Non-insulin dependent diabetes mellitus treatment. E11 Non-insulin dependent diabetes mellitus. Long acting insulins

Insulin dependent diabetes endocrine disease, predominantly affects young people, including children and adolescents. It develops as a result of the cessation of the production of the hormone insulin by the pancreas, which is responsible for normal carbohydrate metabolism and entry of glucose into tissue cells. Due to malfunctions endocrine system pancreatic beta cells that produce the hormone die. Due to its lack, the breakdown of sugar into glucose does not occur, and its content in the blood rises significantly. Held drug treatment aimed at ensuring the intake of insulin from the outside into the body. Since it is impossible to take this hormone in the form of tablets, a patient with insulin-dependent type 1 diabetes is forced to constantly inject.

Why does the disease occur

Doctors believe that diabetes is not only genetic disease. The main reason is considered to be transferred inflammatory diseases in the pancreas, after which the body's immune system attacks the cells that produce insulin. But also genetic predisposition should not be discounted, because people with IDDM have children with big share probabilities will "pick up" the baton in terms of illness.

Factors that may affect the likelihood of the onset of the disease:

• hereditary factor.
• viral nature.
• Disorders of the immune system.
• Obesity.
• Stress, prolonged periods of depression.
• Pathological love for sweet foods.

insulin dependent diabetes Type 1 develops in humans young age, and the onset of the disease is very rapid. Often, insulin-dependent diabetes is diagnosed in women who are expecting a baby. Another name for this type of disease is gestational diabetes. Correct and timely treatment Type 1 diabetes can provide significant support to the body of the mother and child. After childbirth, the symptoms may disappear completely. However, the possibility of developing non-insulin-dependent type of diabetes in the future remains.

By international classification(code E-11) the second type of diabetes is called insulin-independent, that is, it does not require hormone injections. However, this type of disease can eventually develop into another stage. So, in the patient's body there is no decrease in glucose levels, so insulin production increases. The pancreas begins to work intermittently, and beta cells are simply destroyed.

How to suspect the disease yourself

The insulin-dependent type of the disease, like non-insulin-dependent diabetes mellitus, has several characteristic features. Typical signs:

• Increased thirst.
• Polyuria (frequent urination).
• Feeling constantly tired.
• Rapid weight loss with sufficient diet.
• Visual impairment, skin problems appear: itching, rash, irritation.
• Insomnia, irritation, apathy.

Other signs may also appear: cramps, numbness of the legs, the smell of acetone from the mouth.

Diagnosis of insulin-dependent type 2 diabetes is based on the characteristic complaints of patients. As a rule, they go to the doctor when the symptoms become pronounced, so that errors are excluded. To confirm the diagnosis of insulin-dependent diabetes mellitus, the following laboratory tests are performed:

• Blood analysis. Studies are conducted on the amount of sugar in the blood, glycosylated hemoglobin, glucose tolerance.
• Analysis of urine. The presence of sugar, signs of acetone are determined.

In a diabetic patient, the function of the pancreas is disturbed and there is a lack of insulin.

Complications of the disease

Insulin-dependent type 2 diabetes, like type 1 diabetes, is a serious disease, and their complications are severe. They are of two types - chronic and short-term, quickly passing.

A typical complication is hypoglycemia, sharp drop the amount of glucose in the blood.

It also appears in patients with non-insulin-dependent type 2 diabetes mellitus when taking drugs based on urea. If this condition is not stopped in time, then the person may lose consciousness and fall into a coma.
Chronic complications can accompany a patient with insulin-dependent type 2 diabetes in the same way as those suffering from type 1 diabetes. If not treated chronic pathologies, then non-insulin-dependent diabetes mellitus, like insulin-dependent, will not leave the patient a chance for a long and happy life.

Chronic complications include:

• Increased blood pressure.
• Atherosclerotic changes in blood vessels.
• Stroke.
• Myocardial infarction.
• Severe retinal lesions, cataracts.
• skin diseases, trophic ulcers, gangrene.
• Kidney problems, nephropathy.

Each of these diseases, especially together with IDDM, has a strong negative impact on the body. Treatment must be carried out in a complex and in a timely manner.

