Diabetes mellitus is a very diverse disease. Distinguish between its types as symptomatic and true diabetes.

The first is only a manifestation of the underlying disease (for example, with damage to the endocrine glands) or occurs as a result of taking a number of drugs. In some cases, it can occur during pregnancy or with malnutrition. But, thanks to timely and correct treatment of the underlying disease, symptomatic diabetes disappears.

In turn, true diabetes is divided into two types: insulin-dependent (type 1) and non-insulin-dependent (type 2). Insulin dependent type diabetes mellitusAs a rule, it develops in young people and children, and non-insulin-dependent - in people over 40 who are overweight. The second type of disease is most common.

With an insulin-dependent type of diabetes mellitus, the human body suffers from an absolute deficiency of insulin, which is caused by a malfunction of the pancreas. And with type 2 disease, there is a partial insulin deficiency. At the same time, pancreatic cells produce a sufficient amount of this hormone, but glucose is disrupted in the bloodstream.

Why is diabetes developing?

It has been established that diabetes is caused by genetic defects, and it is also firmly established that diabetes cannot be infected !!! The reasons for IDDM are that insulin production is reduced or completely stopped due to the death of beta cells under the influence of a number of factors (for example, an autoimmune process, when antibodies are produced to their own normal cells and begin to destroy them). With NIDDM, which is 4 times more common, beta cells produce insulin with reduced activity, as a rule. Due to the excess of adipose tissue, which receptors have a reduced sensitivity to insulin.

1. Of primary importance is the hereditary predisposition! It is believed that if your father or mother suffered from diabetes, then the likelihood that you will also get sick is about 30%. If both parents were sick, then - 60%.
2. The next leading cause of diabetes is obesity, which is most characteristic of patients with NIDDM (type 2). If a person knows about his hereditary predisposition to this disease. Then he needs to strictly monitor his body weight in order to reduce the risk of a disease. At the same time, it is obvious that not everyone who is obese, even in severe form, is ill with diabetes.
3. Some diseases of the pancreas that result in damage to beta cells. A provoking factor in this case may be injury.
4. Nervous stress, which is an aggravating factor. It is especially necessary to avoid emotional overstrain and stress for people with a hereditary predisposition and overweight.
5. Viral infections (rubella, chickenpox, epidemic hepatitis and other diseases, including influenza), which play a trigger role in the development of the disease for people with aggravated heredity.
6. Risk factors also include age. The older the person, the more reason to fear diabetes mellitus. The hereditary factor with age ceases to be decisive. The greatest threat is obesity, which in combination with old age, past diseases, which usually weakens the immune system, lead to the development of mainly type 2 diabetes.

Many people believe that diabetes occurs in the sweet tooth. This is more of a myth, but there is also some truth, if only because excess consumption sweetens excess weight and, later on, obesity, which can be an impetus for type 2 diabetes.

In rare cases, some hormonal disorders lead to diabetes, sometimes diabetes is caused by damage to the pancreas that occurs after the use of certain drugs or as a result of prolonged alcohol abuse. Many experts believe that type 1 diabetes can occur with viral damage to the pancreatic beta cells that produce insulin. In response, the immune system produces antibodies called insular antibodies. Even those reasons that are precisely defined are not absolute.

An accurate diagnosis can be made based on an analysis of blood glucose.

Varieties

The causes of this disease lie in metabolic disorders in the body, in particular carbohydrates, as well as fats. Depending on the relative or absolute insufficiency of insulin production or the deterioration of tissue sensitivity to insulin, two main types of diabetes and other types are distinguished:

• Insulin dependent diabetes mellitus - Type 1, the causes are associated with insulin deficiency. In this type of diabetes mellitus, the lack of a hormone leads to the fact that it is not enough even to process a small amount of glucose received in the body. As a result, a person’s blood sugar level rises. To prevent ketoacidosis - an increase in the number of ketone bodies in the urine, patients are forced to constantly inject insulin into the blood in order to live.
• Non-insulin-dependent diabetes mellitus - 2 types, the causes of its occurrence lie in the loss of tissue sensitivity to the hormone of the pancreas. With this type, there is both insulin resistance (insensitivity or reduced sensitivity of tissues to insulin), and its relative disadvantage. Therefore, sugar-lowering tablets are often combined with the administration of insulin.

According to statistics, the number of patients with this type of diabetes is much more than 1 type, about 4 times, they do not need additional insulin injections, and for their treatment, drugs are used that stimulate the pancreas to insulin secretion or reduce tissue resistance to this hormone. Type 2 diabetes, in turn, is divided into:

• occurs in people with normal weight
• appears in overweight people.

Gestational diabetes mellitus is a rare type of diabetes that occurs in women during pregnancy, it develops due to a decrease in the sensitivity of a woman's own tissues to insulin under the influence of pregnancy hormones.

Diabetes, the occurrence of which is associated with a lack of nutrition.

Other types of diabetes, they are secondary, because they occur with the following provoking factors:

• Pancreatic diseases - hemochromatosis, chronic pancreatitis, cystic fibrosis, pancreatectomy (this is type 3 diabetes, which is not recognized on time)
• mixed-nutrition malnutrition - tropical diabetes
• Endocrine, hormonal disorders - glucagonoma, Cushing's syndrome, pheochromocytoma, acromegaly, primary aldosteronism
• Chemical diabetes - occurs with the use of hormonal drugs, psychotropic or antihypertensive drugs, thiazide-containing diuretics (glucocorticoids, diazoxide, thiazides, thyroid hormones, dilantin, nicotinic acid, adrenergic blocking agents, interferon, vaccor, pentamidine, etc.)
• Abnormality of insulin receptors or genetic syndromes - muscular dystrophy, hyperlipidemia, Huntington's chorea.

Violation of glucose tolerance, an unstable complex of symptoms that most often pass on their own. This is determined by analysis 2 hours after glucose loading, in this case the patient’s sugar level ranges from 7.8 to 11.1 mmol / L. With tolerance on an empty stomach sugar - from 6.8 to 10 mmol / l, and after eating the same from 7.8 to 11.

According to statistics, approximately 6% of the country's population suffers from diabetes mellitus, this is only according to official data, but the real number, of course, is much larger, because it is known that type 2 diabetes can develop in latent form for years and have minor symptoms or go completely unnoticed.

Diabetes mellitus is a rather serious disease, as it is dangerous with the complications that develop in the future. According to diabetes statistics, more than half of diabetics die from foot angiopathy, heart attack, nephropathy. Each year, over a million people are left without a leg, and 700 thousand people lose their sight.

Symptoms of Diabetes

Insulin deficiency can occur acutely or in chronic form.

In acute insulin deficiency, the main symptoms of diabetes are noted:

• dry mouth, thirst;
• dry skin;
• weight loss on the background of increased appetite;
• weakness, drowsiness;
• itchy skin;
• furunculosis.

Chronic deficiency does not differ in severe symptoms, it takes a long time and ends with complications of the disease in the form of:

• retinal lesions (diabetic retinopathy) - is manifested by visual impairment, often a veil appears in front of the eyes;
• kidney damage (diabetic nephropathy) - manifested by the appearance of protein in the urine, the gradual progression of renal failure;
• lesions of the peripheral nerves (diabetic neuropathy) - manifested by tingling, pain in the limbs;
• vascular lesions (diabetic angiopathy) - manifested by chilliness, cooling of the extremities, seizures in them, trophic ulcers.

The main signs that diabetes is developing in men The following symptoms are:

• the occurrence of general weakness and a significant decrease in performance;
• the appearance of itching on the skin, especially this applies to the skin in the genital area;
• sexual disorders, the progression of inflammatory processes and the development of impotence;
• the occurrence of feelings of thirst, dryness in the oral cavity and a constant feeling of hunger;
• the appearance on the skin of ulcerative formations, which do not heal for a long time;
• frequent urination;
• tooth decay and baldness.

The first signs that diabetes is developing in a womanthe following symptoms are:

• a sharp decrease in body weight is a sign that should alert, if the diet is not followed, the previous appetite remains. Weight loss occurs due to insulin deficiency, which is necessary for the delivery of glucose to fat cells.
• thirst. Diabetic ketoacidosis causes uncontrolled thirst. In this case, even if you drink a large amount of liquid, dry mouth remains.
• fatigue. A feeling of physical exhaustion, which in some cases has no apparent reason.
• increased appetite (polyphagy). A special behavior in which saturation of the body does not occur even after eating enough food. Polyphagy is the main symptom of impaired glucose metabolism in diabetes.
• violation of metabolic processes in the body of a woman leads to a violation of the microflora of the body. The first signs of the development of metabolic disorders are vaginal infections, which are practically not cured.
• non-healing wounds that turn into ulcers are characteristic first signs of diabetes in girls and women
• - accompanies insulin-dependent diabetes mellitus, because a lack of this hormone directly affects the formation of bone tissue.

Features of the course of type I diabetes

• It is characterized by severe clinical manifestations.
• It develops mainly in young people - under the age of 30–35 years.
• Poorly treatable.
• The onset of the disease is often acute, sometimes manifested by a coma.
• When receiving insulin therapy, the disease is usually compensated - the so-called honeymoon of a diabetic occurs, that is, a remission occurs in which the patient does not need insulin.
• After a viral infection or other provoking factors (stress, physical trauma), diabetes develops again - there are signs of decompensation with the subsequent development of complications.

