Abstract
Regretfully, diagnosis of diabetes is very common nowadays. Diabetes has become a worldwide epidemic and one of the leading causes of premature morbidity and mortality because it often leads to amputation of limbs, loss of sight, kidney failure and provokes cardiovascular disease. However, it is not that hard to suspect a high risk of developing diabetes or the disease itself before the analysis of blood sugar levels. Many of the signs of diabetes are visible to the naked eye. Paying attention to them in timely manner can avoid the severe consequences of the disease. Patients with diabetes can lead an active lifestyle, according to certain rules. Today, drugs that can cure the disease, has not yet been found, but development in this area is conducted continuously. In the meantime, to prevent disease, pay attention to the prevention of diabetes, especially if there is a genetic predisposition.
The management of diabetes is a major health challenge, and its prevalence is increasing at an alarming rate, especially in the developing world. According to the International Diabetes Federation, diabetes currently affects more than 415 million people worldwide, a figure that is expected to rise to 642 million by 2040. ("Diabetes: facts and figures", 2016) Diabetes is a disease caused by an absolute or relative deficiency of insulin and described by an outrageous infringement of carbohydrate metabolism with hyperglycemia and glycosuria and other metabolic disorders. (Leslie, 2012)
The etiology has a value hereditary predisposition, vascular and autoimmune disorders, obesity, physical or mental trauma, viral infection etc. Insulin level lessens in the blood with absolute insulin deficiency because of infringement of its synthesis or secretion from the beta cells of the islets of Langerhans. (Holt, 2010) Relative insulin deficiency might be the consequence of abatement of insulin movement in view of its high protein official, upgraded demolition of liver catalysts, the commonness of the impacts of hormonal and non-hormonal opponents of insulin (glucagon, hormones of the adrenal cortex, thyroid, development hormone), change the affectability of insulin-ward tissues to insulin.
The insufficiency of insulin leads to violation of carbohydrate, fat and protein metabolism. Permeability to glucose of cellular membranes is reduced in adipose and muscle tissue, enhanced gluconeogenesis, hyperglycemia occurs, glycosuria, accompanied by polyuria and polydipsia. In addition, formation and increased breakdown of fat reduces too and it leads to an increase in blood levels of ketone bodies. This causes a shift of the acid-alkaline condition in the direction of acidosis, expanded discharge of potassium ions, magnesium, sodium in the urine, disturbs the function of the kidneys. Significant loss of fluid due to polyuria leads to dehydration occurs. The body's excretion of potassium, chloride, nitrogen, phosphorus, calcium increases.
Scientists distinguish such types of diabetes:
Insulin-dependent diabetes (type 1 diabetes) that develops mainly in children and young people;
Non-insulin dependent diabetes (type 2 diabetes) - usually develops in people over 40 years who are overweight. This is the most common type of disease (found in 80-85% of cases). (Holt, 2010)
Type 1 diabetes there is absolute deficiency of insulin due to the malfunction of the pancreas. Type 1 diabetes (formerly called juvenile-onset or insulin-dependent diabetes) is most commonly diagnosed in childhood, but it may present at any age in life. About 2 million of the individuals with diabetes have type 1 diabetes. This sort of disease requires outside insulin (not made by the body), which empowers the glucose to enter the cells. Outside insulin is vital in light of the fact that the body is unable to produce the insulin the cells require. When a patient with type 1 diabetes is deprived of external insulin, they will turn out to be sick. Type 1 diabetics will usually be thin or not overweight. (Thygerson, Thygerson, Gulli, & Piazza, 2012) On another hand, type 2 diabetes noted a relative deficiency of insulin. Cells of the pancreas thus produce enough insulin (sometimes even an increased amount). Nevertheless, the number of structures that provide the contact with the cell and helps the glucose from your blood to enter inside the cell is blocked or dimished on the surface of cells. The deficit of glucose in cells is a signal for more insulin production, but it has no effect, and over time insulin production declines significantly.
