Latent (hidden) diabetes mellitus is quite difficult to detect, because the disease does not make itself felt for a long time. Obvious symptoms appear only when the pathology goes into the following form. Prior to this, something wrong can be suspected only by minor changes in the body and by the results of analyzes. In this case (even if there are no alarming signs), the disease destroys the body. Possible symptoms and treatment guidelines for latent diabetes mellitus will be discussed later.
The essence of the disease
Diabetes mellitus is a very dangerous disease characterized by impaired glucose metabolism. Sugar does not enter the cells and accumulates in the bloodstream due to insufficient production of insulin, which increases the concentration of glucose, which is necessary to provide the body with energy. Cells feel a lack of this substance. The disease is especially dangerous for the body if treatment is ignored.
There is a special form of diabetes - latent, or prediabetes. The disease does not manifest itself in any way, proceeds secretly, no clinical picture is observed. It is quite difficult to determine the disease in latent form. A person with diabetes can feel normal. The only way to determine the disease is to undergo a comprehensive diagnosis. You can suspect diabetes in a latent form by the presence of sugar in the urine or blood of the patient.
Even without obvious signs of pathology, the disease can cause serious harm to the patient’s body, who does not even suspect a problem. The disease damages the walls of blood vessels, they become more fragile, and the internal organs, too. As a result of which a heart attack, hypertension, stroke can develop, problems with vision or disturbances in the central nervous system appear. You can avoid complications if you regularly take tests and pay attention to the slightest possible manifestations of the disease.
Risk factors
Symptoms of diabetes can occur in people who are at risk. Such patients need to be more careful about their own health and not ignore preventive examinations. Pathology can begin to progress with physical inactivity, frequent stress, decreased immunity, due to a genetic predisposition or hormonal imbalance, with a low level of potassium in the blood, frequent pressure surges, drinking a lot of sugary and alcoholic beverages, pancreatic diseases, and so on.
Of great importance to people who are prone to the disease is age. According to statistics, about 85% of elderly patients suffer from this disease or have some signs of latent diabetes mellitus. Most often, the genetic factor makes itself felt. If one of the relatives was ill with diabetes, then you should definitely take tests from time to time to notice the onset of the disease in time.
Often, diabetes can provoke the appearance of excess weight. Failure to comply with the diet, an unhealthy diet and addictions can lead to metabolic disorders and obesity. One in four patients with an increased body mass index has signs of latent diabetes. This indicator can be calculated independently to determine belonging to a risk group.
The body mass index can be calculated by the formula: body weight in kilograms divided by height (in meters) squared. If the BMI in adults is below 18.5, this indicates body weight below normal, 18.5 - 24.9 - normal weight, 25.0 - 29.9 - the presence of excess weight, above 30 - obesity.
Reflects the risk of developing dangerous diseases and waist circumference. So, for a woman, the optimal indicator is up to 79 cm. With a circumference of 80 to 87 cm, there is an increased risk of pathologies, and an indicator of 88 cm indicates a high risk. For men, the optimal waist circumference is up to 93 cm. Indicators above 94 cm and 102 cm are associated with an increased and, accordingly, high risk of complications.
At risk are pregnant women. During the expectation of a child, serious hormonal changes occur in the body, weight increases. In this regard, all women in the situation from time to time without fail take blood tests in order to prevent or detect dangerous diseases in a timely manner. If you suspect diabetes, the doctor will prescribe a special diet for the patient.
Any diseases that affect the pancreas or upset the hormonal balance can also be a provoking factor for the development of latent diabetes mellitus. There is a high risk of developing the disease in women with polycystic ovary, as well as patients who have suffered a virus etiology or infection. In patients with such diagnoses, pancreatic diseases are often detected.
Main danger
Symptoms of the latent form of diabetes are quite difficult to distinguish. This is the main danger of this form of the disease. Latent diabetes can occur in both an adult and a child. Significant changes in the human body will already occur, while he himself will not feel unwell.
