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 matter much.

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

Most children suffer from diseases whose manifestations cannot always be detected in time due to mild symptoms.

Due to negligence, the patient did not turn to an endocrinologist who could 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 factors, symptoms and treatment methods.

What is diabetes mellitus?

This pathology is characterized by insufficient levels of insulin in the body, which is a peptide hormone 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 instability 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 quantity, starvation will occur.This happens because of a low amount or absence of insulin, which is produced by the cells of the pancreas.When the movement of accumulated sugar in the blood stops, subsequent metabolic development does not occur;
• the cells responsible for transporting hormones and assimilating glucose at some point become immune and do not respond in any way to substances that have managed not to undergo changes;
• sugar is not converted into nutrients, which starves the body, while a lot of glucose enters the blood, which negatively affects cells;
• the level of damage to the endocrine system depends on the severity of the disease and timely treatment;
• It is easier to deal with problems in the early stages, but many patients come to the clinic much later, which affects the implementation of therapeutic measures even worse.

Many doctors talk about diabetes not as a disease, they agree that the cause of the problem 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.

If 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 coma due to serious complications.It is important, even if there are minor deviations, to make an appointment with a doctor on time.

Type 1 and 2 diabetes

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

We are talking about types like:

• first type, called juvenile, is detected in patients of adolescent 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 small quantities, not enough for the normal life of the victim.About 10% have problems that are largely autoimmune in origin.Sometimes the cause of the pathology is an attack of pancreatitis or necrosis of the pancreas, while the person survives, but the pancreas eventually loses its original properties.The condition does not change over time, it remains until the end of life;
• the second type– due to a decline in metabolism, the hormone stops being produced in the required amount, which causes a relative lack of insulin.Beta cells stop functioning stably;due to pathological processes, they cannot perform the function determined by the body - to produce the necessary substances and reduce glucose in the blood.

Gestational diabetes in women occurs in pregnant women with serum glucose levels that exceed normal levels.One should not ignore detected deviations, because inaction leads to negative effects on the fetus.It is possible to get rid of the disease after childbirth, but disorders regarding the absorption of these organic compounds can also be found in women who initially do not complain of poor health.

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

Symptoms of type 1 and 2 diabetes

The first type has a chronic form, is temporary and quickly passes from the initial stage to the worse, 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 visual aids;
• dry skin and mucous membranes;
• lack of moisture in the oral cavity even though water balance is maintained;
• thirst causes drinking water in large quantities, more than 10 liters;
• itching and purulent formation on the skin;
• frequency of urination, large amount of urine;
• uncontrolled contraction of the muscles of the lower part;
• vomiting and nausea - the relief that comes after emptying the stomach is temporary;
• irritation;
• loss of strength, inability to engage in work for a long time;
• increased appetite;
• an unrelenting desire to eat after a short period of time.

A complication is hyperglycemia - an increase in glucose levels, which can be fatal.Deterioration of the condition, which is manifested in the 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 surface of the genital organs in men and women.Bones become fragile and susceptible to negative influences from the outside.As for immunity, it practically loses its protective properties.

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

• wounds take a long time to heal;
• epidermal infection;
• thirst;
• frequent urination, forcing you to go to the toilet day and night;
• fatigue, slow reactions, sleep disturbances;
• dry mucous membranes;
• numbness, tingling in the limbs;
• increased appetite as a result of the pathology of leptin synthesis;
• dry mouth, you need to drink about 3-5 liters a day;
• itching in 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 of the face and lower legs;
• enuresis of children, shown at night;
• high blood pressure;
• headache and dizziness.

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

Disease pathogenesis

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

• hereditary - the risk of the first type of disease appearing in children increases if parents have the same diagnosis;
• overweight – 80-90% of patients are overweight, because adipose tissue cannot use insulin as intended.A newborn baby should weigh 2.5-3.5 kg;if the indicators increase, an endocrinologist should conduct an examination;
• viruses - cause abnormalities of the pancreas, therefore, due to rubella, measles, chicken pox, previously experienced by a child, they can cause the death of cells in the digestive system;
• age-related changes;
• frequent stressful situations;
• 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.An indicator of 35 or more indicates a 100% probability of diabetes;
• fat deposits around the abdomen;
• disorders of the pancreas for various reasons, including injury to the organ;
• pathological processes in the endocrine system that occur as a result of acromegaly, Itsenko-Cushing syndrome, etc.

The main factors causing the deterioration of the situation are listed;they can have a one-time effect, thus increasing the threat.People who are completely healthy are at risk and are recommended to visit a doctor.

Sugar levels after and before meals

On an empty stomach, there is a low glucose level, which is usually in the range of 3.4-5.5 mmol/l.For diabetic patients, the indicator exceeds the specified value, and is calculated as follows:

• first type - up to 9.3 mmol/l;
• the second type - 8.5 mmol/l.

After eating, the metabolism is activated, as a result of which glucose is released.How much the level of organic compounds will increase depends on the ability to assimilate them.In practice, the examination is not carried out when the stomach is full.The most accurate information is obtained 1-3 hours after eating.

Normal blood sugar levels for diabetes for women, men and children over 12 years of age are:

• 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 diabetes patients with the same time period:

• until 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, glucose levels continue to drop until they return to normal.

What are the phases of diabetes?

The classification is based on the level of development of the pathology of carbohydrate metabolism, therefore the distribution into the following phases:

• compensation– succeed in achieving glucose content according to natural indications;
• small compensation– sometimes the volume of the material 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– the improvement of the condition occurs due to the right choice of diet and regimen.Positive effects are evident when following a diet, while the use of hypoglycemic agents will bring double benefits.The possibility of transition from one level to another is minimized;
• average– You can't do without medicine that lowers your sugar level.They are used continuously, but cannot protect against vascular pathology;
• heavy– the use of hypoglycemic agents and insulin, which are sometimes used without combination with other drugs, should not be interrupted.There is a threat to develop encephalopathy, neuropathy, and vascular angiopathy.

