Diabetes: Everything about the symptoms and treatment of diabetes

Type 1 and type 2 diabetes are the most common types of diabetes. This article will look at different types of hormones such as glucagon and insulin and different types of diabetes.

Diabetes occurs when the hormone insulin, which regulates blood sugar, is not produced enough in the body or the body’s tissues do not respond appropriately. As a result, the body’s sugar metabolism is disrupted, blood sugar rises above average, and eventually, the symptoms of diabetes appear as overeating, binge drinking, and urination. The hormone insulin, which is secreted by cells from Langerhans’ islets into the pancreas, has various body functions. For example, it facilitates the entry of sugar from the blood into the cells. The cells can use it to supply energy. If insulin is deficient or ineffective, sugar cannot enter the cells, resulting in high blood sugar.

In the long run, high blood sugar causes damage to almost every vital organ of the body, including the heart, brain, eyes, kidneys, etc.

The pancreas of people with this type of diabetes produces insulin, but this amount is not enough to regularly keep blood sugar or glucose levels. An essential factor in developing insulin resistance and high blood sugar in these patients is their obesity. There is no cure for type 2 diabetes, but several things can be done to treat and prevent them. To control and prevent this disease, you should eat a healthy diet, exercise enough, and keep your weight balanced.

In diabetes, the body does not produce enough insulin hormone.

Patients in whom these measures do not work are usually treated with oral hypoglycemic pills; however, these pills may lose their effect in the long run. The patient may be forced to keep his blood sugar regular by injecting insulin. Careful control of this disease and normalization of blood sugar in both types of this disease can prevent threatening long-term complications and ensure patients’ everyday lives. Naturally, your body converts sugars and carbohydrates into glucose. Glucose is the fuel for the body’s cells, but the cells also need insulin. Insulin is a hormone in your bloodstream that helps cells absorb and use enough glucose.

Type 1 diabetes (insulin-dependent):

The disease is caused by an immune reaction (Type 1A), a known heterogeneous disorder caused by mutations (autosomal recessive and X-dependent recessive), as well as multigene/monogenic inheritance. Type 1 diabetes accounts for 5 to 10 percent of all types of diabetes. In this type of disease, beta cell destruction occurs in the pancreas—the leading cause of beta-cell loss in cell damage caused by the “cellular immune response.

Despite these breakdowns, markers are released into the bloodstream, including insulin antibodies, GAD autoantibodies (GAD65), tyrosine phosphatase autoantibodies, IA-2, and IA-2β. These markers may be seen in 85 to 90% of patients. A link has also been found between specific acne and this type of diabetes. Insulin secretion decreases following the destruction of beta cells by lymphocytes; To the extent that the available insulin cannot regulate blood sugar.

Hyperglycemia usually occurs after the loss of 80 to 90% of beta cells and may be diagnosed. At this stage, the patient needs external insulin to prevent ketosis and control hyperglycemia and fat and protein metabolism. Type 1 diabetes is also known as insulin-dependent diabetes. In the past, because this type of diabetes was more common in childhood, it was called adolescent diabetes. This is a condition caused by the body’s autoimmune system. This condition occurs when the body’s immune system attacks the pancreas using its antibodies. Because of this, the damaged pancreas does not produce insulin in people with type 1 diabetes.

This type of disease can be a genetic predisposition. Defective beta cells in the pancreas can also be a cause of type 1 diabetes. Having this type of disease puts a person at significant risk. Many of these risks stem from damage to the capillaries of the eye (diabetic retinopathy), the nervous system (diabetic neuropathy), and the kidneys (diabetic nephropathy). Of course, there are more severe problems, such as heart disease and stroke. The only way to control insulin is to inject a layer of fat under the skin. There are several types of insulin on the market.

Insulin pumps are a method of injecting insulin that is as close as possible to the normal secretion of insulin from the pancreas. The pump itself is about the size of a palm. Each pump consists of three parts; An interchangeable insulin reservoir inside the device and an injection kit that includes a special needle and a connecting rubber tube that connects the needle (located under the skin) to the insulin reservoir. Each pump has a program that automatically injects the appropriate insulin concentration under the skin over 24 hours.

