Diabetes mellitus 1 degree. Type 1 diabetes mellitus: signs, diet and prevention of type 1 diabetes. Treatments for diabetes mellitus

Type 1 diabetes mellitus is an insulin-dependent type of disease that has quite specific causes. It most often affects young people under thirty-five years of age. The main source of this disease is genetic predisposition, but experts in the field of endocrinology also identify other predisposing factors.

The pathology has specific symptoms and is expressed in constant thirst and frequent urge to urinate, loss of body weight, which is observed with increased appetite, as well as unexplained itching of the skin.

To establish the correct diagnosis and differentiation diabetes mellitus of the first type, the second will require a wide range of laboratory tests. Physical examination also plays an important role.

Treatment involves the use of only conservative methods, which are based on insulin replacement therapy.

Etiology

The underlying causes of type 1 diabetes are genetic predisposition. It is noteworthy that the likelihood of a child developing the disease will differ slightly depending on which family member suffers from a similar disease. For example:

• with a sick mother, the chances are no more than 2%;
• if the disease is diagnosed in the father, then the possibility varies from 3 to 6%;
• the course of a pathology such as type 1 diabetes mellitus in sibling or sister increases the probability by six percent or more.

Among other predisposing factors that significantly increase the chances of developing the disease, endocrinologists identify:

• one of your close relatives has type 2 diabetes mellitus;
• the acute course of any disease of viral or infectious origin in a person predisposed to the disease - such disorders include or, or, as well as the pathological influence of and;
• destruction of beta cells of an organ such as the pancreas, which is responsible for the secretion of insulin and lowering sugar levels. It is for this reason that it becomes clear why type 1 diabetes is called insulin-dependent;
• sudden or prolonged influence of stressful situations - this is due to the fact that they are provocateurs for the remission of chronic diseases or the actions of pathogens;
• the presence in humans of autoimmune processes that perceive beta cells as foreign, causing the body to independently destroy them;
• indiscriminate use of certain medications, as well as long-term treatment of any cancer process in men or women with chemotherapy;
• influence of chemical substances - cases have been recorded when it was caused by penetration into human body rat poison;
• the occurrence of an inflammatory process in the islets of the pancreas, which are called insulitis;
• the process of rejection of the processes of this organ, which causes the release of cytotoxic antibodies;
• the presence of excess body weight in a person.

It is worth noting that in some cases the reasons for the development of this disease remain unknown.

The answer to the question whether diabetes mellitus is completely curable is dictated by the etiological factor.

Classification

In endocrinology, there are two forms of the disease:

• 1a– type 1 diabetes mellitus occurs in children and is viral in nature;
• 1b– is considered the most common type of disease, since antibodies to insulin cells are released, which causes a decrease or complete cessation of insulin secretion by the pancreas. This type develops in adolescents and people under thirty-five years of age.

In total, such diabetes is diagnosed in approximately 2% of cases.

For reasons of development, the following types of pathology are distinguished:

• autoimmune– the occurrence is explained by the occurrence of one or another autoimmune process;
• inflammatory– expressed against the background of inflammatory damage to pancreatic cells;
• idiopathic– in such cases, the causes of the disease remain unknown.

During its formation, the disease goes through three stages:

• prediabetes– there are no deviations in the patient’s well-being or in laboratory tests;
• hidden form– characterized by the fact that symptoms will be completely absent, but minor deviations will be noted in laboratory samples of urine and blood;
• explicit form, in which the symptoms are expressed as clearly as possible.

In addition, there are the following degrees of type 1 diabetes:

• light– clinical signs do not appear, but there is a slight increase in glucose in the blood and its complete absence in the urine;
• moderate– is such if glucose is present both in the blood and in urine. There is also a slight expression of the main symptoms - weakness, thirst and frequent urination;
• heavy– the symptoms are pronounced, which is fraught with the development of other complications in men and women.

Symptoms

Despite its chronic course, the disease, under the influence of unfavorable factors, is characterized by rapid development and transition from one stage of severity to another.

The most characteristic signs of type 1 diabetes mellitus are:

• constant thirst - this leads to the fact that a person can drink up to ten liters of liquid per day;
• dryness in the mouth - expressed even against the background of heavy drinking;
• copious and frequent urge to urinate;
• increased appetite;
• dry skin and mucous membranes;
• causeless skin itching and purulent lesions of the skin;
• sleep disorders;
• weakness and decreased performance;
• cramps of the lower extremities;
• loss of body weight;
• visual impairment;
• nausea and vomiting, which only bring relief for a while;
• constant feeling of hunger;
• irritability;
• bedwetting - this symptom is most typical for children.

In addition, during the course of such an illness, women and men often develop dangerous conditions that require immediate qualified assistance. Otherwise, complications arise that lead to the death of the child or adult. These conditions include, which is characterized by a significant increase in glucose levels.

Also, with prolonged progression of the disease, the following occurs:

• reduction in the number of hairs, up to their complete absence, on foot
• the appearance of xanthomas;
• formation in men and women;
• decreased immune system resistance;
• damage to the skeletal system, making a person more susceptible to fractures.