Clinical features of type II diabetes mellitus

• It develops without signs of decompensation, gradually.
• More often, people over 40 are sick, more often women.
• Obesity is one of the first manifestations of the disease and a risk factor at the same time.
• Usually patients about their disease and do not know. An increased level of glucose in the blood is diagnosed when they turn to a neuropathologist - about a neuropathy, a gynecologist - due to itching of the perineum, a dermatologist - with fungal skin lesions.
• More often the disease is stable, the clinical manifestations are mild.

The liver suffers regardless of the type of diabetes. This is largely due to an increase in glucose levels in cuts and impaired insulin metabolism. If you do not treat this disease or run it hard, then the liver cells (hepatocytes) will inevitably die and be replaced by connective tissue cells. This process is called cirrhosis. Another equally dangerous disease is hepatosis (steatohepatosis). It also develops against the background of diabetes and consists in “obesity” of liver cells due to an excess of carbohydrates in the blood.

Stages

This differentiation helps to quickly understand what happens to the patient at different stages of the disease:

• First stage. Mild (I degree) form of the disease is characterized by a low level of glycemia, which does not exceed 8 mmol / l on an empty stomach, when there are no large fluctuations in the sugar content in the blood throughout the day, insignificant daily glucosuria (from traces to 20 g / l). Compensation is maintained through diet therapy. With a mild form of diabetes, angioeuropathy of the preclinical and functional stages can be diagnosed in a patient with diabetes mellitus.
• Second stage. With moderate (II degree) severity of diabetes mellitus, fasting glycemia rises, as a rule, to 14 mmol / l, glycemic fluctuations throughout the day, daily glucosuria usually does not exceed 40 g / l, ketosis or ketoacidosis occasionally develops. Compensation of diabetes is achieved by diet and the administration of sugar-lowering oral drugs or the administration of insulin (in the case of secondary sulfamide resistance) in a dose that does not exceed 40 OD per day. In these patients, diabetic angioneuropathies of various localization and functional stages can be detected.
• Third stage. Severe (III degree) form of diabetes is characterized by high levels of glycemia (on an empty stomach more than 14 mmol / l), significant fluctuations in blood sugar throughout the day, high glucosuria (over 40-50 g / l). Patients need constant insulin therapy at a dose of 60 OD or more; they have various diabetic angioneuropathies.

Diagnostics

Diagnosis of the disease is carried out on the basis of blood and urine tests.

For the diagnosis, the concentration of glucose in the blood is determined (an important circumstance is the re-determination of high sugar levels on other days).

The results of the analysis are normal (in the absence of diabetes mellitus)

On an empty stomach or 2 hours after the test:

• venous blood - 3.3–5.5 mmol / l;
• capillary blood - 3.3–5.5 mmol / l;
• venous blood plasma - 4-6.1 mmol / L.

Test results for diabetes

• venous blood more than 6.1 mmol / l;
• capillary blood more than 6.1 mmol / l;
• venous blood plasma of more than 7.0 mmol / L.

At any time of the day, regardless of the meal time:

• venous blood more than 10 mmol / l;
• capillary blood more than 11.1 mmol / l;
• venous blood plasma of more than 11.1 mmol / L.

The level of glycated hemoglobin in diabetes mellitus exceeds 6.7–7.5%.

The concentration of immunoreactive insulin is reduced in type 1, normal or increased in type 2.

The determination of blood glucose concentration for the diagnosis of diabetes mellitus is not carried out against the background of acute illness, trauma or surgical intervention, against the background of short-term use of drugs that increase the concentration of glucose in the blood (adrenal hormones, thyroid hormones, thiazides, beta-blockers, etc.), patients with cirrhosis of the liver.

Glucose in the urine with diabetes appears only after exceeding the "renal threshold" (approximately 180 mg% 9.9 mmol / l). Significant threshold fluctuations and a tendency to increase with age are characteristic; therefore, the determination of glucose in urine is considered an insensitive and unreliable test. The test serves as a rough guide to the presence or absence of a significant increase in blood sugar (glucose) and, in some cases, is used to daily monitor the dynamics of the disease.

How to treat diabetes?

Today effective methods full treatment for patients with diabetes does not exist, and basic measures are aimed at reducing the symptoms and supporting normal blood glucose values. Postulated Principles:

1. Drug compensation UO.
2. Normalization of vital signs and body weight.
3. Treatment of complications.
4. Teaching a patient a special lifestyle.

The most important element in maintaining the patient’s normal quality of life can be considered their own self-control, primarily through proper nutrition, as well as constant ongoing diagnosis of blood glucose levels using glucometers.

Key events at type 1 diabetes aimed at creating an adequate ratio between absorbed carbohydrates, physical activity and the amount of insulin injected.

1. Diet therapy - reducing carbohydrate intake, controlling the amount of carbohydrate food consumed. It is an auxiliary method and is effective only in combination with insulin therapy.
2. Physical activity - ensuring an adequate mode of work and rest, ensuring a decrease in body weight to optimal for a given person, control of energy consumption and energy consumption.
3. Substitution insulin therapy - selection of the baseline level of extended insulins and relief after a single rise in blood glucose using short and ultrashort insulin.
4. Pancreatic transplantation - usually a combined kidney and pancreas transplant is performed, therefore, operations are performed in patients with diabetic nephropathy. If successful, provides a complete cure for diabetes [source not specified 2255 days].
5. Pancreatic islet cell transplantation is the newest direction in the cardinal treatment of type I diabetes. Langerhans islets are transplanted from a cadaveric donor and, as in the case of pancreatic transplantation, requires careful donor selection and powerful immunosuppression

Treatment methods used for type 2 diabetes, can be divided into 3 main groups. This is non-drug therapy, used in the early stages of the disease, medication, used in decompensation of carbohydrate metabolism, and the prevention of complications, carried out during the entire course of the disease. Recently, a new method of treatment has appeared - gastrointestinal surgery.

Diabetes Medicines

In the later stages of diabetes, medications are used. Usually, the doctor prescribes oral medication, that is, prescribes tablets for type 2 diabetes. Reception of such medicines is carried out once a day. Depending on the severity of the symptoms and the condition of the patient, the specialist may prescribe not one drug, but a combination of antidiabetic drugs.

The list of the most popular medicines include:

1. Glycosidase inhibitors. These include acarbose. Its action is aimed at blocking enzymes that break down complex carbohydrates to glucose. This allows you to slow down the absorption and digestion of carbohydrates in the small intestine and prevent an increase in blood sugar concentration.
2. Drugs that enhance insulin secretion. These include drugs such as Diabeton, Glipizid, Tolbutamid, Maninil, Amaril, Novonorm. The use of these funds is carried out under the supervision of a doctor, as in elderly and debilitated patients allergic reactions and adrenal gland dysfunctions are possible.
3. Drugs that work to reduce intestinal glucose absorption. Their action allows you to normalize the synthesis of sugar by the liver and increase the sensitivity of tissues to insulin. Metformin-based drugs (Gliformin, Insufor, Diaformin, Metfogama, Formin Pliva) cope with this task.
4. Fenofibrate - activates alpha receptors, normalizes lipid metabolism and slows the progression of atherosclerosis. The drug works to strengthen the vascular wall, improves blood microcirculation, reduces uric acid and prevents the development of severe complications (retinopathy, nephropathy).

Specialists often use combinations of drugs, for example, prescribe a patient glipizide with metformin or insulin with metformin.

In most patients, over time, all of the above funds lose their effectiveness, and the patient has to be transferred to insulin treatment. The doctor selects the necessary dosage and treatment regimen individually.

Insulin is prescribed in order to provide the best compensation for blood sugar and prevent the development of dangerous complications in type 2 diabetes. Insulin therapy is used:

• With a sharp and unmotivated decrease in body weight;
• With insufficient effectiveness of other sugar-lowering drugs;
• When symptoms of complications of diabetes appear.

A suitable insulin preparation will be selected by a specialist. It can be insulin of fast, intermediate or prolonged action. It will need to be administered subcutaneously in a specific pattern.

How many times a day do you need to "inject" insulin?

In the treatment of diabetes, we strive to ensure that, as much as possible, the blood sugar level matches the sugar level in healthy people. Therefore, intensive insulin regimes are used, i.e., the patient should administer insulin 3-5 times a day. This regimen is used for young patients, when complications may arise with poor control of sugar levels for a long time.

It is absolutely necessary for pregnant patients to administer insulin frequently so that the fetus does not suffer from too high or too low sugar levels. In elderly patients, on the contrary, they seek to limit the number of injections to 1-3 times a day in order to avoid hypoglycemia due to probable forgetfulness.

Insulin administration

When insulin is injected at the injection site, it is necessary to form a skin fold so that the needle goes under the skin and not into the muscle tissue. The skin fold should be wide, the needle should enter the skin at an angle of 45 °, if the thickness of the skin fold is less than the length of the needle.

When choosing the injection site, densified skin areas should be avoided. The injection sites cannot be changed haphazardly. Do not inject under the skin of the shoulder.

