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Diabetes

Diabetes,What are the early signs of diabetes?,Symptoms,Treatment & Causes

What is it

Diabetes is a chronic disease that arises because the pancreas does not synthesize the amount of insulin that the human body needs , makes it of inferior quality or is not able to use it effectively.

The insulin is a hormone produced by the pancreas. Its main function is the maintenance of adequate blood glucose values . It allows glucose to enter the body and be transported into cells, where it is transformed into energy for muscles and tissues to function. In addition, it helps cells store glucose until its use is necessary.

In people with diabetes there is an excess of blood glucose (hyperglycemia) because it is not distributed properly. Experts warn that if patients do not follow the proper treatment the tissues can end up damaged and very serious complications can occur in the body.

Incidence

The study [email protected] published in 2012 placed the prevalence of diabetes in Spain at around 13.8 percent of the population.

“The results of the study also confirm the association between diabetes, obesity and hypertension and the importance of physical activity as a prevention method,” explains Rebeca Reyes, of the Endocrinology Unit of the Rafael Méndez General University Hospital in CuidatePlus. (Murcia) and coordinator of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN). “In addition, the study indicates that 6 percent of people with type 2 diabetes do not know that they suffer from this disease.”

On the other hand, Reyes points out that the prevalence is greater as the patient’s age increases . In fact, it is estimated that it can affect up to 25-30 percent of the elderly population. “It also increases as the prevalence of obesity increases,” he says.

Causes

The time of onset of the disease, as well as the causes and symptoms that patients present, depend on the type of diabetes:

Diabetes type 1

The most frequent ages in which it appears are childhood, adolescence and the first years of adult life . It usually presents itself abruptly and often regardless of whether there is a family history.

The causes of type 1 diabetes are mainly the progressive destruction of the cells of the pancreas, which produce insulin. This has to be artificially administered from the beginning of the disease. Its particular symptoms are the increase in the need to drink and increase in the amount of urine, the feeling of fatigue and weight loss despite the increased desire to eat.

Type 2 diabetes

It usually arises at older ages and is about ten times more frequent than the previous one. Typically, type 2 diabetes is also diagnosed or has been suffered by other people in the family.

It originates due to a lack of insulin production , together with the insufficient use of said substance by the cells. Depending on which defect of the two predominates, the patient will have to be treated with antidiabetic pills or with insulin (or with a combination of both). In these cases the patient usually does not present any type of discomfort, nor specific symptom, reason why it can happen unnoticed for the affected person during long time.

Gestational diabetes

It is considered an occasional diabetes that can be controlled just like the other types of diabetes. During pregnancy, insulin increases to increase energy reserves. Sometimes, this increase does not occur and can cause diabetes during pregnancy. It also has no symptoms and detection is almost always done after the routine analysis to which all pregnant women are submitted after 24 weeks of gestation. What does increase the risk of developing diabetes after a few years?

symptoms

The main symptoms of diabetes include:

  • Frequency of urination (phenomenon of wet bed in children).
  • Sensation of unusual hunger.
  • Excessive thirst.
  • Weakness and fatigue.
  • Weightloss.
  • Irritability and changes in mood.
  • Feeling sick in the stomach and vomiting.
  • Cloudy view
  • Cuts and scratches that do not heal, or heal slowly.
  • Itching or numbness in the hands or feet.
  • Recurrent infections in the skin, gum or bladder ( cystitis ).
  • High levels of glucose in the blood and urine.

Prevention

For type 1 diabetes there is no effective method of prevention at the moment. Instead, it is proven that of type 2 , which is the one that appears most frequently, being related to obesity can try to avoid largely adopting a healthy lifestyle .

“Different studies have shown that physical activity and weight loss prevent the development of diabetes in people predisposed to it, even in those who already have some degree of impaired glucose tolerance (or prediabetes),” says Rebeca Reyes, coordinator of the Diabetes Mellitus Working Group of the SEEN. “In addition, the recently published Predimed study shows that the Mediterranean diet prevents cardiovascular disease so it should be the diet of choice.”

Tips to prevent hypoglycemia in diabetics

  • Adjust the doses of the medicines to the real needs.
  • Maintain a regular meal schedule as much as possible.
  • Take moderate amounts of carbohydrates before exercising.
  • Always carry sugar.