It is also worth considering that pregnancy with type 1 diabetes mellitus significantly aggravates the course of the pathology.

Diagnostics

The disease can be diagnosed only through laboratory studies of blood and urine, as well as through specific samples and tests. However, their implementation is preceded by personal work of the gastroenterologist with the patient, which is aimed at:

• collecting a life history and studying the medical history of both the patient and his immediate relatives - in this case it is possible to accurately determine the cause or factor that influenced the development of the disease;
• conducting a thorough physical examination, which must include a study of the condition of the person’s skin and mucous membranes;
• a detailed interview with the patient is necessary to establish the first time of onset and severity of symptoms, which will allow the doctor to determine the stage of the pathology.

Laboratory diagnosis of type 1 diabetes involves:

• general clinical blood test - to identify the progression of inflammation in the body;
• tests to determine fasting blood glucose levels - it is very important that the patient fasts for at least eight hours, but no more than fourteen;
• oral glucose tolerance test - performed when the previous diagnostic method has questionable indicators. At the same time, it is also very important that the patient follows the rules of preparation, including three days of unlimited nutrition and normal physical activity. Before the test, eight hours before, you can drink only water, and also requires a complete cessation of smoking;
• test for determining glycosylated hemoglobin;
• samples to establish glycemic profiles - this evaluates glucose fluctuations throughout the day;
• general urine analysis;
• blood biochemistry;
• tests to detect the content of acetone in urine and C-peptides in the blood.

Instrumental examinations are limited to ultrasound or MRI to confirm the presence of pancreatic lesions.

Treatment

After confirming the diagnosis, many patients are interested in the question: can type 1 diabetes be cured? It is not completely curable, but it is possible to improve the patient’s condition for many years with the help of the following therapeutic measures:

• insulin replacement therapy - the dosage of such a substance is selected individually depending on the severity of the course and the age category of the patient;
• a gentle diet;
• specially designed regime physical activity– In general, patients are advised to perform at least an hour of light to moderate exercise daily.

A diet for type 1 diabetes requires adherence to the following rules:

• complete exclusion of products such as sugar and honey, homemade jam and any confectionery, as well as carbonated drinks;
• It is recommended to enrich the menu with bread and cereals, potatoes and fresh fruits;
• frequent and fractional food consumption;
• limiting the intake of animal fats;
• control over the consumption of grain crops and dairy products;
• avoiding overeating.

A complete list of permitted and prohibited ingredients, as well as other nutritional recommendations, can only be provided by the attending physician.

In addition, treatment of diabetes mellitus in children and adults is aimed at informing the patient and his relatives about the principle of using insulin and providing first aid in the development of comatose states.

Patients should take into account that pathology can only be treated traditional ways, and the use of folk remedies can only worsen the condition.

Complications

Ignoring symptoms and inadequate treatment can lead to severe complications of type 1 diabetes. These include:

• – this pathological condition is also known as ketoacidotic coma;
• hyperosmolar coma;
• diabetic ophthalmology and nephropathy;
• formation of ulcers on the skin, up to necrosis.

When the disease develops in a pregnant woman, complications will include spontaneous miscarriage and fetal malformations.

Prevention

To date, specific prevention of type 1 diabetes has not been developed. To reduce the likelihood of developing the disease, it is recommended:

• completely abandon bad habits;
• Healthy food;
• take medications only as prescribed by your clinician;
• avoid stress if possible;
• maintain body weight within normal limits;
• careful pregnancy planning;
• promptly treat any infectious or viral illnesses;
• Regular examination by an endocrinologist.

The prognosis, as well as how long people live with type 1 diabetes, directly depends on how carefully the patient follows all the therapeutic recommendations of the endocrinologist. Complications can be fatal.

IN modern world Diabetes mellitus is one of the diseases that is classified as a serious medical and social problem on a global scale, as it has a high prevalence, severe complications, and also requires significant financial costs for diagnostic and therapeutic procedures, which the patient will need throughout his life . That is why a lot of effort and resources throughout the healthcare sector are aimed at a more in-depth study of the causes and mechanisms of the development of diabetes mellitus, as well as to find new effective methods prevention and control.

What is type 1 diabetes?

Diabetes mellitus is a chronic disease, the characteristic feature of which is a violation of metabolic processes, accompanied by hyperglycemia (increased blood glucose levels), which occurs as a result of impaired insulin production by the gland internal secretion(pancreas), or disruption of its action. Statistics show that the total number of people with diabetes mellitus of all forms in the world exceeds currently 160 million people. New cases of morbidity are recorded so frequently that the number of patients doubles every decade. The most severe form of diabetes mellitus in terms of correction and possible complications is considered to be type 1 diabetes mellitus, the incidence of which ranges from 8-10% of all cases of the disease.

Diabetes mellitus type 1 - a disease of the endocrine system, for which a characteristic feature is an increased concentration of glucose in the blood, which develops due to destructive processes in specific cells of the pancreas that secrete the hormone insulin, resulting in an absolute lack of insulin in the body. A high incidence of type 1 diabetes is observed in children of adolescence and young adulthood - 40 cases per 100,000 people. Previously, this form of diabetes was called insulin-dependent and juvenile diabetes.