• Short-acting insulin preparations should be introduced into the subcutaneous fatty tissue of the anterior abdominal wall 20-30 minutes before a meal.
• Long-acting insulin preparations are injected into the subcutaneous fatty tissue of the thighs or buttocks.
• Ultrashort insulin injections (humalog or novorpid) are carried out immediately before meals, and if necessary, during or immediately after a meal.

Warm and exercise stress increase the rate of absorption of insulin, and cold reduces it.

Physical exercises

Physical activity in type 2 diabetes is aimed at reducing weight, increasing the sensitivity of tissues to insulin and preventing possible complications. Exercise improves the functioning of the cardiovascular and respiratory systems and contributes to increased performance.

Performing a specific set of physical exercises is indicated for any form of diabetes. Even with bed rest, certain exercises are recommended that are performed while lying down. In other cases, the patient is engaged in sitting or standing. Warm up begins with the upper and lower extremities, then proceed to weight training. For this, an expander or dumbbell up to 2 kg is used. Useful breathing exercises, dynamic loads (walking, cycling, skiing, swimming).

It is very important that the patient controls his condition. If in the process of training there is a sudden weakness, dizziness, trembling in the limbs, you need to finish the exercises and be sure to eat. In the future, you should resume classes, simply reducing the load.

Diet and nutrition rules

The diet should be made for each patient individually, depending on body weight, age, physical activity, and taking into account whether he needs to lose weight or get better. The main goal of the diet for diabetics is to maintain blood sugar levels within the limits that correspond to the level of a healthy person, as well as blood fats and cholesterol. In addition, it is important that this diet is diverse and contains a sufficient amount of essential nutrients - proteins, mineral salts and vitamins. At the same time, it should provide such an amount of energy that the patient's body weight approaches the ideal and is maintained at this level for a long time. Diet must comply with the principles of good nutrition.

Diet is the basis of treatment. If it is not respected, there is a danger of poor compensation with the risk of complications. If you do not follow a diet and increase doses of drugs or doses of insulin, the patient may increase weight, deteriorate the sensitivity of cells to insulin, and diabetes treatment will fall into a vicious cycle. The only way to avoid these complications is to adjust the diet in such a way as to normalize the weight and maintain it.

The correct diet for diabetics \u003d 55-60% carbohydrates + 25-20% fat + 15-20% protein. Carbohydrates (saccharides) should be maximally represented by complex carbohydrates (starches), food should contain a sufficient amount of fiber (fiber), which prevents the rapid absorption of carbohydrates and the rapid rise of glycemia after eating.

Simple carbohydrates (glucose) are absorbed instantly and cause an increase in sugar c. blood. Fats should be mainly of plant origin, the amount of cholesterol in food must be regulated depending on its level in the blood, diet should not lead to an increase in cholesterol above critical. Proteins should be 15-20%, but their total daily dose cannot exceed 1 g in terms of 1 kg of body weight. For adolescents and pregnant women, the required dose of protein rises to 1.5 g per 1 kg of weight per day. High-protein diets previously prescribed can lead to kidney damage.

Diet for diabetes does not prohibit, and in some cases recommends the following foods to be consumed in the diet:

• black or special diabetic bread (200-300 gr. Per day);
• vegetable soups, cabbage soup, okroshka, beetroots;
• soups cooked in meat broth can be consumed 2 times a week;
• lean meat (beef, veal, rabbit), poultry (turkey, chicken), fish (pike perch, cod, pike) (about 100-150 gr. per day) in boiled, baked or aspic;
• cereals (buckwheat, oat, millet) are useful, and pasta, legumes can be consumed every other day;
• potatoes, carrots and beets - no more than 200 gr. in a day;
• other vegetables - cabbage, including cauliflower, cucumbers, spinach, tomatoes, eggplant, as well as greens, can be used without restrictions;
• eggs can be no more than 2 pieces per day;
• 200-300 gr. on the day of apples, oranges, lemons, it is possible in the form of juices with pulp;
• fermented milk products (kefir, yogurt) - 1-2 glasses per day, and cheese, milk and sour cream - with the permission of the doctor;
• low-fat cottage cheese is recommended to be consumed daily at 150-200 g. per day in any form;
• from fats per day, you can eat up to 40 g. unsalted butter and vegetable oil.

• all bakery products and cereals not listed in the table;
• cookies, marshmallows, marshmallows and other confectionery, cakes, pastries, etc .;
• honey, not specified chocolate, sweets, naturally - white sugar;
• potatoes, fried carbohydrate breading vegetables, most root vegetables, except as mentioned above;
• shop mayonnaise, ketchup, frying in a soup with flour and all sauces based on it;
• condensed milk, store ice cream (any!), complex store products marked “milk”, because these are hidden sugars and trans fats;
• fruits, berries with high GI: banana, grapes, cherries, pineapple, peaches, watermelon, melon, pineapple;
• dried fruits and candied fruits: figs, dried apricots, dates, raisins;
• shop sausages, sausages and the like, where there is starch, cellulose and sugar;
• sunflower and corn oil, any refined oils, margarine;
• large fish, canned oil, smoked fish and seafood, dry salty snacks, popular with beer.

It’s allowed to drink black from drinks, green tea, weak coffee, juices, stewed berries of sour varieties with the addition of xylitol or sorbitol, rosehip broth, from mineral waters - narzan, essentuki.

It’s important for people with diabetes to limit their intake of easily digestible carbohydrates. Such products include - sugar, honey, jam, confectionery, sweets, chocolate. The use of cakes, muffins, from fruits - bananas, raisins, grapes is strictly limited. In addition, it is worth minimizing the use of fatty foods, primarily lard, vegetable and butter, fatty meat, sausages, mayonnaise. In addition, it is better to exclude fried, spicy, spicy and smoked dishes, savory foods, salted and pickled vegetables, cream, alcohol from the diet. Salt per day can be consumed no more than 12 grams.

Sample menu for the week

What can you eat and what can not? The following weekly menu for diabetes is not strict, the individual components must be replaced within the same product groups while maintaining the basic constant indicator of daily bread units used.

1. Day 1. Breakfast with buckwheat, low-fat cottage cheese with 1 percent milk and a rosehip drink. For lunch, a glass of 1 percent milk. We have lunch with cabbage soup, boiled meat with fruit jelly. Snack - a couple of apples. For dinner, we cook cabbage schnitzel, boiled fish, as well as tea.
2. Day 2 We have breakfast with pearl barley porridge, one soft-boiled egg, coleslaw. For lunch, a glass of milk. We dine mashed potatoes, pickle, boiled beef liver and dried fruit compote. Afternoon fruit jelly. For dinner, a piece of boiled chicken garnished is enough stewed cabbage and tea. The second dinner is kefir.
3. Day 3 For breakfast - low-fat cottage cheese with the addition of low-fat milk, oatmeal and a coffee drink. Lunch - a glass of jelly. We have lunch without meat, boiled chicken and buckwheat. Have an afternoon snack with two unsweetened pears. We have dinner with vinaigrette, one boiled egg and tea. Before going to bed, you can eat a little yogurt.
4. Day 4 For breakfast, we prepare buckwheat porridge, low-fat cottage cheese and a coffee drink. The second breakfast is a glass of kefir. For lunch, prepare cabbage soup, boil a slice of low-fat beef in milk sauce and a glass of compote. We have an afternoon 1-2 small pears. We have dinner with cabbage schnitzel and boiled fish with tea.
5. Day 5 For breakfast, we prepare vinaigrette (we don’t use potatoes) with a teaspoon of vegetable oil, one boiled egg and a coffee drink with a slice of rye bread and butter. For lunch, two apples. We have lunch with sauerkraut with stewed meat and pea soup. For afternoon tea and dinner, respectively, fresh fruit and boiled chicken with vegetable pudding and tea. Before going to bed, you can consume yogurt.
6. Day 6 Breakfast - a piece of lean stew, millet porridge and a coffee drink. For a second breakfast, you can eat a decoction of wheat bran. We have lunch boiled meat, fish soup and lean mashed potatoes. Have an afternoon glass of kefir. For dinner, cook oatmeal and cottage cheese with milk (low-fat). Before going to bed, you can eat one apple.
7. Day 7 We have breakfast with buckwheat porridge with hard-boiled egg. You can eat a few apples before lunch. For lunch - beef cutlet, barley and vegetable soup. We have an afternoon snack with milk, and have dinner with boiled fish and steamed potatoes, as well as a vegetable salad with tea. Before going to bed, you can drink a glass of kefir.

Daily set of products for 2,000 kcal

An approximate daily set of products (in grams) for 2,000 kcal for a patient with diabetes is shown in the table below, these foods should be eaten and include them in your menu. The weight of the products in the table is indicated in grams.

