Diabetic

 

Living with diabetes

Being a diabetic can mean important changes in a person's daily life. Individuals with this disease, due to the inability of their own body to control blood sugar levels and convert this into the necessary biological energy, must carry out a control over different aspects of their daily life. World Diabetes Day is celebrated every November 14th. This date is celebrated from 1991 to commemorate the anniversary of the birth of the Canadian Frederick Banting (1891-1941), whose investigations, together with those of Charles Best (1899-1978), would lead to the discovery of insulin in October 1921.

What is the diabetes?

Sugar diabetes, or diabetes mellitus, is a metabolic disorder characterized by an increase in blood sugar levels (hyperglycemia), caused by a defect (complete or otherwise) in the secretion or action of a hormone: insulin. Insulin is produced in special formations found in the pancreas: the islets of Langerhans.
Blood sugar levels are maintained, in non-diabetic people, within very narrow normal limits, exceeding very rarely the 130 mgr. by dl, even when foods rich in sugar have been taken.
This stability of glycemia is due to the existence of an extraordinarily fine and sensitive regulatory mechanism.
In non-diabetic people, blood sugar levels remain within very narrow normal limits, exceeding very rarely the 130 mgr. by dl, even when foods rich in sugar have been taken.
When a non-diabetic person ingests food, the sugars that they contain are absorbed from the intestine and pass into the blood, tending to raise the sugar levels in the blood. Such a tendency to elevation is immediately detected by insulin-producing cells that respond rapidly by secreting this hormone.
Insulin, in turn, acts as a key that opens the doors of the cells in the muscles, fatty tissue and liver, allowing the sugar to enter and therefore lowering its level in the blood. All this mechanism acts very quickly, without giving time for the glycemia to rise.
Once the sugar has entered the tissues, it is burned (metabolized) and produces energy that is used to maintain the functions of the organs and their structure.
In a person with diabetes, the production of insulin is so diminished that the entire regulatory mechanism is altered: blood sugar elevations are not followed by a sufficient increase in insulin, sugar can not penetrate the cells and its quantity continues rising up.
Clinical expressionThe fact that the cells lack fuel (sugar), causes them not to produce enough energy and alter their functions. This lack of energy is the reason that a poorly controlled diabetic can experience:
Sensation of fatigue, lack of strength: known in medical terms as asthenia.Sensation of hunger: the cells are hungry, this being the reason that a person with uncontrolled diabetes can feel hungry (polyphagia).Thinning: since energy can not be received from sugars, the organism tries to obtain it from fats, producing a mobilization of those stored in adipose tissue.Increased thirst sensation: due to high levels of blood sugar the kidney, which acts as a filter for it, receives a remarkable sugar overload. Since the capacity of the kidney to concentrate it is limited, it is forced to dilute it using water from the organism. This situation leads to a certain dehydration that is perceived by the diabetic as an increase in the sensation of thirst: (polydipsia).Increased need to urinate: increased water elimination causes people with uncontrolled diabetes to urinate more than normal (polyuria).
Thus, we see how the increase in blood sugar, due to lack of insulin, leads to those considered as cardinal symptoms of diabetes: polyuria, polydipsia, polyphagia, weight loss and asthenia.
The main symptoms of diabetes are: polyuria, polydipsia, polyphagia, weight loss and asthenia
Types of diabetesAlthough the general considerations that we have pointed out in the previous section are applicable to any form of diabetes, the causes for which it occurs, the way in which it occurs and the way in which it evolves, distinguish some well-differentiated types of diabetes. diabetes.