As soon as the first signs of hypoglycemia appear, take sugar (2 or 3 lumps), crackers (3 to 5 units) or drink a glass (150 ml) of a drink containing fast-absorbing carbohydrates (fruit juices). , tail, etc.).

The symptoms usually happen in 5 or 10 minutes. If the hypoglycaemia is severe or the person could lose consciousness, it is necessary to inject an ampoule of glucagon subcutaneously (same as insulin) or intramuscularly (in the buttock). Glucagon mobilizes the body’s glucose reserves and takes effect in about 10 minutes. If there is no recovery, the affected person should receive immediate medical assistance.

Types

Diabetes Mellitus type 1 mediated by autoimmune processes:

  • It is caused by the autoimmune destruction of the cells of the pancreas.
  • It represents the majority of cases of type 1 diabetes mellitus.
  • It is normal to appear in children or young adults, but it can also occur at other ages.
  • It usually starts abruptly.
  • The risk factors are not well defined, but it is known that genetic, autoimmune and environmental factors are involved in their appearance.
  • Usually the weight is normal or below normal, although the presence of obesity is not incompatible with the diagnosis.
  • Patients are prone to suffer other alterations of the immune system.

A minority of patients with type 1 diabetes develop idiopathic type 1 diabetes mellitus , of which the cause that triggers this subtype that mainly affects people of African and Asian origin is unknown.

In the idiopathic, the hereditary factor is very important and there are no alterations of the immune system. In addition, the need for insulin may appear or disappear.

According to the International Diabetes Federation , the number of people with type 1 diabetes increases every year . Although the causes of this increase are not clear, they estimate that it may be due to changes in environmental risk factors, to circumstances during development in the womb , to feeding during the first stages of life or to viral infections.

In addition, the Federation insists that these patients can have a normal life if they continue the treatment by combining the daily administration of insulin with close monitoring, regular exercise and a healthy diet.

Diabetes mellitus type 2:

  • Although it can appear at any age, it is usual to begin in adulthood, after 40 years although today there is an increase in young people and children.
  • It is characterized by insulin resistance and is usually associated with a relative deficit in the production of this hormone by the pancreas.
  • The obesity is present in 80 percent of patients.
  • The risk of developing this form of diabetes increases with age, weight and lack of physical activity. It is more frequent in women with a history of gestational diabetes and in individuals with hypertension or disorders in the metabolism of fats.
  • It represents 90-95 percent of the total cases of diabetes mellitus.
  • Patients do not need insulin, although they may require insulin to control their glucose level.
  • It is frequently associated with a strong genetic predisposition, although this factor is complex and not clearly defined.

Unlike patients with type 1 diabetes, people with type 2 diabetes do not usually need daily doses of insulin to survive. However, in some cases you may need insulin linked to an oral medication, a healthy diet and increased physical activity.

As in type 1 diabetes, cases of type 2 diabetes are increasing worldwide. The causes are related to changes in lifestyle as a result of economic development. Other causes could be the aging of the population, the increase in urbanization, changes in diet and the decrease in activity.

Gestational diabetes:

  • It begins or is diagnosed for the first time during pregnancy.
  • It appears in between 2 and 5 percent of the gestation processes.
  • Usually, the patient recovers the normal state after delivery.
  • Women with gestational diabetes have a higher risk of developing type 2 diabetes in the short, medium or long term.
  • The risk factors for gestational diabetes are obesity and family history.

Other types of diabetes:

There are other types of diabetes caused by a malfunction of the cells of the pancreas or insulin that they produce, due to metabolism problems, and so on. Many times these dysfunctions are caused by genetic defects, drugs, infections or other diseases.

Diagnosis

The diagnosis of diabetes occurs when the patient has abnormally elevated levels of glucose in the blood . This analysis is usually monitored and measured during a routine annual examination or a clinical examination that is done before joining a new job or practicing a sport.

Tests may also be done to determine the possible cause of symptoms such as increased thirst, urination, hunger, or if there are characteristic risk factors, such as family history of diabetes, obesity, frequent infections or any other complication associated with diabetes. .

As stated by Rebeca Reyes, coordinator of the Diabetes Mellitus Working Group of the SEEN, the diagnosis of diabetes is made through a blood test . “The current diagnostic criteria, according to the American Diabetes Society in its recommendations for 2015, are the following:

  • Glycosylated hemoglobin greater than or equal to 6.5 percent.
  • Fasting basal glycemia greater than or equal to 126 mg / dl or glycemia at 2 hours of an oral glucose tolerance test with 75 grams of glucose greater than or equal to 200 mg / dl.