Name	amount	Squirrels	Fats	Carbohydrates	Kcal
Black bread
Potatoes
Groats
Meat
A fish
Egg
Cottage cheese
Milk
Kefir
Butter
Vegetable oil
Fresh fruit
Dried fruits
Vegetables
TOTAL:
	I breakfast
Black bread
Groats
Egg
Butter
Milk
TOTAL:
	II Breakfast
Black bread
Cottage cheese
Fruits
TOTAL:
	Lunch
Black bread
Potatoes
Meat
Vegetable oil
Dried fruits
Vegetables
TOTAL:
	High tea
Black bread
Milk
Fruits
TOTAL:
	Dinner
Black bread
Potatoes
A fish
Vegetable oil
Vegetables
Fruits
TOTAL:
	II Dinner
Black bread
Kefir
TOTAL:

Use of sweeteners and sweeteners

For thousands of years, humans (along with other representatives of the animal world) have been eating natural products (cereal grains, vegetables, fruits, and legumes), which contain, in addition to complex carbohydrates, plant fiber, vitamins, mineral salts, and other substances useful to the living organism. However, over the past hundred years, the composition of food has radically changed in the direction of excessive consumption of refined (refined) carbohydrates. For example, in the USA, the average sugar consumption per year per person from 1900 to 2006 increased from 2.5 to 80 (!) Kg. It is known that excessive consumption of refined sugars leads to increased insulin secretion by beta cells of islets of Langerhans.

In turn, excessive insulin production increases appetite and contributes to excessive food intake. In addition, against the background of inactivity, excessive consumption of refined sugars is not spent on the energy needs of the body, but is metabolized in the liver to neutral fats and deposited in adipose tissue (mainly under the skin), thus being one of the reasons for the increase in the number of cases of obesity. Based on the foregoing, the most important task of rational diet therapy for diabetes mellitus in modern conditions is to replace the excess intake of refined carbohydrates with sweeteners that have a sweet taste, but do not contain calories and practically do not stimulate insulin secretion. According to the decision of the International Association for Sweeteners:

• fructose, xylitol and sorbitol are attributed to the group of sweeteners (in the process of metabolism during the combustion of 1.0 grams 4 kcal of energy)
• the group of sweeteners (do not participate in metabolism: their calorie content is 0 kcal) includes cyclamate, sucralose, neohesperidin, thaumatin, glycyrrhizin, stevioside and lactulose.

Modern pharmacology, in order to satisfy the human penchant for a sweet life when sugar and sugar-containing products are excluded from the diet, widely introduces the use of sweeteners (high-calorie) and sweeteners (non-high-calorie), although from the point of view of physiology the use of such chemicals is not necessary.

Folk remedies

Before use folk methods with diabetes, it is possible only after consultation with an endocrinologist, because there are contraindications.

1. Millet against infection. Against infection and for the prevention of diabetes, you can use the following recipe: take 1 handful of millet, rinse, pour 1 liter of boiling water, insist night and drink throughout the day. Repeat the procedure for 3 days.
2. Lilac buds. The infusion of lilac buds helps to normalize blood glucose levels. At the end of April, the kidneys are collected in a swelling stage, dried, stored in a glass jar or paper bag and used all year round. Daily rate of infusion: 2 tbsp. tablespoons of dry raw materials pour 0.4 l of boiling water, insist 5-6 hours, filter, divide the resulting liquid by 4 times and drink before meals.
3. Lemon and eggs. Squeeze the juice from 1 lemon and mix well 1 raw egg with it. Drink the resulting product 60 minutes before meals, for 3 days.
4. Burdock juice. Effectively reduces sugar level juice from chopped burdock root dug in May. It is taken three times a day for 15 ml, diluting this amount with 250 ml of cool boiled water.
5. In diabetes mellitus, ripe walnut partitions (40 g) simmer in 0.5 l of boiling water over low heat for 1 hour; take 3 times a day for 15 ml.
6. Plantain seeds (15 g) are poured in an enameled bowl with a glass of water, simmer for 5 minutes. The cooled broth is filtered and taken 1 dessert spoon 3 times a day.
7. Baked onion. You can normalize sugar, especially in the initial phase of the disease, by daily use of baked onions in the morning on an empty stomach. The result can be tracked after 1-1.5 months.
8. Helps reduce blood sugar and regular bay leaf. You need to take 8 pieces of bay leaf and pour it with 250 grams of “boiling” boiling water, the infusion should be insisted in a thermos for about a day. The infusion is taken warm, each time you need to filter out the infusion from a thermos. Take twenty minutes before meals, 1/4 cup.

Consequences and Complications

Diabetes mellitus in the absence of proper control over the current state of the patient’s body and the necessary complex therapy, almost always causes a number of complications:

Early:

1. Hypoglycemia against the background of concomitant diseases, malnutrition, drug overdose.
2. Ketoacidosis with accumulation of plasma metabolites of fats, in particular ketone bodies. It provokes violations of the basic functions of the body.
3. Hyperosmolar or lactic acidotic coma.

Late:

1. Different types of angiopathies with persistent violation of the permeability of vascular structures.
2. Retinopathy with damage to the eye retina.
3. Extensive nephropathies, often leading to chronic renal failure.
4. Polyneuropathies with loss of temperature-pain sensitivity.
5. Ophthalmopathies, including cataracts.
6. A variety of arthropathies.
7. Encephalopathy with the development of emotional lability and systemic depressive change in the mental profile.
8. Diabetic foot in the form of purulent and fret necrotic processes on this part of the body, often leading to forced amputation.

Prevention

Unfortunately, not in all cases it is possible to affect the inevitability of the appearance of type 1 diabetes. After all, its main causes are the hereditary factor and small viruses that every person encounters. But the disease does not develop at all. And although scientists have found that diabetes is much less common in children and in adults who were on breastfeeding and treated for respiratory infections with antiviral drugs, this can not be attributed to specific prevention. Therefore, truly effective methods do not exist.

A completely different situation is with the prevention of type 2 diabetes. After all, it is very often the result of an improper lifestyle.

Therefore, to the full preventive measures include:

1. Normalization of body weight;
2. Control of arterial hypertension and lipid metabolism;
3. Proper fractional diet with a minimum content of carbohydrates and fats capable of easy absorption;
4. Dosed physical activity. They suggest the fight against physical inactivity and the rejection of excessive loads.

Patients with identified diabetes mellitus are registered with the endocrinologist. When organizing the right lifestyle, nutrition, treatment, the patient can feel satisfactory for many years. It complicates the prognosis of diabetes and shortens the life expectancy of patients with acute and chronically developing complications.

Diabetes - a group of diseases of the endocrine system that develop due to a lack or absence of insulin in the body (hormone), resulting in a significant increase in the level of glucose (sugar) in the blood (hyperglycemia).

Diabetes mellitus is mainly a chronic disease. It is characterized by metabolic disorders - fatty, carbohydrate, protein, water-salt and mineral. With diabetes, the pancreas functions, which actually produce insulin, are impaired.

Insulin - a protein hormone produced by the pancreas, the main function of which is to participate in metabolic processes - the processing and conversion of sugar into glucose, and the subsequent transportation of glucose to cells. In addition, insulin regulates blood sugar.

In diabetes mellitus cells do not receive the necessary nutrition. It is difficult for the body to retain water in the cells, and it is excreted through the kidneys. Disorders in the protective functions of tissues occur, skin, teeth, kidneys, nervous system are affected, the level of vision decreases, develops,.

In addition to humans, this disease can also affect some animals, such as dogs and cats.

Diabetes mellitus is inherited, but it can be acquired in other ways.

Diabetes. ICD

ICD-10: E10-E14
ICD-9: 250

The hormone insulin turns sugar into glucose, which is an energy substance necessary for the normal functioning of body cells. When there is a failure in the production of insulin by the pancreas, disturbances in the metabolic processes begin. Glucose is not delivered to the cells, and settles in the blood. Cells, in turn, starving begin to malfunction, which externally manifests itself in the form of secondary diseases (diseases of the skin, circulatory system, nervous and other systems). At the same time, there is a significant increase in blood glucose (hyperglycemia). The quality and effect of blood deteriorate. This whole process is called diabetes.

Diabetes mellitus is called only that hyperglycemia, which was originally caused by dysfunction of insulin in the body!

How harmful is high blood sugar?

High blood sugar can cause dysfunction of almost all organs, up to a lethal outcome. The higher the blood sugar level, the more obvious is the result of its action, which is expressed in:

- obesity;
- glycosylation (sugaring) of cells;
- intoxication of the body with damage to the nervous system;
- damage to blood vessels;
- the development of minor diseases affecting the brain, heart, liver, lungs, gastrointestinal tract, muscles, skin, eyes;
- manifestations of syncope, coma;
- fatal.

Blood sugar

On an empty stomach: 3.3-5.5 mmol / L.
2 hours after a carbohydrate load: less than 7.8 mmol / l

Diabetes mellitus in most cases develops gradually, and only rarely does the disease progress rapidly, accompanied by an increase in glucose to a critical level with various diabetic comas.

The first signs of diabetes

- constant feeling of thirst;
- constant dry mouth;
- increased urine output (increased diuresis);
- increased dryness and severe itching of the skin;
- An increased predisposition to skin diseases, pustules;
- prolonged healing of wounds;
- a sharp decrease or increase in body weight;
- increased sweating;
- muscle.

Signs of diabetes

In addition, diabetes can develop against the background of:

- adrenal hyperfunction (hypercorticism);
- tumors of the digestive tract;
- increase the level of hormones that block insulin;
— ;
— ;
- poor digestibility of carbohydrates;
- a short-term increase in blood sugar.

