Type 1 and 2 diabetes mellitus

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 approximately 250 million people affected by one form or another of the disease.The real number of patients exceeds the official figures, as many are unaware of the existing violations.

Most children suffer from a disease, the manifestations of which cannot always be detected in a timely manner due to mild symptoms.

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

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

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

• The internal organs are nourished with glucose, and if it is not supplied in sufficient quantities, starvation will occur.This happens due to little or no insulin being produced by the pancreatic cells.When the movement of accumulated sugar in the blood stops, subsequent metabolic development does not occur;
• the cells responsible for transporting the hormone and assimilating glucose become immune at a certain point and do not react in any way to a substance that has 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 degree of damage to the endocrine system depends on the severity of the disease and timely treatment;
• It is easier to deal with the problem at an early stage, but many patients come to the clinic much later, which affects the implementation of therapeutic measures for the worse.

Many doctors talk about diabetes not as a disease, but 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 change your work and rest schedule, follow your doctor's recommendations and monitor your well-being and blood sugar levels.

If no measures are taken, there is a risk of damage to all organs.In advanced cases, the patient is exposed to the danger 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.

Types of diabetes 1 and 2

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

We are talking about varieties such as:

• first type, called juvenile, detected in patients of adolescence and advanced age.It is transmitted to children mainly from close relatives.Beta cells undergo changes that negatively affect their structure.Insulin is produced in minimal quantities, insufficient for the normal life of the victim.About 10% face a problem that is largely autoimmune in origin.Sometimes the cause of the pathology is an attack of pancreatitis or pancreatic necrosis, while the person survives, but the pancreas eventually loses its original properties.The situation does not change over time, it remains until the end of life;
• second type– due to a deterioration in metabolism, the hormone ceases to be produced in the required volumes, which causes a relative lack of insulin.Beta cells stop functioning permanently;due to pathological processes, they are unable to perform the functions specified by the body: produce the necessary substance and reduce blood glucose.

Gestational diabetes in women occurs in pregnant women with serum glucose levels that exceed normal levels.It is impossible to ignore the detected deviations, since inaction leads to a negative impact on the fetus.It is possible to eliminate the disease after giving birth, but disturbances in the absorption of this organic compound can be found even in women who initially do not complain of poor health.

There are other types in which the situation develops negatively due to the use of drugs, destabilization of the endocrine system, pancreatic dysfunction and the like.

Symptoms of type 1 and 2 diabetes

The first type has a chronic form, is transient and quickly passes from the initial stage to the most severe one, which occurs against the background of adverse effects of various factors.

Distinctive features include:

• sudden weight loss;
• nocturnal urinary incontinence, more common in children;
• deterioration of the visual system;
• the skin and mucous membranes dry out;
• lack of moisture in the oral cavity even if water balance is maintained;
• thirst causes drinking water in large quantities, exceeding 10 liters;
• itching and purulent formations on the skin;
• frequency of urination, large amounts of urine;
• uncontrolled contraction of the muscles of the lower limbs;
• vomiting and nausea: the relief that comes after emptying the stomach is temporary;
• irritability;
• loss of strength, inability to engage in work for a long time;
• increased appetite;
• an incessant desire to eat after a short period of time.

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

The appearance of benign yellowish formations is observed in the tendons, on the mucous membranes of the internal organs and on the skin.Inflammation can be observed on the surfaces of the genital organs in both men and women.The bones become fragile and are easily 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 allow you to determine which type you are dealing with.The following signals are identified:

• wounds take a long time to heal;
• infection of the epidermis;
• feeling of thirst;
• frequent urination, which forces you to go to the bathroom both day and night;
• exhaustion, slow reaction, sleep disturbances;
• the mucous membranes are dry;
• numbness, tingling in the limbs;
• increased appetite resulting from pathology of leptin synthesis;
• dry mouth, drink about 3-5 liters a day;
• itching in the groin area: confusion occurs, which pushes you to contact a gynecologist or dermatologist instead of an endocrinologist;
• hungry after 1-2 hours of meal;
• swelling on the face and lower legs;
• infantile enuresis, manifested at night;
• hypertension;
• headache and dizziness.