The person with diabetes also regulates the time and amount of insulin needed for meals. New pumps can easily calculate the amount of insulin needed to be injected into your everyday meal based on your current blood sugar level, the number of carbohydrates in the food, and even how long it has been since the previous injection. These pumps also have an alarm and, for example, warn the diabetic if they forget to inject insulin or stop the flow of insulin. The most critical obstacle to using insulin pumps is their high cost.

Type 2 diabetes (non-insulin dependent):

Insulin is a hormone that is naturally produced in the body. The pancreas produces it and releases it into the body when you eat. Insulin helps transfer sugar from the bloodstream to cells throughout the body, used as energy. If you have type 2 diabetes, your body will become insulin resistant and will no longer use this hormone effectively. This causes the pancreas to work harder and produce more insulin. Over time, this can damage the cells in your pancreas, and gradually your pancreas may no longer be able to produce insulin.

If your body does not produce enough insulin or does not use it effectively, glucose builds up in the bloodstream, causing the body to need energy. Doctors do not know what triggers this series of events. This condition may be due to dysfunction of pancreatic cells or due to disruption of cellular messaging. In some people, the liver produces too much glucose. A genetic predisposition may also cause type 2 diabetes. There is also a genetic predisposition to obesity, which can increase the risk of type 2 diabetes. Research is ongoing to find out the causes of type 2 diabetes.

This diabetes is also known as adult-onset diabetes; Ninety-five percent of adult-onset diabetes cases are related to type 2 diabetes. This type of diabetes was initially known as adult-onset diabetes; But with the rise of obese children and adolescents who are overweight, the disease has also spread to people in this age group. Type 2 diabetes is also known as non-insulin-dependent diabetes. Type 2 diabetes is usually milder than type 1 diabetes. However, ignoring it will undoubtedly have dire consequences. These consequences usually occur in the capillaries responsible for delivering blood to the kidneys, nerves, and eyes.

In people with type 2 diabetes, the pancreas usually produces some insulin. But the problem is that this amount of insulin is not enough for the body, or the cells have become resistant to it. Insulin resistance, or insensitivity to it, occurs primarily in fat, liver, and muscle cells. People who are 20 percent overweight are more likely to develop this type of disease and the complications of diabetes. These people are resistant to insulin, which causes the pancreas to work harder and harder to produce insulin. However, there is still not enough insulin to control blood sugar.

Type 2 diabetes is progressive, and therefore the patient should also take diabetes medications. Scientists have found that by injecting polymer sponges into the tissues of patients with type 2 diabetes, the relationship between fat and other parts of the body is restarted, thus preventing weight gain. (Hepatitis: Types, Symptoms, Treatment, And Prevention)

In new research on type 2 diabetes, researchers have found that implanting polymer sponges in body tissue could open up new avenues for the disease. Researchers at the University of South Carolina in Colombia have found that obese mice with type 2 diabetes with a high-fat diet implanted in polymer sponges gained less weight and blood sugar after three weeks than similar untreated mice. They had.

Gestational Diabetes:

Due to changes in lifestyle and diet in recent years, it may be one of the concerns of pregnant women with gestational diabetes. During pregnancy, this condition increases blood sugar levels during pregnancy that occur in some women and usually occurs between 24 and 28 weeks of pregnancy. Having a disease during pregnancy does not mean that you had diabetes before pregnancy or after childbirth. However, getting gestational diabetes will increase your chances of developing type 2 diabetes. The underlying cause of gestational diabetes is unknown, but hormones may play a role. During pregnancy, your body produces more of some hormones; For example, human placental lactogen (HPL) and hormones that increase insulin resistance. These hormones affect the placenta and prevent miscarriage.