There are two forms of diabetes mellitus type 1: autoimmune and idiopathic.

Causes contributing to the development of type 1 diabetes mellitus

Development autoimmune form of diabetes mellitus type 1 often begins in childhood, however, it can also be diagnosed in older people. This identifies autoantibodies (antibodies produced against one’s own antigens). human body) to the structural components of β-cells - specific pancreatic cells that produce insulin, namely, their surface antigens, insulin, glutamate decarboxylase, etc. They are formed due to congenital or acquired loss of tolerance (insensitivity) to self-antigensβ-cells. As a result of this process, autoimmune destruction of β-cells develops. In children, the process of decay of these cells is rapid, so already a year after the onset of the pathological process, the secretion of insulin in the pancreas completely stops. In the body of adults, the process of cell destruction takes longer, so β-cells can secrete sufficient amounts of insulin over a long period of time, which can prevent the development of such complications of diabetes as ketoacidosis. However, a decrease in insulin secretion is inevitable, and after a certain time its absolute deficiency develops.

Predisposes to autoimmune breakdownpancreatic cells that produce insulin, and a number of genetic factors. Type 1 diabetes mellitus is often diagnosed in combination with autoimmune diseases such as diffuse toxic goiter, autoimmune thyroiditis, Addison's disease, vitiligo, and autoimmune syndrome-complex.

Idiopathic form of diabetes mellitus type 1 is quite rare. In this case, patients do not have immunological and genetic factors for type 1 diabetes mellitus, but there are symptoms confirming absolute insulin deficiency.

The course of type 1 diabetes mellitus

Type 1 diabetes is characterized by a latent period, the duration of which can range from a year to several years. The development of the disease goes through several stages:

Stage 1.Presence of genetic predisposition. If specific antigens of the system are detected in the blood HLA , then the likelihood of developing type 1 diabetes increases significantly.

Stage 2.Suspected trigger factor. It can be agents of an infectious nature - enteroviruses, retroviruses, togaviruses, as well as non-infectious causes - diet, psycho-emotional stress, exposure to chemicals, toxins and poisons, insolation (solar irradiation), radiation, etc.

Stage 3.There are disorders of the immune system - the appearance of autoantibodies to antigensβ-cells, insulin, tyrosine phosphatase - with normal levels of insulin in the blood. In this case, the first phase of insulin production is absent.

Stage 4.It is characterized by serious immune disruptions, namely, insulin secretion rapidly decreases due to the development of insulitis (inflammation in the islets of Langerhans of the pancreas, containing cells that produce insulin), glucose resistance is impaired, while blood sugar levels remain within normal limits.

Stage 5.It is characterized by pronounced clinical manifestations, since three quartersβ-cells are destroyed at this point. Only residual secretion of C-peptide is preserved.

Stage 6.Total death of β-cells. C-peptide is not detected, antibody titers decrease. This stage is otherwise called total diabetes. The course of diabetes mellitus becomes uncontrollable, which threatens the development of severe complications - disseminated intravascular coagulation, edema of the cerebral cortex and the development of diabetic coma.

How does type 1 diabetes manifest?

Since clinical signs appear when most of the β-cells of the pancreas are destroyed, the onset of the disease is always acute and may appear for the first time severe acidosis or diabetic coma. In children and adolescents, the onset of the disease is characterized by signs of ketoacidosis. Sometimes patients can clearly name the day when they noticed the signs of the disease. Sometimes the onset of the disease may be preceded by severe viral infection(flu, mumps, rubella).

Patients may complain of dry mouth and a feeling of thirst caused by excessive excretion of fluid from the body by the kidneys, frequent urination, increased appetite along with an impressive loss of body weight (up to 10-15 kg per month), general weakness, and fatigue. In addition, patients may complain of itching, pustular processes on the skin and nails, and blurred vision. On the sexual side, patients note a decrease in sexual desire and potency. In the oral cavity, signs of periodontal disease, alveolar pyorrhea, gingivitis, and stomatitis may be detected. carious lesions of teeth.

When examining patients with type 1 diabetes, an increase in the concentration of sugar in the blood and its presence in the urine is detected. In the stage of decompensation, experts note dryness of the skin of patients, their mucous membranes, tongue, decreased turgor of subcutaneous fat, redness of the cheeks, forehead and chin due to dilation of the skin capillaries of the face. If the decompensation process is prolonged, patients may develop complications such as diabetic ophthalmopathy, nephropathy, peripheral neuropathy, diabetic osteoarthropathy, etc. Girls may develop infertility, and children may experience noticeable impairment and retardation in growth and physical development.

Diagnostic criteria for type 1 diabetes mellitus

If, along with clinical signs, there is an increased concentration of glucose in the blood (more than 11.1 mmol/l) at any time of the day, then we can talk about diabetes mellitus.

Experts from the World Health Organization developed whole line criteria used to make a diagnosis of diabetes mellitus. First of all, this is determining the level of glucose in the blood on an empty stomach, that is, when at least 8 hours have passed since the last meal. It is also necessary to determine the level of glucose in the blood randomly, namely, at any time within 24 hours, regardless of the time of food consumption.