Diabetes Classification

Due to the fact that diabetes has many different etiologies, signs, complications, and of course, the type of treatment, experts have created a fairly comprehensive formula for classifying this disease. Consider the types, types and degrees of diabetes.

By etiology:

I. Type 1 diabetes mellitus (insulin-dependent diabetes, juvenile diabetes). Most often, this type of diabetes is observed in young people, often thin. It’s hard. The reason lies in the antibodies produced by the body itself, which block the β-cells that produce insulin in the pancreas. Treatment is based on the constant intake of insulin, with the help of injections, as well as strict adherence to the diet. From the menu it is necessary to completely exclude the use of easily digestible carbohydrates (sugar, sugar-containing soft drinks, sweets, fruit juices).

Divided by:

A. Autoimmune.
B. Idiopathic.

II. Type 2 diabetes mellitus (non-insulin-dependent diabetes). Most often, type 2 diabetes affects obese people over 40 years old. The reason lies in the overabundance of nutrients in the cells, which is why they lose their sensitivity to insulin. Treatment is based primarily on a diet for weight loss.

Over time, it is possible to prescribe insulin tablets, and only as a last resort, insulin injections are prescribed.

III. Other forms of diabetes:

A. Genetic disorders of b-cells
B. Genetic defects in insulin action
C. Diseases of the endocrine cells of the pancreas:
1. trauma or pancreatectomy;
2. ;
3. neoplastic process;
4. cystic fibrosis;
5. fibrocalculeous pancreatopathy;
6. hemochromatosis;
7. other diseases.
D. Endocrinopathies:
1. Itsenko-Cushing's syndrome;
2. acromegaly;
3. glucomanoma;
4. pheochromocytoma;
5. somatostatinoma;
6. hyperthyroidism;
7. aldosteroma;
8. other endocrinopathies.
E. Diabetes as a result of side effects of drugs and toxic substances.
F. Diabetes as a complication of infectious diseases:
1. rubella;
2. cytomegalovirus infection;
3. other infectious diseases.

IV. Gestational diabetes. Blood sugar rises during pregnancy. Often passes suddenly, after childbirth.

According to the severity of the disease:

Diabetes mellitus 1 degree (mild). Characterized by a low level of glycemia (blood sugar) - not more than 8 mmol / l (on an empty stomach). The level of daily glucosuria is not more than 20 g / l. May be accompanied by angioneuropathy. Treatment at the level of diet and taking certain medications.

Diabetes mellitus 2 degrees (middle form). Relatively small, but with a more obvious effect, an increase in the level of glycemia at the level of 7-10 mmol / l is characteristic. The level of daily glucosuria is not more than 40 g / l. The manifestations of ketosis and ketoacidosis are periodically possible. Gross disturbances in the functioning of organs do not occur, but at the same time, some disturbances and signs in the functioning of the eyes, heart, blood vessels, lower extremities, kidneys and nervous system are possible. Symptoms of diabetic angioneuropathy are possible. Treatment is carried out at the level of diet therapy and oral administration of sugar-lowering drugs. In some cases, the doctor may prescribe insulin injections.

Diabetes mellitus 3 degrees (severe form). Typically, the average glycemia level is 10-14 mmol / l. The level of daily glucosuria is about 40 g / l. High levels of proteinuria (protein in urine) are noted. The picture of the clinical manifestations of target organs is intensified - eyes, heart, blood vessels, legs, kidneys, nervous system. Vision decreases, numbness and pain in the legs appear, and it rises.

Diabetes mellitus 4 degrees (super severe form). A characteristic high level of glycemia is 15-25 mmol / l or more. The level of daily glucosuria is over 40-50 g / l. Proteinuria is enhanced, the body loses protein. Almost all organs are affected. The patient is prone to frequent diabetic coma. Life is maintained purely on insulin injections - at a dose of 60 OD or more.

By complications:

- diabetic micro- and macroangiopathy;
- diabetic neuropathy;
- diabetic nephropathy;
- diabetic retinopathy;
- diabetic foot.

The following methods and analyzes have been established for the diagnosis of diabetes mellitus:

- measurement of blood glucose (determination of glycemia);
- measurement of daily fluctuations in the level of glycemia (glycemic profile);
- measurement of insulin levels in the blood;
- glucose tolerance test;
- a blood test for the concentration of glycosylated hemoglobin;
— ;
- urinalysis to determine the level of white blood cells, glucose and protein;
- abdominal organs;
- Reberg test.

In addition, if necessary, carry out:

- study of the electrolyte composition of blood;
- urinalysis to determine the presence of acetone;
- fundus examination;
— .

Before starting treatment, it is necessary to conduct an accurate diagnosis of the body, as a positive prognosis of recovery depends on this.

Diabetes treatment is aimed at:

- decrease in blood sugar;
- normalization of metabolism;
- prevention of diabetes complications.

Treatment for type 1 diabetes (insulin-dependent)

As we already mentioned in the middle of the article, in the section “Classification of diabetes mellitus”, patients with type 1 diabetes constantly need insulin injections, since the body cannot itself produce this hormone in sufficient quantities. Other methods of delivering insulin to the body, except for injections, currently do not exist. Insulin-based tablets for type 1 diabetes will not help.

In addition to insulin injections, treatment for type 1 diabetes includes:

- dieting;
- the implementation of dosed individual physical activity (DIF).

Treatment for type 2 diabetes (non-insulin dependent)

Treatment for type 2 diabetes is treated with diet and, if necessary, with sugar-lowering drugs, which are available in pill form.

Diet for type 2 diabetes is the main method of treatment due to the fact that this type of diabetes just develops due to improper human nutrition. With improper nutrition, all types of metabolism are disturbed, therefore, by changing his diet, the diabetic in many cases receives recovery.

In some cases, with persistent types of type 2 diabetes, the doctor may prescribe insulin injections.

When treating any type of diabetes, dietary therapy is a must.

A nutritionist with diabetes, after receiving tests, taking into account age, body weight, gender, lifestyle, paints an individual nutrition program. When dieting, the patient should calculate the amount of calories, proteins, fats, carbohydrates, vitamins and minerals consumed. The menu should be observed strictly according to the prescription, which minimizes the risk of complications of this disease. Moreover, following a diet for diabetes, it is possible to defeat this disease without additional medication.

The general focus of diet therapy for diabetes is on eating food with a minimal content or lack of easily digestible carbohydrates, as well as fats, which are easily converted to carbohydrate compounds.

What to eat with diabetes?

The menu for diabetes consists of vegetables, fruits, meat and dairy products. The diagnosis of diabetes mellitus does not mean that you need to completely refuse glucose in food. Glucose is the "energy" of the body, with a lack of which, protein breaks down. Food should be rich in protein, and.

What can I eat with diabetes: beans, buckwheat, oatmeal, barley, wheat and corn grits, grapefruit, orange, apples, pears, peach, apricot, pomegranate, dried fruits (prunes, dried apricots, dried apples), cherries, blueberries, blackberries, currants, gooseberries, walnuts, pine nuts, peanuts, almonds, brown bread, butter or sunflower oil (not more than 40 g per day).

What you can not eat with diabetes: coffee, alcoholic drinks, chocolate, confectionery, sweets, jam, muffin, ice cream, spicy dishes, smoked meats, salty dishes, fat, pepper, mustard, bananas, raisins, grapes.

What is better to refrain from: watermelon, melon, store juices. In addition, try not to consume a product about which you know nothing or little.

Conditionally approved products for diabetes:

Exercise for diabetes

In the current “lazy" time, when the world was captured by television, the Internet, sedentary, and at the same time often highly paid work, an increasing number of people are moving less and less. Unfortunately, this is not the best way to affect health. Diabetes mellitus, hypertension, heart failure, visual impairment, spinal diseases are just a small part of the ailments in which the sedentary lifestyle is indirectly and sometimes directly guilty.

When a person leads an active lifestyle, he walks a lot, rides a bicycle, does exercises, plays sports, metabolism speeds up, blood “plays”. At the same time, all cells receive the necessary nutrition, organs are in good shape, the immune system works perfectly, and the body as a whole is less susceptible to various diseases.

That is why moderate exercise in diabetes has a beneficial effect. When you do physical exercises, increased oxidation of glucose from the blood occurs in the muscle tissues, and therefore, the blood sugar level decreases. Of course, this does not mean that you will now change into a sportswear and run a few kilometers in an unknown direction. The necessary set of exercises for you will be prescribed by your doctor.

Diabetes Medicines

Consider some groups of drugs against diabetes (antipyretic drugs):

Drugs that stimulate the pancreas to produce more insulin: Sulfonylureas (Glyclazide, Glycvidon, Glipizide), Meglitinides (Repaglinide, Nateglinide).

Pills that make body cells more sensitive to insulin:

- Biguanides (“Siofor”, “Glucophage”, “Metformin”). Contraindicated in people with heart and kidney failure.
- Thiazolidinediones ("Avandia", "Pioglitazone"). They increase the effectiveness of insulin (improving insulin resistance) in adipose and muscle tissues.