Consumption of vegetables, natural juices and foods with low content carbohydrates lower blood sugar levels

How sickness is healed

It is impossible to completely cure IDDM, it belongs to the category of chronic, requiring therapy throughout a person's life. Treatment is prescribed depending on the signs of which of the two types of the disease are diagnosed.

Drug therapy is not aimed at treatment, but at the normalization of blood parameters, the condition and well-being of a person. It is intended to support optimal level blood sugar (so that it does not exceed 5.6 mmol / l).

The initial stage of the disease, especially the insulin-independent type of diabetes, is corrected by taking hypoglycemic tablets. In the future, the introduction of hormonal injections is required, as a rule, therapy is prescribed for life. Great importance have a diet, food, the regularity of its intake and quality. It determines digital indicators blood sugar.

Medications (replacement therapy):

• Short-acting insulin (several hours). Actrapid.
• Long-acting insulin (up to 36 hours). Its action begins 14 hours after the injection.
• Intermediate insulin. Protafan. It acts 9-10 hours, its "work" begins 1-2 hours after the injection.

Treatment for type 1 IDDM with insulin medications involves replacing the activity of the pancreas. When prescribing therapy, it is important to determine the level of sugar in the blood and establish the necessary adequate dose.

How long will a person with IDDM live?

The danger of diabetes lies in the development of complications - diseases, each of which can significantly reduce life expectancy or reduce its quality. The primary task of each patient is to start timely treatment. And you should pay attention not only to the level of sugar in the blood, but also to therapy. concomitant diseases.

IDDM is corrected by an appropriate diet. It is low carbon and low calorie diet, which allows you to gradually reduce the level of glucose in the blood, keep yourself in shape, not gain weight.

In IDDM, a diabetic must receive daily injections of the hormone insulin to regulate blood sugar levels. It is imperative to measure the level of sugar - each patient must know exactly this parameter, as well as signs of hypoglycemia.

Beneficial physical activity. Adequate exercise will help get rid of excess weight, maintain state of cardio-vascular system in good shape.

Insulin-dependent diabetes mellitus (type I) is a chronic endocrine disease caused by insufficient insulin synthesis by Langerhans cells of the pancreas, resulting in an increase in the level of glucose in the blood serum, but its deficiency in the cells. Among all cases of diabetes mellitus, this type occurs in up to 10% of cases. This disease is most often found in young people.

Causes

The exact cause of the development of insulin-dependent diabetes mellitus has not been established. However, there are several causal factors contributing to its development:

• hereditary predisposition (in the presence of type I diabetes mellitus in one of the parents, the probability of developing it in a child is 2-10%);
• viral infection (passed viral hepatitis, rubella, parotitis, Coxsackie viruses);
• toxic effects (pesticides, nitrosamines, streptozocin, rat poison, some medicines);
• autoimmune reaction cellular immunity(insulin-dependent diabetes mellitus is often combined with another autoimmune pathology - diffuse toxic goiter, thyrotoxicosis, vitiligo, etc.).

The main pathogenetic link in type I diabetes mellitus is the death of 80-90% of pancreatic β-cells (islets of Langerhans), which produce insulin. As a result, insulin deficiency develops, which leads to an increase in blood sugar levels and its inaccessibility to body cells.

Symptoms of insulin dependent diabetes mellitus

With this pathology, all types of metabolism are disturbed: electrolyte, protein, enzymatic, immune, peptide and water. Insulin-dependent diabetes mellitus usually manifests in young or childhood with the appearance of severe thirst, dry mouth, severe fatigue, headache, weight loss with increased appetite, sleep disturbances, irritability, frequent profuse urination. You may also experience itching and dry skin, pustular infections skin, visual disturbances and seizures calf muscles, nausea, abdominal pain, nocturia (the predominance of nocturnal diuresis). With the course of the disease, symptoms of complications may appear, such as atherosclerosis of the vessels of the brain, coronary vessels, diabetic foot syndrome, nephropathy (renal dysfunction), (decreased visual acuity), neuropathy (paresthesia, cold extremities, etc.), frequent infections. In the absence of insulin therapy, the smell of acetone from the mouth appears, ketoacidosis develops and impaired consciousness up to coma. Ketoacidosis occurs due to the breakdown of fats (as an energy source) instead of sugars, which increases the number of ketone bodies.

