Type 1 diabetes mellitus: pathogenesis, etiology, diagnosis and treatment

Diabetes mellitus (DM) of the first type is a disease of the pancreas , expressed in the destruction of cells that produce the hormone insulin. In turn, a lack of insulin in the blood leads to deadly conditions.

Types

The disease can be of two types:

1. Type 1 diabetes (or insulin-dependent diabetes). In this case, the patient completely stops producing insulin. The pathogenesis of type 1 diabetes is based on the complete absence of this hormone in the body. Most often, this type of disease occurs in children and young people of both sexes.
2. The pathogenesis of type 2 diabetes reflects the condition of an acquired non-insulin-dependent disease. That is, the human endocrine system works well, it normally produces a hormone, but sugar in the body ceases to be absorbed by cells. This type of disease is characteristic of the elderly, prone to fullness. You should be aware that this type of diabetes occurs in 80% of all patients with diabetes.

There are several types of diabetes, but this is not a disease, but rather temporary conditions of the body caused by some event in life. For example, symptoms of diabetes occur during pregnancy or during malnutrition.

Causes of occurrence

The etiology and pathogenesis of type 1 diabetes are still being studied. A clear cause for the development of this disease has not yet been identified. There is a hypothesis that the disease is inherited at the gene level. This is confirmed by many studies and statistical reports on the appearance of the disease in children. However, this assumption is not confirmed in cases where diabetes is diagnosed in a child in whose family no cases of this disease have been identified before the third knee.

Thus, the etiology and pathogenesis of type 1 and type 2 diabetes continue to be studied by scientists from all countries. For type 2 diabetes, another major cause is obesity. This type of disease occurs in most people with excess weight and a sedentary lifestyle.

The mechanism of the origin of the disease

The pathogenesis of type 1 diabetes is characterized by complete destruction of beta cells in the pancreas. Usually, the consequence of this condition appears rather quickly - after a maximum of 3 months. And if a child or a young person is not provided with medical attention on time, a ketoacidotic coma and death can occur.

The pathogenesis of type 2 diabetes is characterized by a loss of cells to the ability to metabolize glucose. And this is manifested as a whole in the same way as in the case of type 1 diabetes. An exception is how lipid metabolism occurs in the blood of patients.

The pathogenesis of type 1 diabetes leads to the fact that without insulin in the body there is an energy deficit, which is eliminated by the breakdown of lipids. But this behavior of the body leads to a rapid loss of body weight of the patient. The significant role of IL1 in the pathogenesis of type 1 diabetes is undeniably proven by doctors. Antigen-presenting cells secrete IL-1, which causes the development of diabetes.

The pathogenesis of type 2 diabetes is characterized by the reverse situation - there is an accumulation of fat cells in the body and an increase in the painful state. Moreover, with type 2 diabetes, a huge amount of unspent sugar accumulates in the blood, which destroys the walls of blood vessels. And this, in turn, leads to a variety of conditions - from gangrene of the extremities to a heart attack.

Despite the fact that the pathogenesis of type 1 and type 2 diabetes is different, this disease has a number of identical symptoms:

1. Constant thirst due to dehydration in the body. And this is despite the fact that a person is able to drink up to 5 liters of water.
2. Increased urination frequency.
3. General malaise, expressed in muscle weakness.
4. Itching of the skin.
5. Anorexia, as a rule, in the direction of increasing food intake.
6. Feeling sleepy - a sick person is able to sleep while sitting, literally shutting down for a few minutes.
7. Long healing of wounds, often leading to the formation of purulent ulcers. Most often occurs on the feet and soles of the feet.

Briefly: the pathogenesis of type 1 diabetes is manifested by painful thinness, 2 - by obesity. Everything else arises as a result of an individual reaction of the body to a lack of insulin and sugar in the body.

Complications

DM leads to the most dangerous conditions that most often end in the death of the patient. For example, the pathogenesis of type 1 diabetes in children is characterized by severe abdominal pain, vomiting, smell of acetone from the mouth, loss of consciousness, and the patient falls into a diabetic coma. And all this in just a few hours, since with this type of disease in the blood, the content of ketone toxic cells rises sharply. In an adult, ketone cell poisoning is slow, but also inevitable.

