Welcome to a great article to answer the question of what is diabetes. Diabetes mellitus is a disease of the endocrine system in which the correct metabolism is disturbed due to the complete absence of insulin secretion (insulin-dependent diabetes type I), or a decrease in the sensitivity of cells to insulin and a decrease in its production (insulin-independent diabetes type II). Insulin is produced by the pancreas, located directly behind the stomach, between the spleen and duodenum. Its weight is 70-100 grams.
The beta cells that produce insulin are located in small groups all over the gland. These groups are called “islands of Langerhans.” The gland of a healthy adult consists of approximately 1 million islets, which weigh a total of 1-2 g. Along with beta cells, alpha cells are located on the “islands of Langerhans”. They are responsible for the production of the hormone glucagon, the action of which is the opposite of insulin. Pancreatic cells produce pancreatic juice that enters the duodenum and is involved in the digestion of fats, proteins and carbohydrates.
Types Of Diabetes
1. Insulin-Dependent Diabetes Mellitus (Type I Diabetes)
Developed in people with inability to produce insulin with specific beta cells of the pancreas. This type of diabetes most often occurs at an early age – in children, adolescents and young people. The cause of type I diabetes is not fully elucidated, but there is a strict connection with impaired function of the immune system, manifested by the presence of antibodies in the blood (the so-called “autoantibodies” directed against the patient’s own cells and tissues of the patient’s body) destroying the pancreatic beta cells.
The appearance of autoantibodies is associated with viral diseases. The role of hereditary factors cannot be excluded. Insulin is the most important hormone necessary for the absorption of blood sugar (glucose) by all cells of the body. Glucose is the main energy fuel of cells. Without glucose, the life of cells and tissues is greatly disturbed. In order for glucose to penetrate from the blood into the cells of the body and nourish them, insulin is needed. If insulin is not produced enough, then glucose accumulates in high concentrations in the blood (hyperglycemia), and does not enter the cells. Patients with type I diabetes require constant insulin injections.
Features of Type I Diabetes
Due to an increase in blood sugar (glucose) and an increase in the renal threshold (blood sugar above 10 mmol / l), glucose appears in the urine (glucosuria), there is excessive urination (polyuria) and an unquenchable thirst (polydipsia), leading to dehydration. The patient feels dry mouth (especially at night during sleep), can quickly lose weight (unlike patients with type II diabetes), often despite the constant feeling of hunger. May appear blurred vision (“white veil” before the eyes). There is also a slow cure of infectious diseases and wound healing, a decrease in body temperature below the average mark, the appearance of ketone bodies in the urine. It is important to remember that since autoantibodies appear in the blood of type I patients with diabetes, the risk of damage to other endocrine organs also increases. That is why the endocrinologist pays special attention to the function of the thyroid gland and adrenal glands, which can also be damaged in patients with type I diabetes.
2. Insulin-Independent Diabetes Mellitus (Type II Diabetes)
The most common type of diabetes, often inherited (familial form of diabetes). The first signs of it appear in people of mature age (after 40 years), almost always with increased body mass. This type of diabetes manifests itself in excessive, normal or slightly reduced insulin production by the pancreas and is not associated with a lack of insulin, as in Type I diabetes, but with the fact that the body’s cells are immune to insulin.
Insulin, which is present in sufficient concentration in the blood, is not able to manifest its main action and carry out the penetration of glucose from the blood into the tissues. There is a so-called “insulin-insensitivity” of cells to insulin. In this form of diabetes, glucose also cannot enter the cells and accumulates in excess in the blood, causing a symptom of hyperglycemia.
With type II diabetes, there is no need for constant insulin injections. Basically, enough diet, proper physical exertion and hypoglycemic drugs.
Features of type II diabetes
In patients with diabetes mellitus of the second type, hyperglycemia, obesity, hypertension (increase in blood pressure) are observed. These patients develop cardiovascular diseases (ischemic heart disease, myocardial infarction), diabetic retinopathy (decreased vision), neuropathy (decreased sensitivity, dryness and peeling of the skin, pain and cramps in the extremities), nephropathy (urinary protein, disturbance kidney function).
3. Pregnancy Diabetes
This type of diabetes does not belong to either type I or type II, although closer to insulin-independent diabetes. Unrecognized in term diabetes of pregnancy, is fraught with complications, both in the mother and the fetus. That is why it is extremely important to early detection of this type of diabetes (measuring the concentration of glucose in the blood, glucose and ketone bodies in the urine at 24-28 weeks of pregnancy), as well as proper monitoring and management of such pregnant women.
It develops in about 4% of women in the 24-28 weeks of pregnancy and usually spontaneously passes after delivery. However, it is very important to control and correct the elevated blood glucose level in a timely manner to avoid complications in the mother and fetus. It is important to know that approximately 40% of women with diabetes of pregnancy after delivery continue to suffer from type II diabetes and need monitoring and hypoglycemic therapy.
The categories of high risk of developing diabetes pregnancy include pregnant women:
1-Over 25 years old with overweight;
2- 25 years and older;
3- Women whose first-generation relatives suffered from diabetes.
Features Of Pregnancy Diabetes
Pregnancy diabetes is the most common complication of pregnancy. The signs are close to those of type II diabetes.
On the mother’s side, this is manifested by an increase in blood pressure, kidney damage and pre-eclampsia leading to premature labor. It also increases the risk that the diabetes of pregnancy passes into the mother’s persistent life-long type II diabetes after delivery.
On the part of the fetus, there may be an increase in its intrauterine weight, incorrect positions of the fetus, increasing the risk of injury and death of the fetus during natural delivery. The need for cesarean delivery is increasing. Children are born with low blood glucose and blood calcium, as well as with increased red blood cell count (erythremia) and increased blood bilirubin. Newborns also suffer from respiratory problems due to.
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What is Common Between Different Types Of Diabetes?
High blood sugar syndrome (hyperglycemia), when glucose accumulates in the blood in an excess amount, but is not able to penetrate into the cells to maintain their normal functioning. In this case, the cell still struggles for its survival and begins to extract energy from other sources available to it, for example, fatty acids (subcutaneous fatty tissue). In the process of “burning” of fatty acids in the cell accumulate side toxic compounds for the body, the so-called ketone bodies.
Chronic complications. Over time, a prolonged and persistent increase in blood sugar (glucose) concentration leads to serious and irreversible chronic complications, such as kidney damage (diabetic nephropathy), retinal eyes (diabetic microangiopathy and retinopathy progressing to blindness), peripheral nervous system (diabetic neuropathy) , and also large blood vessels (diabetic macroangiopathy) and heart.