Diabetes

 What is diabetes

Syndrome

Causes and risk factors

Multiples

The diagnosis

treatment

protection

The term Diabetes includes a number of disorders in the process of metabolism and metabolism of carbohydrates.

Normal metabolism

Carbohydrates that the body gets from eating bread, potatoes, rice, cakes and many other foods, are gradually broken down and decomposed.

This process of disintegration and decomposition begins in the stomach and then continues in the duodenum (Duodenum) and in the small intestine.

This process of disintegration and decomposition produces a group of sugars (carbohydrates) that are absorbed into the circulation.

Internal secretion cells in the pancreas, which are called beta cells, are very sensitive to high blood sugar levels and secrete the hormone insulin.

Insulin is an essential bridge for the entry of sugar molecules, glucose, into muscles where it is used as an energy source, and into fat and liver tissues where it is stored.

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Glucose reaches the brain, too, but without the help of insulin.

In the pancreas, another type of cell is alpha cells, which secrete another extra hormone called Glucagon. This hormone causes sugar to be excreted from the liver and activates the action of other hormones that block the action of insulin.

The balance between these two hormones (insulin and glucagon) keeps the level of glucose in the blood stable and avoids severe changes.

People of a healthy weight and a lot of physical activity need a small amount of insulin to balance the action of glucose entering the blood. The more obese and less physically fit a person is, the more insulin is needed to process an equivalent amount of glucose in the blood. This condition is called "insulin resistance."

Having diabetes

When the beta cells in the pancreas are damaged, the amount of insulin secreted gradually decreases, and this process continues for many years.

If this condition is accompanied by the presence of "insulin resistance", then this combination of a low amount of insulin and a low level of activity leads to a deviation from the normal level of glucose (sugar) in the blood, in which case the person is defined as having diabetes (Diabetes).

It is known that the normal level of blood sugar after fasting eight hours should be less than 108 mg / dL, while the borderline level is 126 mg / dL.

If a person's blood glucose level is 126 mg / dL and above, on two or more tests, then that person is diagnosed with diabetes.

Types of diabetes

The types of diabetes are:

1- Type 1 diabetes

Type 1 diabetes (diabetes in children / juvenile diabetes) is a disease in which the immune system destroys beta cells in the pancreas, for reasons that are unknown and have not been identified, until now.

In boys, this process of destruction takes place quickly and lasts from a few weeks to a few years, but in adults, it may last for many years.

Type 1 diabetes may affect a person at any stage of life, but it often appears in childhood or adolescence.

Many people who develop Diabetes Type 1 at an advanced age are mistakenly diagnosed with Diabetes Type 2.

2- Type 2 diabetes

 Type 2 Diabetes (or: Type 2 Diabetes / Adult Diabetes) is a disease in which beta cells in the pancreas are destroyed and destroyed for genetic reasons, most likely supported by external factors, this process is very slow and lasts for decades.

The likelihood of a healthy weight and in good shape developing diabetes is small, even if he has decreased insulin secretion.

The risk of diabetes for an obese person who is not physically active is a great possibility, given that he is more likely to develop "insulin resistance" and thus diabetes.

It is the most common, it can appear at any age, as the statistics indicate that the number of people with type 2 diabetes in the world has recorded a very large increase in recent decades, as it reached about 150 million people, and is expected to rise to 330 million people with disease Diabetes, through 2025. Fortunately, it can often be prevented and avoided.

Diabetes symptoms

Diabetes symptoms differ according to the type of diabetes.

Sometimes, people with "prediabetes" or pregnancy diabetes may not have any symptoms at all.

Or they may feel some or all of the symptoms of type 1 diabetes and type 2 diabetes.

Symptoms of diabetes:

Thirst

Urinating a lot, often

Very severe hunger

Low weight for unknown and unknown reasons

Tired

Blurred vision

Slowly heal (heal) wounds

Frequent infections (infections) in: the gums, skin, vagina or urinary bladder.

Causes and risk factors of diabetes

Among the main causes of this sharp increase in diabetes are:

Obesity

Lack of physical activity

Changes in types of foods: Common foods today include ready-to-eat foods that cause diabetes, as they are rich in fats and sugars that are easily absorbed into the blood, which leads to an increase in "insulin resistance."

