E11 Non-insulin dependent diabetes mellitus. insulin dependent diabetes mellitus insulin dependent type 2 diabetes treatment

Type 1 diabetes is a severe metabolic disease in which there is insufficient production of insulin by the pancreas, due to which there is an increase.

Type 1 diabetes is also commonly known as insulin-dependent diabetes mellitus. In the pancreas of sick people, there are practically no cells that are responsible for the production of the protein hormone - insulin, therefore, with this disease, the human body stops producing its own insulin.

Type 1 diabetes accounts for only 2-10% of all cases of diabetes. The risk of developing this disease is only 0.5% for the white population. Most often, this pathology occurs at a younger age (10-13 years).

Provided that the disease is adequately compensated (when the glycated hemoglobin is close to the normal level, as in healthy people) and the likelihood of complications is very low, the life expectancy of a patient with insulin-dependent diabetes of more than 55-50 years is quite possible.

Etiology

Usually insulin-dependent type 1 diabetes mellitus develops due to pathological reactions of the body, as a result of which the immune system destroys the cells of the pancreas that produce insulin. So far, the etiology of the disease does not contain the exact causes that cause it.

Causes

According to experts, there are several possible causes for the development of this disease.

These include:

• . If one of the parents has type 1 diabetes, then the chance of developing the disease in a child increases by 4-10%, unlike other people.
• External factors. The prevalence of the disease among Caucasian people in different countries is very different. Moreover, in those people who migrated from places with a low incidence of diabetes to an area with a high incidence, type 1 diabetes is more common than in those who remained in their country of birth.
• Viruses. There is a theory that an autoimmune reaction to pancreatic cells occurs due to viruses. It is assumed that Coxsackie and rubella viruses have a certain effect, but there is no exact evidence for this.
• Medicines and chemicals. Streptozocin, used in the treatment of pancreatic cancer, is particularly toxic to the beta cells of the organ. It may be one of the causes of insulin-dependent diabetes mellitus. Also, pancreatic beta cells are also affected by rat poison, which is used in some countries to this day.

Symptoms

The classic signs of type 1 diabetes are:

• Polyuria(frequent and profuse urination). Hyperglycemia provokes increased excretion and utilization of sugar from the body, which increases the frequency of urination. Young children may have urinary incontinence.
• Polydipsia(strong and constant thirst). Occurs due to excessive loss of moisture.
• Dramatic weight loss. It is a consequence of indigestibility of sugar (loss of energy) and polyuria. Weight loss is especially common in children.

Other manifestations of insulin-dependent diabetes include:

• Rapid fatigue, weakness are the consequences of a violation of electrolyte metabolism and the utilization of sugar in the body.
• Dryness of mucous membranes and skin.
• (constant feeling of hunger) - caused by a lack of cell nutrition (due to unabsorbed glucose).
• Frequent infections.

The first symptoms of insulin-dependent type 1 diabetes mellitus in childhood are diabetic ketoacidosis or ketoacidotic coma.

Most diabetics (over 80%) go to a specialist no later than 3 weeks after the onset of severe symptoms.

Complications

Insulin-dependent diabetes often has consequences. Complications of the disease are short-term and chronic.

Short term complications

They usually respond well to treatment. With insufficient or no treatment, type 1 diabetes mellitus can develop.

Also a common complication in insulin-dependent diabetes is (when blood sugar drops sharply to a dangerous level). If a patient with hypoglycemia is not provided with medical care in time, he may lose consciousness and even fall into a coma.

Chronic complications

The course of such complications is more difficult to control, and their progression can cause premature death of a diabetic.

Careful control of blood sugar reduces the risk of such problems, but does not eliminate them completely.

With a long course of diabetes, they occur even in patients with well-compensated disease.

Complications of insulin-dependent type 1 diabetes are:

• Cardiac and vascular diseases (atherosclerosis, hypertension, ischemia, stroke).
• Lesions of small blood vessels of all tissues and organs (etc.).
• Damage to the nervous system - loss of sensation in the limbs, dizziness, erectile dysfunction in men, the development of ulcers, gangrene.
• Kidney failure, etc.

Disability

It is not so easy for people with diabetes to get a disability. Even the third group of disability can be obtained only with the establishment of moderate disorders in the body. It turns out that type 1 diabetes mellitus and its complications should prevent the patient from living a full life, and this must be proved by doctors.

