Insulin-dependent diabetes mellitus (type I) is a chronic endocrine disease caused by insulin deficiency in Langerhans cells of the pancreas, which increases the level of glucose in the blood serum, but its deficiency in cells. Among all cases of diabetes, this type occurs up to 10% of cases order captopril. This disease is most often found in young people.
The exact cause of the development of insulin-dependent diabetes mellitus is not established. However, there are several causal factors contributing to its development:
Hereditary predisposition (in the presence of type I diabetes in one parent the probability of developing it in a child is 2-10%);
Viral infection (transmitted viral hepatitis, rubella, epidemic parotitis, Coxsackie viruses);
Toxic effects (pesticides, nitrosamines, streptozocin, rat poison, certain medicines);
Autoimmune reaction of cellular immunity (insulin-dependent diabetes mellitus is often combined with other autoimmune pathology - diffuse toxic goiter, thyrotoxicosis, vitiligo, etc.).
The main pathogenetic link of Type I diabetes mellitus is the death of 80-90% of pancreatic β-cells (islets of Langerhans), which produce insulin. As a result, insulin deficiency develops, which leads to an increase in the level of sugar in the blood and its inaccessibility to the cells of the body.
With this pathology, all types of metabolism are violated: electrolyte, protein, enzyme, immune, peptide and water. Insulin-dependent diabetes mellitus manifests, as a rule, in young or childish years with the appearance of intense thirst, dry mouth, severe fatigue, headache, weight loss with increased appetite, sleep disorders, irritability, frequent profuse urination. Itching and dry skin, pustular skin infections, visual disturbances and gastrocnemius muscle cramps, nausea, abdominal pain, nocturia (predominance of nocturnal diuresis) can also be noted.
Symptoms such as cerebral arteriosclerosis, coronary vessels, diabetic foot syndrome, nephropathy (renal dysfunction), retinopathy (reduced visual acuity), neuropathy (paresthesia, cold extremities, etc.), frequent infections may appear with the course of the disease. In the absence of insulin therapy, there is a smell of acetone from the mouth, ketoacidosis develops and consciousness is disturbed right up to the coma. Ketoacidosis occurs due to the splitting of fats (as an energy source) instead of sugars, which increases the amount of ketone bodies.
In addition to the clinical picture in the diagnosis of insulin-dependent diabetes mellitus, glucose in the blood serum is important. The presence of diabetes indicates a fasting glucose level of more than 6.5 mmol / L and / or more than 11.1 mmol / L two hours after the test for glucose tolerance. In urine, glucose can also be detected (when it exceeds the "renal threshold" in the blood - more than 7.7-8.8 mmol / l) and ketone bodies.
In addition, the prescription of hyperglycemia may be indicated by an elevated level of glycosylated hemoglobin. The level of insulin and C-peptide is significantly reduced in type 1 diabetes mellitus. In order to identify possible complications, as well as for differential diagnosis, ultrasound of the kidneys, rheoencephalography, rheovasography of the lower limbs, EEG of the brain, ophthalmological examination.
Insulin-dependent diabetes mellitus is classified according to the etiology into autoimmune and idiopathic. Distinguish the severity of the flow (light, medium and heavy) and the degree of compensation of the pathological process (compensated, subcompensated and decompensated).
If you develop at least a few of the above symptoms, you need to consult a specialist endocrinologist.
In the treatment of insulin-dependent diabetes mellitus, there are two main tasks - changing the lifestyle and adequate medication. The first implies compliance with a special diet with the calculation of grain units, metered physical exertion and constant self-control. The second task is individual selection of the regimen and dosage of insulin therapy.
There is a regular regime of insulin therapy, a constant subcutaneous insulin infusion and multiple subcutaneous injections. Any additional physical exertion or food intake should be taken into account when calculating the dose of insulin administered.
Complications of insulin-dependent diabetes mellitus may be hyperosmolar coma, ketoacidosis, hypoglycemic coma (with incorrect calculation of insulin dose), diabetic nephropathy, retinopathy, encephalopathy, polyneuropathy, micro- and macroangiopathies, arthropathy, etc.
Preventive measures regarding insulin-dependent diabetes mellitus do not exist. However, whenever possible, viral infections that can contribute to the manifestation of the disease should be avoided.