Type 1 and 2 diabetes mellitus

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

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

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

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

To avoid an unpleasant situation, you should study in detail what is meant by diabetes mellitus, what are the predisposing factors of development, 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 that is concentrated in the cells of the pancreas.Diabetes mellitus appears in the form of a large number of diseases related to damage to the endocrine system.There is an active production of glucose in the blood, which also increases in urine, and destabilization of metabolic processes also occurs.

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

• The internal organs feed on glucose, and if it is not supplied in sufficient quantities, starvation will occur.This happens due to a low amount or lack of insulin, which is produced by the cells of the pancreas.When the movement of accumulated sugar in the blood is stopped, subsequent metabolic development does not occur;
• the cells responsible for hormone transport and glucose assimilation 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 die of starvation, while too much 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 adversely affects the implementation of therapeutic measures.

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

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

When measures are not taken, then there is a risk of damage to all organs.In advanced cases, the patient exposes himself to the threat of falling into a coma due to serious complications.It is important, even if there are small deviations, to make an appointment with a doctor in time.

Type 1 and 2 diabetes

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:

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

Gestational diabetes in women occurs in pregnant women with serum glucose levels that exceed normal levels.Detected deviations cannot be ignored, as inaction leads to a negative impact on the fetus.It is possible that the disease will go away after childbirth, but concerns about the absorption of this organic component can be observed even 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 transitory and quickly passes from the initial stage to a more severe one, which occurs against the background of the negative 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;
• skin and mucous membranes dry;
• lack of moisture in the oral cavity even if the water balance is maintained;
• thirst provokes drinking water in large quantities, over 10 liters;
• itching and purulent formations on the skin;
• frequency of urination, copious amount of urine;
• uncontrolled contraction of the muscles of the lower extremities;
• vomiting and nausea - the relief that comes after emptying the stomach is temporary;
• nervousness;
• 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.

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

The appearance of benign yellow formations in the tendons, in the mucous membrane of the internal organs and the 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 external influences.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 which type you are dealing with.The following signs have been identified:

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

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

Pathogenesis of the disease

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

• heredity - the risk of the appearance of the first type of disease in a child increases if the parents have the same diagnosis;
• overweight – 80-90% of patients suffer from excess body weight, as adipose tissue is unable to use insulin as intended.Newborns should weigh 2.5-3.5 kg;if the indicators increase, the endocrinologist should perform 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 a 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;
• breakdown of the pancreas for various reasons, including damage to the organ;
• pathological processes in the endocrine system that occurred due to acromegaly, Itsenko-Cushing syndrome, etc.

The primary factors that cause the deterioration of the condition are listed;they can have a one-time impact, thus increasing the threat.Absolutely healthy people are at risk and it is recommended to see 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:

• the 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 an organic compound will increase depends on the ability to assimilate it.In practice, the examination is not performed when the stomach is full.The most accurate information will be obtained 1-3 hours after the meal.

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

• after 1 hour - up to 8.6-8.9;
• after 2 hours - up to 7.0-7.2;
• after 3 hours - up to 5.8-5.9.

For type 1 diabetics with the same time period:

• until 11;
• up to 10-10.3;
• until 7.5.

If you have type 2 diabetes:

• 9.0;
• 8.7;
• 7.5.

After three or more hours, the glucose level continues to decrease until it returns to normal.

What are the stages of diabetes?

The classification is based on the degree of development of the pathologies of carbohydrate metabolism, i.e. the distribution in the following stages:

• compensation– managed to achieve glucose content in accordance with natural indicators;
• undercompensation– 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 progress;three forms are known.Among them are:

• light- the improvement of the condition occurs due to the choice of the right diet and regime.The positive effect is evident when you follow a diet, while the use of a hypoglycemic agent will bring double benefit.The possibility of transition from one stage to another is minimized;
• average- You cannot do without medications that lower the sugar level.They are used continuously, 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 discontinued.There is a risk of developing encephalopathy, neuropathy and vascular angiopathy.

Differences between type 1 and type 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 distinguishing features of these varieties in order to have an idea about each of them and be able to determine the type of disease based on its characteristics.