The first group of disability is given on condition:

Obvious disorders in the body:

• (blindness in both eyes).
• Neuropathy (ataxia and paralysis).
• in a severe stage (diabetic foot, gangrene).
• Heart failure of the 3rd stage on the background of diabetes.
• Frequent hypoglycemic coma.
• Chronic renal failure in the terminal stage.
• Severe mental disorders (diabetic encephalopathy).
• At the same time, the patient should need constant care and assistance.

The second group of disability is awarded to diabetics with:

The third group of disability is awarded for:

• Mild or moderate diabetes mellitus.
• Moderate pathologies of organs and systems.
• Disability of the 3rd group must be regularly confirmed by passing a medical commission.

Pregnancy

• The presence of insulin-dependent diabetes mellitus in the mother indicates the predisposition of her children to the development of this disease in the future.
• Pregnancy with insulin-dependent diabetes requires at least 2 injections of insulin per woman per day. on an empty stomach should be no more than 5.0, and 2 hours after a meal - no more than 6.6 mmol / liter.
• Pregnancy with diabetes in the first trimester is often accompanied by hypoglycemia, in the 2nd and 3rd trimester insulin resistance and hyperglycemia increase, so the patient must carefully monitor blood sugar levels.
• Pregnant women with type 1 diabetes have regular ultrasound examinations to monitor fetal development and prevent polyhydramnios.
• Pregnant diabetics need to visit a doctor every 2 weeks, and after 30 weeks of pregnancy - every week.

In addition to a general examination of a pregnant woman with insulin-dependent diabetes mellitus, ophthalmoscopy, ECG, creatinine and protein are also prescribed and performed, and the level of electrolytes and total cholesterol in the blood is determined.

Ischemic heart disease associated with type 1 diabetes mellitus may be a medical indication for abortion, since maternal mortality with this complication is too high and is about 67%.

Diabetes mellitus is a chronic disease, regardless of its type.

Juvenile diabetes mellitus occurs most often in children under 15 years of age, beginning to develop rapidly in a growing body.

There are 2 types of diabetes - type 1 and type 2. A couple of years ago, this was considered an axiom. Nowadays, doctors have had to revise the outdated classification, because. scientists have discovered another version of this disease.

LADA is latent autoimmune diabetes in adults, which is characterized by signs of type 1 and 2 of the disease.

Autoimmune diabetes mellitus, which occurs in an unexpressed form, is a separate variant of the passage of type 1 diabetes mellitus, which develops in adults.

Diabetes is a disease that people have been suffering from for hundreds of years. It is characterized by an increased level of sugar in the body. Diabetes mellitus is a very serious disease that affects not only the blood, but also almost all organs and systems. The following types of disease are distinguished: the first and second. The first is characterized by the fact that almost 90% of the cells of the pancreas cease to function.

In this case, complete insulin deficiency occurs, that is, the body does not produce insulin at all. This disease mainly occurs before the age of twenty and is called insulin-dependent diabetes mellitus.

The second type is non-insulin-dependent diabetes mellitus. In this case, the body produces insulin in large quantities, however, it does not perform its function. The disease is inherited and affects people after forty years of age, and those who are overweight.

Type 1 diabetes

They are characterized by the fact that they develop very quickly and occur in children and young people. It is also called "juvenile diabetes". For prevention, insulin injections are used, which are done regularly. Usually, the disease occurs due to the body's improper response to the pancreas (the cells that produce insulin are destroyed by the immune system).

Viral infections greatly increase the risk of type 1 diabetes. If a person has been ill with inflammation of the pancreas, then in 80% of cases this disease awaits him. Genetics play an important role, however, transmission in this way is rare.

Very often, type 1 diabetes mellitus (IDD) occurs suddenly during pregnancy. In this case, insulin injections are administered in order to support the body of the pregnant woman and the fetus. This type of diabetes in pregnant women has the ability to disappear after childbirth. Although women who have had this disease are at risk.

This type is more dangerous than the second and is caused by the following symptoms:

• weakness of the body;
• insomnia;
• rapid weight loss;
• elevated levels of acetone;
• migraine;
• aggressiveness;
• muscle pain.

For the treatment of this disease use:

• insulin;
• physical exercise;
• diet
• help of a psychologist;
• self-control.

The issue of assigning disability is decided by considering the entire medical history of the patient.

Type 2 diabetes

This form of the disease is less dangerous than the first, and occurs after 40 years. It is characterized by excessive secretion. It is treated with pills that normalize cells and increase the rate of glucose processing, intestines, liver and muscles.

The disease is manifested by the following symptoms:

• scabies;
• obesity;
• migraine;
• dry mouth;
• pustular rash on the skin.