Diagnostics

Except clinical picture in the diagnosis of insulin-dependent diabetes mellitus importance has a serum glucose level. The presence of diabetes is indicated by a fasting glucose level of more than 6.5 mmol/l and/or more than 11.1 mmol/l two hours after the glucose tolerance test. In the urine, glucose can also be determined (if it exceeds the "renal threshold" in the blood - more than 7.7-8.8 mmol / l) and ketone bodies. In addition, the prescription of the existence of hyperglycemia may indicate elevated level glycosylated hemoglobin. Insulin and C-peptide levels are significantly reduced in type I diabetes. In order to identify possible complications, as well as for differential diagnosis, ultrasound procedure kidneys, rheoencephalography, rheovasography lower extremities, EEG of the brain, ophthalmological examination.

Types of disease

Depending on the etiology, insulin-dependent diabetes mellitus is classified into autoimmune and idiopathic. The severity of the course is distinguished (mild, middle degree and severe) and the degree of compensation pathological process(compensated, subcompensated and decompensated).

Patient's actions

With the development of at least a few of the above symptoms, it is necessary to consult an endocrinologist for a consultation.

Treatment of insulin-dependent diabetes mellitus

In the treatment of insulin-dependent diabetes mellitus, there are two main tasks - lifestyle changes and adequate drug therapy. The first implies compliance special diet with calculation bread units, dosed physical exercise and constant self-control. The second task is the individual selection of the regimen and dosage of insulin therapy. There is a conventional regimen of insulin therapy, continuous subcutaneous insulin infusion, and multiple subcutaneous injections. Any additional physical activity or meals should be taken into account when calculating the dose of insulin administered.

Complications

Complications of insulin-dependent diabetes mellitus can be hyperosmolar coma, hypoglycemic coma (if the insulin dose is incorrectly calculated), diabetic nephropathy, polyneuropathy, micro- and macroangiopathies, arthropathy, etc.

Prevention of insulin-dependent diabetes mellitus

There are no preventive measures for insulin-dependent diabetes mellitus. However, whenever possible, viral infections that can contribute to the manifestation of this disease should be avoided.

Comments: 0

Comments:

Almost everyone has heard of such a disease as diabetes mellitus. A similar affliction very common in old age. Few people know that young people and even children can get sick with diabetes. Distinguish insulin-dependent diabetes mellitus and insulin-independent. These varieties of the same disease differ from each other. Type 1 diabetes (dependent) is much less common. It accounts for less than 10% of total number cases of this pathology. If viral and other infectious diseases can be cured with medications, then in this situation everything is much more complicated.

This disease develops as a result of metabolic disorders in the human body. They arise due to the destruction of pancreatic cells responsible for the production of a very valuable hormone - insulin. The latter is involved in the utilization of carbohydrates (glucose) by tissues and cells of the body. With development, glucose is not absorbed and accumulates in the blood. It is impossible to completely cure diabetes with drugs. Such patients need insulin for life. In addition, the insulin-dependent type of the disease can lead to dysfunction of other organs and systems. This is why he is dangerous. Let us consider in more detail what is the etiology, clinic and treatment of this disease.

Features of type 1 diabetes

Type 1 diabetes refers to autoimmune pathology. This means that immune cells show a certain aggressiveness towards a person's own cells. Insulin-dependent diabetes mellitus is also called juvenile diabetes because it can occur in children and adolescents. Most often, this disease is diagnosed in people under 30 years of age. This is its important distinguishing feature. Type 2 diabetes mellitus (non-insulin-dependent) occurs in old age. All the symptoms of this disease are associated with an absolute deficiency in the body of insulin.

It should be noted that with the correct correction of blood glucose levels and the rational selection of the dose of insulin, sick people can live a full life. long years. An important condition is the absence of any serious complications. What are the reasons for the development of this endocrine disease? To date, there is no consensus on this matter. Insulin-dependent diabetes can be caused by the following reasons: as a result of hereditary factors, when exposed to various infectious agents or toxic substances. Of great importance are external factors. They include territorial affiliation. There is evidence that people who have moved to more unfavorable areas for diabetes mellitus get sick much more often. As for infectious causes, then they include various viruses.

