The term diabetes includes a number of disorders in the process of carbohydrate metabolism ie catabolism and synthesis.
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normal metabolism process
The carbohydrates that the body obtains from eating bread, potatoes, rice, cake and many other foods gradually break down and decompose, as this process of disintegration and decomposition begins in the stomach, then continues in the duodenum and in the small intestine, where it is produced by the process of Dissociation and decomposition These are a group of sugars that are absorbed into the circulation.
The balance between the two hormones insulin and glucagon maintains the stability of the level of glucose in the blood and avoids sharp changes. The cells responsible for secreting these hormones include the following:
1. Internal secretion cells
In the pancreas, there are cells called beta cells that are very sensitive to high blood sugar levels as they secrete the hormone insulin.
Insulin is the main bridge for the entry of glucose and sugar molecules into the muscles where it is used as a source of energy, and into fat tissues and the liver where it is stored, and glucose reaches the brain as well, but without the help of insulin.
2. Alpha cells
They are also present in the pancreas and secrete another additional hormone called glucagon. This hormone causes the release of sugar from the liver and activates the action of other hormones that block the action of insulin.
People of a healthy weight who do a lot of physical activity need a small amount of insulin to balance the work of glucose that reaches the blood, and the more obese and less physically fit a person becomes, the more insulin is needed to process a similar amount of glucose in the blood, this condition is called insulin resistance (insulin resistance).
diabetes
When the beta cells in the pancreas are damaged, the amount of insulin secreted gradually decreases, and this process continues for many years.
If this condition is accompanied by the presence of insulin resistance, this combination of a small amount of insulin and its low level of effectiveness leads to a deviation from the proper level of glucose, that is, sugar in the blood, in which case the person is defined as having diabetes (Diabetes).
After fasting for eight hours, the result of the analysis may indicate the following:
It is known that a healthy level should be less than 108 mg/dL.
The borderline level is 126 mg/dL.
The infection level is 126 mg/dL and above, on two or more tests.
How does diabetes affect the level of sugar in the blood?
Diabetes symptoms
diabetes symptoms
Symptoms of diabetes vary depending on the type of diabetes. Sometimes people with prediabetes or gestational diabetes may have no symptoms at all.
Or they may feel some of the symptoms of type 1 diabetes and type 2 diabetes, or all symptoms together, and symptoms of diabetes include:
thirst;
Urinate often and often .
Extreme hunger.
Weight loss for unknown and unknown reasons.
Tired.
blurred vision
Healing and wound healing slowly.
Frequent infections of the gums, skin, vagina or urinary bladder.
Causes and risk factors of diabetes
Causes and risk factors of diabetes
Below is an explanation of the main causes and risk factors:
1. The main causes and risk factors for diabetes
Among the main reasons for this sharp rise in diabetes are the following:
obesity;
Lack of physical activity.
Changes in the types of foods The common foods today include ready-made foods that cause diabetes, as they are rich in fats and sugars that are easily absorbed into the blood, which leads to an increase in insulin resistance.
2. Causes and risk factors for type 1 diabetes
In type 1 diabetes, the immune system attacks and damages the insulin-producing cells in the pancreas rather than attacking and destroying harmful germs or viruses as it normally would.
As a result, the body remains with little or no insulin, in which case sugar collects and accumulates in the blood circulation instead of being distributed to the various cells in the body.
The true ocular cause of type 1 diabetes is not yet known, but the following are the most prominent risk factors, which include the following:
Family history: People who have a parent or sibling who has diabetes have an increased risk of developing type 1 diabetes.
exposure to viral diseases.
2. Causes and risk factors for type 2 diabetes
In prediabetes, which may progress to type 2 diabetes, cells resist the action of insulin while the pancreas fails to produce enough insulin to overcome this resistance.
In these cases, sugar accumulates and accumulates in the blood circulation instead of being distributed to cells and reaches them in various parts of the body, and the direct cause of these cases is still unknown, but it seems that excess fat, especially in the abdomen, and lack of physical activity are important factors in this happening.
Researchers are still searching for a real and accurate answer to the question: Why do prediabetes and type 2 diabetes affect only certain people?
However, there are several factors that clearly increase the risk of developing diabetes, including:
Age: Age greater than or equal to 45 years.
Weight: Overweight defined as a BMI greater or equal to 25.
Genetics: A first-degree relative has diabetes.
Ethnicity: Certain ethnic groups are known to have a high risk of developing diabetes.
Physical activity: lack of physical activity.
High blood pressure: It is more than 140/90 mm Hg.