Learn about the causes and risk factors for developing diabetes, by type:

Type 1 diabetes factors

In type 1 diabetes, the immune system attacks and destroys the cells responsible for secreting insulin in the pancreas, rather than attacking and destroying harmful germs and / or viruses, as it usually does in normal (healthy) cases.

As a result, the body remains with little or no insulin. In this case, sugar collects and builds up in the circulation, instead of being distributed to various cells in the body.

It is not known, until now, the true eye cause of type 1 diabetes, but it appears that family history probably plays an important role.

The risk of developing type 1 diabetes increases for people whose parents or siblings have diabetes. There are additional factors, as well, that may cause diabetes, such as exposure to viral diseases.

Factors of type 2 diabetes

In people with "prediabetes" that may worsen and turn into type 2 diabetes, cells resist the effect of insulin action, while the pancreas fails to produce enough insulin to overcome this resistance.

In these cases, sugar accumulates and accumulates in the blood circulation instead of being distributed to cells and reaching them in various parts of the body.

The direct cause of these conditions is still unknown, but it appears that excess fat - especially in the abdomen - and lack of physical activity are important factors in this occurring.

Researchers are still looking for a real and accurate answer to the following question: Why do the conditions of "prediabetes" and type 2 diabetes affect certain people, specifically, and not others.

However, there are several factors that appear to increase the risk of developing diabetes, including:

Age: Age greater than or equal to 45

Weight: Excess weight defined as a BMI greater than or equal to 25.

Genetics: a close family member who has diabetes.

Race: Certain ethnic groups known to have a high risk of developing diabetes.

Physical activity: lack of physical activity.

Hypertension / hypertension: defined by blood pressure values ​​higher than 90/140 mmHg.

Hypercholesterolemia: LDL is harmful

High level of triglycerides in the blood: It is one of the types of fats in the body. Higher values ​​than 250 mg / dL.

Polycystic ovary syndrome.

Vascular disease: a personal history of these diseases.

The birth of a high-weight baby: a personal history of women, including the birth of a baby with a weight greater than 4.1 kg (the baby's weight immediately after birth).

Gestational diabetes: a personal history of gestational diabetes.

Hemoglobin Glucosylate: HBA1C values ​​are greater than or equal to 5.7%.

Impaired glucose tolerance: those with impaired glucose tolerance

Glucose Values: Those with an account / problem with impaired fasting glucose on a post-fasting scan.

When these factors appear - hypertension, hyperglycaemia and blood lipids above the normal level - along with obesity (excess weight), a relationship emerges between them, together, and insulin resistance.

Factors of gestational diabetes

During pregnancy, the placenta produces hormones that aid and support pregnancy, and these hormones make cells more resistant to insulin.

In the second and third trimesters of pregnancy, the placenta enlarges and produces large amounts of these hormones, which make insulin difficult to work.

Under normal conditions, the pancreas produces a response by producing more insulin to overcome this resistance.

But the pancreas does not, sometimes, keep up with the pace, which leads to the arrival of a very small amount of sugar (glucose) to the cells, while it collects and accumulates a large amount of it in the blood circulation. Thus, gestational diabetes (diabetes during pregnancy) is formed.

Any pregnant woman may develop gestational diabetes, but some women are at greater risk than others.

The risk factors for developing diabetes include:

Women over the age of 25 years

Family or personal history

Overweight

Diabetes complications

Diabetes may lead to:

Gradual rise in blood pressure

Characteristic disorders of blood lipids, especially elevated triglycerides

Decreased high-density lipoprotein (good cholesterol - HDL).

In general, diabetics suffer distinct damage: in the kidneys, in the retina of the eyes, and in the nervous system.

But complications arising from diabetes vary depending on the type of diabetes.

Complications of type 1 and type 2 diabetes

Short-term complications from type 1 and type 2 diabetes require immediate treatment. Such cases, which are not treated immediately, may lead to convulsions and coma.

