Causes of type diabetes

 This type of disease is caused by insulin resistance that occurs in adulthood. The pancreas continues to produce the necessary hormone, but it does not work. In this case, one speaks of its relative deficit.

 

The body may perceive this as a lack of insulin (although in fact it is not) and produce it in excess of the norm. Then there is hyperinsulinemia and metabolic syndrome. Causes of insulin resistance can be:

 

excess fat cells in the abdominal cavity;

hypertonic disease;

polycystic ovary syndrome (in women);

other endocrine pathologies;

taking certain medications, including combined oral contraceptives ( Diana and others)..

Insulin resistance is also physiological. This is common in teenagers, pregnant women and the elderly. Its short-term manifestations occur in the second phase of the menstrual cycle and during sleep.

 

Diabetes and obesity

 

Scientists have identified a relationship between diabetes and overweight. On the one hand, insulin prevents the breakdown of fat, which makes losing weight almost impossible for a diabetic. On the other hand, obesity complicates the course of the disease:

 

fat is deposited in the abdomen;

the pancreas and liver are compressed;

carbohydrate-lipid metabolism is disturbed;

insulin production is activated;

insulin sensitivity decreases.

Visceral (intra-abdominal) obesity can be the result of a sedentary lifestyle, an excess of androgens (male hormones), and can also be inherited. According to the standards of the World Organization of Gastroenterology, it is diagnosed with a waist circumference of more than 80 cm in women and more than 94 cm in men. The US National Cholesterol Education Program also focuses on the waist-to-hip ratio - more than 0.85 for women and more than 0.9 for men.

 

Diabetes mellitus and polycystic ovary syndrome

 

PCOS is the formation of multiple follicular cysts in the ovaries. Ovulation occurs rarely or stops altogether. Women with this diagnosis always have a history of hyperandrogenism (excess testosterone) and often insulin resistance.

 

Diabetes mellitus and polycystic ovary syndrome are interdependent. On the one hand, androgen excess contributes to visceral obesity, which ultimately leads to the development of insulin resistance and type 2 diabetes. On the other hand, hyperinsulinemia promotes an increase in the number of follicles and subsequently formed cysts. At the same time, excess insulin suppresses ovulation. It also inhibits the production of sex hormone-binding globulin, which is necessary for the “neutralization” of testosterone.

 

Who is at risk

 

Patients with overweight or polycystic ovary syndrome have a higher chance of developing diabetes. Also at risk are people:

 

over 45 years old;

having diabetic parents;

suffering from arterial hypertension;

leading a sedentary lifestyle;

deprived of breastfeeding in childhood;

eating a lot of simple carbohydrates and fats;

smokers.

Reduced glucose tolerance is also a reason to closely monitor health. Diabetes may appear more than ten years after the diagnosis of prediabetes. In this case, the disease at the initial stage may not attract attention due to mild symptoms.

 

A blood glucose test should be taken at least once a year, more often for people at risk. According to WHO standards, the upper limit of normal is 6.1 mmol / l, the American Diabetes Association - 5.6 mmol / l.

 

Diagnostics

 

Higher than normal blood glucose results suggest diabetes. But to clarify the diagnosis, the endocrinologist will also prescribe:

 

fasting glucose test;

oral glucose tolerance test;

blood chemistry;

analysis for glycated hemoglobin (norm - no more than 6%);

cholesterol analysis (total, high density and low density lipoproteins);

determination of the index of insulin resistance.

In addition to blood tests, urinalysis may be required. Doctors are interested in indicators of urea, uric acid, creatinine.

 

If there are indications, the patient should visit narrow specialists to prevent complications. Usually this is a cardiologist and ophthalmologist.

 

Treatment of diabetes

 

Treatment methods depend on the type of disease. Although it is impossible to completely get rid of diabetes, it is quite possible to relieve symptoms and prevent complications.

 

According to WHO forecasts, in 10 years, diabetes will become the seventh leading cause of death in the world's population. Therefore, it is important to treat the disease in a timely manner and ensure the availability of medicines for patients.

 

For patients with type 1 diabetes, insulin is vital. Its analogues ( Humulin and others) should replenish the functions of beta cells. There are 3 types of drugs:

 

Type of drugs Peak action after administration How long does the effect last ?

 

Patients with type 2 diabetes rarely need insulin. They usually have more than they need. Treatment is reduced to taking drugs that lower blood sugar levels (for example, Siofor y), and lifestyle changes.

 

Possible Complications

 

Violation of carbohydrate metabolism, hyperglycemia and hyperinsulinemia are reflected in different organs. The main danger of diabetes is damage to micro- and macrovessels, many of which significantly reduce the quality of life and can even lead to death:

 

diabetic retinopathy - aneurysms of the retinal capillaries, leading to its detachment;

diabetic nephropathy - damage to the renal glomeruli, a complication of which is renal failure;

diabetic neuropathy - damage to neurons, leading to dysfunction of the nerves (from pain to atrophy of the limbs);

atherosclerosis leading to angina pectoris, myocardial infarction, stroke, or peripheral arterial disease.

The disease also suppresses the immune system, causes skin ulceration up to gangrene, deformity of the fingers, and numerous pathologies of the joints. Lack of treatment for lesions of peripheral arteries often results in amputation of the lower extremities and sepsis.