Hypercholesterolemia: What is meant here is high bad cholesterol.
High level of triglycerides in the blood: It is one of the types of fats found in the body.
Vascular diseases: where there is a personal history of these diseases.
Birth of a large baby: a personal history of women who gave birth to babies weighing more than 4.1 kilograms.
Gestational diabetes: a personal history of gestational diabetes.
Glycosylated hemoglobin values: the assay for glycated hemoglobin is greater than or equal to 5.7%.
Glucose tolerance: Those with decreased or impaired glucose tolerance are more likely to develop the disease.
Glucose values: Those who have a problem with glucose values in the post-fasting test.
3. Causes and risk factors for gestational diabetes
During pregnancy, the placenta produces hormones that help and support pregnancy. These hormones make cells more resistant to insulin. In the second and third trimesters of pregnancy, the placenta enlarges and produces large amounts of these hormones, which impede the work of insulin and make it more difficult.
In normal, normal cases, the pancreas produces a reaction to this, which is to produce an additional amount of insulin to overcome this resistance, but the pancreas sometimes cannot keep up with the pace, which leads to the arrival of a very small amount of glucose to the cells, while it accumulates and a large amount of it accumulates in the blood circulation Thus, gestational diabetes is formed .
Any pregnant woman may develop gestational diabetes, but some women are more likely than others, and risk factors for diabetes during pregnancy include:
Women over 25 years old.
Family or personal history.
Overweight.
Diabetes complications
The most notable complications include the following:
1. General complications
Diabetes may lead to:
Gradual rise in blood pressure.
Distinctive disorders of blood lipids, especially high triglycerides.
Low protein good cholesterol.
Distinguished damage: to the kidneys, to the retina of the eyes (retina), and to the nervous system.
But complications from diabetes vary, depending on the type of diabetes.
2. Complications of type 1 and type 2 diabetes
Short-term complications of type 1 and type 2 diabetes require immediate treatment. Conditions that are not treated immediately may lead to:
convulsions;
coma .
An elevated level of ketones in the urine.
Sudden drop in blood sugar
Sudden rise in blood sugar.
3. Long-term complications of diabetes
As for the long-term complications caused by diabetes, they appear gradually, as the risk of complications increases whenever the diabetes is at a younger age and in people who are not keen to balance the level of sugar in the blood, and complications of diabetes may eventually lead to disabilities or even death. It includes the following:
Cardiovascular disease.
Nerve damage.
Kidney damage.
damage to the eyes;
Damage to the feet.
Diseases in the skin and in the mouth.
Bone and joint problems.
4. Complications of gestational diabetes
The majority of women who develop gestational diabetes give birth to healthy babies. However, if the diabetes in a pregnant woman’s blood is unbalanced and not monitored and treated properly, it may cause harm to both the mother and the newborn. The most prominent complications include the following:
Complications that may occur in a newborn due to gestational diabetes
The most notable complications include the following:
overgrowth;
Hypoglycemia .
Respiratory distress syndrome.
jaundice;
Type 2 diabetes at an advanced age.
the death.
Complications that may occur in the mother due to gestational diabetes
Pre-eclampsia.
Gestational diabetes in the next pregnancy, too.
5. Complications of onset diabetes
Early onset diabetes may progress to type 2 diabetes.
Diagnosis of diabetes
Diagnosis of diabetes
Diagnostic methods include the following:
1. Blood tests
There are many blood tests that can diagnose symptoms of type 1 diabetes or symptoms of type 2 diabetes, including:
Random blood sugar level check.
Checking blood sugar level while fasting.
If a person is diagnosed with symptoms of diabetes according to the results of the tests, the doctor may decide to conduct additional tests in order to determine the type of diabetes, in order to choose the appropriate and effective treatment, knowing that the methods of treatment differ from one type of diabetes to another.
The doctor may also recommend a glycosylated hemoglobin A1C/ glycosylated hemoglobin test.
2. Tests to detect gestational diabetes
Screening tests for gestational diabetes are an integral part of regular and routine examinations during pregnancy.
Most medical professionals recommend a blood test for diabetes called a glucose challenge test , which is done during pregnancy between the 24th and 28th week of pregnancy, or earlier in women at high risk of developing gestational diabetes.
The glucose challenge test begins with drinking a sugar syrup solution, and an hour after that a blood test is done to measure the level of glucose concentration in the blood. If the blood sugar is higher than 140 mg/dL, this usually indicates the presence of gestational diabetes.