Hyperglycemia (hyperglycemia)

An elevated level of ketones in the urine (diabetic ketoacidosis)

Low blood sugar (hypoglycemia).

The long-term complications of diabetes appear gradually.

The risk of complications increases as diabetes develops at a younger age and in people who are not careful to control blood sugar levels. Ultimately, diabetes complications may lead to disability or even death.

Cardiovascular disease (in the heart and blood vessels)

Nerve damage (neuropathy)

Damage to the kidneys (nephropathy)

Damage to the eyes

Damage to the shoulders of the feet

Diseases of the skin and in the mouth

Problems with bones and joints.

Complications of gestational diabetes

The majority of women who develop gestational diabetes give birth to healthy babies. However, if diabetes in the blood of a pregnant woman is unbalanced and not monitored and treated properly, it may cause harm to both the mother and the newborn.

Complications that may occur in the newborn due to gestational diabetes:

Overgrowth

Hypoglycemia

Respiratory distress syndrome

Jaundice

Type 2 diabetes in an advanced age

the death

Complications that may occur in the mother due to gestational diabetes:

Pre-eclampsia

Gestational diabetes in the next pregnancy as well

Complications of prediabetes

Prediabetes may progress to and become type 2 diabetes.

Diagnose diabetes

There are many blood tests that can diagnose the symptoms of type 1 diabetes or symptoms of type 2 diabetes, including:

A random check for the level of diabetes in the blood.

Checking the level of diabetes in the blood while fasting.

If a person is diagnosed with symptoms of diabetes, according to the results of the tests, it is possible that the doctor will decide to conduct additional tests in order to determine the type of diabetes, with the aim of choosing the appropriate and effective treatment, noting that the treatment methods differ from one type of diabetes to another.

The doctor may also recommend a hemoglobin A1C / glycosylated hemoglobin test.

Tests to detect gestational diabetes

Screening tests for gestational diabetes are an integral part of the regular, routine exams during pregnancy.

Most medical professionals recommend a blood test for diabetes called the "Glucose Challenge Test". Which takes place during pregnancy, between the twenty-fourth week of the twenty-eighth week of pregnancy, or earlier in women at high risk of developing gestational diabetes.

The “Glucose Challenge Test” begins with drinking a sugar syrup solution. An hour later, a blood test is performed to measure the level (concentration) of diabetes in the blood. If blood diabetes is higher than 140 mg / dl (mg / dl), this usually indicates gestational diabetes.

In most cases, a repeat test is needed to confirm a diagnosis of diabetes.

In preparation for the (additional) repeat test, a pregnant woman undergoing the test should fast the night before the test. Here, again, a sweet-tasting solution, this time containing a higher concentration of glucose, is drunk, and then the blood glucose level is measured every hour, for a period of three hours.

 Tests to detect "prediabetes"

The American College of Endocrinology usually recommends screening for "prediabetes" for everyone with a family history of type 2 diabetes, for those who are obese or have a metabolic syndrome.

It is also recommended that you undergo this examination, too, for women who have had gestational diabetes in the past.

The doctor may recommend one of the following two tests to diagnose "prediabetes":

Checking blood sugar during fasting

Glucose tolerance test.

Diabetes treatment

As mentioned, the treatment for diabetes depends mainly on its type, and this means the following:

Type 2 diabetes treatment

Diabetes treatment varies from person to person, according to the personal laboratory tests that each patient performs and their blood glucose (sugar) values.

It is worth noting that according to the complications of diabetes that we presented earlier, the risk of developing microvascular and microvascular and macrovascular diseases is high as the blood sugar concentration is higher over long periods of disease.

In addition to cardiovascular diseases, the risk of which also increases as the patient’s age and the duration of diabetes is greater. That is why we must treat this category seriously and balance the values ​​of glucose (sugar) concentration in the blood as much as possible.

Treatment in this category of persons should contain prevention of cases of severe hypoglycemia (hypoglycemia), or a severe decrease in blood circulation (severe hypotension).

As well as attention to the overall health of the patient and the overall medication with which he is treated, so that it is possible for the diabetic patient to suffer from more than one disease in addition to diabetes.

