Diabetes

Disease Definition and Causes

Diabetes is defined as a group of metabolic disorders characterized by uncontrolled increases in blood glucose levels. Insulin hormone, secreted by the pancreas, regulates glucose absorption by cells and carbohydrate metabolism in the body. Various pathological conditions can lead to either insufficient insulin secretion (Type 1 diabetes) or cells’ unresponsiveness to this hormone (Type 2 diabetes). Symptoms include frequent urination, constant thirst, and severe hunger. Untreated, elevated blood sugar levels can lead to complications affecting the heart, blood vessels, nervous system, lower limbs, and vision.

Definition:
Diabetes is one of the most prevalent diseases globally. Different types of diabetes are diagnosed in about 8% of individuals during their lifetime, with the number of affected individuals increasing over time due to diverse dietary characteristics. With effective symptomatic treatment and dietary management, patients’ quality of life can be maintained at a good level.

Types of Diabetes:
There are different types of diabetes:

1. Type 1 (Insulin-dependent or juvenile diabetes): Typically develops in childhood or adolescence, caused by insulin deficiency due to pancreatic cell damage. People with this type need regular insulin injections.
2. Type 2 (Non-insulin-dependent or adult-onset diabetes): Usually develops in adulthood but is now becoming common among children and teenagers. It results from the body tissues’ insensitivity to insulin, leading to impaired glucose absorption. Individuals with this type can control blood sugar levels through proper nutrition, physical activity, and sugar-reducing medications. In severe cases, insulin therapy may be required.
3. Gestational diabetes: Develops exclusively during pregnancy and usually disappears after childbirth. Compliance with a special diet is required, and if ineffective, insulin therapy may be needed.

Severity of Diabetes:

• Mild (HbA1c less than 6.5%): Blood sugar level is within or close to the normal range, with minimal harmful symptoms.
• Moderate (HbA1c 6.5-7.9%): Slight elevation in glucose level with specific symptoms or early signs of complications.
• Severe (HbA1c 8% and above): Characterized by a significant increase in glucose level, evident symptoms, and complications.

Diabetes is also classified based on blood sugar level control, the presence of complications, and can be categorized as compensated, partial, or uncompensated.

Diabetes is defined as a group of metabolic disorders characterized by uncontrolled increases in blood glucose levels. Insulin hormone, secreted by the pancreas, regulates glucose absorption by cells and carbohydrate metabolism in the body. Various pathological conditions can lead to either insufficient insulin secretion (Type 1 diabetes) or cells’ unresponsiveness to this hormone (Type 2 diabetes). Symptoms include frequent urination, constant thirst, and severe hunger. Untreated, elevated blood sugar levels can lead to complications affecting the heart, blood vessels, nervous system, lower limbs, and vision.

Definition:
Diabetes is one of the most prevalent diseases globally. Different types of diabetes are diagnosed in about 8% of individuals during their lifetime, with the number of affected individuals increasing over time due to diverse dietary characteristics. With effective symptomatic treatment and dietary management, patients’ quality of life can be maintained at a good level.

Types of Diabetes:
There are different types of diabetes:

1. Type 1 (Insulin-dependent or juvenile diabetes): Typically develops in childhood or adolescence, caused by insulin deficiency due to pancreatic cell damage. People with this type need regular insulin injections.
2. Type 2 (Non-insulin-dependent or adult-onset diabetes): Usually develops in adulthood but is now becoming common among children and teenagers. It results from the body tissues’ insensitivity to insulin, leading to impaired glucose absorption. Individuals with this type can control blood sugar levels through proper nutrition, physical activity, and sugar-reducing medications. In severe cases, insulin therapy may be required.
3. Gestational diabetes: Develops exclusively during pregnancy and usually disappears after childbirth. Compliance with a special diet is required, and if ineffective, insulin therapy may be needed.

Severity of Diabetes:

• Mild (HbA1c less than 6.5%): Blood sugar level is within or close to the normal range, with minimal harmful symptoms.
• Moderate (HbA1c 6.5-7.9%): Slight elevation in glucose level with specific symptoms or early signs of complications.
• Severe (HbA1c 8% and above): Characterized by a significant increase in glucose level, evident symptoms, and complications.

Diabetes is also classified based on blood sugar level control, the presence of complications, and can be categorized as compensated, partial, or uncompensated.

Symptoms of diabetes

Symptoms of diabetes depend on the type and severity of the disease. Type 1 diabetes develops rapidly and often causes complications in young individuals, while type 2 diabetes can exist for a long time without any symptoms. In many cases, the disorder can only be detected through specialized tests.

Possible symptoms and signs include:

• Frequent urination and increased urine volume.
• Severe thirst and consumption of large amounts of fluids.
• Dry mouth.
• Deterioration of vision and dizziness.
• Excessive appetite and hunger.
• Appearance of lesions on various areas of the skin and slow wound healing.
• Insomnia and rapid fatigue.
• Decreased ability to work.
• Unexplained weight loss or obesity.
• Frequent occurrence of inflammatory diseases.

Only a doctor can accurately differentiate between signs of different types of diabetes. The long-term development of the disease contributes to the appearance of additional symptoms associated with complications.

