What You Need To Know About Diabetes

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What You Need To Know About Diabetes
What You Need To Know About Diabetes

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What you need to know about diabetes

November 14 is World Diabetes Day. According to the International Diabetes Federation IDF, half of people with diabetes are unaware of their disease. At the same time, only early diagnosis and timely treatment can prevent complications of this insidious disease. The expert explains how to recognize diabetes at an early stage and whether it can be prevented.

What you need to know about diabetes
What you need to know about diabetes

Photo: Stuart Bradford / NY Times /

World Diabetes Day is celebrated on 14 November. According to the International Diabetes Federation IDF, half of people with diabetes are unaware of their disease. At the same time, only early diagnosis and timely treatment can prevent complications of this insidious disease. How to recognize diabetes at an early stage and whether it can be prevented, said Marina Vershinina, a leading expert of the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor.

Why does a person get diabetes?

Type 1 diabetes mellitus develops mainly in childhood and young age. The reason is the death of specific cells in the pancreas that produce insulin. The disease develops quickly, with severe symptoms. And only substitution therapy - insulin in the form of a medicine - can save lives.

Diabetes mellitus of the second (adult) type develops mainly in the elderly. Tissues lose their ability to respond to insulin. Initially, the pancreas makes more and more insulin to overcome resistance in the tissues. But then its capabilities are depleted, and the production of insulin decreases. People who are sick often do not notice symptoms until the changes in the body become irreversible.

How to recognize type 2 diabetes

Type 2 diabetes mellitus develops and progresses rather slowly, gradually. The sick person, as a rule, does not feel a sharp deterioration in well-being, has time to get used to, adapt to the changes taking place. This is the insidiousness of diabetes. Often it is diagnosed only at the stage of development of complications, which significantly worsens the prognosis of the disease.

However, there are signs to watch out for. Patients with diabetes mellitus experience weakness, increased fatigue, and poor tolerance to daily physical activity. The most specific symptoms for diabetes are increased urination (the body tries to remove the glucose accumulated in the blood), thirst (fluid is needed to "dilute" glucose in the blood and compensate for its loss in the urine) and increased appetite (cells of organs and tissues are "starving", not getting glucose). Typical complaints are itching of the skin, the appearance of boils, exacerbation of candidiasis (thrush), the addition of fungal infections of the skin and nails. There is a decrease in visual acuity, the appearance of unexplained sensations (feeling of "crawling creeps", tingling) in different parts of the body.

You can assess your own risk of developing diabetes mellitus by filling out specialized questionnaires. One of the most recommended is the FINDRISC (The Finnish Diabetes Risk Score) questionnaire, developed by the Finnish Diabetes Association. This questionnaire is available on the Internet. You can take online testing on the website of our laboratory. If, according to the results of the questionnaire, the points scored indicate an increased degree of risk, it is necessary to undergo a laboratory examination.

What is this survey

Before the onset of symptoms, at the stage of minimal pathological changes, diabetes mellitus and prediabetes can be detected only on the basis of laboratory results. Therefore, if the patient is at increased risk of developing type 2 diabetes mellitus, it is necessary to be tested regularly. The most important tests are blood glucose and glycated (glycosylated) hemoglobin levels.

Measuring blood glucose with a household glucose meter is not suitable for diagnosis (this device is used for self-monitoring during treatment). If an elevated glucose level is measured with the meter, this result must be double-checked in the laboratory.

In the early stages of impaired carbohydrate metabolism, the level of "lean" glucose often remains within normal limits. Therefore, it is also recommended to investigate the level of glycated hemoglobin (a biochemical compound that is formed during prolonged interaction of erythrocyte hemoglobin with glucose). Erythrocytes (red blood cells) live in the bloodstream for about 3 months, so an elevated glycated hemoglobin level indicates that serum glucose has been steadily elevated for at least several weeks.

An endocrinologist diagnoses diabetes mellitus and prediabetes only after repeated testing. The diagnostic criteria take into account the results of a glucose exercise test ("Oral glucose tolerance test"). The patient is tested for glucose in a fasting blood sample. Then they give a saturated glucose solution to drink and re-measure the glucose in the serum after 2 hours, during which time the glucose level should drop less than 7.8 mmol / l. But this test can only be done under medical supervision.

What is prediabetes

Prediabetes is an early disorder of carbohydrate metabolism that can be detected by laboratory methods (oral glucose tolerance test). Glucose in the blood of such patients may remain elevated 2 hours after eating a portion of glucose in food, or it rises moderately on an empty stomach.

Prediabetes is reversible; it is not a disease yet. But only under the condition of active lifestyle changes: revision of dietary habits (reduction of calories, restriction of fats and simple carbohydrates), weight loss (target value - 5-7% of the initial value), regular physical activity (walking, swimming, cycling - at least 150 minutes per week). Medicines can be prescribed by the doctor's decision.

Who is at risk

The risk of developing type 2 diabetes at any age increases being overweight. The risk is especially high in people prone to obesity by the abdominal type (accumulation of adipose tissue mainly in the abdomen). According to the national recommendations "Prevention of chronic non-communicable diseases", more than 80% of cases of type 2 diabetes are associated with overweight and obesity.

Risk factors for patients with normal weight are heredity, ethnicity, age, high blood pressure, bad habits, physical inactivity, and insufficient intake of foods rich in dietary fiber. However, the risk of developing diabetes is directly related to high sugar intake: high blood glucose levels in diabetics are not a cause, but an effect.

The disease is not inherited, but people with relatives with diabetes have a higher risk of developing the disease than the general population. A healthy lifestyle, a balanced diet and sufficient physical activity can hinder the implementation of the genetic program.

Is it necessary to treat diabetes

It is imperative to treat diabetes. With the help of modern drugs, it is possible to achieve very effective control over carbohydrate metabolism. The better the mechanism of artificial regulation of glucose levels is debugged, the lower the risk of complications. Diet alone is not enough - the root of the problem lies in the hormone insulin, which is the main regulator of blood sugar levels. And the appointment of a special diet has only one goal - to reduce the load on the insular apparatus. Eating excesses in diabetes are unacceptable, but eating restrictions do not solve the problem. And fasting in diabetes is generally categorically contraindicated.

Patients with type 1 diabetes mellitus need insulin injections. Adult patients with type 2 diabetes are usually prescribed pills to help lower blood sugar. These drugs stimulate the pancreas to produce more insulin to overcome tissue resistance (resistance) or increase tissue sensitivity to insulin. But in those cases when it is not possible to take control of carbohydrate metabolism indicators, insulin injections are also prescribed for type 2 diabetes mellitus.

Adequately selected treatment and careful adherence to the doctor's prescriptions, regular monitoring of laboratory parameters allow you to live a full life for many years.

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