Means with incretin activity: DPP-4 inhibitors (Vildagliptin, Sitagliptin), glucagon-like peptide-1 receptor agonists (Liraglutid, Exenatide).

Drugs that block the absorption of glucose in the digestive tract: alpha glucosidase inhibitor ("Acarbose").

Can diabetes be cured?

A positive prognosis in the treatment of diabetes depends largely on:

- type of diabetes;
- time of detection of the disease;
- an accurate diagnosis;
- strict adherence by the diabetic to the doctor's prescriptions.

According to modern (official) scientists, it is currently impossible to completely recover from type 1 diabetes, as well as persistent forms of type 2 diabetes. At least, such medicines have not yet been invented. With this diagnosis, treatment is aimed at preventing complications, as well as the pathological effect of the disease on the work of other organs. After all, you need to understand that the danger of diabetes lies precisely in complications. With the help of insulin injections, you can only slow down the pathological processes in the body.

Treatment of type 2 diabetes mellitus, in most cases, with the help of nutrition correction, as well as moderate physical activity, is quite successful. However, when a person returns to the old way of life, hyperglycemia does not take long to wait.

I would also like to note that there are unofficial methods of treating diabetes, for example - therapeutic fasting. Such methods often end up for a diabetic resuscitation. From this we must conclude that before applying various folk remedies and recommendations, be sure to consult a doctor.

Of course, I can not help but mention another way to cure diabetes - prayer, turning to God. Both in the Holy Scriptures and in the modern world an incredibly large number of people received healing after turning to the Lord, and, in this case, it does not matter what a person is sick with, because what is impossible for a person, everything is possible for God.

Alternative treatment for diabetes

Important! Before using folk remedies, be sure to consult your doctor!

Celery with lemon. Peel 500 g of celery root and twist them together with 6 lemons in a meat grinder. Boil the mixture in a pan in a water bath for 2 hours. Next, put the product in the refrigerator. The mixture must be taken 1 tbsp. spoon in 30 minutes Before breakfast, for 2 years.

Lemon with parsley and garlic. 100 g of lemon peel are mixed with 300 g of parsley root (you can put leaves) and 300 g. We twist everything through a meat grinder. The resulting mixture is put in a jar and put in a cool dark place for 2 weeks. The resulting product should be taken 3 times a day, 1 teaspoon 30 minutes before a meal.

Linden. If you have high blood sugar, drink linden-colored infusion instead of tea for several days. To prepare the product, put 1 tbsp. spoon of lime on 1 cup of boiling water.

You can also cook and decoction of linden. For this, 2 cups of linden blossom pour 3 liters of water. Boil this product for 10 minutes, cool, strain and pour into jars or bottles. Keep in the refrigerator. Eat half a cup of lime tea every day when you feel thirsty. When you drink this portion, take a break for 3 weeks, after which the course can be repeated.

Alder, nettle and quinoa. Mix half a glass of alder leaves, 2 tbsp. spoons of quinoa leaves and 1 tbsp. a spoonful of flowers. Pour in a mixture of 1 liter of water, shake well and place for 5 days in an illuminated place. Then add a pinch to the infusion and consume 1 teaspoon in 30 minutes. Before meals, morning and evening.

Buckwheat. Grind with a coffee grinder 1 tbsp. a spoonful of buckwheat, then add it to 1 cup of kefir. Insist on overnight and drink 30 minutes before meals in the morning.

Lemon and eggs. Squeeze the juice from 1 lemon and mix well 1 raw egg with it. Drink the resulting product 60 minutes before meals, for 3 days.

Walnut. Pour a partition of 40 g with a glass of boiling water. Then darken them in a water bath for about 60 minutes. Cool and strain the infusion. You need to take an infusion of 1-2 teaspoon 30 minutes before meals, 2 times a day.

A walnut leaf remedy also helps. To do this, fill in 1 tbsp. a spoonful of well-dried and ground leaves 50 ml of boiled water. Next, boil the infusion for 15 minutes over low heat, then leave to infuse for about 40 minutes. The broth should be filtered and taken 3-4 times a day in half a glass.

Hazel (bark). Finely chop and pour 400 ml of pure water 1 tbsp. a spoonful of hazel bark. Leave the product to infuse overnight, after which we place the infusion in an enameled pan and put on fire. Cook the remedy for about 10 minutes. After which we cool the broth, divide it into equal parts and drink throughout the day. Keep the broth in the refrigerator.

Aspen (bark). Put in a enameled pan a handful of planed aspen bark, which pour 3 liters of water. Bring the product to a boil and remove from heat. The resulting broth must be drunk instead of tea, for 2 weeks, after which a break for 7 days and again repeat the course of treatment. Between the 2nd and 3rd courses, a break is made for a month.

Bay leaf. Put 10 dry bay leaves in an enameled or glass dish and pour them with 250 ml of boiling water. Wrap the container well and let it stand for 2 hours. The resulting infusion for diabetes should be taken 3 times a day in half a glass, 40 minutes before a meal.

Flax seeds. Grind into flour 2 tbsp. tablespoons of flax seeds and fill them with 500 ml of boiling water. Boil the mixture in an enamel container for about 5 minutes. The broth must be drunk completely for 1 time, in a warm state, 30 minutes before a meal.

For wound healing in diabetes, use lotions on an insulin basis.

Diabetes Prevention

To prevent the onset of diabetes, experts recommend adhering to preventive rules:

- monitor your weight - prevent the appearance of extra pounds;
- to live an active lifestyle;
- eat right - eat fractionally, as well as try to avoid foods that are rich in easily digestible carbohydrates, but focus on foods rich in minerals;
- to control

The phenomenon is much more insidious. Unfortunately, it is impossible to cure him. But you can prevent it. In this article, we will not talk about how terrible the consequences of diabetes are.

We’ll talk about prevention, the first symptoms of diabetes, and how to detect the disease at the very beginning. Tells endocrinologist of the Chernigov city polyclinic № 3 Elena Piskun.

If all the diseases in our country were called non-romantic ancient Greek phrases, then it would be much easier to understand their essence. Indeed, the wise Greeks encrypted in the names not only the essence of the disease, but also its symptoms. For example, the disease diabetes mellitus could only be referred to as “a person losing sugar”.

The essence of the disease is pancreatic dysfunction, which cannot produce enough insulin. And why do we need insulin?

We are losing him!

Imagine the cells of the body as some sphere with closed doors. Glucose accumulates around cells, but cannot get inside without the help of insulin. It serves as a key to the door of the cell. Glucose, in turn, is necessary for cells to exist, just as gas is needed for a car to drive.

What happens in a situation where there is little or no insulin at all? Here food enters the body, then complex carbohydrates are processed into monosugar (mainly glucose) and, being absorbed through the intestinal wall into the blood, are carried throughout the body. It seems like glucose is there and everything is fine, but it cannot get into cells without insulin. As a result, the cells starve, but the blood sugar level rises.

Head as an indicator

Where does glucose get if there is no insulin and it cannot get into the cells? Part of it interacts with non-insulin-dependent tissues, which absorb sugar from the blood, despite the lack of insulin, and if there is too much sugar, then they absorb it in excess.

First of all, the brain, nerve endings and nerve cells act as such sinks of sugar. Yes, that’s why the first symptoms of diabetes are heaviness in the head, fatigue, fatigue, impaired attention, a little later cataract or clouding of the lens of the eye appears, vision deteriorates (a white veil appears before a person).

Glycemic index. Who needs it?

The glycemic index reflects the rate at which a particular product is broken down in our body and converted to glucose. Glucose itself is taken as a standard and, accordingly, is equated to 100 units. For all other products, the glycemic index (GI) varies from 0 to 100 or more, depending on how quickly they are absorbed.

If a product has a low glycemic index, it means that when it is consumed, the blood sugar level rises slowly. The higher the glycemic index, the faster the sugar level rises after consuming the product and the higher the instantaneous blood sugar level after eating food will be.

Heredity. There are observations that type 1 diabetes is inherited with a probability of 3-7% on the mother's side and with a probability of 10% on the father's side. If both parents are ill, the risk of the disease increases several times and amounts to 70%. Type 2 diabetes is inherited with a probability of 80% on both the maternal and paternal side, and if both parents suffer from non-insulin-dependent diabetes mellitus, the probability of its manifestation in children approaches 100%, but, as a rule, in adulthood. Well, in this case, doctors differ only in the number of percentages, for the rest they are in agreement: heredity is the main factor in the onset of diabetes.

Obesity. From the point of view of developing diabetes, it is especially dangerous if the body mass index is more than 30 kg / m2 and obesity is abdominal, that is, the shape of the body takes the form of an apple. Of great importance is the circumference of the waist. The risk of diabetes increases with a waist circumference for men more than 102 cm, for women more than 88 cm. It turns out that aspen waist is not only a fad, but also a sure way to protect yourself from diabetes. This factor, fortunately, can be neutralized if a person, aware of the entire measure of danger, will struggle with overweight (and win in this fight). Best recipe from doctors in this case - give up a sedentary lifestyle. Just 30 minutes of exercise a day or 3 hours a week can work wonders.