In order to assess at what stage of diabetes the patient is, the following laboratory tests are necessary:

General analysis of urine and blood;

The concentration of glucose in the blood on an empty stomach, and then a couple of hours after eating;

Determination of the level of glycosylated hemoglobin;

Level of ketone bodies and glucose in daily urine;

Blood chemistry;

Urinalysis according to Nechiporenko.

For the purpose of differential diagnosis of type 1 diabetes mellitus, an analysis is carried out for the content of immunological and genetic markers and the level of C-peptide.

In addition, patients undergo a number of mandatory instrumental studies- electrocardiography, x-ray of organs chest and ophthalmoscopy.

Despite the fact that the clinical picture of insulin-dependent and non-insulin-dependent diabetes mellitus has many similarities, the differential diagnosis between them is based on a number of differences. If type 1 diabetes mellitus is characterized by a decrease in the body weight of patients, then type 2 diabetes mellitus is characterized by weight gain. Type 1 diabetes mellitus begins acutely, unlike type 2 diabetes mellitus, which is characterized by a slow increase in symptoms. Type 2 diabetes mellitus is more often diagnosed in adults and older people (over 45 years of age), and type 1 diabetes mellitus is more often diagnosed in children and young people. In laboratory studies, antibodies to β-cell antigens are detected only in insulin-dependent diabetes.

If a patient is diagnosed with type 1 diabetes for the first time, he must be hospitalized in order to select an insulin treatment regimen, learn how to independently monitor blood glucose levels, develop a diet and work regimen. In addition, patients in a precomatous and comatose state, with diabetic ketoacidosis, with an increase in angiopathy, with the addition of infections, as well as if any surgical intervention is necessary, are subject to hospitalization.

Treatment of type 1 diabetes

The main goal of treating patients with type 1 diabetes is to preserve their life, as well as improve its quality. For this purpose, preventive measures are taken to prevent the development of acute and chronic complications and correction of concomitant pathologies.

Treatment of type 1 diabetes mellitus involves a complex of measures, including insulin therapy, which is currently the only method for correcting absolute insulin deficiency. For these purposes, our country uses analogues of human insulin or insulin obtained by genetic engineering. Insulin replacement therapy can be carried out according to the traditional regimen, when a certain level of insulin is administered subcutaneously without constantly adapting the dose to the glycemic level. Intensive insulin therapy has great advantages, which includes multiple insulin injections, diet correction by counting bread units and monitoring glucose levels throughout the day.

The next point in the diabetes treatment regimen is the development of a special nutrition program that will normalize body weight and help maintain blood glucose levels within normal limits. Food for patients with diabetes should be low in calories, not contain refined carbohydrates (confectionery, sweet drinks, jams), and meal times should be strictly observed. It is necessary to exclude canned food, smoked meats, and foods high in fat (sour cream, mayonnaise, nuts) from the diet. The ratio of the main energy components in the diet is usually equated to physiological, and it is 3:1:1.

Physical activity for patients with type 1 diabetes should be moderate and selected individually, based on the severity of the disease. The most best view physical activity are walking. However, it should be remembered that shoes should be selected in such a way as to prevent the formation of corns and calluses, which can become the beginning of a dangerous complication of diabetes - diabetic foot.

The outcome of diabetes treatment is directly related to active participation it contains the patient himself, who must be trained by medical personnel in methods of self-monitoring of blood glucose levels using glucometers and test strips, because he needs to carry out this manipulation at least 3-4 times a day. In addition, the patient must assess his condition, control his diet and amount of physical activity, and also regularly visit the attending physician, who, in addition to talking with the patient, must examine his legs and measure arterial pressure. Once a year, a patient with type 1 diabetes must undergo all the necessary tests (biochemical blood test, general blood and urine test, determination of the level of glycosylated hemoglobin), undergo an examination by an ophthalmologist and neurologist, and have a chest x-ray.

Preventing the development of type 1 diabetes mellitus

The development of type 1 diabetes mellitus in people with a high genetic predisposition can be prevented by preventing intrauterine viral infections, as well as contracting viral infections in childhood and adolescence. You should not include in the diet of children predisposed to the disease, nutritional formulas containing gluten, foods with preservatives and dyes that can cause an autoimmune reaction against insulin-producing cells of the pancreas.

• Complications of diabetes

  The main reason for the development of complications of diabetes mellitus is vascular damage due to prolonged decompensation of diabetes mellitus (prolonged hyperglycemia - high blood sugar). First of all, microcirculation suffers, that is, the blood supply to the smallest vessels is disrupted

• Treatment of diabetes

  Diabetes mellitus is a group of metabolic diseases characterized by high levels of glucose (“sugar”) in the blood

• Types of diabetes

  Currently, there are two main types of diabetes mellitus, differing in the cause and mechanism of occurrence, as well as in the principles of treatment

• Diet for diabetes

  Numerous studies around the world have focused on finding effective means treatment of diabetes mellitus. However, we should not forget that in addition to drug therapy, recommendations for lifestyle changes are no less important.

