Contents
- What you need to know about diabetes: a checklist from an endocrinologist
- What is diabetes and how is it dangerous? What is the difference between the 2 main types of the disease?
- Why are obesity and diabetes related diseases? How does one affect the other?
- When are insulin injections necessary, and when can they be avoided?
- What type of diabetes can only women face?
- Who is at risk? What factors can contribute to the onset of diabetes?
- What tests do you need to take if you suspect diabetes mellitus?
- What if a specialist has confirmed the diagnosis?
- Are there new treatments for diabetes?
What you need to know about diabetes: a checklist from an endocrinologist
Developments by Canadian physiologist Frederick Bunting have transformed diabetes from a deadly disease into a manageable disorder.
In 1922, Banting gave his first insulin injection to a diabetic boy and saved his life. Almost a hundred years have passed since then, and scientists have made significant progress in understanding the nature of this disease.
Today, people with diabetes – and there are almost 70 million of them in the world, according to WHO, – can live long and active lives, provided that medical recommendations are followed.
But diabetes is still incurable, and moreover, the disease has been steadily getting younger lately. With the help of an expert, we have compiled a diabetes guide for Healthy Food Near Me readers, collecting useful information that everyone needs to know, because many of us are at risk.
Clinical hospital “Avicenna”, Novosibirsk
What is diabetes and how is it dangerous? What is the difference between the 2 main types of the disease?
Diabetes mellitus (DM) is a group of diseases characterized by a constant increase in glucose (usually called sugar) in the blood. It can cause damage and dysfunction of various organs – eyes, kidneys, nerves, heart and blood vessels.
The most common type 2 diabetes mellitus is 90% of all diagnosed cases of the disease.
In the classic version, this type of diabetes occurs in overweight adults with concomitant cardiovascular diseases. But lately, endocrinologists all over the world have been observing a tendency to “rejuvenate” this disorder.
Type 1 diabetes mellitus develops mainly in childhood or adolescence and is characterized by a sharp onset of the disease, often requiring hospitalization.
The main difference between the first and second types of diabetes is the presence or absence of its own insulin. Insulin is a hormone produced by the pancreas in response to an increase in blood sugar.
For example, when a person eats an apple, complex carbohydrates are broken down in the digestive tract to simple sugars and absorbed into the bloodstream. The blood sugar level begins to rise – this becomes a signal for the pancreas to produce the correct dose of insulin, and after a few minutes the blood sugar level returns to normal. It is thanks to this mechanism that in a person without diabetes mellitus and any disorders of carbohydrate metabolism, the blood glucose level always remains normal, even if he eats a lot of sweets. I ate more – the pancreas produced more insulin.
Obesity and overweight are risk factors for developing type 2 diabetes. The deposition of fat reserves on the abdomen is especially dangerous. This is an indicator of visceral (internal) obesity, which underlies insulin resistance – the main cause of diabetes 2. On the other hand, weight loss in diabetes can be extremely difficult, since the disease causes a whole complex of biochemical changes in the body that are closely related to each other. Therefore, it is extremely important to direct therapy not only to normalize blood sugar, but also to reduce weight.
When are insulin injections necessary, and when can they be avoided?
In type 1 diabetes, the cells in the pancreas that produce insulin are destroyed. The body does not have its own insulin, and there is no natural way to lower high blood sugar. In this case, insulin therapy is necessary (the introduction of insulin using special devices, syringe pens or insulin pumps).
About 100 years ago, before the invention of insulin, the life expectancy of patients with type 1 diabetes averaged from several months to 2-3 years after the onset of the disease. Nowadays, modern medicine allows not only to increase the life expectancy of patients, but also to remove the maximum restrictions for them.
With type 2 diabetes, the level of its own insulin is not reduced, and sometimes even higher than normal, but it cannot work correctly. Most often this occurs due to a decrease in the sensitivity of the body’s cells to this hormone, insulin resistance occurs. Therefore, the treatment of type 2 diabetes is based on non-insulin therapy – tablet and injectable drugs, aimed, among other things, at making one’s own insulin more effective.