The pathogenesis of type 1 diabetes is characterized by a sharp response to an overdose of insulin, which leads to a hypoglycemic coma. That is, to help a person in a critical condition, an individual dose of insulin is needed only for his condition.

The complication of type 2 diabetes is somewhat different. All of them are mainly caused by the destruction of the walls of blood vessels:

1. First of all, these are all kinds of heart pathologies.
2. The destruction of small and large vessels in the lower extremities leads to the appearance of non-healing wounds. Sometimes a patient has to take away a sore leg almost completely in order to prevent gangrene from killing him.
3. In a patient with diabetes, vision is weakening, since the fundus is poorly supplied with blood through damaged vessels.
4. The skin is flaky, and chronic pain appears in the joints.
5. The work of the kidneys is disturbed.
6. Weakening of the immune system leads to the development of various infections on the skin, nails and internal organs of a person.

Just as with the pathogenesis of type 1 diabetes, with type 2 diabetes, everything ends in the death of a person.

Diagnostics

The pathogenesis of diabetes in children has such striking manifestations that doctors do not experience difficulties in its diagnosis. Usually, conclusions about the presence of a disease in a patient can be made after a superficial examination of the patient and history.

However, therapy involves determining the exact doses of insulin-containing drugs, which is why the patient goes through a series of tests and analyzes:

1. First of all, he takes blood from a finger for analysis. It reveals the content of sugar in the body.
2. The tolerance of the body to glucose is determined, for this the patient drinks a solution of sugar in water - about 70 g per 200 ml and after 1-2 hours gives blood for analysis.
3. In urine samples, the level of ketone bodies and glucose is determined.
4. Blood samples determine the level of insulin and C-peptide in the body.
5. The condition of the internal organs, namely the pancreas, is evaluated not only by blood and urine tests. For this, instrumental research is used. For example, ultrasound or computed tomography.

Drug therapy

Treatment of diabetes mellitus (pathogenesis does not play a role here) is a comprehensive event.

Unfortunately, neither type 1 nor type 2 diabetes can be completely cured, but with the right treatment, the quality of life and, accordingly, its duration will increase significantly.

Drug treatment is aimed at restoring blood insulin. This primarily relates to type 1 diabetes. In this case, the insulin introduced into the body has a synthetic origin, because the pancreas of the patient does not produce a hormone.

The dosage and regimen of insulin is calculated by the doctors for each patient separately. In order for the amount of insulin to correspond to the norm of the body, the hormone is injected. This improves dosage accuracy. Preparations for obtaining insulin orally have not yet been developed, since in this case the amount of the hormone in the blood will be practically unregulated. And as you know, elevated insulin levels are as dangerous as its lack.

Drug therapy for type 2 diabetes is aimed at strengthening the walls of blood vessels destroyed by sugar, as well as the immune system and the fight against infections that hit a weakened body. In each individual case, the complex of drugs is selected separately, depending on the condition of the patient.

Therapeutic diet

Diet for diabetes is developed individually. But there are a number of general recommendations that all patients should adhere to.

First of all, you need to review the number of meals per day. A diabetic should eat 6-7 times a day with small portions. This will allow you to more accurately control the amount of sugar in the blood and, accordingly, body weight. With type 1 diabetes, the patient must gain weight, and with type 2 diabetes, lose weight.

It is necessary to familiarize yourself with the glycemic index of certain products. This is the amount of sugar produced by digesting the product.

It is necessary to reduce the content in the diet of sweets and products from quickly digestible carbohydrates - baking, fast food and soda. You should forever give up alcohol and cigarettes. Alcohol changes the glucose content in the blood, and nicotine destroys the walls of blood vessels.

Food should be varied, but not greasy, meat can only be eaten boiled. Preferably chicken or veal.

Physiotherapy

Diabetes therapy is not possible without regular exercise. If we recall that type 2 diabetes develops precisely because of a sedentary lifestyle, it is logical to assume that regular exercise will help improve the patient's condition.

Sports exercises are prescribed for absolutely all patients, but the loads, of course, are calculated depending on the general condition of the person. The only thing you need to understand is that sports exercises should not contain extreme loads. So, the patient should not engage in weightlifting or marathon. Otherwise, everything is useful - from hiking to easy running or swimming. The main thing in sports and physiotherapy exercises is the regularity of training.

