Insulin deficiency syndrome | Metabolic syndrome | Symptoms of Diabetes | Microvessels | Late complications | Diabetic retinopathy | Diabetic nephropathy | Diabetic angiopathy | Diabetic neuropathy | Diabetic encephalopathy
Disorders that occur with both types of diabetes affect a variety of processes in the body. However, the manifestations of diabetes can be divided into four categories:
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1. Insulin deficiency syndrome.
It is caused by a deficiency of energy in the cells of the liver, muscles and adipose tissue: after all, despite the abundance of glucose fuel in the blood, insulin-sensitive cells cannot receive it and begin to suffer from acute hunger. In response, the body “turns on” the same mechanisms as in ordinary hunger: hormones of cortisol, glucagon and somatotropin are released, inhibiting the formation of insulin and mobilizing glucose from cells. As a result, blood glucose levels continue to increase, and cell hunger intensifies.
Redness of the skin in the area of the chin and cheekbones (diabetic skin rubeosis)
Also, these hormones activate the decay of fats and the formation of so-called ketone bodies: a certain amount of energy is released. Ketone bodies are poorly excreted, accumulate and have a toxic effect on the body. An increase in the concentration of ketone bodies leads to the appearance of a smell of acetone from the mouth and a characteristic reddening of the skin in the area of the chin and cheekbones (diabetic skin rubeosis).
Due to a persistent lack of fuel in the cells, the patient begins to suffer from a constant feeling of hunger. However, eating only leads to increased formation of ketone bodies, so patients often experience nausea and vomiting soon after eating, which does not bring relief. An increase in the concentration of glucose in the blood provokes a feeling of thirst. The body tries to excrete glucose in the urine, which leads to rapid urination. Depletion of glucose reserves, fat breakdown, dehydration associated with frequent urination and vomiting, lead to weight loss, fatigue appears.
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2. Metabolic syndrome.
These are various metabolic disorders that occur due to an increased level of glucose and insulin in the blood (the syndrome is characteristic of type 2 diabetes mellitus). The manifestations of the metabolic syndrome include progressive obesity of the abdominal type (predominant accumulation of fat in the abdomen), hypertension (arterial hypertension), early atherosclerosis, coronary heart disease, blood clotting disorders, etc.
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3. Diabetes affecting microvessels.
This can cause a weakening of immunity, a slowdown in recovery processes in damaged tissues. Among the symptoms may be skin lesions (furunculosis, eczema, rapid suppuration and slow healing of wounds); early and rapidly progressing cataract; dental problems – recurrent stomatitis, periodontal disease, rapidly progressive caries; manifestations of the nervous system – fatigue, memory impairment, learning ability, etc.
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4. Late complications are the main cause of disability and death of patients with diabetes.
As a rule, they appear 5-7 years after the onset of the development of the disease. However, given that the disease lasts for a long time without symptoms and the first signs appear several years after the development of the first disorders, late complications often develop shortly after diagnosis. Most late complications are associated with vascular damage. Glucose accumulates in the walls of blood vessels, which leads to edema, carbohydrate and lipid metabolism suffer, the work of the genes responsible for protein synthesis is disrupted, inflammation develops, the permeability of the vascular walls increases, and oxygen starvation of vascular cells occurs. This leads to the destruction of blood vessels, their narrowing, blockage, as a result of which the function of organs to which blood flows through damaged vessels is disrupted.
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Diabetic retinopathy
Diabetic retinopathy – damage to the small vessels of the fundus with a gradual decrease in vision and the development of blindness, its occurrence is accompanied by an increased risk of retinal detachment.
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Diabetic nephropathy
Diabetic nephropathy – damage to the small vessels of the renal glomeruli, leads to the development of hypertension (arterial hypertension), and in the final stage to renal failure.
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Diabetic angiopathy
Diabetic angiopathy of the lower extremities and diabetic neuropathy. Diabetic angiopathy of the lower extremities is a disruption of the blood supply to the tissues of the lower extremities. In the early stages it is manifested by pain, especially when moving, in the later stages it leads to atrophy (“drying out”) of the muscles, the appearance of ulcers and gangrene, requiring amputation.
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Diabetic neuropathy
Diabetic neuropathy is a whole array of complications consisting in impaired nerve function. It can be manifested by a violation of sensitivity (increase, decrease, loss of pain sensitivity); motor neuropathy (impaired muscle innervation with the development of weakness and atrophy); violation of the function of nerves going to the internal organs, which affects their work (violation of the heart rhythm, intestinal motor function, urination and sexual function, etc.).
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Diabetic encephalopathy
Diabetic encephalopathy – acute (strokes) and chronic (impaired memory, learning) disorders of the blood supply to the brain.