What type of diabetes can only women face?
Another common type of diabetes mellitus is gestational diabetes mellitus. This is an increase in blood sugar during pregnancy, which can be accompanied by complications for both the fetus and the woman. To diagnose this disease, all pregnant women are tested for fasting blood glucose at the beginning of pregnancy and a glucose tolerance test is performed at 24-26 weeks of pregnancy. If abnormalities are detected, the gynecologist sends the patient for a consultation with an endocrinologist to resolve the issue of therapy.
Another gynecological diagnosis associated with type 2 diabetes is polycystic ovary syndrome, which, as with type 2 diabetes, is also based on insulin resistance. Therefore, if a woman is observed with this diagnosis by a gynecologist, it is imperative to exclude diabetes and prediabetes.
There are also “other specific types of diabetes” arising against the background of certain diseases, taking medications and as a result of genetic defects, but statistically they are relatively rare.
Who is at risk? What factors can contribute to the onset of diabetes?
Diabetes mellitus is a disease with a hereditary predisposition, that is, the risk of getting sick is higher in those people whose close relatives suffer from this disorder. For example, the probability of a child developing type 1 diabetes is 6% if his father has the disease, 2% – in the mother, and 30-35% if both parents have type 1 diabetes.
However, if the family does not have diabetes, this does not guarantee protection against the disease. There are no methods of preventing type 1 diabetes.
For type 2 diabetes, experts identify constant risk factors that we can no longer influence. These include: age over 45 years, the presence of relatives with type 2 diabetes, gestational diabetes in the past (or the birth of children weighing more than 4 kg).
And the modifiable risk factors include overweight or obesity, habitually low physical activity, high blood pressure and high cholesterol levels. In practice, this means that reducing body weight and normalizing blood pressure can reduce the risk of developing type 2 diabetes.
What tests do you need to take if you suspect diabetes mellitus?
To confirm the diagnosis, you need to take a fasting blood glucose test. The normal indicator will be a blood glucose level of less than 6,1 mmol / L if you donate blood from a vein and less than 5,6 mmol / L if you donate blood from a finger.
You can also determine the level of glycosylated hemoglobin in the blood, which will show the average blood glucose level over the last 3 months. If you have deviations in these parameters, contact an endocrinologist, he will conduct an additional examination and prescribe the necessary therapy.
What if a specialist has confirmed the diagnosis?
If you have already been diagnosed with diabetes mellitus, you should not be afraid, but you definitely need to carefully consider this, and the first thing to do is find an endocrinologist with whom you will be constantly monitored. At the onset of the disease, the doctor will determine the type of diabetes mellitus, the level of insulin secretion, the presence of complications or diseases associated with diabetes and will prescribe appropriate treatment.
In addition to drug therapy, nutrition and physical activity issues are discussed with an endocrinologist, which help in the treatment of diabetes mellitus. At home, self-monitoring of blood glucose is carried out with a special device – a glucometer, in order to assess the effectiveness of prescriptions. You need to visit an endocrinologist once every 1-3 months, depending on the condition of the disease, while maintaining blood sugar in normal values, fewer visits to the doctor are required.
Are there new treatments for diabetes?
Even 10 years ago, type 2 diabetes was considered a progressive disease, that is, with a gradual deterioration, the development of complications; often it led to disability. Now there are new groups of drugs that effectively normalize blood glucose and reduce the risk of complications.
Metabolic surgery is a type of surgery on the stomach and small intestine, which leads to a change in the absorption of food and the production of certain hormones and enzymes, which allows you to lose weight and normalize blood sugar.
Remission of type 2 diabetes occurs in 50-80%, depending on the type of operation performed. Currently, surgical treatment is the most effective method of treating diabetes mellitus. The indication for metabolic surgery for type 2 diabetes is a body mass index (BMI) of more than 35 kg / m2 or the impossibility of correcting diabetes mellitus with medication and with a BMI of 30-35 kg / m2.