Insd is much easier than the insulin-dependent type. Complications of this disease are associated with poor functioning of the organs and systems of the body. If treatment is not carried out, then the following complications arise:

• atherosclerosis;
• neuropathy;
• cardiovascular diseases;
• diabetic coma.

Treatment is carried out in two interrelated areas:

• lifestyle changes;
• medical treatment.

The main symptoms of type 1 and type 2 diabetes

Diabetes mellitus of both types has the following symptoms:

• constant desire to drink liquids (thirst);
• bad sleep;
• excessive urination;
• apathy towards the outside world;
• laziness.

In some cases, the patient experiences severe nausea, turning into vomiting, acetone in the blood rises and clouding of mind occurs. If such symptoms appear, a person should immediately receive qualified help. Otherwise, the likelihood of diabetic coma increases.

Secondary manifestations of the disease include:

• physical exhaustion;
• loss of strength in the muscles;
• sudden weight loss;
• sudden deterioration of vision;
• constant drops in blood pressure;
• migraine;
• metallic taste in the mouth.

Causes of diabetes

Type 1 diabetes occurs as a result of the pathology of the immune system, in which pancreatic cells are perceived as foreign objects and destroyed.

Diabetes (insulin-dependent) often develops in childhood and in pregnant women. Reliable reasons why this happens, doctors can not find until now. But the emphasis is on the following factors:

• viral infections;
• autoimmune disorders of the body;
• liver problems;
• genetics;
• excessive abuse of sweets;
• big weight;
• mental disorders.

Diagnosis of diabetes

In diabetes mellitus, it is extremely important to choose the right, high-quality and safe treatment. If the disease is diagnosed at an early stage, then it has a high chance of recovery. Persons with this disease should first of all contact an endocrinologist and register with him. Diagnosis of diabetes mellitus is carried out in the following areas:

• examination by an endocrinologist;
• study by echography;
• cardiogram;
• keeping records of the state of blood pressure (several times a day);
• conducting laboratory tests.

For a blood test you need:

• donate blood on an empty stomach and 2 hours after eating;
• blood for hemoglobin glycosylation;
• blood for glucose tolerance.

A urine test for sugar and acetone is also carried out.

Nutrition in insulin-dependent diabetes mellitus is not limited. If the dose of the drug used is calculated correctly, then the patient can take almost all products.

However, it should be remembered that sugar levels can fluctuate, and therefore it is still worth sticking to a certain diet. The main rule is to constantly monitor your condition and calculate the dose of the medicine.

Today, this is easy to do, since a device such as a glucometer is used. It is also recommended to record all the results in a diary specially designated for this.

This control is necessary not only in the first form of diabetes, but also in the second. And in this case, the patient will always take insulin.

Treatment with insulin

Treatment depends on insulin intake. In order for the disease to make itself felt as little as possible, you need to take into account the amount of sugar that enters the body with food.

A person who has such a diagnosis needs to understand that it will not be possible to completely overcome this disease. It is necessary to use not only medications, but also proper nutrition. The treatment of this disease is a new stage in a person's life, as he will need to constantly monitor sugar in order to prevent complications.

To date, insulin therapy is the most effective method of blocking pathology. But the patient must learn to self-inject himself (they can be replaced with an insulin pump, since the introduction of the hormone through a catheter is more convenient).

The principle of nutrition is to get the right amount of calories and carbohydrates, but with a small amount of fat. In this case, fluctuations in glucose levels will not be too sharp. It is worth remembering that you need to veto all foods that contain a lot of calories and sugar. If all these rules are observed, diabetes mellitus will progress minimally.

Patients with diabetes eat 5-6 times a day the following foods:

• vegetable soups;
• lean meat;
• seafood;

• vegetables (except potatoes);
• low-fat dairy products;
• sweet and sour fruits and honey.

Such folk remedies are very effective:

• ground pear - eat raw;
• juice of one lemon and a chicken egg - on an empty stomach;
• walnut leaf tea;
• ground grain - drink a spoonful of powder with milk.

Complications of type 1 and type 2 diabetes

Diabetes has a very negative effect on the immune system. Therefore, a person becomes easily susceptible to various infections. Passes into an acute and chronic form. The most severe complications are hypoglycemia and ketoacidosis. With these complications, instead of glucose, the breakdown of fats occurs and the acidity in the blood increases.

If the diet is not followed and the amount of insulin administered is controlled, glucose decreases sharply and a glypoglycemic syndrome develops. In the case of insulin-dependent diabetes mellitus, this prognosis does not at all please the patient and his doctor. The body does not receive enough energy and reacts pathologically to this - if you do not give the body sweet, then a coma will come. If insulin-dependent diabetes is not treated, chronic diseases occur:

• stroke;
• heart attack;
• hypertension;
• atherosclerosis;
• ulcers;
• cataract;
• kidney disorders.

