Having passed many tests, having received a disappointing diagnosis and life-long treatment, all diabetics inevitably ask themselves: “Why me? Was it possible to avoid it?” The answer is disappointing: in most cases, the disease could have been prevented, knowing why diabetes occurs, and taking timely action.
Type 2 disease, diagnosed in 90% of patients, is largely the result of our lifestyle. No wonder that for many years it was considered a disease of the rich, and now it is increasingly common in countries with a growing standard of living. Lack of movement, refined foods, obesity - all these causes of diabetes, we organize ourselves. But the development of type 1 disease does not affect our living conditions, there are no proven means of prevention.
What makes diabetes mellitus
The number of diabetics in the world is growing steadily. The disease develops in people of any age, has no race or gender. The total in all patients is a high level of glucose in the vessels. This is the main sign of diabetes, without it, the disease will not be diagnosed. The reason for the violation is the insufficiency of insulin, a hormone that purifies the blood from glucose, stimulating its movement into the cells of the body. Interestingly, this shortage can be absolute and relative.
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When absolute, insulin ceases to be synthesized in the pancreas. With a relative and iron works fine, and the level of insulin in the blood is high, and the cells refuse to recognize it and stubbornly do not let the glucose inside. Relative deficiency is observed at the beginning of type 2 diabetes, absolute - with the onset of type 1 and prolonged type 2 disease. Let's try to figure out what factors lead to such consequences and provoke the development of diabetes.
Type 1 diabetes
Insulin is synthesized in cells of a special structure - beta cells, which are located in the protruding part of the pancreas - tail. With type 1 diabetes, the beta cells are destroyed, which stops insulin production. Blood sugar rises when more than 80% of the cells are damaged. Up to this point, the process goes unnoticed, the function of destroyed cells is taken over by the remaining healthy beta cells.
At the stage of growth of sugar, any treatment is useless, the only way out is insulin replacement therapy. It is possible to detect the process of destruction at an early stage only by chance, for example, during examination before the operation. In this case, it is possible to slow down the development of diabetes with the help of immunomodulators.
Type 1 diabetes is divided into 2 subtypes, depending on the cause of the damage to beta cells:
- 1A is caused by an autoimmune process. Roughly speaking, this is a mistake of our immunity, which considers its own cells alien and begins work on their destruction. At the same time, the adjacent alpha cells synthesizing glucagon and delta cells producing somatostatin do not suffer. The speed of the process varies considerably among different people, symptoms may appear after a few months, and a week later. The main symptom associated with the onset of diabetes mellitus 1A is the presence of various autoantibodies in the blood. Antibodies to islet cells (80% of cases) and to insulin (50%) are most common. After the work of immunity is completed, the autoimmune process is terminated, therefore, with long-term diabetes, antibodies are not detected.
- 1B is called idiopathic, occurs in 10% of patients. It has an atypical development: insulin synthesis ceases, blood sugar rises, despite the absence of signs of an autoimmune process. What causes diabetes 1B, is still unknown.
Type 1 diabetes is a disease of young people with strong immunity, most often it debuts in adolescence. After 40 years, the risk of diabetes of this type is minimal. The cause can be infectious diseases, especially rubella, mumps, mononucleosis, hepatitis. There is evidence that allergic reactions, stress, chronic viral and fungal diseases can trigger an autoimmune process.
Scientists have identified a hereditary predisposition to the development of type 1 disease. Having close relatives with diabetes increases the risk by an order of magnitude. If one of two people with a common genotype (twins) has diabetes, in 25-50% of cases it will occur in the second. Despite the obvious connection with genetics, 2/3 of diabetics have no sick relatives.
Type 2 diabetes
There is no generally accepted theory why type 2 diabetes appears. This is largely due to the multifactorial nature of the disease. A connection has been found with genetic defects and with the lifestyle of the patients.
In any case, the onset of diabetes is accompanied by:
- insulin resistance - impaired cell response to insulin;
- problems with insulin synthesis. First, there is a delay in admission to the blood of a large amount of glucose, it can be identified using the glucose tolerance test. Then there are changes in the production of basal insulin, which is why sugar increases on an empty stomach. Increased load on the pancreas leads to a decrease in the number of beta cells, until the cessation of insulin synthesis. It has been established: the better diabetes is compensated, the longer the beta cells will function, and the later the patient will need insulin therapy.
