How to live with diabetes: We learn the causes and symptoms with an endocrinologist

Diabetes is a disorder of glucose metabolism in the body associated with a lack of insulin. Glucose is the energy substance of cells, and insulin is a hormone that helps cells penetrate. Without insulin, glucose remains in the blood, leading to high blood sugar and the risk of complications with the kidneys, eyes, nerves, heart and blood vessels. Diabetes cannot be cured, but it can be controlled with proper diet, physical activity, and medications. Endocrinologists discuss this in more detail.

Diabetes classification

Most people are only aware of two types of diabetes. In fact, there are many more such people. According to the causes and mechanisms of disease, it can be divided into the following pathological types:type 1 diabetes(insulin dependent). In this type, the pancreas is unable to produce insulin because the beta cells that synthesize insulin are destroyed. The cause of this process is not fully understood, but is believed to be influenced by genetic and environmental factors. Type 1 diabetes is usually diagnosed in childhood or adolescence and requires continuous insulin injections.type 2 diabetes(Non-insulin dependent). In this type of disease, the pancreas produces insulin, but not enough to maintain normal blood sugar levels, or the cells become insensitive to it. This is caused by overweight, obesity, sedentary lifestyle, poor nutrition and genetic predisposition. Type 2 diabetes occurs most commonly in adults.gestational diabetes(Pregnancy period). In this type of disease, blood sugar levels rise during pregnancy and usually disappear after delivery. This is caused by changes in hormonal levels and metabolism in women. They can cause decreased insulin production or less effective insulin. Women with gestational diabetes are at increased risk of developing type 2 diabetes in the future.Other specific types of diabetes. This group includes rare diseases that occur due to genetic defects, pancreatic diseases, endocrine disorders, certain drugs, or infections.

symptoms of diabetes

Typical symptoms of diabetes are related to too much glucose in the blood. These include:

• Polyuria (frequent and frequent urination).
• Polydipsia (increased thirst).
• Polyphagia (increased appetite).
• Dry mouth.
• Fatigue, weakness, irritability.
• Weight loss (for type 1 diabetes) or weight gain (for type 2 diabetes).
• Itching of the skin, mucous membranes, and genitals.
• Wounds heal slowly and are susceptible to infection.
• Visual impairment, spots appearing in front of the eyes.
• Numbness, tingling, and pain in the limbs.

causes of diabetes

Diabetes is a multifactorial disease that can occur for a variety of reasons. Some of them are:

• Genetic susceptibility.Having a relative with diabetes increases the risk of diabetes in offspring. This is especially true for type 1 diabetes, which is associated with genetic defects in the immune system.
• Obesity and overweight.Excess fat in the body can cause poor insulin action and increase blood sugar levels. Particularly dangerous is visceral fat, which surrounds the internal organs and releases inflammatory mediators that disrupt metabolism.
• Malnutrition.A diet high in simple carbohydrates, fats, salt, alcohol and a lack of complex carbohydrates, protein, fiber, vitamins and minerals can lead to metabolic disorders and elevated blood sugar levels. Regularity and frequency of meals is also important, as long breaks between meals can lead to hypoglycemia (low blood sugar levels), while frequent snacking can lead to hyperglycemia (high blood sugar levels).
• Lack of physical activity.Physical activity helps lower blood sugar levels by increasing energy expenditure and glucose absorption by cells. In addition, physical activity improves blood circulation, strengthens the cardiovascular system, boosts immunity, promotes weight loss, and prevents diabetic complications.
• pressure.Stressful situations cause the release of adrenaline, cortisol, and glucagon. They increase blood sugar levels, inhibit insulin production and increase inflammation. Stress can also cause disruptions in eating, sleeping, and physical activity.
• Pancreatic disease.If the pancreas is damaged by inflammation, stones, tumors, or chronic pancreatitis, it may lead to decreased insulin production and the development of diabetes. There are also some genetic diseases that can cause pancreatic dysfunction, such as cystic fibrosis, Schwartz-Barter syndrome, Johnson-Blitzer syndrome, etc.
• Endocrine disorders.The endocrine system is a collection of organs that produce hormones that regulate various body functions. Some hormones, such as glucagon, glucocorticoids, growth hormone, thyroid hormones, and catecholamines, counteract the effects of insulin and increase blood sugar levels.
• taking certain medications.Some drugs may increase blood sugar levels, suppress insulin production, or decrease insulin sensitivity. These drugs include corticosteroids, thiazide diuretics, beta-blockers, some anticonvulsants, some antivirals, some antipsychotics, etc. Taking these medications may cause a temporary or permanent increase in blood sugar levels, which may require a dose adjustment or medication change.
• Infect.Infectious diseases such as viral hepatitis, cytomegalovirus infection, chickenpox, rubella, mumps, meningitis, and sepsis can damage the pancreas, causing inflammation and impaired insulin production. Infections also increase the release of stress hormones, which increase blood sugar levels.

Diagnosis of diabetes

Making a diagnosis requires a thorough examination. Initially, the patient will be examined and interviewed by an endocrinologist. It identifies characteristic symptoms, taking into account the circumstances of their occurrence, concomitant diseases and genetic factors. Then check in detail:Laboratory research.The main way to diagnose diabetes is to measure blood sugar levels. To do this, the following tests are required:

• Fasting blood glucose.
• Glucose tolerance test.
• Glycated hemoglobin (HbA1c)

Instrumental studies.To identify complications of diabetes and assess the condition of target organs, the following studies were conducted:

• Ophthalmoscopy.This is an examination of the eye using a special device (an ophthalmoscope) that examines the retina, optic nerve, and blood vessels of the eye.
• Kidney ultrasound.This is an ultrasound of the kidneys that allows you to evaluate the size, shape, structure, presence of stones, tumors, cysts, and inflammation of the kidneys.
• Doppler angiography of lower extremity vessels.This is an ultrasound examination of the blood vessels in the lower extremities that allows you to evaluate their lumens, vessel walls, blood flow, and the presence of blood clots, atherosclerotic plaques, stenoses, and aneurysms.
• Electrocardiogram (ECG).This is a study of the heart that allows you to evaluate its rhythm, conductivity, contractility, presence of ischemia, myocardial infarction, arrhythmias, and obstructions.