Causes of diabetes:
Diabetes arises due to imbalances in pancreatic functions or disorders in cell regulation, where even if insulin production is sufficient, it does not contribute to lowering blood sugar levels. Factors such as obesity, pancreatic disorders, lack of physical activity, poor genetics, and other conditions are considered risk factors for developing the disease. Type 1 diabetes is usually diagnosed in men and women under the age of thirty, while type 2 diabetes is more common among obese elderly individuals. However, different types of disorders can occur in patients of any age group, so reliance solely on risk factors is not advisable.

Potential causes and risk factors include:

• Genetic disorders contributing to the development of autoimmune diseases and pancreatic disorders. Having relatives with diabetes is considered a significant risk factor.
• Obesity. Excess fat accumulation contributes to metabolic disorders, making tissues less sensitive to insulin.
• Immune system disorders, leading to damage to pancreatic tissues.
• Viral infections and the effects of toxins on the pancreas.
• Use of corticosteroids and other medications contributing to the development of diabetes.
• Disorders in adrenal gland functions.
• Heart and blood vessel disorders.

Diabetes is rarely congenital, but genetic factors contribute to the rapid development of this disease at any age.

Diagnosis of diabetes:
To diagnose the disease, the patient should schedule an appointment with an endocrinologist or general practitioner. The doctor conducts a consultation, during which they examine the patient’s complaints and gather medical history to identify diabetes risk factors. Continuous increase in blood sugar levels and other clinical signs of diabetes are detected through specialized tests, so after the consultation, the endocrinologist determines all necessary procedures.

Tests include:

• Fasting blood glucose test. The patient is asked to refrain from eating for several hours before the test. A glucose level of 6.5 mmol/L or higher in the sample indicates diabetes.
• Hemoglobin A1c blood test. This test determines the level of this substance, indicating the glucose content in the blood over a period of three months, so the doctor conducts this test for initial diagnosis and monitoring of diabetes treatment. A concentration of hemoglobin A1c of 6.5% or higher indicates diabetes.
• Stress test. The first step in the search is to determine the glucose level in the blood on an empty stomach. Then the doctor asks the patient to drink a cup of water with sugar, and after 2 hours, the blood is analyzed again. If the results of the first test show a moderate increase in blood glucose level (up to 6.5 mmol/L), and the second test shows a significant increase in the index (about 11 mmol/L), the diagnosis is confirmed.
• Blood test to determine C-peptide level. The endocrinologist determines this analysis to accurately evaluate insulin production over a certain period.
• Random blood test. This test is to confirm signs of the disease. A glucose level of 10 mmol/L or higher in several blood samples regardless of mealtime indicates diabetes.
• Urine test. Elevated glucose levels in the urine are detected in patients with diabetes. In addition, there may be the presence of ketones, indicating a disorder in glucose metabolism.

Treatment of diabetes:
The doctor studies the diagnosis results and recommends appropriate treatment. Among the main tasks are lowering blood glucose levels, preventing complications, and relieving uncomfortable symptoms. In addition to medication, the endocrinologist directs the patient to a special diet that allows monitoring blood sugar levels. Compliance with all doctor’s recommendations can significantly improve the quality of life and avoid negative consequences of diabetes.

Two types of drug therapy are used to correct the disorder:

1. Prescription of medications that reduce blood glucose levels. The endocrinologist’s choice of treatment depends on the diagnosis results and the patient’s medical history, where they direct treatment with sulfonylurea derivatives, meglitinides, alpha-glucosidase inhibitors, biguanides, or thiazolidinediones. Often, taking several medications with strict compliance with doses and monitoring blood sugar levels is required. These drugs work to improve insulin production in the pancreas, enhance tissue sensitivity to glucose, and reduce glucose absorption from food.
2. Insulin injections using needles. The endocrinologist recommends this type of treatment for all patients with type 1 diabetes and those with type 2 diabetes if medications that reduce blood sugar levels are ineffective or have warnings. Insulin therapy is also directed to pregnant women with gestational diabetes. The endocrinologist first directs long-acting insulin injections – this medication should be taken once a day regardless of food intake. Fast-acting insulin medications are given in hospitals to treat complex forms of diabetes and when there is a sharp increase in blood sugar levels. The doctor explains the rules for administering injections and the required doses during the consultation.

Prevention of diabetes:
The main methods of prevention are:

1. Weight modification and moderate physical activity.
2. Immediate treatment of pancreatic diseases.
3. Healthy diet, which includes consuming sufficient amounts of vegetables and fruits.

Sources:

1. Mikhliev, S.S., Safarov, A.U.U., Aminov, A.K.U., Kurbanova, N.S. Diabetes Mellitus. Science and Education. 2023. No. 5.
2. Shozhalilova, Z.A., Sadriddinova, M.A. Aspects of Diabetes Mellitus. World Science. 2017. No. 4 (4).
3. Kudencova, L.A., Davydov, D.V., Chernavskiy, S.V., Stremoukhov, A.A. Classification of Diabetes Mellitus: A New Perspective on the Problem. LV (Endocrinology News). 2022. No. 5-6.