— What happens to the body of a person with diabetes?
— At the heart of the occurrence of diabetes mellitus is a violation of metabolic processes. Most of all, carbohydrate metabolism suffers — therefore, the level of glucose in the blood constantly rises. In addition to carbohydrates, fat, protein and water-electrolyte metabolism is disturbed.
— Why is diabetes dangerous?
— Diabetes itself is not terrible, its complications are dangerous. Excess glucose — hyperglycemia — has a detrimental effect primarily on blood vessels and nerves, and as a result, all organs and tissues suffer. Diabetes mellitus is rightfully called cardiovascular disease. More than 70% of patients with this disease die from myocardial infarction, cerebrovascular accident, and heart failure. Diabetes is the most common cause of blindness, kidney failure and limb amputation. About 80% of patients with diabetes mellitus have arterial hypertension and almost 100% have high cholesterol levels.
— Is high blood glucose always associated with diabetes?
— Not necessarily. In endocrinology, there is a term “secondary hyperglycemia”. This can be a symptom of certain diseases of the endocrine organs — adrenal glands (pheochromocytoma, hypercortisolism), pituitary gland (acromegaly), thyroid gland (hyperthyroidism), pancreas (tumors — glucagonoma). If these diseases are eliminated, then blood sugar levels can also be normalized.
Diabetes mellitus affects the eyes, kidneys, heart, brain and legs the most.
— With diabetes mellitus, another situation is possible when the blood sugar level, on the contrary, is too low. Why is this happening and what is the danger?
— Low blood sugar, or hypoglycemia, develops as a result of a sharp drop in blood glucose levels — below 3–3.5 mmol / l. As a result, an energy deficit develops in the brain. If sugar continues to fall, then hypoglycemia becomes severe, up to loss of consciousness and the development of hypoglycemic coma. Typically, in severe hypoglycemia, blood sugar is below 2.8 mmol / L. Most often, hypoglycemia is provoked by an overdose of insulin, tableted antihyperglycemic agents, skipping or insufficient food intake against the background of antihyperglycemic therapy, increased physical activity, and excessive alcohol intake.
Every diabetic should know how hypoglycemia can manifest itself. Usually it is sweating, headache, hunger, feeling of inner trembling, weakness, drowsiness, often disorientation in space, behavior disorder. People with diabetes should explain to family and friends how they can help in this situation. It is good if someone close to you learns to inject the hormone glucagon if you pass out during a hypoglycemic episode. This will help restore blood glucose balance.
The best way to avoid hypoglycemia is to strictly follow the developed treatment plan, do not skip meals and medications, constantly monitor blood glucose levels and correct any deviations in time.
— Can the patient independently control the blood glucose level?
— Sure. Now there are many options for portable devices — glucometers. You could even say that diabetes without self-control of sugar is a waste of time and money.
— If diagnosed with diabetes, does this mean lifelong dependence on insulin injections?
— For many, the word “insulin” said by a doctor is associated with hopelessness. “Now I will need injections forever,” rushes through the minds of patients. But it’s not that bad. Regular insulin administration is mandatory for patients with type 1 diabetes. They practically do not produce it in their bodies. And therefore, without injections, such patients can die.
Those with type 2 diabetes are mostly treated with pills. If such therapy does not give results due to not following the doctor’s recommendations or due to depletion of the pancreas, then insulin is prescribed. It can often be given temporarily to lower blood sugar more effectively. With its help, we sort of unload and save the pancreas. This allows it to take a breath and start producing its own insulin with renewed vigor. In some cases, there are contraindications for prescribing tablet drugs, which also requires the appointment of insulin therapy.
Doses of insulin and the frequency of its administration are selected by the endocrinologist. But at the same time, the patient should be not just an object of treatment, but an active partner and companion of the doctor, he must know and understand all the nuances of glycemic control. For this, there are schools for patients with diabetes.