Insulin-dependent diabetes mellitus is a serious disease that often leads to death. It is necessary to undergo regular examinations and take blood tests, this will help preserve the health of the body for many years.

Type 1 diabetes mellitus, or insulin-dependent diabetes mellitus (IDDM), is a fairly common serious illness associated with a malfunction of the pancreas. For some reason, this organ stops producing the required amount of the hormone insulin, which negatively affects the human hormonal background and all body systems.

How does this health disorder affect human health and is it possible to cure the insulin-dependent form of the disease?

Why does the disease develop?

If we consider the causes of type 1 diabetes, then they are based on the pathological effect of the protective functions of the body. In this case, the immune system begins to perceive pancreatic cells as foreign elements and seeks to destroy them.

Type 1 diabetes is more common in children, adolescents, and young adults. This ailment also does not bypass women during the bearing of a child, but, after the appearance of the baby, the symptoms disappear. However, in such a situation there is a risk that the disease will manifest itself, but already in the form of type 2 diabetes mellitus - non-insulin dependent.

Among the main reasons leading to the development of IDDM, experts note the following phenomena:

• infections caused by viral pathogens;
• autoimmune diseases;
• liver pathology in severe forms;
• heredity;
• regular consumption of large amounts of sugary foods;
• obesity;
• frequent stressful situations;
• depressive state.

In order not to cause insulin-dependent diabetes, this disease can radically change a person's life, and in addition to the status of "diabetic", he receives a lifelong dependence on insulin.

different stages of the disease

The disease has several stages, and each of them is accompanied by a number of clinical manifestations.

I stage

At the beginning of development, the disease does not manifest itself in any way, but as a result of genetic analyzes, defective genes can be detected.

Doctors are sure that preventive measures are extremely important if there are risks of developing the disease.

II stage

The transition of type 1 diabetes mellitus to the next stage is associated with the activation of catalysts. It is still not known exactly what becomes the impetus for this process, but if stage 1 is only a genetic predisposition, then here we are talking about pathological changes.

III stage

To determine the disease at this stage, the patient is prescribed tests to detect a specific antigen to b-cell antibodies. During diagnostic studies, specialists detect a decrease in the number of these cells, naturally, such a change leads to a decrease in insulin levels and an increase in glucose.

IV stage

It is called tolerant diabetes mellitus, the pronounced symptoms of which are still absent. But patients can still be bothered by common signs: mild malaise, increased inflammation of the conjunctiva and furunculosis, which often recur.

V stage

During this period, there are clear signs that occur with type 1 diabetes.

Symptoms are quite intense and after a few weeks, if the patient does not receive proper treatment, complications may occur in the form of ketoacidosis, a serious metabolic disorder.

If insulin replacement therapy is started in a timely manner, the progression of the disease can slow down significantly.

VI stage

We are talking about a severe course of ISD, in which the results of the analysis are disappointing - the production of insulin by the pancreas is completely stopped.

Symptoms of insulin dependent diabetes

As already noted, type 1 insulin-dependent diabetes mellitus at a certain stage manifests itself in the form of serious symptoms. Especially bright signs of the disease are manifested in children:

• if in adults there is an increase in urination, then in babies it can manifest itself in the form of urinary incontinence;
• energy loss leads to weight loss and a similar symptom is again more often manifested in young patients;
• mucous membranes and skin become dry;
• Diabetics are constantly hungry.

As for life-threatening complications - ketoacidosis or ketoacidotic coma, they are often the first signs of illness in children. This is due to the fact that babies are not able to talk about their own well-being.

According to statistics, more than 80% of people seek advice from a specialist no later than 3 weeks after they show clear signs of the disease.

Diagnostic examination

An endocrinologist knows how to detect insulin-dependent diabetes mellitus. First of all, he collects an anamnesis (history) of the disease, based on the patient's complaints, the symptoms present. Then he establishes a preliminary diagnosis and, in order to confirm it, appoints a series of laboratory tests:

• a blood test that detects sugar levels (taken on an empty stomach and two to three hours after eating);
• a blood test for the amount of glycated hemoglobin;
• urine tests - for sugar and for the presence of acetone.

Having studied the results, the doctor will be sure whether the patient has type 2 diabetes or type 1 and will be able to determine the therapeutic treatment regimen.

How is insulin dependent diabetes treated?