Pancreatic disease. Pancreatitis, pancreatic cancer, diseases of other endocrine glands - everything that provokes pancreatic dysfunction contributes to the development of diabetes. By the way, often physical damage can contribute to pancreatic damage.

Viral infections. Rubella, chickenpox, epidemic hepatitis and several other diseases, including the flu, increase the risk of diabetes. These infections play the role of a trigger, as if provoking the disease. Clearly, for most people, the flu will not be the beginning of diabetes. But if this is a obese person with aggravated heredity, then for him a simple virus poses a threat. A person in whose family there were no diabetics can repeatedly suffer the flu and other infectious diseases, and the likelihood of developing diabetes is much less than that of a person with a hereditary predisposition to diabetes. So the combination of risk factors increases the risk of the disease several times.

The diabetes prescribed in the genes may not occur if one of the following factors does not trigger it: nervous stress, a sedentary lifestyle, malnutrition, lack of ability to breathe fresh air and spend time in nature. All these “urban” troubles only increase the risk. Add to this the increase in life expectancy (the highest incidence of diabetes has been recorded in people over 65), and we get huge statistics on the number of patients with diabetes.

Diabetes young and old

There are two types of diabetes. What are their features?

1st type. Insulin dependent.

This disease is most often genetically determined; it can manifest itself at any age, more often at a young age (even in the first months of life). In the first type, pancreatic cells are destroyed, which leads to absolute insulin deficiency. Which, in turn, leads to an increase in blood sugar, constant thirst and weight loss (despite the fact that the appetite is usually good). The first type of diabetes is only treated with subcutaneous insulin injections.

A special diet and a minimum of nervous shocks are also needed.

2nd type. Non-insulin independent.

This type of disease usually develops over the years. Most often, he is diagnosed in adulthood. In type 2 diabetics, only relative insulin deficiency develops, i.e. pancreatic insulin is produced in sufficient quantity, but the sensitivity of cell receptors is impaired, which leads to impaired carbohydrate metabolism and a high level of glucose in the blood.

The cause, and with it the symptom of this type of diabetes, is often obesity. Such diabetes is kept under control by sugar-lowering pills, diet and, again, the right way of life.

Myths and facts about diabetes

If a child is given a lot of sweet, he will develop diabetes.

It is not true. As we have already found out, the amount of sugar in foods does not directly affect blood sugar. In the case of children, it is necessary to understand whether they have a hereditary predisposition to the disease. If there is, then you need to draw up a menu based on indicators of the glycemic index of products. If the hereditary factor is excluded, then there is a need in the form of prevention to maintain a healthy body weight and a healthy psyche of the child. But the amount of candy eaten by him does not affect the development of diabetes.

Infectious diabetes.

This is a one hundred percent myth, which is the result of misinformation. Unfortunately, a large number of materials are replete with allegations that diabetes can be “caught” through dishes or physical contact with a sick person, as well as through the blood of a diabetic.

This is absolute nonsense. Diabetes is a pancreatic dysfunction. And that’s all! It's not about the quality of the blood, not about the viral bacteria, but about the specific characteristics (or acquired diseases) of the body.

But ordinary flu can also trigger diabetes, but only if the person already has a predisposition to diabetes.

Diabetes is dangerous for the legs.

Indeed, most is a foot disease, the so-called "diabetic foot." Most often, this phenomenon can be seen in type 2 diabetics with 15-20-year experience. First, wounds similar to a funnel appear on the surface of the feet, which eventually grow and turn into an ulcer.

Diabetes mellitus destroys the nervous system and blood vessels. Foot - that part of the body that is constantly experiencing increased stress and is often injured. And in conditions of impaired blood circulation, the protective function of tissues is reduced, and any minor injury (scuff, abrasion) can lead to a long-term non-healing wound.

Type 2 diabetes diet

Breakfast:

Eggs - 2 pcs., Hard boiled

Boiled meat with stewed zucchini

Coffee or tea with milk

Butter (10 g) and 2 slices of rye bread

Lunch:

Fish or meat broth soup with meatballs

Low-fat boiled meat with stewed cabbage

Fresh apple or jelly compote

High tea:

Bran cheesecake

Rosehip infusion or tea with lemon

Dinner:

Stuffed cabbage with meat or cod in marinade

Tea or infusion of chamomile

For the night:

Sour milk or apple

Diabetes mellitus is a disease of the endocrine system that occurs due to a lack of insulin and is characterized by metabolic disorders and, in particular, carbohydrate metabolism. In diabetes mellitus, the pancreas loses its ability to secrete the required amount of insulin or to produce insulin of the required quality.

The name "diabetes", according to a resolution of the World Health Organization in 1985, is the name of a whole list of diseases that have common features: according to various factors, the owner of any of these diseases rises the level of sugar (glucose) in the blood.

Diabetes is a rarely diagnosed disease.

There is a number factorsthat predispose to the onset of diabetes. In the first place is a hereditary predisposition; the second leading cause of diabetes is obesity; the third reason is some diseases that result in damage to the beta cells that produce insulin (these are pancreatic diseases - pancreatitis, pancreatic cancer, diseases of other endocrine glands). The fourth reason is a variety of viral infections (rubella, chickenpox, epidemic hepatitis and some other diseases, including influenza); fifth place is nervous stress as a predisposing factor; in sixth place among the risk factors is age. The older a person, the more reason he has to fear diabetes. It is believed that with an increase in age for every ten years, the likelihood of developing diabetes doubles.

In rare cases, some hormonal disorders lead to diabetes, sometimes diabetes is caused by damage to the pancreas that occurs after the use of certain drugs or as a result of prolonged alcohol abuse.

Depending on the reasons for the rise in blood glucose, diabetes is divided into two main groups: type 1 diabetes and type 2 diabetes.

Type 1 diabetes - insulin dependent. It is associated with damage to the pancreas, absolute insufficiency of its own insulin, and requires the introduction of insulin. Type 1 diabetes mellitus occurs, as a rule, at a young age (this form of diabetes mainly affects young people under the age of 30).

Second type of diabetes- non-insulin-dependent, occurs in connection with the relative insufficiency of insulin. In the early stages of the disease, insulin administration is usually not required. Type 2 diabetes mellitus is a disease of adulthood (older people mostly suffer from it). In such patients, insulin is produced, and by following a diet, leading an active lifestyle, these people can achieve that for quite a long time the sugar level will be normal, and complications can be safely avoided. Treatment of this type of diabetes can be limited only to the use of tablet preparations, however, in some patients, the need for additional prescription of insulin arises over time. This is not a mild form of diabetes, as was previously thought, since type 2 diabetes is one of the main risk factors for developing coronary heart disease (angina pectoris, myocardial infarction), hypertension, and other cardiovascular diseases.

Symptoms

There is a complex of symptoms characteristic of both types of diabetes mellitus: frequent urination and a feeling of unquenchable thirst; rapid weight loss, often with good appetite; feeling weak or tired; fast fatiguability; blurred vision ("white veil" before the eyes); decreased sexual activity, potency; numbness and tingling in the limbs; feeling of heaviness in the legs; Dizziness protracted course of infectious diseases; slow healing of wounds; a drop in body temperature below the average mark; spasms of the calf muscles.

There are times when a chronic increase in blood sugar for some time may not have such typical diabetes manifestations as thirst or a significant increase in the daily amount of urine. And only over time, patients pay attention to general weakness, constantly bad mood, itching, frequent abscesses of the skin, progressive weight loss.

The onset of type 1 diabetes is characterized by a rapid deterioration in well-being and more pronounced symptoms of dehydration. Such patients need urgent administration of insulin preparations. Without appropriate treatment, a life-threatening condition, a diabetic coma, can occur. As for type 2 diabetes, in almost all cases, weight loss and significant physical activity can prevent the progression of diabetes and normalize blood sugar levels.

In order to install diagnosis diabetes, it is necessary to determine the level of sugar in the blood. When fasting blood sugar is less than 7.0 mmol / L, but more than 5.6 mmol / L, a glucose tolerance test is necessary to clarify the state of carbohydrate metabolism. The procedure for this test is as follows: after determining the fasting blood sugar (fasting period of at least 10 hours), 75 g of glucose must be taken. The next measurement of blood sugar is made after 2 hours. If the blood sugar level is more than 11.1, you can talk about the presence of diabetes. If the blood sugar level is less than 11.1 mmol / l, but more than 7.8 mmol / l - they indicate a violation of tolerance to carbohydrates. At lower blood sugar levels, the test should be repeated after 3-6 months.

Treatment Depends on the type of diabetes. Type I diabetes should always be treated with insulin, compensating for its absence in the body. Type II diabetes can be treated first with a diet, and in case of failure of this treatment, tablets are added (antidiabetic oral drugs, i.e. taken orally); as the disease progresses, the person switches to insulin therapy. In most countries of the modern world, the patient's need for insulin is completely covered by genetically engineered human insulin preparations. This is a biosynthetic or recombinant human insulin and all dosage forms obtained on its basis. According to the International Diabetes Federation, at the end of 2004, more than 65% of the countries in the world used only genetically engineered human insulins to treat diabetes.

