Diabetes: who is warned…
Nine interesting facts about diabetes
Vadim Kirillov, MedPulse
It would seem that only today patients do not know about diabetes mellitus – one of the most common diseases of our time? Mostly thanks to the efforts of the media.
Nevertheless, the endocrinologist Leonid Zaitsev tried to collect and present to the readers of MedPulse little-known and curious facts about this disease.
About how diabetes was treated beforeThe first attempts to treat diabetes were made before our era.
Ancient Greek and Roman physicians used massage, gymnastics, baths, aromatherapy and much more for this. In the XIX century, a meat diet with a low carbohydrate content was developed for diabetics. A few decades later, many more diets appeared, opium therapy and bloodletting became popular. However, the most effective diets were those in which the amount of calories consumed was strictly limited. This was difficult for patients, but it somewhat prolonged the life of patients with type 2 diabetes, in which it is not the production of insulin that decreases, but the sensitivity of cells to it. With type 1 diabetes (partial or complete cessation of insulin production), things were much sadder: before the advent of insulin therapy, patients with this disease died shortly after the onset of the first symptoms.
The first attempt to treat diabetes mellitus with insulin injections was made in 1922. But it was not entirely successful: the patient, 14-year-old Leonard Thompson, immediately developed adverse reactions. The drug had to be hastily modified and in just 3 weeks scientists managed to create a drug that effectively and without side effects reduced glucose levels from 28.9 to 6.7 mmol / L. After starting insulin therapy, Thompson lived for another 13 years and died of pneumonia, which developed, however, against the background of ketoacidosis – a complication of diabetes mellitus.
About "insulin addiction"There is an opinion that, having started injecting insulin, a person will no longer be able to refuse it, so it is better not to use "this stuff" at all or at least postpone the first injection "for a rainy day".
However, in fact, this behavior is fraught with complications. In diabetes mellitus, there is always an insulin deficiency, it can be absolute (with type 1 diabetes) or relative (with type 2 diabetes). Medicine does not know any ways to make up for the absolute lack of insulin, in addition to regular injections. Therefore, if you call insulin a drug, then it would be fair to include air and water in this category.
However, with type 2 diabetes mellitus, the start of insulin therapy can be postponed for a long time or even forever, following the recommendations of the attending physician: following a diet and taking hypoglycemic drugs. But if it is not possible to keep the glucose level within the normal range and the doctor advises starting insulin therapy, it is better to agree, otherwise serious complications may develop prematurely: including diabetic foot syndrome and diabetic encephalopathy, characterized in particular by memory and attention disorders.
About new methods of insulin administrationIn the 1940s, the first long-acting insulin appeared, which worked twice as long as the standard 6-8 hours.
By our decade, the duration of action has already grown to 26 hours, and at the moment the injection scheme in general looks like this: injections of "long" insulin 1-2 times a day and "short" – before each meal.
However, it is quite possible that this state of affairs will change in the near future. A group of researchers from the Massachusetts Institute of Technology has developed a new method of delivering insulin to patients with type 1 diabetes - an injectable gel with nanoparticles. According to scientists, it may eventually become the main treatment for diabetes and allow patients not only to live without frequent injections, but also without special monitoring. The nanoparticles contained in the gel react to the concentration of glucose in the body and automatically produce the right amount of insulin. So far, however, the gel has not yet reached the stage of clinical research.
In addition, more recently, the pharmaceutical company Novo Nordisk announced that by 2020, insulin in tablets will be on sale. But Pfizer's inhaled insulin failed to gain popularity. Some other methods of insulin delivery (in particular, eye drops or injection of insulin using a needle-free injector through the pores) are also not being betted now because the exact dose of insulin that enters the blood cannot be calculated in these cases.
About diabetes preventionAs a rule, the cause of type 1 diabetes is autoimmune aggression - the destruction of insulin–producing cells by the immune system.
The process can be provoked, for example, by a transferred cold – any physiological or psycho-emotional stress, but only if there is a genetic predisposition, which modern medicine is unable to influence. However, a project to develop a vaccine against type 1 diabetes has recently been launched in the UK. It is unlikely to protect completely from the disease, but it will prolong the period of life preceding the disease and slow down the development of the disease.
But to protect yourself from type 2 diabetes, in general, it is possible. However, you will have to give up not only sweets, but also fatty and flour, as well as long gatherings on the couch, because the risk of developing this disease directly depends on the amount of extra pounds. It should be remembered, however, that refusing sweets in itself is not a way to treat diabetes that has already developed for about the same reason that wearing a helmet does not get rid of the existing concussion. Frequent consumption of sweets depletes the reserves of the pancreas and reduces the sensitivity of body tissues to insulin, and these processes are poorly reversible. It is much easier to prevent the development of insulin resistance (violation of the relationship between insulin and receptors) than to return the ability to tissues.
About diabetes and sportsAlthough diabetes mellitus is a serious and sometimes disabling disease, modern medications and glucose meters (glucose level measuring devices) allow patients to lead an active lifestyle.