Unfortunately, modern medicine cannot offer a treatment that can completely rid the patient of this disease. In addition, with this type of diabetes, the patient needs a constant supply of insulin from the outside.

The list of insulins is quite wide, they differ in duration of action and only a doctor can prescribe the appropriate drug and its regimen.

Table number 1. Insulins used to treat insulin-dependent diabetes

Duration of insulin action	Name of funds	Nuances of use
Ultra-short action (three to five hours)	Apidra, Humalog, Novorapid.	Very soon they have an effect - from 1 to 20 minutes. The action lasts an average of 4 hours.
short action (6 – 8 hours)	insuman, Actrapid, Humulin regular.	The effect is exerted half an hour after use. The maximum effect is achieved in the period from 2 to 4 hours after the injection.
medium long action (from 16 hours to a day)	insuman basal, Monotard NM, Humulin NPH, Insulatard.	They act an hour after penetration into the body. The maximum effect occurs after 4-12 hours.
Prolonged (long) action (average day)	lantus, glargin, Levemir, Detemir.	Allows you to forget about insulin starvation even in the absence of food. They work evenly throughout the day. It is required to enter once or twice a day.
Combined preparations, which include various insulins (6-18 hours)	InsumanCombi 25, Mixtard 30, Humulin MZ, NovoMix 30.	They take effect in 30-45 minutes. The maximum effect is after 1-3 hours.

In addition to the fact that the diabetic is prescribed drugs for continuous use, he faces another task - control of blood sugar levels.

In modern medicine, there are several options for devices that inject insulin and measure sugar levels.

Diet correction

Although insulin is the mainstay of treatment, the role of proper nutrition should not be underestimated. Since the disease is associated with metabolic processes and its manifestations become more intense when the body does not absorb food well enough, it is very important for the patient to know what he needs to eat, when and in what quantities.

In insulin-dependent diabetes mellitus, a low-carbohydrate diet is indicated, in which it is recommended:

• twice a day intake of protein products;
• saturation of the diet with foods rich in useful minerals and vitamins;
• exclusion from the menu of food that is a source of fast carbohydrates.

Diabetics need to know which foods can aggravate the condition

The exclusion of harmful products will not only eliminate the risks of complications, but also allow the patient to lose weight, which will also have a positive effect on overall well-being. But it is worth remembering that the ingestion of additional carbohydrates into the body can lead to its excess and the patient should calculate its amount himself.

Physical activity in insulin-dependent diabetes

Experts unanimously repeat that type 1 diabetes mellitus (insulin-dependent) does not exclude, but even, on the contrary, requires some mobility and activity from the patient. Indeed, this will have a positive effect on blood sugar levels and help avoid hypoglycemia, however, by itself, physical activity cannot normalize this indicator.

When doing this, you need to take into account the following features:

• physical activity leads to an increase in the rate of insulin absorption from the injection site;
• against their background, glucose consumption increases, but the need for insulin remains the same;
• it is important to take care of a sufficient amount of insulin, otherwise the muscle cells will not be able to absorb glucose.

Patients diagnosed with type 1 diabetes should remember that during intensive training the body depletes stored glycogen in the liver, so there is a risk of developing hypoglycemia. However, if a person is engaged regularly, then preventing pathological changes becomes not such a difficult task.

If the disease is not treated

Type 1 diabetes is a disease that causes serious changes in the body, without timely treatment can lead to serious consequences.

Depending on the degree of development, it can cause a weakening of the immune system and the body will not be able to resist infectious pathogens. In addition to the mentioned ketoacidosis and hypoglycemia, insulin-dependent disease exacerbates the existing symptoms up to the development of a coma and death.

If nutrition and insulin dosage are not balanced, then a critical decrease in blood glucose levels and the manifestation of a hypoglycemic syndrome are possible.

But in addition to transient complications, against the background of diabetes, the development of chronic diseases and conditions is also possible:

• atherosclerosis,
• hypertension,
• stroke,
• myocardial infarction, etc.

Unfortunately, today far from everything is known about type 1 diabetes mellitus, and scientists have not been able to invent a successful variant of its cure. Yes, the question of implantation of the pancreas is being studied, but so far this operation has not justified itself, since the survival rate of the transplanted organ is too low. Therefore, a diabetic will have to inject daily with insulin, take care of health and an active lifestyle.

The insulin-dependent form of diabetes is characterized by the cessation of the production of its own hormone. As a result, to maintain the viability of the body, patients need daily injections of insulin.