Symptoms occur when glucose levels exceed levels that can easily be determined by the presence of sugar in the urine.

Pathogenesis of the disease

The factors that cause the onset of diabetes mellitus have been identified.Among these are:

• heredity – the risk of the first type of disease appearing in a child increases if parents have the same diagnosis;
• excess weight – 80-90% of patients suffer from excess body weight, as adipose tissue is not able to use insulin as intended.Newborns should weigh 2.5-3.5 kg;if the indicators increase, the endocrinologist must conduct an examination;
• viruses: cause abnormalities of the pancreas, therefore, due to rubella, measles, chickenpox, previously suffered by a child, they can lead to the death of cells of the digestive system;
• age-related changes;
• regular stressful situations;
• an unhealthy lifestyle and poor diet: a body mass index above 30 complicates the situation leading to insulin resistance, the probability of this happening increases by 2 times.Indicators of 35 or higher indicate a 100% chance of diabetes;
• fat deposits around the abdomen;
• disruption of the pancreas for various reasons, including injury to the organ;
• pathological processes in the endocrine system that occurred due to acromegaly, Itsenko-Cushing syndrome and so on.

The main factors that cause the condition to worsen are listed;they can have a one-off impact, thus increasing the threat.Absolutely healthy people are at risk and are recommended to visit a doctor.

Sugar levels after and before meals

On an empty stomach the glucose level is low, normally between 3.4 and 5.5 mmol/l.In diabetics, the indicators exceed the specified value and are calculated as follows:

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

After eating, metabolism is activated, as a result of which glucose is released.How much the level of an organic compound will increase depends on the ability to assimilate it.In practice the test is not carried out on a full stomach.The most accurate information will be that obtained 1-3 hours after the meal.

The normal blood sugar level for diabetes for women, men and children over age 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 frame:

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

If you have type 2 diabetes:

• 9.0;
• 8.7;
• 7.5.

After three or more hours, your glucose level continues to decline until it returns to normal.

What are the stages of diabetes?

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

• compensation– managed to achieve the 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 based on the severity of its course;three forms are known.Among these are:

• light– the improvement of the condition occurs thanks to the choice of the right diet and regime.The positive effect is noticeable when following a diet, while the use of a hypoglycemic agent will bring a double benefit.The probability of transition from one phase to another is minimized;
• average– You can't do without drugs that lower sugar levels.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 association with other drugs, must not be interrupted.There is a risk of developing encephalopathy, neuropathy and vascular angiopathy.

Differences between type 1 and 2 diabetes

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

Characteristics	First type	Second type
Period	Autumn, winter, spring	Not noticed
Cases (%)	10-20%	80-90%
Type	More often men	More often women
Age	Up to 40 years	Children, adults over 40 years old
Weight	Standard or reduced	Additional kg
Development	Transient	Slow, does not appear brilliantly
Vascular anomalies	Mostly small	Mostly large
Cellular sensitivity to insulin	Yes	Bass
Antibodies against insulin and beta cells	Yes	No
Therapy	Insulin	Diet, hypoglycemic drugs, insulin (at a later stage)

Diagnosis of the disease

Before finding out 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 body weight, or significant weight loss.The following also applies:

• Ultrasound;
• determination of pathological insulin;
• electrocardiography – study of the electric fields of the heart;
• Rehberg test: evaluation of renal conditions;
• biochemical blood test;
• fund study.

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

Type 1 medicines

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

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

Insulin lispro

An analogue of insulin produced in the human body acts quickly – 15 minutes after injection.Glucose metabolism is controlled 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 decreases by 22% and blood sugar 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 established taking into account the individual characteristics of the patient.

Insulin aspart

A latest generation hypoglycemic agent, whose action is aimed at correcting glucose levels.There are slight differences compared to the human hormone, which allows the results to appear faster.After use you can start eatingAnd, 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, increasing the dose can be avoided.

Medicines for the second type

The species 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, reduces the concentration of glucose in the blood and does not cause the production of insulin.