Clinical manifestations

Type 1 diabetes, like non-insulin-dependent diabetes mellitus, has its own distinctive features. Symptoms largely depend not only on the type of diabetes mellitus, but also on the duration of its course in a sick person, the stage of the disease, and the presence of complications from the blood vessels. In insulin-dependent diabetics, all symptoms can be conditionally divided into 2 groups.

The first group includes those signs that indicate decompensation of the disease. AT similar situation protective and adaptive forces of the body are not able to cope with insulin deficiency. The second group is represented by signs that are associated with the formation or other complications.

Type 1 diabetes always presents with symptoms such as hyperglycemia. Increased content blood sugar is important diagnostic criterion. It is discovered during biochemical analysis blood. Hyperglycemia, in turn, causes a number of other important symptoms. These include impaired urination (an increase in the daily volume of urine), thirst, weight loss, weakness, apathy. The weight loss of the patient is observed due to the lack of the body's main source of energy - carbohydrates. Type 1 diabetes can present increased appetite. Type 1 diabetes almost always leads to increased sugar in the urine.

In adults and children suffering from this disease, such serious complications like angiopathy of the retina, impaired renal function, neuropathy. Retinopathy is a non-inflammatory disease. This disrupts the blood supply to the retina. Left untreated, retinopathy can lead to reduced visual acuity and even blindness. It is represented by damage to various structures of the kidneys: tubules, glomeruli, arteries and arterioles. In this case, very often there is vascular sclerosis, pyelonephritis, renal papillitis.

This pathology affects small vessels, but may be affected more large vessels (coronary arteries, vessels of the brain, vessels of the legs). Often in medical practice at type 1 is formed. In this case, various skin defects (ulcers, cracks, fungal infections) that are difficult to treat.

The most formidable complications of diabetes

Type 1 diabetes, like non-insulin-dependent diabetes mellitus, is dangerous in its own way. possible complications. The latter can be long-term and short-term.

In the latter case, ketoacidosis may occur. It is characterized by an increase in the acidity of the blood as a result of the breakdown of fats. During this splitting, intermediate decomposition products are formed - ketones. Against the backdrop of ketoacidosis untimely treatment may develop diabetic coma. It is important that short-term complications can be quickly eliminated with adequate treatment.

Another dangerous complication is hypoglycemia. It is formed at sharp decline blood sugar concentration. If it was not provided health care, then a sick person may lose consciousness and even fall into a coma. Hypoglycemic coma most often occurs when taking a large dose of insulin.

Patients with diabetes may have nervous system. In this case, neuropathy, paralysis and paresis occur, which are accompanied by pain.

There are also chronic complications. They are more difficult to treat and total absence capable of leading to lethal outcome. This group includes kidney damage, cardiovascular diseases(atherosclerosis, stroke, ischemia). With a long course of diabetes, damage to the joints with the development of diabetic arthritis is possible. In some cases, arthritis can lead to permanent disability.

Diagnostic measures

In order to prescribe adequate treatment, the doctor must put correct diagnosis. Type 1 is based on the results of a patient interview, laboratory tests, and external examination data. The patient's complaints about urination disorders (polyuria) and intense thirst. In this case, the doctor must simultaneously exclude the possibility of the presence of another pathology similar in manifestations. Differential Diagnosis carried out with diseases such as hyperparathyroidism, chronic renal failure.

The final diagnosis is made on the basis of a laboratory study of blood and urine for sugar. If there is diabetes mellitus, then the glucose concentration will be more than 7 mmol / l on an empty stomach. It must be remembered that the glucose content is determined in the plasma of capillary blood. Very often, doctors use a glucose tolerance test. The patient 3 days before the study should eat normally. The test itself is carried out on an empty stomach in the morning. The patient should not eat 10-14 hours before the study. In a patient in lying position and relaxed state, the glucose level is measured, after which the patient drinks a glass of warm sweet water. Thereafter, blood glucose levels are measured every half an hour. At healthy person 2 hours after the test, the glucose level is less than 7 mmol / l.

Therapeutic measures

Treatment of type 1 diabetes mellitus is carried out in order to eliminate the main symptoms of the disease, prevent complications, and improve the quality of life of sick people. Treatment must be comprehensive. Diet plays an important role in the treatment of diabetes. The main feature of the diet is that it is required to reduce the amount of carbohydrates consumed. They should account for 50-60% of the calorie content of food. You need to limit your consumption of sweets. Confectionery can be consumed only with hypoglycemia. In the presence of overweight the body also needs to reduce the amount of fat consumed.