Most often, latent diabetes affects the blood vessels, resulting in a significantly increased risk of cardiovascular disease. For example, the probability of a fatal outcome with a heart attack is several times higher if the patient has latent diabetes. Also, problems with nerve endings often appear and vision is reduced.
According to WHO, about two million people die every year from diabetes and complications from this disease in the world. In the absence of proper support of the body (drug therapy, a special diet and regular monitoring by a specialist), the disease quickly and asymptomatically leads to various complications that destroy the human body.
Among the complications, trophic ulcers, gangrene, nephropathy (bilateral damage to kidney tissue, acute or chronic renal failure), hypoglycemia (endocrine disorder, which is characterized by a low level of glucose in the blood plasma), ketoacidosis (a life-threatening condition in which a high blood acetone level). Diabetes often leads to the development of tumors. In most cases, the patient either dies after a long struggle with a serious illness, or becomes disabled.
Possible symptoms
How is latent diabetes manifested? In most cases, there is no clinical picture of the disease, that is, the patient feels well, and the disease is diagnosed by chance during a routine examination.
Some patients nevertheless note alarming changes and sound the alarm. But this rarely happens. Most latent diabetics live for many years, completely unaware of a serious illness.
Some characteristic symptoms help to recognize latent diabetes mellitus. The skin begins to peel off, itching appears. These signs appear due to the fact that with increased sugar in the blood, certain microorganisms develop extremely quickly. There is also no special protection on the skin of diabetics that can prevent the development of such symptoms.
Constant thirst, dry mouth are symptoms that occur in any form of diabetes. But many patients do not pay attention to this symptom, especially during the summer heat.
A symptom of latent diabetes is a sharp change in body weight. At the same time, the diet remains the same as it was before. Usually, a person first loses weight dramatically, and then rapidly gaining extra pounds. All this is accompanied by increased appetite and the desire to eat sweets.
Additional signs of latent diabetes mellitus are dizziness, pain in the chest area, decreased visual acuity, mood swings, sleep disturbance, increased irritability. But these are not specific symptoms that accompany many diseases.
How to detect latent diabetes? Most often, women begin to sound the alarm, who notice that the skin has become dull. Pigmentation appears, severe itching in the perineum, the hair is split, and the nails become brittle.
The symptoms of latent diabetes mellitus indicate a prediabetic state, which, when influenced by favorable factors, quickly passes into an open form. For a long time, the disease does not manifest in any way, but pathology can be recognized by the following signs: a feeling of bitterness in the mouth, skin irritation, poor healing of wounds and cuts, decreased visual acuity, periodic attacks of hunger, sharp weight gain, constant thirst, decreased concentration and working capacity, frequent mood swings, decreased immunity, numbness of the limbs.
How to identify latent diabetes? Symptoms may not appear for a very long time, so the disease can often be determined only by accident. To start treatment on time, it is recommended to regularly take a sugar test and listen to your body. It is especially important to undergo a diagnosis from time to time to those people who are at risk of developing the disease.
Diagnostic Methods
Diagnosis of latent diabetes is complicated by the lack of a clinical picture. The disease proceeds without causing any changes. A routine analysis may not show the presence of pathological changes in the endocrine system. The only truly reliable way to determine diabetes is a glucose tolerance test.
However, at the first visit to the therapist, the doctor most often directs the patient to a regular blood test for sugar. The biological material is taken on an empty stomach (after the last meal, at least 8 hours should pass). Drinking 8 hours before taking a blood test for diabetes can only ordinary water. Alcohol is not recommended for two days, so as not to distort the results. The result may be incorrect after physiotherapeutic procedures, during an infectious disease, when taking certain medications.
A blood test for latent diabetes can be carried out independently (using a glucometer). This is an express method. It is enough to place a drop of blood on the test strip - and the test will show the result. No need to visit the hospital, it is possible to track blood sugar throughout the day, but the result will be inaccurate. If you need to get an accurate result, then it is better to use one of the diagnostic methods. They usually take blood from a finger, but sometimes the sampling is carried out from a vein.