• Gestational diabetes mellitus during pregnancy

  Gestational diabetes mellitus can develop during pregnancy (in approximately 4% of cases). It is based on a decrease in the ability to absorb glucose

• Hypoglycemia

  Hypoglycemia is a pathological condition characterized by a decrease in plasma glucose concentration below 2.8 mmol/l, occurring with certain clinical symptoms, or less than 2.2 mmol/l, regardless of the presence or absence of clinical signs

• Coma with diabetes mellitus

  Information about the most dangerous complication diabetes mellitus requiring emergency medical care - coma. The types of comas in diabetes mellitus, their specific symptoms, and treatment tactics are described.

• Autoimmune polyglandular syndrome

  Autoimmune polyglandular syndrome is a group of endocrinopathies, which is characterized by the involvement of several endocrine glands in the pathological process as a result of their autoimmune damage

  Diabetic foot syndrome is one of the complications of diabetes mellitus, along with diabetic ophthalmopathy, nephropathy, etc., which is a pathological condition resulting from damage to the peripheral nervous system, arterial and microvasculature, manifested by purulent-necrotic, ulcerative processes and damage to the bones and joints of the foot

• About diabetes

  Diabetes mellitus is a term that combines endocrine diseases, characteristic feature which is a lack of action of the hormone insulin. The main symptom of diabetes mellitus is the development of hyperglycemia - an increase in the concentration of glucose in the blood, which is persistent.

• Diabetes symptoms

  The effectiveness of diabetes treatment directly depends on the time of detection of this disease. In type 2 diabetes mellitus, the disease can cause only mild complaints for a long time, to which the patient may not pay attention. Symptoms of diabetes can be subtle, making diagnosis difficult. The earlier it is delivered correct diagnosis and treatment is started, the lower the risk of developing complications of diabetes mellitus

  Very often, patients under 18 years of age come to see specialists at the Northwestern Endocrinology Center. For them, the center has special doctors - pediatric endocrinologists.

Type 1 diabetes mellitus is a disease of the endocrine system, often of an autoimmune nature, which is caused by impaired insulin production due to the death of pancreatic beta cells, which leads to increased sugar levels in the blood and urine. There are several types of the disease that can be diagnosed in both adults and children. Type 1 diabetes is usually characterized by a rapid onset, its onset occurs in childhood and young adulthood (up to 25-30 years).

Clinic "Energo" is a medical diagnostic center offering diagnostic and treatment services for many medical problems, including those of an endocrine nature. Treatment regimen in each specific case is selected individually, taking into account the characteristics of the body of a particular patient.

Diabetes mellitus type 1: causes

Experts generally believe that type 1 diabetes mellitus is largely a genetic disease, so if there have been cases of this type of diabetes in the family, other family members have a higher risk of getting it, although the exact causes of type 1 diabetes mellitus that provoke this disease are still unknown not found. Moreover, the genetic component of the disease is directly related to the human immune system. That is why most often this type of diabetes develops against the background of an autoimmune failure, which leads to the destruction of pancreatic cells responsible for the production of insulin. Insulin becomes insufficient and requires external administration, which is why this type of diabetes is often called insulin-dependent diabetes mellitus. Moreover, with diabetes mellitus of this type, insulin production stops completely (unlike non-insulin-dependent type 2 diabetes).

Another name for type 1 diabetes is juvenile diabetes, since this type of disease is most often diagnosed in children and people under 30 years of age.

Often the cause of autoimmune failure is a viral infection. The immune system a person reacts most strongly to infections (chicken pox, mumps, etc.), and a strong immune response to them, in the presence of a genetic predisposition, can lead to the child developing insulin-dependent diabetes mellitus type 1 (juvenile diabetes). Due to an autoimmune failure, pancreatic cells will be perceived as foreign and actively attacked by the body.

To other factors external environment, which play a minor role in the development of diabetes of this type, can also include:

• Not proper nutrition With big amount carbohydrates and fats;
• excess weight (which is usually a consequence of poor nutrition);
• states of severe stress: cases of diabetes and sudden jumps in sugar were diagnosed in a state of severe stress or after it.

Diabetes mellitus: consequences

The consequences of diabetes can be very serious. Thus, during a pronounced increase in blood sugar concentration (at the onset of the disease or due to lack of proper control, for example), diabetic ketoacidosis, or a metabolic disorder characterized by a specific breath odor (the smell of acetone or almonds), deep rapid breathing, and often nausea, may develop. , vomiting and confusion. In serious cases, if timely treatment is not started, a lack of insulin in the blood in insulin-dependent diabetes mellitus in children and adults can lead to diabetic coma and death.