Features	The first type	The second type
Period	Autumn, winter, spring	It is not noticed
Cases (%)	10-20%	80-90%
Gender	More often men	More often women
Age	Up to 40 years old	Children, adults over 40
Weight	Standard or reduced	additional kg
COUNTRY DEVELOPMENT	TRANSITIONAL	Slow, does not appear bright
Vascular anomalies	Mostly small	Mostly big
Cell sensitivity to insulin	yes	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 finding out how to treat diabetes, a blood sugar test is done, which is the main way to calculate 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 - the study of the electrical fields of the heart;
• Rehberg test - assessment of kidney condition;
• biochemical blood test;
• fundus study.

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

Medicines from type 1

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

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

Insulin lispro

An analogue of insulin that is produced in the human body is fast-acting - 15 minutes after injection.Glucose metabolism is controlled and anti-catabolic and anabolic effects occur in tissues.

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

Insulin glulisine

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

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

Insulin aspart

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

At night, hypoglycemia occurs much 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

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

Biguanide

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

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

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

Exenatide-based GLP-1 receptor agonist

It is administered using a syringe designed for home procedures.

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.

Liraglutide-based GLP-1 receptor agonist

A formula has been invented to prolong the effect.

Course - 1 time a day 1 hour before meals.

It is necessary to do 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 have to stick to a certain time frame.

You will need 100 mg for 1 daily dose.

It is possible to use both a separate drug and in combination with other drugs.

DPP-4 inhibitor based on saxagliptin

It is included in the category of DPP-4 inhibitors, suitable for combined therapy and monotherapy.

Type 1 diabetes becomes a complication, which requires the administration of insulin after meals.

DPP-4 inhibitor based on vildagliptin

It should be taken 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 is reduced.

How to monitor your glucose levels

The patient must independently monitor the concentration of sugar.For these purposes, it is advisable to keep a diary where you should make important notes.You will need to check your glucose level regularly 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 return the indicators to normal.However, you will still need to take tests at an outpatient clinic, where more reliable information is provided.

Documents for the prescription of drugs

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

• Identity card;
• medical insurance;
• individual insurance policy;
• document showing 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 ease the patient's condition.

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

	BREAKFAST	Second breakfast	lunches	Afternoon snack	Dinner
1 day	Buckwheat, cottage cheese, milk 1% fat	A glass of milk	Cabbage soup, boiled meat, fruit jelly	Two apples	Shnitzel with cabbage, boiled fish, tea
Day 2	Barley porridge, soft boiled egg, cabbage salad	A glass of milk	Mashed potatoes, pickles, boiled beef liver, dried fruit compote	Fruit jelly	A piece of boiled chicken, 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 beef, compote	1-2 pears	Schnitzel, boiled fish, tea
5 days	Vinaigrette without potatoes with 1 tbsp.vegetable oil, eggs, coffee, slices of rye bread with butter	Two apples	Sauerkraut with stewed meat, pea soup	Fresh fruits	Boiled chicken, vegetable pudding, tea.Yogurt before bed
Day 6	Boiled meat, millet porridge, coffee	Wheat bran stew	Boiled meat, fish soup, fat-free mashed potatoes	Kefir	Oatmeal, cottage cheese, milk, apple
Day 7	Buckwheat, boiled egg	Two apples	Beef cutlets, pearl barley, vegetable soup	milky	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.

Namely:

• Fill the container with 1 liter of boiled water, add 100 g of cinnamon powder, mix, add 200 g of honey.Let it bake for 3 hours in a cool place.Course - 3 times a day;
• sturgeon flowers 1 tbsp.l.pour 1 glass of boiling water, the decoction can replace black tea;
• Throw in a meat grinder 300 g of peeled garlic and the same amount of parsley root, 100 g of lemon peel.Place the ground ingredients in a jar, cover with a lid and set aside in a dark, dry place for 2 weeks.Drink 1 tbsp.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, leave in a dry place for 1 hour.Strain, take ½ cup 3 times a day.

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

Sports and physical education

A lot of glucose is burned through physical activity, the metabolism and the functioning of the cardiovascular system are also stabilized, so it is important to perform at least simple exercises every day.

Overvoltage should not be allowed, as it will have negative consequences.Increased appetite forces you to consume large amounts of food, due to which the efforts made earlier lose their meaning.

When fatigue occurs, stress occurs, adrenal hormones are released, after which the glucose level rises.

The best options to achieve excellent results are morning exercises, dumbbell exercises, walking, running, cycling, swimming.

Prognosis for type 1 and type 2 diabetes

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

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