According to WHO, about 6% of the world’s population suffers from diabetes. And the saddest thing is that the disease is getting younger: if before type 2 diabetes mellitus appeared more often in people over 50 years old, now it also occurs in 30-year-olds. Thirty years ago, type 30 diabetes was called geriatric diabetes.
What is diabetes
Diabetes mellitus is a whole group of diseases that are united by hyperglycemia, that is, an increase in blood glucose levels. This is due to defects in the production or action of insulin.
Diabetes leads to damage and problems in the functioning of various organs, especially the eyes, kidneys, nerves, heart and blood vessels.
The reasons for this can be different, depending on the type of diabetes.
Official statistics say that type 2 diabetes is the most common – according to WHO statistics, in Russia from 1994 to 2010 the number of patients with type 2 diabetes increased from 8 to 13 million (that is, by 62%). And in the world by 2025 this disease should reach the number of 380 million people in the world. But it is already clear that this figure will be much higher, because according to the latest data, the number of patients with type 2 diabetes is 422 million.
In general, according to official estimates, every 10 seconds in the world there are two more patients with diabetes mellitus. Not surprisingly, there is even a World Diabetes Day, and all the states of the world, in one way or another, are implementing various programs to stop growth and reduce mortality.
Types of Diabetes
There are several types of diabetes.
- Diabetes mellitus type 1. It occurs when the pancreas for one reason or another does not produce its own insulin and there is a deficiency of this hormone in the blood. It most often occurs in children and young adults.
- Diabetes mellitus type 2. This is the most common option. It occurs when the pancreas produces too much insulin, but at the same time it cannot transport the glucose molecule to the cells of the body.
“Glucose is an energy substrate that gives energy, it’s like gasoline for a car,” says endocrinologist, PhD, senior researcher at the Faculty of Fundamental Medicine, Moscow State University Zukhra Pavlova. – If insulin does not work in the blood, it is not enough in the body, then glucose does not enter the cell and the cell cannot work. It can enter some cells by simple diffusion. It simply penetrates the cell, moves from one part to another. And there are cells into which glucose cannot get on its own, it must be brought there by protein. This protein is like a transport, it is produced under the influence of insulin.
- Gestational diabetes. It is observed only in pregnant women. It happens that after childbirth, when carbohydrate metabolism is restored, it disappears, but it can also turn into type 2 diabetes.
In addition, there are many other specific types of DM, usually caused by genetic defects. But they are extremely rare.
Causes of diabetes
Type 1 diabetes mellitus appears against the backdrop of an autoimmune process in the body: a “system failure” occurs, and immune cells that are supposed to protect the body begin to attack the pancreas. Over time, the supply of pancreatic beta cells, which produce insulin, decreases, and symptoms of diabetes begin to appear.
But we ourselves provoke the appearance of type 2 diabetes mellitus.
“It’s no secret that obesity is the epidemic of the XNUMXst century,” reminds endocrinologist Zukhra Pavlova. – What about diabetes? The fact is that in almost 80% of cases, obesity sooner or later leads to diabetes. One in two obese people may develop diabetes.
About 20 years ago in America they conducted a study – they watched nurses. It has been conducted for decades, and the result was clear: when nurses, who at the beginning of the study were overweight, but not yet obese, gained weight to degree 1 obesity, their risk of developing diabetes increased by 70%.
“Obesity is not a cosmetic defect,” explains Dr. Pavlova. – This is a complex of metabolic disorders that ultimately lead to type 2 diabetes. Especially if it is superimposed also on age. When a person begins to eat more than he can spend, those extra energy resources that come into his body for a long time begin to be stored in fat cells. These fat cells cannot grow indefinitely. They reach a certain size – about 100 microns and can no longer increase, because there are problems with the blood supply.
As a result, microhypoxia develops – a violation of blood microcirculation in these cells. The body perceives such cells as a threat and begins to destroy them.
“And if there were few such cells, then everything would have cost minimal losses,” says Zukhra Pavlova. – But since a person with overweight has a lot of such cells, then all this comes to the beginning of large and negative events. The fact is that in the process of destruction of excessively developed fat cells, inflammation develops. Around large and dying adipocytes, white blood cells accumulate, further stimulating and supporting inflammation. The more cells, the more inflammation, the more it will stimulate the recruitment of white blood cells and inflammatory factors. In other words, inflammation becomes self-sustaining.
The problem is that this chronic inflammation in the body does not manifest itself in any way.
“It doesn’t make people feel dangerous,” Dr. Pavlova continues, “that is, when we have SARS, everyone understands: it’s a temperature and other typical symptoms, everything is obvious, a person begins to take action. And obesity flows imperceptibly, progressing with inflammation. A person, of course, has changes, for example, weakness and fatigue. But no one pays attention to them.
As a result, chronic inflammation on the background of obesity leads to insulin resistance, that is, the body becomes immune to the action of insulin.
– Glucose cannot enter the cell, the cell signals the brain that we do not have enough energy, the brain activates the center of hunger, explains the mechanism of type 2 diabetes endocrinologist Zukhra Pavlova. – A person, as a rule, most of all wants sweets, because sweets provide the body with energy very quickly. This is the simplest product that quickly increases blood glucose and gives energy. There is more glucose in the blood. And additional insulin synthesis begins. What do we get? We have a lot of glucose in the blood, a lot of insulin, it turns out a kind of sugar compote, but there is still very little glucose in the cells.
The brain continues to give a signal that there is not enough energy, and the person begins to eat uncontrollably and, above all, sweet, high-calorie, saturated with energy. As a result, she gains even more weight, and the more weight, the more diabetes progresses.
Now it has become quite obvious that the increase in type 2 diabetes is directly related to the increase in the number of obese people. Until recently, doctors assumed that by 2025 there would be 380 million patients diagnosed with diabetes, but they were mistaken – there are already much more of them in Russia already. And by 2025, this figure will definitely exceed 400 million.
Methods of treatment and prevention
Type 1 diabetes is treated with insulin alone. But even here there are different options.
This can be basal bolus therapy, where the person injects several times a day. And also the patient can use a pump – a special device that continuously injects insulin into the body.
Currently, the issue of the effectiveness of pancreas transplantation from a donor is being considered. Several such operations have already been performed.
There are more treatment options for type 2 diabetes. First, a certain diet and lifestyle may be enough. In some cases, the doctor may prescribe pills. If the pancreas has completely used up its supply of insulin, insulin is added to the therapy.
“Now there are many effective drugs for diabetes, they can significantly extend your life,” says Zukhra Pavlova. “But I would advise everyone not to face this disease. And when on one side of the scale lies the use of goodies, and on the other the quality of your life, its duration, you probably need to make an unambiguous choice – to change your lifestyle. A quality and healthy life is the best and most “delicious” thing that can be in the life of any person.
Actually this is the best prevention of type 2 diabetes. And, of course, to proper nutrition, you need to add physical education or at least walking.
But there are no preventive measures to prevent type 1 diabetes. The only thing that can be done is to take an antibody test for a child born to parents diagnosed with type 1 diabetes. If the presence of antibodies is confirmed, then parents will be on their guard and more carefully monitor the indicators of glycemia and the well-being of the baby. But this is not a guarantee either.