Over time, the amount of these hormones in the body increases and may lead to insulin resistance. Insulin helps the glucose needed for energy to enter the cells through the blood. The body becomes less resistant to insulin during pregnancy, and more glucose remains in the bloodstream. If insulin resistance increases, blood sugar levels become abnormal; This can lead to gestational diabetes. Some doctors begin examining the disease during pregnancy with a glucose challenge test; This test does not require any initial preparation. For this test, you should drink a glucose solution and have a blood test an hour later.

If your blood sugar is high, your doctor may order an Oral Glucose Tolerance Test (GTT). Gestational diabetes is divided into two categories: type 1 gestational diabetes can only be controlled with proper diet; But in type 2 gestational diabetes, a person must use insulin or oral medications to control their diabetes. If you have gestational diabetes, your treatment will depend on your blood sugar level throughout the day. In most cases, your doctor will ask you to measure your blood sugar levels before and after eating and manage your condition with a healthy diet and regular exercise; In some cases, insulin injections are prescribed.

According to reports, only 10 to 20 percent of women with the disease need insulin injections during pregnancy to control their disease. If your gestational diabetes is not managed correctly, your blood pressure will remain high during pregnancy. This can cause potential dangers and affect your child. For example, a baby may have problems after birth, such as high birth weight, difficulty breathing, low blood sugar, and shoulder dystocia.

Genetic defects of beta cells:

Neonatal diabetes mellitus is another heterogeneous group of the disease that occurs up to 6 months of age and affects one in every 200,000 live births. These babies are small during pregnancy and have degraded subcutaneous fat. Types of diabetes mellitus are a heterogeneous group of diabetics caused by a “genetic mutation” and are characterized by impaired insulin secretion. It is estimated that these mutations cause 5% of all types of diabetes; however, accurate diagnosis is essential in treating prognosis and family members’ risk. The most common type is usually characterized by increased blood sugar at a young age (under 25 years) called MODY. The inheritance of this type is “autosomal recessive”; Disorders in six gene loci have so far been identified for the disease, the most common of which is on chromosome 12 in the hepatic transcription factor as the “HNF-1α” mutation.

Mutations in the glucokinase gene, located on the 7p chromosome, leading to the production of the defective molecule glucokinase, which converts glucose to glucose-6-phosphate and stimulates insulin secretion

 Because of this mutation, higher levels of glucose are needed to lead to normal insulin secretion. The rarer form of the mutation is in other transcription factors, such as “HNF-4α”, “HNF-1β”, “IPF-1”, and “NeuroD1”. Genetic testing for this type is usually recommended when the age of onset of diabetes is low; unusual symptoms are observed depending on type 1 and type 2 diabetes or strong family history. Spot mutations on “exclusively mitochondrial dyes” inherited from the mother (NIDDM disorder) are associated with diabetes and deafness. The most common form of the 3243 position mutation in the tRNA is the leucine gene.

Genetic insulin dysfunction:

In this type of diabetes, women may show masculine traits and have enlarged ovarian cysts. In the past, this syndrome was considered a type of insulin resistance. Lepperchanism and Robson Mendelhall are two syndromes in children in which the patient has severe insulin resistance.

Extrinsic pancreatic diseases:

This disease is one of the complications of chronic “pancreatitis.” In this type of disease, the entire endocrine glands of the pancreas are destroyed, and these patients are more likely to develop hypoglycemia following treatment. Besides pancreatitis, diabetes can be a complication of any damage to the pancreas, including infections, pancreatic resection, and pancreatic cancer.

Endocrine Disorders:

Several hormones can counteract the function of insulin, and excessive secretion of any of them can lead to the disease. This disorder is more common in people who are already predisposed to diabetes due to deficient insulin secretion. Increased growth hormone and cortisol are common hormonal disorders leading to diabetes.