How active is it? It depends on the person himself. The famous Brazilian footballer Pele diabetes did not prevent him from becoming a record holder for the number of world championships won. The titled American tennis player Bill Talbert lived with the disease for exactly 70 years (he fell ill at 12 and died at 82); and the famous Canadian hockey player Bobby Clark (who fell ill at 13) played as an amateur for 19 years and played hockey professionally for another 15. Manufacturers of glucose meters eventually began to focus on active patients and began to produce devices that, for example, can be used during high-altitude hikes. In particular, the entire line of One Touch glucose meters operates at an altitude of up to 3050 m.
About folk methodsOf course, there are many who want to make money on such a common disease as diabetes.
Sellers of dietary supplements often enter diabetes mellitus into the list of indications simply because it increases sales. But, of course, diabetes is "treated" not only with dietary supplements. Among the variety of methods offered are hundreds of options for herbal medicine, bioresonance therapy, taking all kinds of chemicals, for example, hydrogen peroxide, blood ozonation, the use of silicon, vanadium and other elements. There are even fans of treating diabetes by wearing a string of pearls – supposedly it lowers blood sugar levels.
All "folk remedies" can be divided into two groups: harmful and harmless. It is difficult to start from the effectiveness, since no clinical studies of these methods, of course, have been conducted, and the stories of the "happily healed" are always found. At the same time, there are stories of those who have worsened their health by taking unknown and advertised drugs. For example, homeopathy can hardly harm anyone: the active substances in these preparations are present in such dilutions that, most likely, there will simply not be a single molecule of it in the solution. But herbal medicine can be dangerous: plants contain many different chemical compounds, and side effects from them can be unpredictable. For example, galega officinalis, which is used as a hypoglycemic agent, is toxic, although the substance guanidine obtained from it led researchers to create metformin, a drug often necessary for patients with type 2 diabetes (available in tablets).
About the belief in the benefits of alcohol and smokingThere is a belief that alcohol is only good for diabetic patients, as it lowers blood sugar.
However, this does not correspond to reality, and, moreover, "treatment" with large doses of alcohol can be very dangerous. In fact, the sugar level from alcohol does not fall at all: alcohol only blocks the flow of glucose into the blood from the liver. The supply of carbohydrates in this organ is needed in order to maintain the blood sugar level in normal: when all carbohydrates from food are consumed, glucose from the liver enters the blood. If this mechanism is blocked, a diabetic patient may develop a hypoglycemic coma. This does not mean that people with diabetes should not drink at all. With well-controlled diabetes and properly selected therapy, you can afford a moderate amount of alcohol, preferably with food, in order to avoid hypoglycemia. It is also necessary to remember that after drinking alcohol, the dose of insulin should be reduced.
As for smoking, there is an opinion that smoking diabetics should never get rid of this habit, because in the end you can gain weight and worsen control over the disease. And as if in healthy people, quitting smoking can cause diabetes. As it turned out recently, the development of type 2 diabetes may indeed be associated with quitting smoking and subsequent weight gain (4-5 kg). However, the researchers note that the risks of developing cardiovascular diseases associated with smoking are much more serious than the danger of getting better.
About genetic predisposition to diabetesIn the development of diabetes of both types 1 and 2, heredity really plays a role.
This disease is polygenic – a whole group of genes is responsible for its appearance. But different types of diabetes depend on hereditary factors in different ways. If the mother has type 1 diabetes, the probability that the child will have it is 1% if the woman was over 25 years old during pregnancy, and 4% if less. In the case when the father has type 1 diabetes, the child has a 10% chance of getting sick.
With type 2 diabetes, the situation is worse: if parents have this disease, the risk of its development is significantly higher. However, this is not a verdict. The fact is that parents do not inherit the disease itself, but the factors leading to its development: a tendency to fullness, problems with fat metabolism and with the cardiovascular system. Thus, a balanced diet, weight control and regular sports training will be the most effective prevention.
About other types of diabetesThere are several other extremely rare varieties of this disease.
For example, neonatal diabetes mellitus. This is a fairly rare disease, a change in one gene is responsible for its development. The problem in this case may be a congenital defect of the channels that emit insulin. Neonatal diabetes can be transient, that is, passing independently by about the 3rd month of a child's life (and sometimes returning later), and non-transitory – in this case, children are transferred to insulin therapy or the drug sulfanyl-urea in tablets. In addition, there are several other types of diabetes associated with a breakdown in one gene. Sometimes these diseases do not require any treatment other than exercise and diet. Also, several decades ago it became clear that there is a so-called type 1.5 diabetes (latent autoimmune diabetes in adults, latent autoimmune diabetes in adults, LADA). To put it simply, this is a slowly developing type 1 diabetes, which is often mistaken for type 2 diabetes. According to doctors, LADA develops in 10% of diabetic patients.
Portal "Eternal youth" http://vechnayamolodost.ru12.11.2013