Neurological examination.This is an examination of the nervous system that allows you to evaluate sensitivity, reflexes, coordination, muscle tone, paresthesia, pain, and the presence of movement disorders. With diabetes, nerve changes occur, such as demyelination, degeneration, inflammation, which lead to disruption of the transmission of nerve impulses and the development of polyneuropathy, autonomic neuropathy, mononeuropathy, radiculopathy. This condition is called diabetic neuropathy.Dermatological examination.This is a skin examination that allows you to evaluate the skin's color, fullness, moisture, presence of wounds, cracks, ulcers, fungal, bacterial, viral infections, allergic reactions, pigmentation, atrophy, scleroderma, acanthosis.With diabetes, skin changes may occur, such as xerosis, diabetic dermatosis, diabetic bullous disease, diabetic urticaria, diabetic vasculopathy, diabetic foot, which may lead to disruption of skin protective functions and complications. occurrence of disease.Consult other experts.Depending on the presence of concomitant diseases and complications of diabetes, consultation with other specialists such as cardiologists, neurologists, surgeons, dentists, psychologists, etc. may be necessary. They will help assess the patient's condition, develop necessary treatment plans and provide prevention recommendations.

Insulin treatment for diabetes

Insulin therapy for diabetes is a treatment method in which insulin is administered to the patient from the outside. It is necessary for all people with type 1 diabetes and also for some people with type 2 diabetes when other treatments have not been effective.What types of insulin exist and how to use themThere are different types of insulin, which vary in their onset of action, peak activity, and duration of action. Based on these parameters, insulin is classified into ultra-short-acting, short-acting and prolonged (prolonged) action.

• Ultra-short-acting and short-acting insulins mimic the physiological release of insulin after a meal and are administered 15-30 minutes before a meal.
• Extended-release insulin provides basal levels of insulin in the blood throughout the day and is administered once or twice daily.
• There are also ready-made insulin mixtures with different durations of action for easy use.

Insulin is injected under the skin using a special device such as a pen, pump, or inhaler. The insulin dose is chosen individually for each patient based on blood sugar levels, amount and composition of food, physical activity and other factors.To control blood sugar, patients should measure their blood sugar regularly using a glucometer or continuous glucose monitor.What rules and recommendations should be followed during insulin therapy?Insulin treatment requires strict compliance with diet, physical therapy, and doctor's recommendations. Insulin therapy may cause side effects such as hypoglycemia, allergic reactions, and lipodystrophy (disruption of subcutaneous fat distribution, which may occur at sites of frequent insulin injections). To avoid this, change the insulin injection site and use a fine needle. Therefore, patients need to learn the basics of insulin therapy and consult their doctor when questions or concerns arise.diabetes nutritionNutrition for diabetes is the most important component of treatment. For mild diabetes, diet alone is sometimes enough to reach target blood sugar levels. In more severe cases, drug therapy (oral antidiabetic drugs, insulin) can help.A diabetic diet must adhere to the following general rules:

1. Eat small meals and frequent meals(5-6 times a day), small amounts and often. This will help avoid significant spikes in blood sugar levels.
2. Eat at the same time. The same applies to taking blood sugar-lowering medications and injecting insulin.
3. Strict dieting and hunger strikes are prohibited, as they can cause hypoglycemia and disruption of fat and protein metabolism.
4. These are the top choicesCooking methodsLikes: stew, boil, steam, bake. Fried, smoked, pickled and pickled foods should be eliminated or minimized.
5. shouldEliminate digestible carbohydrates from food(Sugar, honey, candies, jams, baked goods, white flour). They can quickly raise blood sugar and lead to obesity. Instead, you can use sugar substitutes (xylitol, sorbitol, fructose, stevia, etc. ) in moderation.
6. Food should contain plenty of fiber,Because these carbohydrates are absorbed more slowly and don't spike blood sugar as much. Fiber also helps normalize bowel function, lower cholesterol and appetite. Sources of fiber include vegetables, fruits, herbs, whole-wheat breads and cereals, legumes, nuts and seeds.
7. Limit animal fat intake(butter, lard, fat). They contain saturated fatty acids, which increase cholesterol levels and contribute to the development of atherosclerosis and coronary heart disease. Preference should be given to vegetable oils (sunflower oil, olive oil, corn oil, etc. ), which contain unsaturated fatty acids that are good for the heart and blood vessels. Fish and seafood are also useful as a source of omega-3 fatty acids, which have anti-inflammatory and anti-sclerotic properties.
8. suggestionFoods have approximately the same caloric content and carbohydrate contentThis is especially important when choosing insulin doses on different days. To calculate the carbohydrate content, you can use a special table that indicates how many grams of carbohydrates are present in various foods.
9. shouldControl salt intake, because excess salt can lead to increased blood pressure, edema and worsening of kidney function. The recommended daily salt intake is no more than 5 grams (1 teaspoon).

Nutrition for diabetic patients should be balanced, diverse and delicious. You don't need to give up your favorite dishes, just learn how to cook them correctly according to your situation and needs.Diabetes is a serious disease that requires ongoing medical monitoring and adherence to a lifestyle. If you notice signs of diabetes in yourself or a loved one, see your doctor immediately. The sooner a diagnosis is made and treatment begins, the less likely complications are and the better the prognosis of the disease is.