Without proper treatment, diabetes can also negatively affect various systems body:

• cardiovascular system: against the background of diabetes, the risk of strokes and heart attacks, as well as coronary heart disease and other problems significantly increases;
• peripheral blood vessels: the walls of blood vessels become fragile due to diabetes (the smallest vessels that deliver nutrients to the nerve bundles are especially affected), which leads to a deterioration in the trophism of the lower extremities, as well as to the development of diabetic retinopathy (damage to the vessels of the retina), which can result in experience a significant decrease in vision or develop blindness. Poor blood supply to the lower extremities, in turn, leads to the development of chronic non-healing ulcers, especially on the feet, which in some cases leads to amputation of the extremities;
• Kidneys: One of the long-term consequences of diabetes can be kidney failure due to damage to the blood vessels of the renal glomeruli, as well as an increase in the amount of protein in the urine. If the disease progresses further, hemodialysis and a kidney transplant may be required;
• nervous system (diabetic neuropathy): manifested in changes in sensitivity in the extremities (numbness, tingling, goosebumps, etc.), palpitations, unstable stools (diarrhea) and abdominal pain, severe sweating, a feeling of heat (autonomic neuropathy).

Diabetes mellitus: symptoms

Symptoms of type 1 insulin-dependent diabetes in adults (men and women) and children are mainly caused by excess sugar in the blood and urine, which causes the body to try to get rid of it.

The main symptoms of diabetes are therefore:

• severe thirst (the patient can drink up to 10 liters of liquid per day);
• frequent urge to urinate with copious amounts of urination: this is due to consumption large quantity water due to thirst;
• severe hunger and weight loss, problems with the absorption of glucose by cells as an energy source lead to the need for the body to obtain energy by breaking down fatty tissue;
• fatigue, feeling of constant tiredness;
• the occurrence of skin irritations, itching (diabetic dermatitis), pustular rashes or boils; there is often a decrease in the regenerative ability of the skin, due to which minor injuries take longer to heal.

IN different cases Type 1 diabetes develops at different speeds (from several months to several years); the signs of type 1 diabetes mellitus can be quite subtle at first, intensifying after an acute respiratory infection, ARVI, or other concomitant diseases.

Considering the range of possible complications in patients with type 1 diabetes, the question of how long it will remain undiagnosed, at what stage it is detected and how quickly it is brought under control largely determines both the patient’s quality of life and its duration (patients who lead a healthy lifestyle maintain normal blood sugar levels, avoid complications, usually live long and do not experience any particular inconvenience). That is why, at the first manifestations of the disease or suspicion of its presence, it is necessary to consult a specialist.

Initial appointment

The initial appointment involves a thorough examination, as well as a questioning of the patient, because collecting an initial history allows us to make an assumption about the presence or absence of the disease, as well as its type. In the event of a sharp complication of the patient’s condition, a dose of insulin can be administered already at the first appointment, if there are indications for this. In this case, the patient will be advised to undergo emergency hospitalization and an ambulance will be called. Also at the first appointment, it is possible to conduct rapid tests to determine the level of sugar in the blood and urine, the presence of ketone bodies in the urine, which are a marker of diabetic ketoacidosis. However, a more thorough diagnosis is required to establish an accurate diagnosis.

Diagnosis of diabetes mellitus is aimed at determining the type of diabetes, as well as differentiating it from other diseases with similar symptoms.

Most often, the diagnosis of diabetes involves laboratory tests:

• determination of sugar level in urine;
• determining blood sugar levels;
• study of insulin and its precursor, C-peptide
• genetic research for a clearer diagnosis of the type of diabetes, prognosis during the course and treatment tactics for a given patient.

Further treatment regimen

If the examination and diagnosis confirm the diagnosis of diabetes mellitus, the treatment prescribed by the specialist will be correlated with the type of diabetes identified and will mainly be aimed at eliminating the symptoms of the disease and normalizing insulin and blood sugar levels.

Treatment of type 1 diabetes mellitus, insulin-dependent, involves the use of a set of measures: drug treatment(insulin therapy is a must!), diet, physical activity - training and nutrition in type 1 diabetes play a very important role, because these measures can significantly neutralize the signs of the disease. In any case, this disease will require significant lifestyle changes.

In the case of diabetes of this type, the main vital drug is insulin, which the patient will need constantly. Due to the fact that insulin must enter directly into the blood (moreover, it cannot overcome the acidic environment of the stomach), insulin administration is only possible by injection, using a syringe or attaching a special insulin pump. The insulin dose is calculated based on the patient’s body weight, current blood sugar level, as well as lifestyle (presence/absence of exercise), dose adjustment is carried out by the patient himself only after carefully teaching the patient the concepts of bread units, hypoglycemia, insulin needs, and so on, and at first - only under the supervision of a doctor. That is why inpatient treatment is required at the onset of type 1 diabetes mellitus, which allows not only to eliminate the symptoms of decompensation of carbohydrate metabolism, but also to instill in patients the knowledge regarding this disease and the basic concepts necessary for subsequent independent treatment and correction of the dose of insulin, dosing of physical activity, etc. .d.

The second important factor in the treatment of type 1 diabetes mellitus is the control of blood sugar levels, which should be carried out by the patient independently after appropriate instructions on the rules of blood sampling (using special device– glucometer) by a specialist.