In most cases, there is a need to repeat the test in order to confirm the diagnosis of diabetes . In preparation for the re-examination, the pregnant woman who is being examined should fast throughout the night before the examination, and here again a sweet-tasting solution is drunk, this time containing a higher concentration of glucose, and then the glucose level is measured in the blood every hour for three hours.
3. Tests to detect the onset of diabetes
The American College of Endocrinology and Endocrinology typically recommends screening for prediabetes for everyone with a family history of type 2 diabetes, obesity, or metabolic syndrome.
Women who have had gestational diabetes in the past are also encouraged to undergo this examination. The doctor may also recommend one of the following two tests to diagnose prediabetes:
Checking blood sugar during fasting.
Glucose tolerance test.
diabetes treatment
diabetes treatment
As we mentioned, the treatment for diabetes depends mainly on its type, and this means the following:
1. Treatment of type II diabetes
The treatment of diabetes varies from one person to another, according to the personal laboratory tests that each patient performs and their blood glucose values. According to the complications of diabetes that we presented earlier, the risk of developing microvascular and pathological diseases is higher the higher the concentration of sugar in the blood over periods of time. long illness.
In addition to cardiovascular diseases, the risk of which also increases as the patient's age increases and the duration of diabetes is greater; That is why we have to treat this category seriously and balance the values of glucose concentration in the blood as much as possible.
In the treatment of this group of people, cases of acute drop in blood sugar concentration, or sharp drop in blood pressure, must be prevented, and attention should be paid to the patient’s overall health condition and the totality of the medications he is being treated with, so that the diabetic patient may suffer from more than one disease in addition to diabetes. .
We can divide the treatment of diabetes into several sections:
Lifestyle changes
Include the following:
Healthy and appropriate nutrition for this category of patients.
The physical exercise recommended by the attending physicians, which suits each patient in particular, according to all the diseases he suffers from, which may affect the practice of physical exercise on a regular and proper basis.
Reducing weight and body mass index that would help the body reduce insulin resistance that causes diabetes.
Oral medications
The most notable medicines include the following:
1. Metformin: It is a first line of treatment, especially for obese people, as it works by inhibiting the production of glucose in the liver, which leads to a decrease in its concentration in the blood.
One of the well-known side effects of this drug is weight loss and its effects on the digestive system. For people with chronic renal failure, this type of medication may be inappropriate and even harmful.
2. Sulfonylurea: It is a drug that helps to secrete insulin in the body through changes in the electrical charge of the membranes of cells that secrete insulin.
One of the well-known and common side effects of these drugs is excessive weight gain and a sharp drop in the concentration of glucose in the blood; Therefore, elderly people and those prone to frequent cases of severe hypoglycemia should be careful not to take these medications, which may be unsuitable for them.
3. Thiazolidinediones: This type of medication improves insulin resistance in the body, as well as can stimulate insulin secretion.
4. Meglitinides: These drugs work similarly to sulfonylureas. A known side effect of this class of drugs is weight gain.
5. Alpha-glucosidase inhibitors: These drugs work by slowing the absorption of sugar in the digestive system. The known side effects of this class of drugs are bloating and diarrhea.
6. Dipeptidyl peptidase-4 inhibitor: These drugs help in the process of regulating the concentration of glucose in the body. In general, these drugs are not as strong and not as effective in lowering the glycosylated hemoglobin significantly as other drugs.
These medications do not increase weight and do not have a high risk of a severe drop in glucose concentration in the body.
7. Glucagon-like peptide-1: These drugs work through the role of peptides in the digestive system to balance the concentration of glucose in the blood. The known side effects of this drug are weight loss, vomiting, nausea and diarrhea.
injection
Include the following:
Insulin: Insulin treatment has become more common in the recent period, although many patients refuse to accept treatment with daily injections. Insulin treatment is divided into two types:
Long-term effective insulin therapy: It is daily injections that provide the body with the basic amount of insulin, which makes it easier for the patient to accept treatment more because there is no need to inject more than once a day, and this type of treatment can be prescribed with other drugs that are taken by mouth to balance disease more effectively.
Treatment with short-term insulin : It is the insulin that is taken immediately after eating the daily meals, and the amount of food is usually adapted to the amount of short-term insulin taken after it.
Pramlintide: It is generally given by injection along with insulin.
Monitoring the concentration of glucose in the blood
Monitoring the concentration of glucose in the blood, especially in the morning hours, is important and usually gives us information about the equilibrium of the disease in these patients, and doctors usually take care of these records in order to decide the appropriate treatment for patients and the need to add other drugs to better balance the disease.
