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Neurology, Ophthalmology, Cardiology, Oncology, Obesity, Endocrinology, Vascular surgery - Causes, Symptoms, Diagnosis, Treatment, description of the disease.

Thursday, 18.04.2024, 01:21
Main » Endocrinology » Diabetes mellitus - Causes and mechanism 
Diabetes mellitus - Causes and mechanism

Diabetes mellitus - Causes and mechanism

Diabetes is a disease of the endocrine system, accompanied by a chronic increase in blood glucose levels caused by absolute or relative deficiency of insulin.

In diabetes disturbed carbohydrate metabolism, protein and fat. The number of diabetic patients is growing, especially in developed countries. It is believed that diabetes sick from 2 to 10% of the population, depending on the country of residence.

Diabetes occurs when chronic deficiency of insulin. Insulin is a hormone that is produced in the endocrine islets of the pancreas, called islets of Langerhans. Pancreatic hormone, insulin, involved in carbohydrate, protein and fat metabolism in the body. On carbohydrate metabolism affects insulin increasing intake of glucose into the cells of the body, activating the alternative ways of glucose synthesis in the body, increasing the stocks of sugar in the liver, through the synthesis of carbohydrate compounds - glycogen. At the same time hinders the process of decomposition of carbohydrates.

Effect of insulin on protein metabolism is to increase the synthesis of proteins, nucleic acids, suppression of protein breakdown. Insulin increases the supply of glucose in fat cells, fat-containing synthesis agents, activates the processes of energy cell and inhibits fat breakdown. Under the action of insulin increased intake of sodium into the cell.

Disruption of insulin may be the shortage of its products or in violation of its action on the tissues (violation of the susceptibility of tissue). Lack of insulin production in the tissues occurs in autoimmune processes in the pancreas, leading to the destruction of the islets of Langerhans cells insulinprodutsiruyuschih. So there is a type of Diabetes. Manifestations of the disease occur when there are less than 20% of the working cells.

Diabetes Type II diabetes occurs when insulin action in violation of the tissues. This condition is called insulin resistance, when the blood is normal or increased amounts of insulin, but cells are insensitive to it. With a lack of insulin supply of glucose into the cell is reduced, blood glucose rises. Activated by alternative ways of processing glucose, which is accompanied by accumulation in body tissues of sorbitol, glycosaminoglycans, glikilirovannogo hemoglobin. Sorbitol contributes to cataracts, disruption of the small arteries - arterioles and capillaries (microangiopathy), disorders of the nervous system (neuropathy). Glycosaminoglycans lead to joint damage.

However, alternative ways of glucose uptake are not sufficient to generate energy. Disturbances of protein metabolism lead to a decrease in the synthesis of protein compounds activated protein breakdown. This leads to muscle weakness, disorders of the heart muscle, skeletal muscle. Peroxidation increases fat oxidation, accumulate the toxic products that damage blood vessels. In the blood, increases the content of products of metabolism called ketone bodies.

For reasons of Diabetes type is subdivided into:
  • autoimmune
  • idiopathic.

Autoimmune diabetes is caused by disorders of the immune system. At the same time in the body form antibodies that damage cells of the islets of Langerhans insulinprodutsiruyuschie in the pancreas. Contribute to the development of the autoimmune process viral infections, exposure to certain toxic substances (nitrosamines, pesticides, etc.).

The causes of idiopathic diabetes of the first type have not been established.

The causes of diabetes of the second type include genetic predisposition and environmental factors. Genetic predisposition plays an important role, however, have the leading role all the same environmental factors.

Consider these factors:

Genetic. In patients who have relatives with diabetes, the risk of the disease earlier. The risk of developing diabetes, if one parent is ill, is from 3 to 9%.

Obese. When overweight and a lot of fat, especially in the abdomen (abdominal type), decreased tissue sensitivity to insulin, which facilitates the emergence of diabetes.

Disturbances in the diet. Food with lots of carbohydrates, fiber deficiency leads to obesity and increased risk of developing diabetes.

Chronic stress situations. As stress is accompanied by an increased amount of blood catecholamines (epinephrine, norepinephrine), glucocorticoids, which promote the development of diabetes.

Atherosclerosis, coronary heart disease, hypertension with prolonged duration of the disease reduced tissue sensitivity to insulin.

Some medications have a diabetogenic effect. This glucocorticoid synthetic hormones, diuretics, especially thiazide diuretics, some antihypertensive drugs, anticancer drugs.

Autoimmune disease (Hashimoto's thyroiditis, chronic insufficiency of the adrenal cortex) contribute to the emergence of diabetes.

Considered normal amount of glucose in blood glucose that does not exceed 6.1 mmol / liter. The amount of glucose from 6.1 to 7.0 is called impaired fasting glucose. A fasting glucose more than 7.0 when it is detected for the first time considered a provisional diagnosis of diabetes mellitus.

The diagnosis of diabetes mellitus should be confirmed by repeated determination of blood glucose at other times, carrying glucose tolerance test, determination of glikilirovannogo hemoglobin.

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