Controlling sugar levels also involves changing your diet: the diet for type 1 diabetes is based on the following basic principles:

• exclusion from the diet of foods containing quickly digestible carbohydrates (sugar and everything that contains it - chocolate, sweets, etc.) - mainly foods with a high sugar content;
• uniform distribution and individual calculation of the amount of slowly digestible carbohydrates (cereals, legumes, potatoes, bread);
• control over the consumption of fatty foods;
• frequent split meals (5-6 times in small portions);
• recognizing and preventing low blood sugar levels (so-called hypoglycemia)

One of the basic principles of nutrition for diabetes of this type is the counting of bread units, which represent the amount of carbohydrates consumed, on which the amount of insulin administered depends. One bread unit is equal to 10–12 grams of carbohydrates or approximately 20–25 grams of rye bread (one piece approximately 1 cm thick).

More detailed information about what you can eat with type 1 diabetes and what you cannot eat should be obtained from a specialist.

Also, with diabetes of this type, the patient may be recommended moderate physical activity, because it helps reduce blood glucose levels and normalize metabolic processes. But exercising when you feel unwell is considered inappropriate and unsafe for health.

It must be remembered that diabetes mellitus of this type is a chronic disease and cannot be completely cured (experiments on pancreas transplantation have not yet given the desired result). Moreover, if all doctor’s instructions are followed, an appropriate lifestyle is maintained and blood sugar is controlled, patients are able to lead a normal, full life without significant manifestations of the disease and with minimal risk of complications. Women with type 1 diabetes mellitus should be especially monitored during pregnancy and at the stage of pregnancy planning.
Due to the fact that the etiology of diabetes has not yet been fully identified, it seems very difficult to develop uniform preventive measures.

However, you can reduce the risk of developing this disease or detect its presence at an early stage, before complications arise, if:

• adhere to a normal diet with plenty of vegetables and a moderate amount of difficult-to-digest carbohydrates, significantly reducing or eliminating easily digestible carbohydrates;
• control weight, especially for people prone to excess weight;
• to live an active lifestyle;
• avoid serious stress;
• in case of infectious diseases children undergo full treatment and follow-up with a specialist;
• take preventive blood sugar tests, especially if there is a history of diabetes in the family, at least once a year;
• If the first signs of diabetes are noticed, consult a specialist for advice and undergo a full examination.

Content

Poor nutrition, unauthorized use of medications, certain diseases of the body and genetic predisposition are the prerequisites that lead to the development of diabetes. The disease is dangerous, accompanied by an increase in blood sugar followed by polyuria. Stage 1 diabetes mellitus develops in young children under 30 years of age.

What is type 1 diabetes

Not only adult patients, but also small children and infants become diabetics. With exacerbation of type 1 diabetes, the synthesis of insulin cells decreases, and destruction of pancreatic tissue is observed. Insulin-dependent diabetes mellitus is a chronic disease, and the patient at any age is under strict medical supervision.

During the pathological process of diabetes mellitus, the concentration of insulin in the blood decreases, hyperglycemia, ketoacidosis, and other complications dangerous to the body develop. An autoimmune disease of the endocrine system can be determined after a series of laboratory tests, including a blood test for sugar levels.

Causes of type 1 diabetes

This disease is diagnosed extremely rarely, according to statistics, in 5% of all clinical pictures. It is a disease of youth that can occur in young children but is rarely diagnosed in adulthood. There is no way to completely cure the disease; the main task of specialists is to compensate for the insulin deficiency using conservative methods. To ensure sustainable positive dynamics, the first step is to find out what the causes of type 1 diabetes are. The etiology of the pathological process has the following prerequisites:

• genetic predisposition;
• increased activity of dangerous Coxsackie viruses, rubella, Epstein-Barr and retroviruses;
• toxic effects of drugs on pancreatic β-cells;
• bacterial activity with the destructive effect of immune T-cells on β-cells;
• diet deficient in water and vitamin D;
• sedentary lifestyle;
• poor nutrition;
• intense physical activity;
• autoimmune diseases;
• systematic stress;
• The etiology of the idiopathic form of the disease is not clear.

Signs of type 1 diabetes

Whatever the causes of diabetes, the onset of the disease is accompanied by severe symptoms. At first, the patient does not pay attention to frequent urination and constant bouts of thirst, but then he realizes that there is a real health problem. Representatives of the risk group should know what the symptoms of type 1 diabetes mellitus look like in order to eliminate the lack of timely diagnosis and treatment. This is how insulin deficiency manifests itself in the body of a sick person:

• increased appetite with sudden weight loss;
• dry mouth;
• dry skin;
• muscle pain and headaches;
• general weakness, increased fatigue;
• low body resistance to pathogenic flora;
• increased sweating;
• skin itching;
• ketosis;
• decreased visual acuity;
• renal failure;
• smell of acetone urine;
• decreased appetite with severe thirst;
• nocturnal hyperglycemia;
• nausea, vomiting, abdominal pain;
• diabetic coma;
• polyuria.

Complications of type 1 diabetes

Patients live with this diagnosis if they follow all medical recommendations. If they are systematically violated and conservative treatment is ignored, serious complications in type 1 diabetes mellitus, requiring immediate hospitalization and resuscitation measures, cannot be ruled out. These are two groups of extensive pathologies with pronounced symptoms:

• neuropathy, when large-scale damage occurs to the proteins of cells of the nervous system;
• angiopathy with destruction of vascular walls and capillaries.