For men and women, the interpretation of the results is the same. The norm is considered to be from 3.3 to 5.5 mmol / L in blood taken from a finger, from 3.7 to 6.1 mmol / L in blood from a vein. With indicators above 5.5, a prediabetes state is diagnosed, and if the result is above 6.1, then we are talking about diabetes.
To confirm the diagnosis, the doctor may prescribe a re-analysis or refer the patient to a glucose tolerance test. This is the most accurate diagnostic method. The procedure is carried out in three stages. First you need to donate blood from a finger on an empty stomach, and then take a solution of 75 g of glucose. After that, you need a break for one hour. Then they take blood again. The study is carried out again after an hour. The results allow us to conclude what is the reaction to incoming sugar.
As soon as it is possible to determine latent diabetes mellitus by symptoms and confirm the diagnosis with laboratory tests, treatment is immediately prescribed that helps reduce the adverse effect of glucose on the body.
Self-medication with such a disease is unacceptable and extremely dangerous not only for the state of health, but also for the life of the patient. The slightest delay can lead to the fact that prediabetes will turn into a full sugar.
Treatment regimen
Symptoms of latent diabetes mellitus will help eliminate complex treatment. Prediabetes needs therapy with full compliance with all the recommendations of the attending physician. Only in this way the condition will not turn into a full-fledged disease and will not cause serious complications.
The complex treatment of the symptoms of latent diabetes mellitus, a diet, an active lifestyle, taking medications, giving up bad habits and drugs that restore normal metabolic processes in the body are supposed.
Food habits need to be changed immediately. The success of treatment directly depends on this. A special diet will allow you to normalize the metabolism and saturate the body with enough potassium. This is necessary to maintain the normal functioning of the cardiovascular system. Restore metabolism will help and feasible physical activity. The muscles absorb part of the glucose, which normalizes the concentration of the substance in the blood.
It is imperative to take all medications prescribed by your doctor. Typically, with this pathology, drugs are prescribed that bind and excrete glucose. You should abandon bad habits that reduce immunity. It is recommended to regularly take multivitamin complexes so that the body does not feel the need for nutrients.
Usually, doctors use the following table when prescribing therapy. In the absence of symptoms of latent diabetes mellitus, treatment with potent medications is not immediately prescribed. Within three months, the patient is recommended to change his lifestyle. This refers to diet and physical activity.
Further therapy depends on test results. If fasting glycemia (mmol / L) is more than 8 units, then insulin is needed. If there is resistance to insulin, then metformin or glitazone + insulin is prescribed, if there is no resistance, then insulin + CM (sulfanylurea) is prescribed.
At 6 - 8 mmol / L, the further course of therapy depends on BMI. If the patient has a BMI greater than 27, metformin and / or glitazones are required; if the UTI is equal to or lower than 27, meglitinides or SM are prescribed. If less than 6.0 mmol / l is detected by the results of glycemia, then an additional analysis is carried out two hours after a meal. In any case, the following shows physical activity and a special diet. If the result of the reanalysis is more than 8 mmol / l, then additionally prescribe acarbose or meglitinides.
Therapy
Drug treatment of latent diabetes mellitus should be aimed at improving the activity of the insular apparatus and reducing peripheral insulin resistance. A medication is prescribed and a lifestyle change is necessary. An integrated approach is best. Most patients need prescribing.
Initial therapy depends on symptomatic manifestations. Currently, three subgroups of drugs are actively used. These are insulin sesitizers that improve insulin sensitivity without stimulating its secretion, secretagogues, that is, secretion stimulants, and glucosidase inhibitors that slow down the absorption of carbohydrates.