Diabetes Insipidus:

DI is a rare disease that occurs when your kidneys cannot retain water. The reason for this naming is that this type of diabetes does not cause high blood sugar levels. Diabetes mellitus should not be confused with diabetes mellitus because these two conditions have nothing to do with each other, and diabetes mellitus is much more common than diabetes mellitus. This means that you can get it without having diabetes; In fact, it can happen to anyone. Diabetes mellitus occurs due to insulin resistance and leads to high blood sugar. Still, diabetes mellitus is caused by the production of abnormal hormones in the brain that are secreted to prevent excessive urination and water retention in the body. Without this hormone, the kidneys are continually producing urine.

Diabetes due to drugs or chemicals:

Irreversible destruction of beta cells may occur in rare cases following the use of Vacor (an anti-mouse toxin) or intravenous pentamidine. Some medications can also interfere with insulin function; For example, “nicotinic acid” and “glucocorticoids” are in this category. Some commonly used and relatively safe drugs are also associated with an increased risk of diabetes, including thiazide antihypertensive drugs, statins, and beta-blockers. In the case of statins, studies show that this increase in risk is minimal, and at present, this increase in risk does not justify discontinuing or reducing the use of statins.

Pre-diabetes:

This complication provides the ground for people to get diabetes. It is best to be aware of the acute symptoms of latent diabetes and see an internist if necessary. Dark skin, lack of sleep, decreased physical activity, blurred vision, increased thirst, and ulcers that heal late are some of the underlying warnings of diabetes. Diabetes is one of the most common diseases in the United States, and the American Diabetes Association estimates that more than 9% of the US population had the disease in 2012. Meanwhile, the pre-diabetic stage, also known as “glucose intolerance,” usually has no specific symptoms. This condition often occurs before serious type 2 diabetes occurs. More than 86 million people over the age of 20 in the United States are pre-diabetic; This means that their blood sugar is higher than usual but not high enough to be considered diabetes.

Glucose and insulin:

Because the disease impairs the body’s ability to use glucose, we first look at glucose to see how it controls the body. Glucose is a simple sugar that provides the energy needed for each cell in the body. Cells take glucose from the blood, break it down, and store the energy inside it for their use. Glucose is not made by the body’s cells, and all of it is made by the foods we eat throughout the day. When you eat food or drink a drink, glucose is drawn out of the food into the digestive tract and into the bloodstream to nourish the cells. With the proper accumulation of glucose in the blood, the body always tries to keep the amount of sugar at the right level and deliver it to the cells during the day.

Otherwise, if the glucose in the food we ate were released all at once, the cells would receive all the glucose simultaneously and be wasted a few minutes after starvation until you ate something again. So when you eat a lot of food and get a lot of glucose into your body, the blood takes it to the liver and muscles and converts it to glycogen. “Glycogen” is a long chain of glucose that the body breaks down during hunger to release glucose. Because of this, even for long periods, a person can provide the necessary fuel for his body without eating food. Two hormones released by the pancreas play an essential role in ensuring that the body does precisely this process and that glucose does not enter the bloodstream all at once: insulin and glucagon. Insulin is produced and secreted by beta cells in the islets of Langerhans.

Langerhans are tiny endocrine glands in the pancreas, which is why the prefix “islands” has been chosen for them. Insulin is a hormonal protein made up of 51 amino acids that almost all the body needs, but its main targets are liver cells, fat cells, and muscle cells. Insulin has the following effects on these cells: Stimulating liver and muscle cells to store glucose as glycogen, stimulating fat cells to make fat from fatty acids and glycerol, stimulating liver and muscle cells to make protein from amino acids, and inhibiting liver and kidney cells—glucose production during the “gluconeogenesis” stage.

A few months ago, researchers used laboratory-engineered human pancreatic cells to treat type 1 diabetes in mice and hope to use the method to treat type 1 diabetes in humans by growing patient tissue in the laboratory. Researchers at the Medical Center of Cincinnati Children’s Hospital, in collaboration with Yokohama University in Japan, have discovered how human pancreatic cells in the laboratory can grow the circulatory system and secrete hormones such as insulin. This study shows that self-compacting cell culture systems can grow tissue blood vessels.