If such serious complications occur, the patient faces health problems such as diabetic retinopathy, chronic hyperglycemia, diabetic foot ulcer, retinal retinopathy, nephropathy, macroangiopathy, diabetic polyneuropathy, hyperglycemic, lactic acidotic and ketoacidotic coma, post-insulin lipid dystrophy. The disease clinic requires urgent response measures, otherwise the patient will face coma and death.

Diagnosis of diabetes mellitus

Since the onset of type 1 diabetes is preceded by the destruction of beta cells of the pancreas, a diabetic can only be identified through laboratory testing. The first blood test: normally the glucose level is 3.3 - 6.1 mmol/l, an increased level is a sign of the disease. A laboratory test of urine determines the acetone index. Another important indicator is glycated hemoglobin, the norm of which should not exceed 5.6 - 7.0%. In addition, the blood-brain barrier is destroyed, reflected in the results of laboratory tests.

Any laboratory tests should be carried out several times, since type 1 diabetes mellitus is characterized only with a steady increase in blood sugar. These tests will have to be taken for several months, while monitoring other symptoms of the disease. A glucose tolerance test is not performed in this clinical picture. A detailed diagnosis of type 1 diabetes involves collecting medical history data for the correct classification of the disease and prescribing insulin therapy.

Treatment of type 1 diabetes

An endocrinologist can determine the cause and stage of development of diabetes mellitus; an appointment with whom must be made after visiting a local physician. Depending on the degree of amino acid entry into the blood, the specialist determines the optimal dose of insulin, features intensive care. When wondering how to treat type 1 diabetes, the patient should know that the hormone can only be purchased or obtained by prescription. Additionally, drug therapy and selection of dietary dishes and low sugar foods.

Antihyperglycemic therapy

Subcutaneous injections of insulin are selected individually, since the body can produce antibodies to the specified medication. The duration of use of such a medicine is lifelong, daily doses are up to 5 subcutaneous injections between meals. The types of medications depend on the degree of the pathological process, a detailed list is presented below:

• ultra-fast acting insulin, which is identical in composition to natural insulin;
• short-acting insulin: Actrapid, Iletin, Humulin;
• intermediate acting insulin;
• long-acting insulin: Monodar-Ultralong, Levemir, Lantus.
• combination medications.

Diet for type 1 diabetics

In addition to taking medications, you need to change your daily diet. Diet menu A diabetic diet consists of dishes with low glucose content, otherwise there is a high probability of another relapse of the underlying disease. Allowed nutrition for type 1 diabetes involves taking a protein meal twice a day, completely eliminating fast carbohydrates and providing the weakened body with valuable minerals and vitamins. The allowed dishes are as follows:

• fresh vegetables;
• nuts and legumes;
• lean meat and fish;
• fermented milk products, especially cottage cheese;
• polyunsaturated oils;
• eggs;
• vegetable soups.

Prohibited foods for adults and children with diabetes:

• fatty meat and fish;
• confectionery;
• conservation;
• semi-finished products;
• spicy seasonings;
• alcohol;
• carbonated drinks, juices.

Treatment of type 1 diabetes without insulin

In the modern world, young people with a typical diagnosis deliberately refuse insulin therapy. An alternative solution has been found, and has found its way into the masses and has undergone numerous clinical trials. Latest methods Treatment of diabetes mellitus involves the use of DNA vaccine BHT-3021. This is a development of genetic engineering; the main purpose of the tablets is to restore the synthesis of natural insulin in the blood. Doctors do not rule out pancreatic cell transplantation, but it is better not to perform the procedure on a sick child.

Folk remedies for type 1 diabetes

If the destruction of beta cells of the pancreas progresses, some women and men voluntarily resort to help traditional treatment. The method is questionable; moreover, it can develop serious complications in the body after just 1-2 weeks of superficial self-medication. To prevent antibody-induced destruction while ensuring relief of clinical symptoms, it is important to discuss alternative methods with your healthcare provider. Effective treatment type 1 diabetes mellitus folk remedies is only auxiliary. Here are effective recipes:

1. To reduce ketone bodies and stimulate the functioning of internal organs, doctors recommend ingesting acorn powder, which in the amount of 1 tsp. take before each meal.
2. Combine 50 ml of lemon concentrate with chicken egg. This is a single dose to correct markers in the blood, which should be taken 30 minutes before meals. The remedy helps if juvenile diabetes develops, type 1, and helps eliminate polyuria.

Prevention of type 1 diabetes

To prevent the islets of Langerhans of the pancreas from being destroyed in adults and children, it is necessary to take timely measures for effective prevention. This is especially true for those patients who are aware of a genetic predisposition to type 1 diabetes. Effective prevention of diabetes involves the following measures:

• active lifestyle;
• combating stress;
• proper nutrition;
• timely treatment of viral and infectious diseases;
• strengthening the immune system.

Video: Insulin-dependent diabetes

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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