumed is adjusted by administering insulin.

The most commonly consumed products can be divided into 3 categories:

• Category 1 is products that can be consumed without restrictions. These include: tomatoes, cucumbers, cabbage, green pea(no more than 3 tablespoons), radishes, radishes, fresh or pickled mushrooms, eggplants, zucchini, carrots, herbs, green beans, sorrel, spinach. Drinks you can consume: drinks with sweetener, mineral water, tea and coffee without sugar and cream (you can add a sweetener).
• Category 2 are products that can be consumed in limited quantities. These include: lean beef and chicken, lean fish, lean boiled sausage, fruits (except for fruits belonging to category 3), berries, eggs, potatoes, pasta, cereals, milk and kefir with a fat content of no more than 2%, cottage cheese with a fat content of no more than 4% and preferably without additives, low-fat cheeses (less than 30%), peas, beans, lentils, bread.
• Category 3 – products that it is advisable to exclude from the diet altogether. These include: fatty meat, poultry, lard, fish; smoked meats, sausages, mayonnaise, margarine, cream; fatty varieties of cheese and cottage cheese; canned food in oil, nuts, seeds, sugar, honey, all confectionery, ice cream, jam, chocolate; grapes, bananas, persimmons, dates. As for drinks, the consumption of sweet drinks, juices, and alcoholic beverages is strictly prohibited.

Diabetes insipidus

Frequent and copious urination (polyuria), thirst (polydipsia), which bother patients at night, disrupting sleep. The daily amount of urine is 6-15 liters. and more, the urine is light. There is a lack of appetite, weight loss, irritability, insomnia, increased fatigue, dry skin, decreased sweating, dysfunction gastrointestinal tract. Children may be delayed in physical and sexual development. Women may experience a disorder menstrual cycle, in men – decreased potency.

The cause may be acute and chronic infections, tumors, injuries, vascular lesions of the hypothalamic-pituitary system. In some patients, the cause of the disease remains unknown.

Diagnosis of diabetes insipidus

The diagnosis is based on the presence of polydipsia (thirst) and polyuria (increased urination) in the absence pathological changes urinary sediment. The prognosis for life is favorable. However, complete recovery is rare.

Treatment of diabetes insipidus

Treatment is aimed at eliminating the cause of the disease (removal of the tumor, elimination of neuroinfection), as well as general restorative therapy. It is necessary to maintain a drinking regime and limit salt intake (so as not to increase thirst) to prevent complications.

Complications of diabetes insipidus

When limiting fluid intake, patients develop symptoms of dehydration: headache, dry skin and mucous membranes, nausea, vomiting, fever, mental disorders, tachycardia (increased heart rate).

Prevention of diabetes

Diabetes mellitus is primarily hereditary disease. The identified risk groups make it possible today to orient people and warn them against a careless and thoughtless attitude towards their health. Diabetes can be both inherited and acquired. The combination of several risk factors increases the likelihood of developing diabetes: for an obese patient who often suffers from viral infections- influenza, etc., this probability is approximately the same as for people with aggravated heredity. So all people at risk should be vigilant. You should be especially careful about your condition between November and March, because most cases of diabetes occur during this period. The situation is complicated by the fact that during this period your condition may be mistaken for a viral infection.

Primary prevention of diabetes

At primary prevention activities are aimed at preventing diabetes mellitus: changing lifestyle and eliminating risk factors for diabetes mellitus, preventive measures only in individuals or in groups at high risk of developing diabetes in the future.

To the main preventive measures NIDDM includes rational nutrition of the adult population, physical activity, obesity prevention and treatment. You should limit and even completely exclude from your diet foods containing easily digestible carbohydrates (refined sugar, etc.) and foods rich in animal fats. These restrictions apply primarily to persons with increased risk diseases: unfavorable heredity in relation to diabetes mellitus, obesity, especially when combined with diabetic heredity, atherosclerosis, hypertonic disease, as well as women with gestational diabetes or impaired glucose tolerance in the past during pregnancy, and women who gave birth to a fetus weighing more than 4500 g. or who had a pathological pregnancy with subsequent fetal death.

Unfortunately, there is no prevention of diabetes mellitus in the full sense of the word, but immunological diagnostic kits are currently being successfully developed, with the help of which it is possible to identify the possibility of developing diabetes mellitus at the most early stages against the background of still full health.

Secondary prevention of diabetes

Secondary prevention involves measures aimed at preventing complications of diabetes mellitus - early control of the disease, preventing its progression .