In this study, researchers examined cells from various tissues, including the pancreas, heart, and brain, and used induced pluripotent stem cells. After transplanting human-engineered cells into mice with the disease, it was observed that these cells act as part of the endocrine system and can secrete insulin and stabilize blood sugar. Currently, the barriers to using this method in humans are nerves and the source of blood tissue.

Glucagon:

Hypoglycemia (hypoglycemia) can occur when blood sugar levels are low. Symptoms may include chills, dizziness, and difficulty speaking. You can usually treat the condition by eating a snack or drink immediately, such as juice, soft drinks, or candy. Hyperglycemia (hyperglycemia) may occur when blood sugar levels are high. Characteristic symptoms include frequent urination and excessive thirst. Glucagon is a hormone secreted by the pancreatic islets of Langerhans Islands alpha cells when glucose concentration in the blood drops. Glucagon, unlike insulin, raises blood sugar.

Glucagon is a large polypeptide with a molecular weight of 3485 and a string length of 29 amino acids. Like insulin, this hormone is made as a precursor and turns into an adult hormone after changes and transformations. Four to six hours after eating, your blood glucose levels drop, which stimulates the pancreas to produce glucagon. This hormone sends a glucose storage signal to liver cells and muscles to change glycogen. These cells then release glucose into the bloodstream so that the cells can use it to produce energy. Glycogen is a substance made from glucose stored in liver cells and muscles and used to produce energy.

The pancreas is an organ in the abdomen that releases insulin and glucagon. If this hormone’s secretion is low, blood sugar drops dangerously low and causes severe damage to the body. But how does the body know when to release insulin and when to release glucagon? Usually, the levels of insulin and glucagon in the blood interact with each other. That is, if the amount of one increases, the other decreases, and vice versa. For example, when we eat, the body is ready to receive large amounts of glucose, fatty acids, and amino acids in food. The presence of such substances stimulates the digestive system, which goes to the beta cells of the pancreas to secrete insulin.

Contrary to the same message given to beta cells, it is also sent to alpha cells to block glucagon secretion. Imagine a few hours after eating a meal, and the body has no sugar to receive from the digestive tract. Your cells work 24 hours a day and do not stop, so they must be supplied with sugar. In this case, the alpha cells are stimulated and used to return glucose to normal by producing glucagon. As you can see, the balance and interaction between these two hormones allow us to have enough energy during the day and to be able to do different activities at any time of the day, without having to eat at all times.

 Hemoglobin test (HbA1C):

Other names for this test are “Glycated Hb” or “Glycosylated HB” and used to control and evaluate diabetes. This test looked at blood sugar levels 2 to 3 months ago. There are different types of hemoglobin, 95% to 97% of which are typically called A1. When sugar is attached to this type of hemoglobin, it is called glycosylated hemoglobin (Hb A1c). So the higher the sugar, the more it binds to hemoglobin and the higher the concentration of Hb A1c. This connection lasts until the end of the red blood cell’s life, which is about 120 days or three months, although many people with the disease measure their blood sugar at home. The doctor needs to monitor long-term control of the disease.

The A1C test gives doctors a glimpse of blood sugar levels over the previous 120 days, roughly equivalent to a red blood cell’s lifespan. Your doctor can use the results of the A1C test to find out if his or her prescription treatment plan has worked for you. This test should be done at least twice a year. Your doctor may perform this test more often if you have difficulty controlling your blood sugar or have recently changed your treatment plan.

Self-monitoring and blood glucose meter:

One of the patient’s most essential tasks in controlling the disease is controlling blood sugar himself using a blood glucose meter. This method helps people with diabetes, especially patients who inject insulin or patients who do not have controlled blood sugar, to monitor their condition more closely. There are many benefits to controlling blood sugar; For example, controlling blood sugar before and two hours after a meal helps the patient determine the effect of food consumption on blood sugar; Realizing this helps the patient choose the right meal. Insulin intake can also be adjusted by regular monitoring of blood sugar during activity or illness.