Insulin-dependent diabetes mellitus (DM) develops as a result of the activation of an autoimmune process that inhibits beta cells that produce insulin. The reasons for this reaction of the body have not yet been elucidated.

Fundamental factors in the development of DM:

• genetic predisposition;
• diseases of the pancreas;
• metabolic disorders and obesity;
• intoxication of the body;
• viral diseases.

Genetic predisposition, today, is a controversial factor. Indeed, the genes that provoke the development of pathology are inherited, but this does not mean one hundred percent probability of developing the disease. If two parents are diagnosed with insulin-dependent diabetes mellitus, the probability of developing pathology in a child does not exceed 17-20%. If only one parent is sick, this probability is reduced to 4-5%.

There are types 1 and 2 diabetes, and the second type of the disease is also insulin-dependent.

A characteristic difference between the two forms is the cause of the development of pathology. The insulin-dependent form of type 1 develops due to inhibition of insulin-producing cells, as a result, hormone production is reduced by 95%, and the substance produced by the body is not enough to normalize sugar levels.

Type 2 diabetes is an acquired form of the disease that develops against the background of impaired carbohydrate metabolism and obesity. The disease is characterized by cell resistance to insulin and glucose, as a result, glucose is not consumed and accumulates in the body.

Clinical picture

The disease is characterized by a violation of all metabolic processes in the body. In this case, first of all, protein and carbohydrate metabolism, immunity and water metabolism suffer. As a rule, this form of pathology develops at a young age. The following symptoms are typical for SD:

• increased water intake due to ever-increasing thirst;
• fast fatiguability;
• rapid weight loss, which is accompanied by an increase in appetite;
• symptoms of intoxication of the body;
• skin irritations and rashes;
• increased frequency of urination;
• nervous disorders - irritability, insomnia, apathy.

The disease affects all body systems. Often there is a decrease in visual acuity. Patients complain of convulsions and numbness of the lower extremities. Diabetes is characterized by a deterioration in immunity and an increase in the frequency of infectious diseases.

A characteristic symptom is the smell of acetone in the exhaled air, which characterizes the development of ketoacidosis.

The insulin-dependent type of the disease is fraught with serious complications. If the necessary measures are not taken immediately upon detection of the first symptoms, the risk of diabetic coma is high.

Insulin dependent type 2 diabetes

Type 2 diabetes is more common than type 1 diabetes. Usually, the acquired form of the disease does not require insulin injections, and compensation is achieved by reducing the patient's weight, diet and exercise.

However, in some cases, type 2 diabetes (acquired with age), but insulin-dependent, occurs. Features of pathology are the immunity of cells to the hormone. As a result, insulin does not lower glucose levels, so hormone secretion increases. Due to the increase in insulin secretion, the pancreas malfunctions and, over time, its cells are depleted and destroyed.

In this case, the therapy of the disease completely repeats the therapy of type 1 diabetes.

Diagnosis of the disease

The disease has characteristic symptoms, but this is not enough to determine the severity and type of diabetes. Diagnosis is carried out using the following tests:

• determination of the amount of glucose in the blood;
• analysis for glycated hemoglobin;
• urinalysis for the determination of ketone bodies;
• determination of insulin levels.

These studies help to get a complete picture of the patient's health, determine the form of the disease and further treatment methods.

Treatment of the insulin-dependent form of the disease

DM is a chronic disease that cannot be cured. All treatment is aimed at compensating for the disease. One can talk about compensated diabetes only when the glucose level is normalized, and sharp jumps and deviations from the norm are not observed for a long time.

The danger of the disease lies in the development of complications of varying severity, some of them significantly reduce life expectancy and lead to death. Compensation of the disease can significantly reduce the risk of complications, so it is a priority for each patient.

Treatment includes:

• daily injections;
• diet therapy;
• physical activity;
• sugar control.

The scheme of hormone administration is selected by the attending physician. At the beginning of the development of the disease, the patient adheres to the insulin therapy regimen recommended by the doctor, however, as the disease progresses, the control over the number of injections and dosage is carried out by the patient independently.

The diet is selected taking into account the amount of carbohydrates in different products. In diabetes, a low-carbohydrate, properly balanced diet is indicated. You should follow the rules of a healthy diet, take into account the glycemic index of products. Patients eat small meals, but often, at least five times a day.

To adjust the menu and determine the effectiveness of insulin therapy, it is necessary to measure blood sugar levels several times a day.

The patient should without fail purchase an accurate portable glucometer.

Insulin-dependent type 2 diabetes is characterized by metabolic disorders, which affects the patient's lifestyle. Often these patients are obese. In this case, therapy necessarily includes exercise and a reduction in the calorie content of the menu.