Diagnosis of diabetes mellitus of both types is facilitated by the presence of main symptoms:
Polyuria;
The concentration of sugar (glucose) in capillary blood on an empty stomach exceeds 6.1 mmol/ l (millimole per liter)
The concentration of sugar (glucose) in capillary blood in 2 hours after a meal (postprandial glycemia) exceeds 11.1 mmol/l; (Holt, 2010)
The problem of nowadays is widely spread in the world of medicine. It is approximately 40% among all cases of disease of the endocrine system. This disease often leads to high mortality and early disability. For the differential diagnosis in patients with diabetes mellitus need to identify the patient's condition, attributing it to one of the classes: neuropathic, antihypoxic, combined version of course of diabetes. (Leslie, 2012)
Treatment of diabetes includes:
Special diet: you must eliminate sugar, alcohol, syrups, cakes, biscuits, sweet fruits. Food should be taken 4-5 times per day in small parcels. Products containing various sweeteners are recommended;
Daily use of insulin (insulin therapy) - patients with diabetes of the first type, and the progression of type II diabetes. The medication is accessible in special syringe pens, which make it easy to do injections. Note that it is necessary to independently control the level of glucose in blood and urine (with the help of special strips) while treatment with insulin;
The use of tablets to reduce sugar level in blood. Typically, such medications begin the treatment of diabetes of the second type. With the progression of the disease is obligatory to start insulin treatment.
The main tasks of the doctor in the diabetes treatment are:
Compensation of carbohydrate metabolism;
Prevention and treatment of complications;
Normalization of body weight;
Patient Teaching. (Leahy, Clark, & Cefalu, 2000)
Treatment of diabetes is conducting on temporary basis. Self-control and precise implementation of the recommendations of the doctor help to avoid or significantly delay the development of complications of the disease. It is worth noting that diabetes must be controlled. With bad control, and is not a suitable lifestyle can happen frequent and sharp fluctuations of glucose in the blood, which in turn leads to complications. Firstly, it leads to severe complications, such as hypo-and hyperglycemia, but later on chronic complications will appear. Worst of all, they occur 10-15 years after the onset of illness, develop quietly and at first does not affect the health. For the high content of sugar in the blood gradually occur and rapidly progressing specific diabetes complications of the eyes, kidneys, feet, and nonspecific - cardio-vascular system. However, unfortunately, coping with complications that are already proved is very difficult.
Diabetes for some patients has a severe course and requires a thorough, careful treatment with insulin, which in such cases introduces large quantities. Hard and average severity of diabetes can give complication in the form of a coma. Diabetic coma occurs in patients with diabetes mellitus in flagrant violation of the diet, errors in the use of insulin and the termination of its use, when intercurrent diseases (pneumonia, myocardial infarction, etc.), trauma and surgical interventions, physical and psychological overstrain.
Hypoglycemic coma often develops as a result of an overdose of insulin or other glucose-lowering drugs. Hypoglycemia may lead to insufficient intake of carbohydrates with the introduction of usual doses of insulin or long breaks in food intake, as well as a large volume and physical work stress, alcohol intoxication, use of blockers, p-adrenergic receptor, salicylates, anticoagulants and some anti-TB drugs. In addition, hypoglycemia (coma) occurs when insufficient intake of carbohydrates in organism (starvation, enteritis) or in an expenditure (physical overload), and hepatic failure. Medical attention should be provided immediately. A favorable outcome of diabetic and hypoglycemic coma depends on the time that has elapsed from the moment when the patient fell unconscious, until the time when assistance will be provided. The sooner measures are taken to eliminate coma, the more favorable the result. The provision of medical care for diabetic and hypoglycemic coma should be under the control of laboratory studies. It is possible to implement in stationary medical institution while attempts to treat such a patient at home may have very unpleasant consequences. (Leahy, Clark, & Cefalu, 2000)
In conclusion, it is worth noting that diabetes can become serious in the short term if sugar level in blood raises or diminishes for excessively. Hypoglycemia can get the chance to be dangerous in case it is not treated quickly, particularly on the off chance that it is a consequence of an insulin overdose.
This issue can regularly be treated at home but if someone is unable to take sugar or does not hint at change after it, other options will be needed such as a glucagon injection or an ambulance.
In case there is glucagon at home, you need to check the guidelines in the glucagon kit and follow them precisely. However, in case you are not certain about using the kit it is necessary to call for an ambulance. ("Diabetic Emergencies - What To Do In An Emergency Or Crisis Situation")
References
Diabetes: facts and figures. (2016). International Diabetes Federation. Retrieved 1 September 2016, from http://www.idf.org/about-diabetes/facts-figures
"Diabetic Emergencies - What To Do In An Emergency Or Crisis Situation". Diabetes.co.uk. N.p., 2016. Web. 4 Sept. 2016.
Holt, R. (2010). Textbook of diabetes. Chichester, West Sussex: Wiley-Blackwell.
Leahy, J., Clark, N., & Cefalu, W. (2000). Medical management of diabetes mellitus. New York: M. Dekker.
Leslie, R. (2012). Diabetes. London: Manson Publishing Ltd.
Thygerson, A., Thygerson, S., Gulli, B., & Piazza, G. (2012). First aid, CPR, and AED. Sudbury, Mass.: Jones & Bartlett Learning.