Prescribed sugar-lowering drugs (TSPs) are prescribed, as well as insulin therapy. The use of TSP is contraindicated in severe forms of diabetes mellitus, during pregnancy and lactation, in severe kidney damage with impaired function, blood diseases, the presence of vascular diseases, significant weight loss, surgical interventions, and acute inflammatory diseases. It is undesirable to use TSP for patients with chronic inflammatory processes.
Sulfanilurea preparations are prescribed in case of inefficiency of physical activity and diet, if insufficient secretion of insulin is diagnosed. Contraindications are pathologies of the kidneys and liver, pregnancy and lactation, as well as ketoacidosis. Meglitinides are necessary for the ineffectiveness of therapeutic nutrition and exercise with severe hyperglycemia after eating. Contraindications are the same as when taking sulfanylurea.
Biguanides can be prescribed if the patient has fasting hyperglycemia, and BMI is significantly increased. In addition to pathologies of the kidneys, pregnancy and lactation, as well as ketoacidosis, such drugs are contraindicated for alcoholism, anemia, heart failure or in old age.Thiazolidinediones are indicated with a predominance of insulin resistance in the absence of a result from physical exertion. Inhibitors of a-glucosidase are needed if hyperglycemia predominates after eating, but is contraindicated in cases of gastrointestinal tract diseases, during pregnancy and lactation, and ketoacidosis.
Therapeutic diet
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Symptoms of latent diabetes mellitus during pregnancy may not be. A potential predisposition to the disease appears if both parents of the patient suffered from diabetes, previously the woman gave birth to children weighing more than 4.5 kg, the pregnant woman is obese, eczema, neurodermatitis, allergic diseases, polyhydramnios or sugar in the urine is diagnosed. Only with the help of tests, latent diabetes is determined. During pregnancy, the symptoms of a clear illness already require special attention to the patient. These signs include:
- a large amount of urine;
- dry mouth and intense thirst;
- itchy skin;
- insatiable hunger;
- exhaustion;
- visual impairment;
- decreased performance;
- insomnia;
- headache;
- irritability;
- muscle pain
- pain in the heart.
Diagnosis and treatment of gestational diabetes
An analysis for latent diabetes mellitus during pregnancy is carried out without fail, if, according to the results of a general laboratory blood test, the doctor suspected a pathology. Treatment consists of careful monitoring and strict control of glucose levels by the doctor, as well as timely therapy in case of complications. This reduces the risk to the mother and the fetus.
In order to minimize risks, the gynecologist should involve an additional team of specialists (nutritionists, general practitioners, nurses and a pediatrician) in monitoring the woman, timely eliminate pregnancy complications (even minor ones), plan births and ensure the presence of an experienced neonatologist, and also make sure that drug therapy is really impossible. Specialists in treating diabetes in pregnant women are located in regional perinatal centers.
With gestational diabetes, diet and exercise are selected individually. The woman's weight during the gestation should not increase by more than 9 kg to avoid complications. For obese women, the maximum weight gain is 7 kg. After eating, moderate exercise is recommended.
Starting from the 32nd week, antenatal diagnostics should be performed weekly. At earlier dates, diagnosis is performed according to indications. The procedure includes non-stress tests, counting of fetal movements and diophysical profile. Insulin treatment is prescribed only for progressive hyperglycemia after a diet with latent diabetes for two weeks. The dose is selected individually.
Birth planning for women with diabetes
With gestational diabetes, natural delivery is possible if the disease is well controlled and there are documented term criteria. Caesarean section is performed according to indications. This may be obstetric complications in previous pregnancies, poor adherence to therapy, inaccurate delivery date, inappropriate prenatal monitoring. Delivery is recommended at the 39th week of gestation.
Disease prevention
Prevention of latent diabetes mellitus symptoms in women and men is based on the same principles. It is necessary to eat healthy foods, engage in feasible sports, get rid of bad habits and keep body weight under control. It is advisable for people who are at risk to take tests from time to time or measure their sugar level daily. If any alarming symptoms appear, you should consult your doctor to stop the development of the disease.