Prevention

Currently, scientists have not identified the main causes of the appearance and development of type 1 or type 2 diabetes, which cannot prevent preventive measures from being taken. Especially if there were people with diabetes in the family, that is, there is a genetic predisposition.

First of all, you need to lead a normal lifestyle, walk more, run. You need to use stairs, not elevators or escalators. If the work is associated with a long sitting position, you need to interrupt every 2 hours at the production gymnastics. This will not only improve well-being, but also increase labor productivity.

It is necessary to abandon addictions such as smoking and drinking alcohol. They destroy the pancreas and blood vessels, so often a healthy person has the symptoms and condition of a patient with diabetes.

To prevent obesity and, as a result, type 2 diabetes mellitus, you need to follow a diet from a young age. Do not eat foods containing fast carbohydrates - sweets, pastries. Also, do not abuse fatty and fried meat, smoked sausage and products containing preservatives and artificial colors.

Forecast

Type 1 and type 2 diabetes are incurable diseases. With a violation of the level of insulin in the blood with type 1 diabetes, a coma can occur within a few hours, and after it the death of a person. In type 2 diabetes, mortality is also a very high percentage. Only timely diagnosis and correct, complex therapy makes the prognosis for this disease positive.

Folk wisdom

The complex treatment for diabetes can include several methods developed by traditional medicine. They, like conservative treatment, will not help cure diabetes, but they can improve the condition of a person, strengthen his blood vessels and the gastrointestinal tract. Moreover, tinctures and decoctions have a positive effect on the human immune system, which is very important for diabetes.

Before starting treatment according to the traditional medicine system, you still need to seek permission from a doctor, because unforeseen side effects and allergic reactions to the components of therapeutic drugs are possible.

• Onion infusion is a good way to improve well-being and strengthen the immune system. To cook it, you need to scroll 2-3 onions in a meat grinder or rub through a grater. Then the resulting mass must be poured into 500 ml of warm water and let the product infuse for at least 10 hours. You need to drink an infusion of 50 ml 3 times a day before meals.
• Strengthen the immune system and improve intestinal function can infusion of a mixture of garlic, parsley and lemon. You need to take all the ingredients in equal proportions and pass through a meat grinder. Lemon before this is not necessary to clean. The resulting slurry should be mixed and left in the refrigerator for 3-4 days. You need to take the drug 1 teaspoon 3 times a day for 30 minutes. before meals.
• Medicinal plants very well help in the fight against the manifestations of diabetes. To prepare a medicinal infusion, you need to take 3 parts of burdock roots, 2 parts of dandelion roots, 1 part of the bark of the blackthorn steppe, pour 500 ml of boiling water and boil over low heat for 10 minutes. When the infusion has cooled, you need to strain it and you can take 100 ml 3 times a day 30 minutes before eating.
• You can drink the infusion from the collection of herbs and berries. 2 parts of flax seed, cuff leaves, 1 part, 2 parts of juniper berries and 4 parts of blueberries. 2 tbsp. Spoons of this collection are brewed with 500 ml of boiling water and simmer for 5 minutes. After the broth has cooled, it must be filtered and taken 100 ml 3 times a day 30 minutes before meals.
• To alleviate the symptoms of diabetes, sometimes it is enough to drink a medicinal infusion from one plant. For example, you can replace everyday tea with infusion of lilac buds or dandelion leaves. By the way, dandelion leaves can be used to make salad, only you need to pre-soak them in salt water to remove the bitterness characteristic of the plant. And oats can not only be eaten in the form of porridge, but also drink oatmeal infusion. To prepare it, it is enough to brew a handful of oat seeds with hot water at night, it is advisable to do this in a thermos. The course of such treatment does not exceed 10 days, after which there is a significant improvement in the well-being of the patient.

Conclusion

Anyone diagnosed with diabetes will be discouraged. After all, it is known that this disease is incurable. At this moment, the patient as never before needs the moral support of relatives and friends. They can convince him that life is not ending right now and that you can live with this disease until old age. Moreover, the quality of life will be much better. And there is nothing wrong with the fact that from now on the patient can not eat a piece of cake or drink a glass of wine. This is the price he must pay for his long, happy years.

It is necessary to help a person understand that the momentary pleasures of alcohol, sweets and cigarettes are not worth it to die young.