The difference between type 1 and type 2 diabetes

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

Characteristics	The first type	The second type
Period	Autumn, winter, spring	Not noticed
Cases (%)	10-20%	80-90%
Gender	More often men	More often women
Age	Up to 40 years	Children, adults over 40 years old
Body weight	Standard or reduced	extra kg
Development	while	Slow, not looking bright
Vascular abnormalities	Most of them are small	Most are large
Cell sensitivity to insulin	yes	low
Antibodies to insulin and beta cells	yes	Nope
Therapy	Insulin	Diet, glucose-lowering drugs, insulin (in later stages)

Disease diagnosis

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

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

• Ultrasound;
• pathological insulin determination;
• electrocardiography - study of the electrical field of the heart;
• Rehberg's test - assessment of kidney condition;
• biochemical blood tests;
• fundus study.

Based on the information received, a clinical picture appears, after which therapeutic techniques are suggested.

Medicines of type 1

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

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

Insulin lispro

Insulin analogs produced in the human body act quickly - 15 minutes after injection.Glucose metabolism is regulated, and anti-catabolic and anabolic effects on tissues appear.

The drug turned out to be the best in the list of similar drugs;per day, sugar concentration decreased by 22%, and glycemic data improved.

Insulin glulisine

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

Used on an empty stomach or after eating, the substance enters the body through injection.The duration of the course and dosage 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 is little difference compared to human hormones, which allows the results to appear faster.After use, you are allowed to start eatinge, because there is no need to rest.

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

Medicines for the second type

This species is not as rare as the first type, so many more drugs have been developed to eliminate the problem.

Biguanides

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

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

The maximum quantity is 6 tablets taken in three doses.The dose is increased gradually if there are no complications.Children over 10 years old and teenagers need 1 tablet a day, after two weeks the dose 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 to carry out the procedure at home.

There are hormones similar to those produced in the digestive tract, which release substances when food enters it.

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

GLP-1 receptor agonist based on liraglutide

The formula has been created to prolong the effect.

Course – 1 time a day 1 hour before meals.

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

DPP-4 inhibitor based on sitagliptin 

Tablets are used before or after meals, you just need to adhere to a certain period of time.

You need 100 mg for 1 daily dose.

It is possible to use both drugs separately and in combination with other drugs.

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 given after meals.

DPP-4 inhibitor based on vildagliptin

It is needed once a day, the required dose is 50 mg, meal time is not important.

The result remains throughout the day, while the negative effects of the drug are reduced.

How to monitor your glucose levels

The patient must monitor the concentration of sugar independently.For this purpose, it is advisable to keep a diary where you need to make important notes.You should regularly check your glucose level using a glucometer;you can not eat before the observation;you should measure it in the morning before and after meals.Based on the data obtained, diet and lifestyle are adjusted to bring the indicators back to normal.However, you still need to do the test in an outpatient clinic, where more reliable information is available.

Documents for drug prescriptions

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

• identification card;
• medical insurance;
• individual insurance policies;
• documents showing disability;
• a document confirming that the patient does not refuse the social package.

Diet for diabetes

A diet estimate 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	Second breakfast	Have lunch	Afternoon snack	dinner
1 day	Buckwheat, cottage cheese, 1% fat milk	A glass of milk	Cabbage soup, boiled meat, fruit jelly	Two apples	Cabbage schnitzel, boiled fish, tea
Day 2	Barley porridge, soft boiled eggs, cabbage salad	A glass of milk	Mashed potatoes, pickles, boiled beef liver, dried fruit compote	Fruit jelly	A piece of boiled chicken, boiled cabbage, tea.Kefir before bed
Day 3	Cottage cheese with milk, oats, coffee	Kissel	Borscht without meat, boiled chicken, buckwheat porridge	Two pears	Vinaigrette, egg, tea.Yogurt before bed
4 days	Buckwheat, cottage cheese, coffee	Kefir	Cabbage soup, lean boiled beef, compote	1-2 pears	Schnitzel, boiled fish, tea
5 days	Potato-free vinaigrette with 1 tsp.vegetable oil, eggs, coffee, slices of rye bread with butter	Two apples	Sauerkraut with stewed meat, bean soup	fresh fruit	Boiled chicken, vegetable pudding, tea.Yogurt before bed
Day 6	Boiled meat, cereal porridge, coffee	Wheat bran stew	Boiled meat, fish soup, fat-free mashed potatoes	Kefir	Oats, cottage cheese, milk, apples
Day 7	Buckwheat, boiled eggs	Two apples	Beef cutlets, 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 a way to eliminate the disease, so some of the most effective recipes are considered.

That is:

• Fill the container 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 flowers 1 tablespoon.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 root, 100 g of lemon peel 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 teaspoon.2 times a day;
• grind dry 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.Filter, take ½ cup 3 times a day.

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

Sports and physical education

A lot of glucose is burned through physical activity, the metabolism and the function of the cardiovascular system are also stable, so it is important to do at least simple exercise every day.

Overvoltage should not be allowed, as there will be negative consequences.The increased appetite forces you to consume large amounts of food, because the efforts made earlier lose their meaning.

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

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

Prognosis for type 1 and 2 diabetes

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

In the early stages it is always easier to fight the disease than in advanced cases.By choosing the most effective therapy, the patient's condition is reduced, thus prolonging life.It is possible to improve the condition through a healthy lifestyle and physical activity.