During physical exercise, the susceptibility of muscle fibers to glucose increases, which always goes into consumption with a strong load. The more developed the muscles, the more they require glucose, which means that its level in the blood is reduced and it is better absorbed. Therefore, exercise is necessary to compensate for the disease.

Daily Injections

Insulin-dependent diabetes mellitus (diabetes mellitus) type 1 requires daily administration of the hormone. As a rule, the insulin therapy regimen is selected individually for each patient and adjusted if necessary.

The purpose of the administered hormone is to effectively lower the sugar level over a certain period of time. There are several types of drugs, depending on the duration of action.

The patient needs to learn to listen to his own body. Features of therapy with an administered drug are that the glucose level can sometimes drop to a critical value, which is fraught with the development of coma. Therefore, the patient must distinguish between the signals of his own body in order to respond in time to a critical level of sugar in the blood and take the necessary measures.

As a rule, injections of a short-acting drug are given before meals. Such drugs help to cope with the amount of glucose that increases immediately after eating. Also, twice a day, injections of a hormone of prolonged action are made, which effectively controls sugar levels throughout the day.

How to learn to live with a diagnosis?

Type 2 diabetes, like the insulin-dependent type of the disease, leaves a certain imprint on lifestyle, but you can learn to live with this diagnosis.

The patient should always listen to his own body and learn to distinguish the slightest hint of an increase or decrease in blood glucose levels. Patients eat according to the schedule. This is necessary in order to make an injection on time and control glucose levels. Foods high in simple carbohydrates are taboo.

Diet therapy and timely injections will avoid the development of complications. Physical activity becomes an important part of life, especially in type 2 pathology. It is impossible to allow excess weight gain, so diet and sports are constant companions of patients.

It should be remembered that a sudden sharp change in the concentration of sugar in the blood can cause negative consequences - confusion, fainting. The impetus for a decrease or increase in sugar is not only nutrition, but also occasional colds, stress, and the day of the menstrual cycle. This somewhat limits the patient's performance, so patients with diabetes should not choose professions that require the utmost concentration of attention. For extreme patients, night shifts and shift work are undesirable, as this leads to metabolic disorders and can cause complications.

However, if you carefully monitor your own health and adhere to the treatment regimen, the diagnosis will not become an obstacle to a fulfilling life.

Content

This is a severe endocrine disease caused by insulin deficiency or cell resistance to this hormone. Diabetes mellitus is a systemic pathology that affects blood vessels, many organs, inhibits metabolic processes in tissues and often leads to disability. However, with adequate treatment, the patient's quality of life can be high.

Signs of diabetes

There are several options for classifying the disease. Endocrinologists in everyday medical practice distinguish the following main types of diabetes mellitus: insulin-dependent (I) and insulin-independent (II). In the first case, the disease occurs because the pancreas produces too little insulin. In the second - because the cells are not able to use it and also experience a deficiency of glucose.

Both types of diabetes have many similar symptoms. They differ mainly in the degree of expression. Symptoms of type I disease are more intense, brighter and appear suddenly, rapidly. People suffering from type II disease often do not realize for a long time that they are sick. General malaise can easily hide the true diagnosis. However, diabetes mellitus is known for its triad of classic symptoms. This is:

• unquenchable thirst;
• increased formation of urine;
• persistent feeling of hunger.

The disease may present with additional symptoms. These ailments are numerous, in adults often occur:

• perspiration in a parched throat;
• "iron" taste in the mouth;
• dryness and peeling of the skin, fungal infections;
• long non-healing wounds;
• debilitating itching in the groin;
• headaches;
• pressure drops;
• insomnia;
• weakening of vision;
• susceptibility to colds;
• weight loss
• muscle weakness;
• prostration.

Causes

Why does the pancreas stop producing a vital hormone? Insulin-dependent diabetes mellitus is a consequence of the pathological action of the immune system. She perceives the cells of the gland as foreign and destroys them. Insulin-dependent diabetes develops rapidly in childhood, adolescents, and young people. The disease occurs in some pregnant women, but disappears after childbirth. However, these women may subsequently develop type II disease.

What are the reasons for this? So far there are only hypotheses. Scientists believe that serious reasons due to which an insulin-dependent type of disease occurs can be:

• viral infections;
• autoimmune diseases;
• severe liver pathology;
• hereditary predisposition;
• sweet tooth;
• overweight;
• prolonged stress, depression.