We can divide diabetes treatment into several sections:

1- Lifestyle changes

Proper and appropriate nutrition for this category of patients.

Physical exercise recommended by the attending physicians, which is specially adapted for each patient according to the total illnesses he suffers from and which may affect the regular and proper physical exercise such as heart disease, physical disabilities and other diseases.

Reducing weight and BMI, which helps the body reduce the insulin resistance that causes diabetes.

2- Medicines taken orally

Metformin: It is considered a first-line treatment, especially for obese people. It works by suppressing the production of glucose in the liver, which leads to a decrease in its concentration in the blood.

Among the known side effects of this medicine are weight loss and gastrointestinal effects. For people with chronic kidney failure, this type of medication may be inappropriate or even harmful.

Sulfonylurea: It is a drug that helps insulin secretion in the body through changes in the electrical charge of the membranes of cells that secrete insulin.

A known and common side effect of these drugs is excess weight gain and a sharp drop in the concentration of glucose (sugar) in the blood (hypoglycemia).

Elderly people and those prone to frequent cases of severe drops in the concentration of glucose (sugar) in the blood (hypoglycemia), they should be careful about taking these drugs, which may be inappropriate for them.

Thiazolidinediones: This type of drug improves insulin resistance in the body and may stimulate insulin secretion.

Meglitinides: These drugs work similarly to the sulfanyl-urea drugs. A common side effect of this class of medication is extra weight gain.

Alpha-glucosidase inhibitors: These drugs work by slowing the absorption of sugar in the digestive system. Common side effects of this class of drugs are flatulence (bloating) and diarrhea.

DPP-IV inhibitors: These medications help regulate glucose (sugar) concentration in the body. In general, these drugs are not strong and not very effective for significantly lowering HBA1C as other drugs.

It is worth noting that these drugs do not gain weight, nor are they of a high risk of a severe drop in the concentration of glucose (sugar) in the body.

GLP-1 drugs: These drugs work by the role of peptides in the digestive system to balance the concentration of glucose in the blood, including GLP-1. Common side effects of this medicine are weight loss, vomiting, nausea and diarrhea.

3- Injections

Insulin: Insulin therapy has become more and more popular in recent times, despite the fact that many patients refuse to accept daily injection therapy. Insulin therapy is divided into two types:

Insulin therapy is a long-acting, daily injection that provides the body with the essential amount of insulin. This makes it easier for the patient to accept the treatment, as there is no need for injections more than once a day. This type of treatment may be prescribed with other oral medications, to balance the disease more effectively.

Treatment with insulin has short-term effectiveness, which is insulin taken immediately after eating daily meals, and the amount of food is usually adjusted to the amount of short-term insulin consumed after it.

Pramlintide: is generally given by supplemental insulin injection.

4- Monitor blood glucose concentration

Monitoring the concentration of glucose (sugar) in the blood, especially in the morning hours, is important and usually gives us information about the balance of disease in these patients.

Also, doctors usually pay attention to these recordings in order to decide the appropriate treatment for patients and the need to add other drugs to better balance the disease.

In addition to direct treatment to lower blood glucose concentration, there is an equally important treatment that reduces the risk of cardiovascular disease, which includes:

Limit smoking as much as possible. Sometimes there are organized group sessions in which doctors advise to help you quit smoking:

Treating hypertension

Treating hyperlipidemia

Aspirin therapy

As mentioned earlier, living in a healthy and proper way, in terms of food and exercise.

Treating type 1 diabetes

1- Monitoring and recording glucose concentration (sugar in the body) values

Research has demonstrated the importance of monitoring and recording glucose values ​​in

Diabetes prevention

Type 1 diabetes cannot be prevented, but a healthy lifestyle that contributes to treating the stage and symptoms of pre-diabetes, type 2 diabetes and gestational diabetes can also contribute to its prevention and prevention.

Take care of a healthy diet

Increase physical activity

Get rid of excess weight.

Medicines can sometimes be used. Oral diabetes medications, such as metformin and rosiglitazone, can reduce the risk of developing type 2 diabetes. However, maintaining a healthy lifestyle remains extremely important.

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