All of them must be repeated twice, except when there are unequivocal signs of diabetes, in which case a blood glucose level of> = 200 mg / dl is sufficient, “he specifies.

Tests

To measure the concentration of glucose in the blood a blood sample is obtained from the patient, who must be fasting at least 8 hours before the test.

It is normal that there is some degree of elevation of blood glucose values ​​after eating, but even then, the values ​​should not be very high. In people older than 65 years it is better to perform the test fasting since the elderly have a greater increase in blood glucose levels after eating.

There is another kind of blood test, called an oral glucose tolerance test, which is done in certain cases, such as when a pregnant woman is suspected of having gestational diabetes.

In this test, a fasting blood sample is obtained to measure the glucose value and the patient is given a special solution for drinking, which contains a standard amount of glucose. During the next two or three hours several blood samples are obtained.

Treatments

The treatment of diabetes mellitus is based on three pillars : diet , physical exercise and medication . It aims to keep blood glucose levels within normal limits to minimize the risk of complications associated with the disease. In many patients with type 2 diabetes, medication would not be necessary if the excess weight was controlled and a regular exercise program was carried out. However, replacement therapy with insulin or the taking of hypoglycaemic drugs by mouth is often necessary.

  • Oral hypoglycaemic drugs:  They are prescribed to people with type 2 diabetes who fail to lower blood glucose through diet and physical activity, but are not effective in people with type 1 diabetes.
  • Treatment with insulin: In patients with type 1 diabetes, exogenous insulin administration is necessary since the pancreas is unable to produce this hormone. It is also required in type 2 diabetes if diet, exercise and oral medication fail to control blood glucose levels. Insulin is administered through injections in the existing fat under the skin of the arm, because if taken orally it would be destroyed in the digestive system before entering the bloodstream. Insulin needs vary depending on the foods that are ingested and the physical activity that is performed. People who follow a stable diet and regular physical activity vary their insulin doses little. However, any change in the usual diet or the performance of a sport requires changes in insulin patterns.
    • Traditional syringes:  They are for single use, graduated in international units (from 0 to 40).
    • Insulin injection pens:  These are pen-shaped devices that have a cartridge inside that contains insulin. The cartridge is changed when the insulin is finished, but the pen is still used.
    • Pre-filled syringes:  These are devices similar to pens, but previously loaded with insulin. Once the insulin is finished, the whole syringe is discarded. The blood glucose level depends on the area of ​​the body in which the insulin is injected. It is advisable to enter the abdomen, arms or thighs. Penetrates more quickly if injected into the abdomen. It is recommended to always inject in the same area, although displacing about two centimeters the injection point from one time to another. Avoid injections in the folds of the skin, the midline of the abdomen and the area of ​​the groin and navel.

Other data

Complications

“There is a direct relationship between compliance and adequate glycemic control, which in turn is related to the risk of developing chronic complications associated with diabetes. Therefore, inadequate compliance increases the risk of developing complications, “says Rebeca Reyes, coordinator of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN).

The International Diabetes Federation highlights that the main complications are cardiovascular, renal, ocular, nervous diseases, as well as the occurrence of diabetic foot . In addition, diabetes can be a threat to oral health and increase the likelihood that sleep apnea will be triggered .

At what time should the patient go to the specialist?

According to Reyes, when patients have symptoms such as constant need to urinate, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue and irritability , frequent infections and / or blurred vision, it is necessary to go to the doctor’s office so they can perform a blood glucose test.

Forecast

As specified by the coordinator of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition, diabetes research currently follows several lines. “The first of these is the research into artificial pancreas systems and stem cells for the replacement of insulin-producing cells,” says Reyes. “This therapy would be applicable to patients with type 1 diabetes.”

The second is aimed at the development of increasingly better insulins , of longer duration and with a lower risk of hypoglycaemia. “Finally, the treatments currently available for the therapy of type 2 diabetes have fewer side effects and also help reduce weight, which is a problem that often coexists with type 2 diabetes,” Reyes concludes.

The post Diabetes appeared first on HealthBodha.com.



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