Diagnosis of type I diabetes

To determine the insulin-dependent variant of the disease is a simple task for an endocrinologist. Complaints of the patient, the characteristics of the skin give grounds to make a preliminary diagnosis, which is subsequently, as a rule, confirmed by laboratory tests. Diagnosis of the disease is carried out with the help of blood and urine tests and tests.

Donate blood:

- on sugar (on an empty stomach and 2 hours after eating);

- glycosylated hemoglobin;

- glucose tolerance (insulin-dependent diabetes must be differentiated from pre-diabetes);

Urine is analyzed:

- for sugar;

- acetone.

Complications

The disease significantly undermines the immune system. The patient becomes very vulnerable to infections. The consequences of the disease can be acute, but transient, and chronic. The most acute complications are ketoacidosis, hypoglycemia. Cells in search of an energy source instead of glucose break down fats. The increasing acidity of the blood in conditions of lack of fluids causes a critical condition of a diabetic - up to a ketoacidotic coma with a fatal outcome. The patient is tormented by dizziness, thirst, vomiting, and smells of acetone from the mouth.

If the amount of food taken and the amount of insulin in the body are not balanced, the blood glucose drops sharply (below 3.3 mmol / l). In this case, the development of a dangerous hypoglycemic syndrome is inevitable. The body is deficient in energy and reacts to it very sharply. The patient is tormented by an attack of severe hunger, he is thrown into sweat, the body trembles. If you do not urgently eat sweets, a coma will come.

Transient complications can be prevented. Chronic effects are difficult to treat. However, if left untreated, an insulin-dependent type of pathology can drastically shorten a person's life. The most common chronic complications:

• atherosclerosis;
• hypertension;
• stroke;
• myocardial infarction;
• trophic ulcers, diabetic foot, gangrene of extremities;
• cataract, retinal damage;
• kidney degeneration.

How to treat diabetes

A person who has been diagnosed with such a diagnosis must realize that it is impossible to completely cure the insulin-dependent variant of the disease. Medications alone will not help either - you need proper nutrition. Treatment should become a new way of life for a person. The most important condition is to maintain the sugar level within optimal limits (not higher than 6.5 mmol / l), otherwise serious complications cannot be avoided.

You should check your condition with a glucometer several times a day. Controlling sugar levels helps to quickly adjust the dosage of medications and the diet. At the initial stage of insulin-dependent diabetes mellitus, treatment often begins with hypoglycemic tablets. However, over time, you often have to switch to hormone injections or combine both.

insulin therapy

Tactics for the treatment of type II diabetes is chosen exclusively individually. Insulin therapy today is an effective method of blocking the pathological process thanks to effective medications. These are hypoglycemic tablets Glyformin, Glucobay, Dibicor and Eslidin. Insulin for injections - Actrapid, Rinsulin, Insuman, etc. - is available in forms of fast and prolonged action. The patient must learn to give himself injections on his own. Injections can be replaced by an insulin pump. Dosed administration of the hormone through a subcutaneous catheter is much more convenient.

Approved Products

The principle of the diet is to get the optimal amount of calories from carbohydrates while eating little fat. Then glucose fluctuations in insulin-dependent diabetes mellitus will not be sharp. An absolute ban on all high-calorie and sweet foods. If you follow this rule of nutrition, the disease progresses minimally.

You need to eat little by little, but often, in 5-6 doses. The following foods are safe and healthy:

• vegetable soup, soups, beetroot, borscht, okroshka;
• porridge (limited);
• lean meat, poultry;
• Fish and seafood;
• vegetables (potatoes - a little);
• low-fat dairy and sour-milk products;
• inedible flour products;
• sweet and sour fruits;
• drinks - with sweeteners;

Folk remedies

Traditional medicine recipes and improvised home remedies can be useful:

1. Jerusalem artichoke is effective in insulin-dependent diabetes mellitus. Tubers are best eaten raw.
2. Chicken egg, beaten with the juice of 1 lemon (on an empty stomach).
3. Infusion of walnut leaves (brewed like regular tea).
4. Millet ground in a coffee grinder. A tablespoon of the powder is washed down with milk on an empty stomach (a recipe that is especially popular among patients with an insulin-dependent variant of sugar disease).

Physical exercise

Insulin-dependent diabetes mellitus recedes before people leading a dynamic lifestyle. Thanks to muscle activity, glucose is better utilized by cells. Recreational jogging, swimming, skiing or walking, gardening, gardening can increase the susceptibility of cells to insulin, and injection dosages will decrease. However, since the "loop" of active actions lasts for many hours, you can not overdo it so that there are no attacks of hypoglycemia. You should consult your doctor about the types of permissible loads.

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