 DIABETES TYPE 1

This form of diabetes, which appears above all in children, adolescents and adults under 30 years, is due to a complete or almost complete destruction of insulin-producing cells, as a result of an autoimmune process.
Type 1 diabetes appears, above all, in children, adolescents and adults under 30 years of age.In autoimmune processes, the system of defense of the organism against external aggressions (immune system), "confuses" with an aggressor element to some substance that, in reality, is a constituent of the organism, attacks and destroys it. In the case of type 1 diabetes, the substance in question would be one of the constituents of the insulin-producing cells in the pancreas.
In addition to the age of onset, type 1 diabetes is characterized by:
A relatively abrupt start, accompanied by all or most of the cardinal symptoms of the ailment.
An absolute, vital need for insulin for treatment. If insulin is not used, diabetics of this type would suffer a rapid aggravation, until they fall into a "diabetic coma". From the point of view of the laboratory, type 1 diabetics have characteristic alterations (absence of insulin secretion, antibodies against insulin-producing cells, ...). Such analyzes are sometimes used for research purposes, but have no utility in the treatment routine. *

TYPE 2 DIABETES

This form of diabetes usually appears in people over 40 years of age, the more advanced the age, the more frequent. Its causes are a combination of genetic and environmental factors, although it is not known exactly what is the trait that is inherited. Most likely, the inherited is a set of traits, often each of them in people, but grouped in a relatively rare combination.
 Type 2 diabetes usually appears behind the age of 40. Its frequency is higher when age is more advanced and if there is overweight, high blood pressure or high cholesterol.
In addition to the age of onset, they are important characters of type 2 diabetes:
The overlapping appearance, with very few or no symptoms. Many times it is discovered casually.
The frequent association with overweight, high blood pressure and alterations of cholesterol and other blood fats. The frequent response, at least initially, to diet, exercise and medications in the form of pills. Insulin is sometimes necessary to get adequate control, but it is not vital. The absence, in the analyzes, of those alterations that characterize type 1 diabetes, (maintenance of insulin production, absence of antibodies, etc.) Type 2 diabetes is by far the most frequent of the forms of diabetes. diabetes in the societies of our environment, constituting more than 80 percent of the total of diabetes.
Type 2 diabetes is by far the most frequent form of diabetes in Western society, accounting for more than 80 percent of all diabetesThe fact that, many times, it lacks symptoms, it makes especially important the search of its diagnosis among the people at greater risk: direct relatives of type 2 diabetics, obese, hypertensive, etc ..., since ignored and untreated, it can lead to complications, in the medium and long term, as important as those of type 1.
* GESTATIONAL DIABETESGestational diabetes is one that appears during pregnancy in a woman who previously did not have it. It should not be confused with the situation of a diabetic (type 1 or type 2) who, at a given time, becomes pregnant.
This is a relatively frequent situation and, therefore, it should be sought in all pregnant women, especially if they present a special risk (previous gestational diabetes, family history, previous changes in the blood glucose curve, etc.).
The detection of gestational diabetes is of great importance, given the consequences that, if passed unnoticed, may have for the pregnancy fruit
The detection of gestational diabetes is of great importance, given the consequences that, if unnoticed, may have for the pregnancy. Its correct treatment, until achieving the almost normalization of sugar levels, is paramount.

OTHER SPECIFIC FORMS OF DIABETES

In this section, a good number of the formerly called secondary diabetes are located, along with a series of genetic syndromes defined in recent years. Among them are:
Genetic defects of beta cell function
Genetic defects of the action of insulin Diseases of the exocrine pancreas Endocrinopathies Drug-induced or chemically-induced Infections Infrequent forms of immune origin Other genetic syndromes related to diabetes Concept of glucose intolerance
Within this category of sugar metabolism alterations are those whose glucose levels are not high enough to be considered diabetic but who, when subjected to an overload of 75 gr. of pure glucose, they respond in an intermediate way between normality and frank diabetes.
Specifically, they are considered to have glucose intolerance who have blood glucose levels two hours after the overload, between 140 and 200 mg.
The glucose intolerance is extraordinarily frequent (approximately twice as much as diabetes itself) and may constitute a previous stage in the natural history of diabetes
The glucose intolerance is extraordinarily frequent (approximately twice as much as diabetes itself) and may constitute a previous stage in the natural history of diabetes, preceding it. In 40% of the cases, the alteration detected with an overload test reverts to normal when the test is repeated. 

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