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

The maximum quantity is 6 tablets taken in three doses.The dose is gradually increased if no complications occur.Children over 10 years old and adolescents will need 1 tablet per day, after two weeks the dosage changes.It is not allowed to exceed the course, which involves the daily use of 4 tablets, distributed three times.

Exenatide-based GLP-1 receptor agonist

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

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

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

Liraglutide-based GLP-1 receptor agonist

A formula was invented to prolong the effect.

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

It is necessary to carry out the procedure simultaneously, this will ensure the activity of the pancreas and the gastrointestinal tract.

Sitagliptin-based DPP-4 inhibitor 

The tablets are used before or after meals, you just have to respect a certain period of time.

You will need 100 mg for 1 daily dose.

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

DPP-4 inhibitor based on saxagliptin

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

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

Vildagliptin-based DPP-4 inhibitor

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

The result remains throughout the day, while the negative effect of the drug decreases.

How to monitor glucose levels

The patient must independently monitor the sugar concentration.For these purposes it is advisable to keep a diary in which you need to 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 bring the indicators back to normal.However, you will still have to undergo tests in an outpatient clinic, where more reliable information will be provided.

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 it the following list of documents must be presented:

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

Diet for diabetes

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

Type 2 diabetes mellitus, what you can eat can be seen in the table where the diet for the week is outlined.

	Breakfast	Second breakfast	Lunch	Afternoon snack	Dinner
1 day	Buckwheat, ricotta, milk 1% fat	Glass of milk	Cabbage soup, boiled meats, fruit jellies	Two apples	Cabbage cutlet, boiled fish, tea
Day 2	Barley porridge, soft-boiled egg, coleslaw	Glass of milk	Mashed potatoes, pickles, boiled beef liver, dried fruit compote	Fruit jelly	A piece of boiled chicken, stewed cabbage, tea.Kefir before going to bed
Day 3	Cottage cheese with milk, oatmeal, coffee	Kissel	Borscht without meat, boiled chicken, buckwheat porridge	Two pears	Vinaigrette, eggs, tea.Yogurt before bed
4 days	Buckwheat, ricotta, coffee	Kefir	Cabbage soup, lean boiled beef, compote	1-2 pears	Cutlet, boiled fish, tea
5 days	Potato-free vinaigrette with 1 tsp.vegetable oil, egg, coffee, slice of rye bread with butter	Two apples	Sauerkraut with stewed meat, pea soup	Fresh fruit	Boiled chicken, vegetable pudding, tea.Yogurt before bed
Day 6	Stewed meat, millet porridge, coffee	Wheat bran decoction	Boiled meat, fish soup, lean mashed potatoes	Kefir	Oatmeal, cottage cheese, milk, apple
Day 7	Buckwheat, boiled egg	Two apples	Beef cutlet, pearl barley, vegetable soup	Milk	Boiled fish, steamed potatoes, vegetable salad, tea.Kefir before going to 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 vessel with 1 liter of boiled water, add 100 g of cinnamon powder, mix, add 200 g of honey.Leave to ferment for 3 hours in a cool place.Course – 3 times a day;
• linden flowers 1 tbsp.the.pour 1 glass of boiling water, the decoction can replace black tea;
• put 300 g of peeled garlic and the same amount of parsley roots, 100 g of lemon zest in a meat grinder.Place the ground ingredients in a jar, cover with a lid and set aside in a dark, dry place for 2 weeks.Drink 1 tsp.2 times a day;
• grind dried walnut leaves, select 1 tbsp.l., pour ½ l of filtered water.Cook for 15 minutes, then remove from heat and set aside in a dry place for 1 hour.Strain, take ½ cup 3 times a day.

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

Sports and physical education

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

Overvoltage should not be allowed, as there would be negative consequences.Increased appetite forces you to consume large quantities of food, so previous efforts become meaningless.

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

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

Prognosis of type 1 and 2 diabetes

If you allow the disease to enter the decompensation stage, 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.You can improve the situation through a healthy lifestyle and physical activity.