What can cause violations:
|Obesity||The risk of diabetes is increasing in direct proportion to the degree of obesity:|
Obesity leads not only to diabetes mellitus, but to a whole complex of disorders, which is called metabolic syndrome. Visceral fat located around the internal organs has the greatest effect on insulin resistance.
|Food with lots of fast sugars, lack of protein and fiber||A large amount of glucose, which enters the blood flow simultaneously, provokes an insulin release "with a reserve". The insulin left after removing sugar causes an acute feeling of hunger. High levels of the hormone provoke cells to increase insulin resistance.|
|Lack of muscle work||With a sedentary lifestyle, muscles need much less glucose than with an active one, so the excess goes to fat synthesis or is retained in the blood.|
The dependence on the genotype can be traced more often than with type 1. The fact is in favor of this theory: if one of the twins gets sick, the likelihood of avoiding diabetes in the second is less than 5%.
Disease in parents increases the risk in children by 2-6 times. Genetic defects that can cause the occurrence of violations have not yet been deciphered. It is assumed that these are separate genes. The first is responsible for the predisposition to insulin resistance, the second - for the violation of insulin secretion.
Thus, 3 out of 4 major causes of diabetes are a result of our lifestyle. If you change food, add sport, adjust weight, genetic factors will be powerless.
The emergence of diabetes in men and women
In the whole world, diabetes is observed with the same frequency in both men and women. The dependence of the risk of the disease on the sex of a person can be traced only in some age groups:
- at a young age, the risk of getting sick is greater in men. This is due to the peculiarities of the distribution of fat throughout the body. For men, abdominal obesity (visceral fat) is characteristic. In women, in the first place, the hips and buttocks increase, the fat is deposited less dangerous - subcutaneous. As a result, men with a BMI of 32 and women with a BMI of 34 have the same probability of developing diabetes;
- after 50 years, the proportion of women with type 2 diabetes increases dramatically, which is associated with the onset of menopause. This period is often accompanied by a slowdown in metabolism, an increase in body weight and an increase in the amount of lipids in the blood. Currently, there is a tendency to earlier menopause, therefore, carbohydrate disorders in women are also getting younger;
- Type 1 diabetes in women begins earlier than in men. The risk of occurrence in children of different sexes:
|Age years||% of cases|
|Older than 14||3||8|
As can be seen from the table, most of the girls fall ill at preschool age. In boys, the peak occurs in adolescence.
- women are more prone to autoimmune diseases than men, so 1A diabetes is more common;
- men more often than women abuse alcohol, and at the same time pay less attention to health. As a result, they develop chronic pancreatitis - permanent inflammation in the pancreas. Diabetes mellitus can occur if long-term inflammation extends to beta cells;
What makes diabetes in children
The peak incidence of type 1 diabetes falls on 2 periods: from birth to 6 years and from 10 to 14 years. It is at this time that provoking factors act that put a strain on the pancreas and the immune system. It is assumed that infants may be caused by artificial feeding, especially with cow's milk or sweetened. Severe infections have a significant effect on immunity.
The surge in morbidity in adolescents is caused by hormonal changes, an increase in the activity of insulin antagonist hormones. At the same time, children's ability to resist stress is reduced, and natural insulin resistance appears.
For many years, type 2 disease in childhood was extremely rare. Over the past 20 years, the number of sick children in Europe has increased by 5 times, there is a tendency to further growth. As in adults, the causes of diabetes are obesity, lack of exertion, poor physical development.
The analysis of a way of life has shown that modern children replaced active sports games with sedentary computer games. Radically changed and the nature of the power of young people. If there is a choice, preference is given to products with high calorie content, but low nutritional value: snacks, fast food, desserts. Chocolate bar has become a normal snack, which was unthinkable in the last century. Often, going to a fast-food restaurant becomes a way to reward the child for achievements, to celebrate a joyful event, which affects his eating behavior in adolescence and adulthood.