In addition to the direct treatment to reduce the concentration of glucose in the blood, there is an equally important treatment that is concerned with reducing the risk of developing cardiovascular diseases, which includes:
Reducing smoking as much as possible, as sometimes there are organized group sessions in which doctors advise to help quit smoking.
Hypertension treatment.
Treatment of hyperlipidemia.
Treatment with aspirin.
Adopting a healthy and sound lifestyle in terms of food and exercise.
2. Type 1 diabetes treatment
Include the following:
Monitor and record glucose concentration values
Research has proven the importance of monitoring and recording blood glucose values on a daily basis and more than once, and the extent to which it helps in treating this category of patients better, as well as to match the appropriate insulin dose.
We can monitor and record the glucose concentration values in the body in two ways:
Measuring with a special stick for the finger (fingerstick) to measure the concentration of glucose with a drop of blood from the finger.
Sophisticated electronic devices under the skin to measure the concentration of glucose in the body sequentially and throughout the day.
Insulin injection
We can divide the treatment with insulin for this category into two parts:
Long-term effectiveness of insulin therapy: It is a daily injection that provides the body with the basic amount of insulin, which makes it easier for the patient to accept the treatment because there is no need to inject more than once a day.
Short-term insulin therapy : It is the insulin that is taken immediately after eating the daily meals, and the amount of food and the concentration of glucose in the blood is usually appropriate to the amount of short-term insulin taken after it.
3. Treatment of gestational diabetes
In order to maintain the health of the fetus and prevent complications during childbirth, the level of sugar in the blood must be balanced.
In addition to taking care of healthy nutrition and exercising, diabetes treatment can also include monitoring the level of sugar in the blood, and even the use of insulin in some cases.
The treating medical staff monitors the blood sugar level, including during the birth process; Because if the blood sugar level of a pregnant woman rises, the fetus's body may secrete the hormone insulin at a high concentration, which will lead to a drop in blood sugar level immediately after birth.
4. Treatment of prediabetes
By maintaining a healthy lifestyle, many people with prediabetes are able to restore their blood sugar level to normal or at least prevent it from rising to levels similar to those recorded in patients with type 2 diabetes.
It may also be helpful to maintain a healthy weight through exercise and a healthy diet.
Sometimes medications may be an appropriate and effective alternative treatment for diabetes in people in one of the at-risk groups, and these include situations in which prediabetes is exacerbated or where the diabetic has another disease, whether it is cardiovascular disease, fatty liver disease, or Polycystic ovary syndrome.
The medicines intended here are medicines to treat diabetes that are taken orally, such as: Metformin, and in other cases there is a need for medicines to balance the level of cholesterol in the blood, especially from the category of statins and medicines to treat hypertension.
Your doctor will likely prescribe low-dose aspirin as a measure to prevent disease, but a healthy lifestyle is key to success.
Diabetes prevention
Diabetes prevention
Type 1 diabetes cannot be prevented, but a healthy lifestyle that contributes to treating the stage and symptoms of pre-diabetes, type 2 diabetes, and gestational diabetes can also contribute to its prevention and prevention, and the most prominent prevention methods include:
Take care of a healthy diet.
Increase physical activity.
Get rid of excess weight.
Medications can sometimes be used. Oral diabetes medications, such as metformin and rosiglitazone, can reduce the risk of developing type 2 diabetes, but maintaining a healthy lifestyle is very important.
Common types
Types of diabetes
Types of diabetes are as follows:
1. Type 1 diabetes
Type 1 diabetes is a disease in which the immune system destroys the beta cells of the pancreas for unknown reasons that have not yet been identified. In children, this process of destruction occurs quickly and lasts from a few weeks to a few years, while in adults it may last for many years.
Type 1 diabetes may strike a person at any age, but it often appears in childhood or adolescence.
Many people who develop type 1 diabetes at an advanced age are mistakenly diagnosed with type 2 diabetes.
2. Type 2 diabetes
Type 2 diabetes is a disease in which the beta cells of the pancreas are destroyed and destroyed, most likely due to genetic reasons, supported by external factors. This process is very slow and takes decades.
A person of a healthy weight and in good physical shape has a small chance of developing diabetes even if he or she has low insulin secretion.
The possibility that an obese person who does not engage in physical activity will develop diabetes is very likely, as they are more likely to develop insulin resistance and thus diabetes.
It can appear at any age, as statistics indicate that the number of people with type 2 diabetes in the world has recorded a very large increase in recent decades, reaching about 150 million people, and it is expected to rise to 330 million people with diabetes By the year 2025, but Fortunately, it can be prevented and often avoided.