Treatment of type 1 diabetes mellitus involves the appointment of patients with insulin.

Currently, there is a large selection of drugs based on insulin. They can be short-term, long-term, medium and ultra-short action. The dose of insulin is prescribed by the attending physician. This drug is administered subcutaneously with the help of special syringes. Thus, type 1 diabetes, like non-insulin-dependent diabetes, is serious illness and is capable of provoking disruption of the work of many other organs and systems.

Thanks for the feedback

Comments

Megan92 () 2 weeks ago

Has anyone managed to completely cure diabetes? They say it is impossible to cure completely ...

Daria () 2 weeks ago

I also thought it was impossible, but after reading this article, I had long forgotten about this "incurable" disease.

Megan92 () 13 days ago

Daria () 12 days ago

Megan92, so I wrote in my first comment) I will duplicate it just in case - link to article.

Sonya 10 days ago

Isn't this a divorce? Why sell online?

Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? They sell on the Internet, because shops and pharmacies set their markup brutal. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs and furniture.

Editorial response 10 days ago

Sonya, hello. This drug for the treatment of diabetes addiction is really not realized through pharmacy chain to avoid overpricing. Currently, you can only order official website. Be healthy!

Sonya 10 days ago

Sorry, I didn't notice at first the information about the cash on delivery. Then everything is in order for sure, if the payment is upon receipt.

This is a severe endocrine disease caused by insulin deficiency or cell resistance to this hormone. Diabetes - systemic pathology, which affects blood vessels, many organs, depresses metabolic processes in tissues and often leads to disability. However, with adequate treatment, the patient's quality of life can be high.

Signs of diabetes

There are several options for classifying the disease. Endocrinologists in everyday medical practice distinguish the following main types of diabetes mellitus: insulin-dependent (I) and insulin-independent (II). In the first case, the disease occurs because the pancreas produces too little insulin. In the second - because the cells are not able to use it and also experience a deficiency of glucose.

Both types of diabetes have many similar symptoms. They differ mainly in the degree of expression. Symptoms of type I disease are more intense, brighter and appear suddenly, rapidly. People suffering from type II disease often do not realize for a long time that they are sick. General malaise can easily hide the true diagnosis. However, diabetes mellitus is known for the triad classic symptoms. It:

• unquenchable thirst;
• increased formation of urine;
• persistent feeling of hunger.

The disease may appear additional symptoms. These ailments are numerous, in adults often occur:

• perspiration in a parched throat;
• "iron" taste in the mouth;
• dryness and peeling of the skin, fungal infections;
• long non-healing wounds;
• debilitating itching in the groin;
• headache;
• pressure drops;
• insomnia;
• weakening of vision;
• susceptibility to colds;
• weight loss
• muscle weakness;
• prostration.

The reasons

Why does the pancreas stop producing a vital hormone? Insulin-dependent diabetes mellitus is a consequence of the pathological action of the immune system. She perceives the cells of the gland as foreign and destroys them. Insulin-dependent diabetes develops rapidly in childhood, adolescents, and young people. The disease occurs in some pregnant women, but disappears after childbirth. However, these women may subsequently develop type II disease.

What are the reasons for this? So far there are only hypotheses. Scientists believe that serious reasons due to which an insulin-dependent type of disease occurs can be:

• viral infections;
• autoimmune diseases;
• severe pathologies liver;
• hereditary predisposition;
• sweet tooth;
• overweight;
• prolonged stress, depression.

Diagnosis of type I diabetes

To determine the insulin-dependent variant of the disease is a simple task for an endocrinologist. Patient complaints, characteristics skin give grounds to put provisional diagnosis, which is usually confirmed later laboratory research. Diagnosis of the disease is carried out with the help of blood and urine tests and tests.

Donate blood:

- on sugar (on an empty stomach and 2 hours after eating);

- glycosylated hemoglobin;

- glucose tolerance (insulin-dependent diabetes must be differentiated from pre-diabetes);

Urine is analyzed:

- for sugar;

- acetone.