Distinguish between drugs of short action, drugs of medium duration and drugs of long action. Along with them, insulin analogues with additional properties are also used. These include ultra-short-acting insulins and prolonged (prolonged) action. As a rule, such drugs are administered subcutaneously, but if necessary, intramuscularly or intravenously.

It has been firmly established that diabetes cannot be infected as it is with the flu or tuberculosis. Diabetes is rightly classified as a disease of civilization, that is, the cause of diabetes in many cases is excessive, rich in easily digestible carbohydrates, "civilized" food.

Diabetes mellitus is the most common endocrine disease worldwide. According to the World Health Organization (WHO), diabetes is the fourth leading cause of premature death, and it is predicted that over the next 10 years the number of deaths from diabetes will increase by more than 50% unless urgent measures are taken.

Despite all the efforts of health organizations and the national programs to combat this disease that are being adopted in many countries of the world, the number of patients with this diagnosis is constantly growing. The incidence of diabetes is increasing not only within the age group over 40 years old, among children there are more and more children and adolescents. According to the International Diabetes Federation and WHO, there are currently more than 200 million people with diabetes worldwide.

According to experts, by 2010 this figure will increase to 239.4 million, and by 2030 - to 380 million. More than 90% of cases in this type of diabetes mellitus type 2.

The indicated values \u200b\u200bcan be very underestimated, since up to 50% of patients with diabetes mellitus remain undiagnosed today. These people do not receive any hypoglycemic therapy and maintain stable hyperglycemia, which creates favorable conditions for the development of vascular and other complications.

Every 10-15 years, the total number of patients doubles. On average, 4-5% of the world's population suffer from diabetes, in Russia - from 3 to 6%, in the USA - from 10 to 20%.

The incidence of diabetes in Russia today has come close to the epidemiological threshold. In Russia, more than 2.3 million diabetics have been registered (unofficial statistics cite numbers from 8.4 to 11.2 million people), of which more than 750 thousand need daily intake of insulin.

Material prepared on the basis of open source information

You can identify diabetes by looking at the symptoms that appear. With this endocrine disease, the health condition worsens. At first, many patients do not even pay attention to the first symptoms of diabetes, although with type I pathology, they reduce the quality of life of a person in a matter of days. The later the disease is detected, the more difficult it is to achieve compensation. Remember the signs of diabetes, this will allow you to see a doctor in a timely manner when they occur.

Disease characteristic

Diabetes mellitus is a serious endocrine pathology in which there is an absolute or relative insulin deficiency. In the first case, it is not produced by the cells of the pancreas in the required quantities, and in the second, it disrupts the interaction of this hormone with the target cells.

Insulin is required so that the glucose entering the body can be absorbed by the tissues. If the hormone does not perform its functions, then sugar circulates in the blood for a long time. As a result, tissues and organs do not receive the necessary energy.

Pathology is manifested by the development of persistent hyperglycemia. Sugar concentration is constantly above normal. With this disease, all types of metabolism are disturbed. Problems arise from carbohydrate, fat, water-salt, protein and mineral metabolism.

Classification

Endocrinologists distinguish the following types of diabetes:

• insulin-dependent (type I);
• insulin independent (type II);
• gestational.

Type I diabetes is insulin-dependent. This form of the disease is detected mainly in children and young people. The main symptoms of type I pathology are pronounced. With this form of the disease, insulin is not produced in the patient’s body, so patients need to inject this hormone daily.

In form II, the first signs do not appear immediately, they are weakly expressed. A person may for several years from the onset of the development of the disease not suspect that he has health problems. Insulin is produced in the body, but target cells become insensitive to it.

Gestational diabetes occurs during pregnancy. After childbirth, the condition normalizes, but the woman must be careful, follow a diet. Patients with this form are at risk of developing type 2 disease.

First signs of diabetes

All symptoms of this endocrine pathology are divided into primary and secondary. Their appearance is characteristic of both forms of the disease. But insulin-dependent people develop mainly the main symptoms. They become pronounced at a time when no more than 20% of the cells that are responsible for insulin production remain in the pancreas.

The main features include the following:

• polyuria - increased urination, increased volume of urine;
• polydipsia - the appearance of an obsessive thirst that cannot be satisfied; the patient can drink more than 5 liters of water daily;
• polyphagy - increased hunger, after meals there is no feeling of satiety;
• weight loss - with the development of insulin dependence, people quickly lose weight.

In the I form of the disease, patients can even approximately name the date when they first felt unwell.

But the main symptoms occur with type II disease. Their severity is growing gradually. Therefore, often the patient cannot say when he felt a change in well-being for the first time. Non-insulin-dependent patients previously notice the occurrence of secondary symptoms. But many of them can be confused with other diseases, so people do not immediately contact the endocrinologist.

Secondary symptoms include the following:

• dry mouth
• itching of the skin and mucous membranes;
• muscle weakness, increased fatigue;
• skin lesions that are difficult to treat;
• visual disturbances;
• persistent headaches;
• metallic taste in the mouth;
• numbness of the limbs.

But the main and secondary signs develop with all forms of pathology. It is possible to understand what kind of patient the patient suffers without conducting a comprehensive examination for specific signs. But to clarify the diagnosis, the selection of treatment, diagnosis is required.

Symptoms of type 1

People who break down the cells responsible for insulin production experience constant hunger. With an increase in the amount of food absorbed, their weight may fall. Having noticed such changes, it is necessary to immediately donate blood for sugar.

Also, the symptoms of the appearance of insulin dependence include:

• increased nervous irritability;
• causeless attacks of vomiting, nausea;
• smell of acetone when breathing;
• pain in the heart;
• sleep disturbance;
• sharp headaches.

The appearance of even 1 symptom cannot be ignored. You can understand that there are problems by passing an analysis to determine your blood sugar. If you do not start insulin therapy when the first signs appear, then the patient's condition will rapidly deteriorate, he may fall into a diabetic coma.

Symptoms of type 2

Specific changes by which it is possible to suspect the development of an insulin-independent form of the disease include the following:

• pain in the limbs;
• muscle cramps in the legs, arms;
• weight gain;
• worsening libido, problems with potency;
• decrease in pain sensitivity;
• weakened immunity;
• the appearance on the body of xanthomas - yellow formations that occur when there is a violation of fat metabolism;
• increased facial hair growth with a simultaneous decrease in the amount of hair on the legs.

But these manifestations in patients are often weakly expressed, so people do not pay any attention to them. Many problems are identified by chance during a routine examination.

Features of occurrence

There are no special differences in the development of the disease in men and women. It starts the same way for both sexes. Only minor symptoms may differ.

The severity of pathological signs and the rate of development of the disease depends directly on the age of the person. In children, adolescents, I form of diabetes is detected. People over 40 develop type II disease.

Non-insulin-dependent pathologies are more often detected in patients who:

• lead an inactive lifestyle;
• are overweight;
• consume simple carbohydrates in large quantities;
• experiencing constant psycho-emotional stress.

You can distinguish between types of disease according to symptoms.

In children

Young people develop a predominantly insulin-dependent form of diabetes. This diagnosis is made for patients under 30 years of age. A doctor’s consultation is necessary if the child or young person has more frequent urination, the volume of fluid consumed has increased significantly.

The likelihood of a disease is higher in those children who:

• have a hereditary predisposition to developing diabetes;
• born with a weight of 4.5 kg or more;
• suffer from metabolic disorders (obesity, hypothyroidism);
• suffered a viral infection, as a result of which cells of the pancreas (rubella, measles, mumps and others) could be damaged.

With a mild form in children and adolescents, symptoms do not always occur, they can be almost invisible. Signs will appear only with the progression of the disease.

In men

In adult patients, there is a risk of developing type 2 pathology. Men who have diabetes are prone to diabetes, who, when gaining excess weight, increase their abdominal volume first. With visceral obesity, pressure on the internal organs increases, the work of the pancreas is disrupted.

Alarming symptoms are weakening of sexual desire and impotence. A characteristic sign can be inflammation of the foreskin - it occurs due to the frequent urination. The development of this condition contributes to the active reproduction of pathogenic bacteria.

Among women

One of the symptoms of diabetes is itching of the mucous membranes. More often, women encounter its occurrence - they have unpleasant sensations in the genital area. Most of them turn to a gynecologist with a suspicion of infection with infections that are transmitted through sexual contact. If there are no STDs based on the results of analyzes, there are no problems with microflora, then the doctor may advise you to check the sugar level.

Diagnostics

When symptoms of endocrine disorders appear, an examination is necessary. To identify diabetes allow tests that determine:

• fasting blood glucose concentration;
• glycated hemoglobin - shows the average level of sugar that the patient has had over the past 2-3 months;
• glucose tolerance test - an analysis that is performed on an empty stomach and is repeated after glucose intake.

Which doctor should I contact

Patients with primary, secondary, or specific signs of diabetes should schedule an appointment with an endocrinologist. But a preliminary diagnosis can be made by a therapist - he will give a direction for the necessary tests.

According to the results of the examination, the endocrinologist can immediately give recommendations on nutrition, lifestyle changes and drug therapy. In the first type of disease, insulin injections cannot be dispensed with. Diet therapy is prescribed for patients with type II diabetes, medications are selected, under the influence of which target cells begin to absorb insulin and glucose more actively.