After discovering insulin, the patient’s control of blood sugar at home has been the second significant human development in the field of this disease. This way, diabetics, especially those who use insulin, can measure their blood sugar and control their diet and insulin dose. To use a blood glucose meter or “glucometer,” a small drop of blood must be placed on the glucometer’s disposable tape and the tape inserted into the device. The chemical compounds used in these strips can show blood glucose levels when they contact blood. Some of these devices measure the amount of electric current in the blood and measure blood sugar.

Others show blood sugar levels in terms of light spectrum reflection and light reflection. Diagnosis of this disease should not be made using these devices, but blood tests must be given. This means that the patient must go to a laboratory to have a sample of their venous blood. Blood glucose monitors usually use fingertip blood. This blood is taken through the capillaries and is complete, meaning it contains both cells and plasma fluid. Simultaneously, the laboratory separates the cell from the blood and shows only the plasma or serum intravenous blood sugar level. This causes the devices’ blood sugar level to be about 15% lower or higher than in the laboratory.

Regular fasting blood sugar for those who do not have the disease should be less than 100 mg/dl. If this rate is more than 126, and this rate is repeated once more, it has this disease. Also, if a person has symptoms of this disease (frequent urination, binge drinking, and weight loss) and at the same time his blood sugar (blood sugar took without regard to time) is even above 200 for once, the person has diabetes. Of course, these criteria are laboratory and should not be diagnosed with a glucometer. Also, a person who’s fasting blood sugar is between 100 and 126 is prone to this disease.

Diabetic foot:

Diabetes can cause severe problems for the organs. One of these problems is chronic and refractory wounds that usually occur in the soles of these patients’ feet. This complication is also called a diabetic foot. Problems with the feet of people with this disease can be attributed to two significant problems. These two problems are peripheral nerve disorders and decreased blood flow to the limbs. The foot’s sole is the farthest part of the body from the heart and receives less blood than other tissues in the body.

That is why in cold weather, the first place the limb cools is the foot. In the long run, diabetes causes a decrease in blood flow throughout the body, but this problem manifests itself more in the foot than elsewhere. This causes the wounds that regularly occur on all people’s feet due to environmental damage but heal quickly to not heal on these people’s feet; Because wound healing requires nutrients and oxygen that reach the tissues through the blood. The germs also see the background and begin to infect the wound. Due to the reduced blood flow to the foot, white blood cells are less likely to travel to the wound site, and the tissue’s immune defenses are reduced.

The disease itself lowers the immune system in general. This spreads the infection to the wound and delays its healing. Another problem for people with diabetes is impaired peripheral nerve function, which reduces their sense of touch. This loss of sensation causes dryness and cracks in the skin that provide the basis for scarring. On the other hand, the patient is less aware of environmental damage due to decreased sensation. For example, the foot is placed next to a hot object without burning, and the person burns.

Diabetes treatment:

Exercise lowers blood sugar by increasing insulin’s effectiveness (i.e., increasing glucose entry into the body’s cells, especially muscle cells). This effect is reduced by lowering fasting blood sugar, and hemoglobin (which indicates your blood sugar’s long-term status during 2. It has been up to 3 months) will show. Diabetes mellitus is the most common “metabolic disease.” Its worldwide prevalence is estimated to reach 21% by 2050. The goal of treatment is to regulate glucose, fat, and blood pressure to prevent or delay the disease’s chronic effects. Diet, medication, and physical activity are the three main ways to control diabetes.

Endurance, resistance, and combined sports are useful in controlling this disease and its dangerous side effects. One session of aerobic exercise increases insulin sensitivity for 24 to 72 hours. The positive effect of exercise leads to weight loss, increased Glut4 muscle, increased blood flow, decreased hepatic glucose production, and normalized blood lipids. Long-term resistance training improves glucose tolerance and insulin sensitivity and increases glycogen stores by increasing skeletal muscle mass. When prescribing exercise for diabetics, the disease’s complications, the level of disability, and orthopedic limitations should be considered.

 

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