Complications

The disease significantly undermines immune system. The patient becomes very vulnerable to infections. The consequences of the disease can be acute, but transient, and chronic. Most acute complications- ketoacidosis, hypoglycemia. Cells in search of an energy source instead of glucose break down fats. The increasing acidity of the blood in conditions of lack of fluids causes critical situation diabetic - up to ketoacidosis coma with a fatal outcome. The patient is tormented by dizziness, thirst, vomiting, and smells of acetone from the mouth.

If the amount of food taken and the amount of insulin in the body are not balanced, the blood glucose drops sharply (below 3.3 mmol / l). In this case, the development of a dangerous hypoglycemic syndrome is inevitable. The body is deficient in energy and reacts to it very sharply. The patient is tormented by an attack of severe hunger, he is thrown into sweat, the body trembles. If you do not urgently eat sweets, a coma will come.

Transient complications can be prevented. Chronic effects are difficult to treat. However, if left untreated, an insulin-dependent type of pathology can drastically shorten a person's life. The most common chronic complications:

• atherosclerosis;
• hypertension;
• stroke;
• myocardial infarction;
• trophic ulcers, diabetic foot, gangrene of extremities;
• cataract, retinal damage;
• kidney degeneration.

How to treat diabetes

A person who has been diagnosed with such a diagnosis must realize that it is impossible to completely cure the insulin-dependent variant of the disease. Medications alone will not help either - it is necessary proper nutrition. Treatment should become a new way of life for a person. The most important condition- maintaining the sugar level within optimal limits (not higher than 6.5 mmol / l), otherwise severe complications can't be avoided.

You should check your condition with a glucometer several times a day. Controlling sugar levels helps to quickly adjust the dosage of medications and the diet. On the initial stage treatment of insulin-dependent diabetes mellitus often begins with hypoglycemic tablets. However, over time, you often have to switch to hormone injections or combine both.

insulin therapy

Treatment tactics sugar disease Type II is selected exclusively individually. Insulin therapy today effective method blocking the pathological process due to effective medicines. These are hypoglycemic tablets Glyformin, Glucobay, Dibicor and Eslidin. Insulin for injections - Actrapid, Rinsulin, Insuman, etc. - is available in forms of fast and prolonged action. The patient must learn to give himself injections on his own. Injections can be replaced by an insulin pump. Dosed administration of the hormone through a subcutaneous catheter is much more convenient.

Approved Products

The principle of the diet is to get optimal amount calories with carbohydrates, eating little fat. Then glucose fluctuations in insulin-dependent diabetes mellitus will not be sharp. An absolute ban on all high-calorie and sweet foods. If you follow this rule of nutrition, the disease progresses minimally.

You need to eat little by little, but often, in 5-6 doses. The following foods are safe and healthy:

• vegetable soup, soups, beetroot, borscht, okroshka;
• porridge (limited);
• lean meat, poultry;
• Fish and seafood;
• vegetables (potatoes - a little);
• low-fat dairy and dairy products;
• lean flour products;
• sweet and sour fruits;
• drinks - with sweeteners;

Folk remedies

Recipes may be helpful. traditional medicine and improvised home remedies:

1. Jerusalem artichoke is effective in insulin-dependent diabetes mellitus. Tubers are best eaten raw.
2. Egg, whipped with the juice of 1 lemon (on an empty stomach).
3. leaf infusion walnut(brewed like regular tea).
4. Millet ground in a coffee grinder. A tablespoon of the powder is washed down with milk on an empty stomach (a recipe that is especially popular among patients with an insulin-dependent variant of sugar disease).

DIABETES type 2(insulin-independent) is chronic illness, in which cells lose sensitivity to insulin or its secretion is disturbed and there is a relative insufficiency of the hormone. In the first case, despite its sufficient production beta-cells, the "locks" remain closed. In the second, it is not enough to open the "locks" of all cells.

The overwhelming majority of people with diabetes mellitus (~90%) are ill with type 2.

Causes of non-insulin dependent diabetes

The causes of type 2 diabetes are fundamentally different from type 1 diabetes.

The hormone insulin is produced beta-cells in sufficient quantities(sometimes even more than necessary), but the cells (fat and muscle) cease to adequately respond to it. Arises resistance to insulin. Despite the fact that there is enough insulin circulating in the blood, glucose still cannot get inside the cells. The conversion of excess blood glucose into glycogen by insulin is also impaired.

When sugar (glucose) cannot enter the cells and is not deposited in glycogen, it accumulates in the blood until high level- arises hyperglycemia.

Type 2 diabetes develops slowly and insidiously and is usually diagnosed in middle-aged people (over 40). In 85% of cases, type 2 diabetes occurs in people who are obese, which in itself is a risk factor for the disease.

The fact is that fat creates a kind of screen around the cells, thereby preventing insulin from approaching them. Cells that need glucose send a signal to the brain: "We need glucose!" In turn, the brain, knowing that insulin is needed to get glucose into muscle cells, which will launch the facilitated diffusion method, sends a signal to beta cells: "Produce the hormone insulin."

Beta cells successfully carry out the order central authority- produce the required amount of insulin, but the muscle cells, to which insulin still cannot break through, send more and more demand signals to the brain. As a result, beta cells, forced to endlessly produce insulin, are completely or partially depleted and can no longer produce the hormone as much as the body needs.

Non-insulin-dependent diabetes also occurs in people with normal weight body (10-15% of all patients). The reason is the same - the immunity of the receptors of the cells of some organs to insulin. Why it occurs is not fully understood.

It has been established that the predisposition to diabetes is polygenic (associated with a group of genes, since 2011, 36 of them have already been identified), so non-insulin-dependent diabetes is hereditary disease. In a family where both parents suffer from non-insulin-dependent diabetes mellitus (type II), the risk of developing the same type of diabetes in their children after 40 years increases to 60-80%. If one of the identical twins is diagnosed with diabetes, the probability of the second one developing diabetes is 70%. If one of the close relatives is sick with type 2 diabetes, then in the presence of obesity, the probability of the disease is almost 100%.

Predisposing factors

There are a number of medications and diseases that predispose to diabetes.

Medications:

• Glucocorticoids;
• beta blockers;
• statins;
• Thiazides;
• Atypical antipsychotic drugs.

Diseases:

• Cushing's syndrome;
• thyrotoxicosis;
• Certain types of cancer (pancreatic);
• Acromegaly;
• Pheochromocytoma.

Diagnostics

To diagnose diabetes, the patient takes a blood test. The concentration of glucose should be (on an empty stomach):

1. The norm is 3.3-5.5 mmol / l, if blood was taken from a finger and 6.0-7.0, if from a vein;
2. Prediabetes - 5.5-6.0 mmol / l;
3. Diabetes mellitus - 6.1 and higher if blood was taken from a finger. 7.0 and higher if the blood was taken from a vein.

The concentration of glucose in the blood after eating rises sharply to 8.0-9.5 mmol / l, and sometimes even higher, so blood is taken for analysis only on an empty stomach.

With a glucose tolerance test: Two hours after an oral dose of glucose, plasma levels should be< 7,8 ммоль/л (норма); ≥ 11,1 ммоль/л (сахарный диабет).

Symptoms of non-insulin dependent diabetes

The symptoms of type II diabetes do not differ much from the symptoms of type I, but are less pronounced, as a result of which it may take several years from the onset of the disease before a diagnosis of diabetes is made:

• increased thirst;
• Frequent urination;
• Constant hunger;
• Dry mouth, itchy skin, boils;
• Fatigue;

Minor signs that may occur as the disease progresses are:

• Blurred vision;
• erectile dysfunction;
• Pain or numbness in the limbs.

Treatment of non-insulin dependent diabetes

The main treatment for non-insulin-dependent diabetes (type 2) is diet, weight control, and physical activity.

If, despite these measures, the level of sugar (glucose) in the blood remains high, then pills are prescribed to lower blood glucose levels.

In some cases, blood glucose levels remain too high despite taking the pills. In such cases, insulin injections are needed.

In the presence of concomitant diseases, symptomatic treatment is prescribed.

Forecast

After a few years, diabetes can lead to serious problems with eyes blood vessels, nerves, kidneys, heart and other organs.

Risk heart attack in a patient with diabetes is the same as in a person who has already had a stroke.

Some people with diabetes get rid of drug addiction weight loss and gain alone motor activity. When they reach their "ideal" weight, their own insulin begins to control their blood sugar levels.