What Types Of Diabetes Are There?How To Prevent It ?
Apr 11, 2022
According to the standards of the World Health Organization, diabetes is mainly divided into four types: type 1 diabetes, type 2 diabetes, other special types of diabetes, gestational diabetes, and secondary diabetes.
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1. Type I diabetes (insulin-dependent)
The age of onset is young, most of them are less than 30 years old, the onset is sudden, the symptoms of polydipsia, polyuria, and polyphagia are obvious, weight loss, high blood sugar level, many patients have ketoacidosis as the first symptom, low serum insulin, and C-peptide levels, ICA, IAA Or GAD antibody can be positive.
Type I diabetes is mainly caused by autoimmune damage, which destroys islet beta cells, resulting in an absolute lack of insulin.
This type of diabetes patient accounts for 5% to 10% of the total.
Type 1 diabetes occurs at an early age and is more common in children and adolescents.
Patients often have an acute onset, and the symptoms of "three more and one less" (eating more, drinking more, urinating more, and losing weight) are more obvious.
Patients with type 1 diabetes need to rely on insulin injections to survive, otherwise, ketoacidosis will occur, which may be life-threatening if not treated in time.
Type 1 diabetes patients are sensitive to insulin and are thin, but a small number of patients develop slowly, and some patients are non-insulin-dependent at the onset, and then gradually become insulin-dependent diabetes.
Type I diabetes is ineffective with oral medication alone and requires insulin therapy.
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2. Type II diabetes (non-insulin-dependent)
Common in middle-aged and elderly people, this type of diabetes accounts for 85% to 90% of the total number of diabetic patients.
Most of the onset occurs after the age of 35, and the onset is slow and insidious. Some patients are found during the health check-up, and most of them are overweight or obese (so, weight management is necessary).
Insulin treatment is generally not required.
Type 2 diabetes is the result of a combination of genetic factors and environmental factors.
Most type 2 diabetes has a slow onset, with mild or atypical symptoms of "three more and one less", and there may be no symptoms in the early stage, and ketosis is less likely to occur.
Most patients can control blood sugar stably after diet therapy and oral hypoglycemic drug treatment. Type 2 diabetes patients with a long course of the disease and pancreatic islet failure, also need to supplement insulin to control blood sugar.
Obese people have a high incidence of disease, often accompanied by hypertension, dyslipidemia, arteriosclerosis, and other diseases.
Insidious onset, no symptoms in the early stage, or only mild fatigue, thirst, and no obvious increase in blood sugar, a glucose tolerance test can be diagnosed.
Serum insulin levels were normal or increased in the early stage and decreased in the late stage.
3. Other special types and gestational diabetes (the cause can be checked)
The etiology of type 1 and type 2 diabetes is not well understood, and we call it primary diabetes.
Other special types of diabetes usually have special causes to be investigated, such as insulin synthesis disorder caused by pancreatic disease, taking drugs that can raise blood sugar at the same time, or other endocrine reasons, such as excessive secretion of anti-insulin hormones, long-term Malnutrition, low protein intake, etc.
Gestational diabetes is a unique type of diabetes diagnosed in women during pregnancy, which refers to diabetes that women develop during pregnancy.
Clinical data show that 2% - 3% of women can develop diabetes during pregnancy, and nearly 35% of pregnant women will have signs of gestational diabetes, and these women may develop type 2 diabetes.
4. Secondary diabetes (the cause can be checked)
Secondary diabetes refers to diabetes with a clear etiology, such as pancreatectomy, acute and chronic pancreatitis, hypercortisolism, and acromegaly.
In addition, long-term use of certain drugs can also cause diabetes, such as prednisone (prednisone), hydrochloride (hydrochlorothiazide), and so on.
Secondary diabetes is far less common than primary diabetes. Diabetes we generally refer to, unless otherwise specified, generally refers to primary diabetes (ie type I and type II diabetes).
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"Cause"
Why do you get diabetes?
The causes of diabetes can be roughly divided into 3 types: genetic factors, immune system problems, and environmental factors.
For healthy people, blood sugar level is one of the important indicators of human life and needs to be controlled within a certain range.
After each meal, blood sugar rises, and the more foods with high sugar content or high glycemic index in the food, the greater the rise in blood sugar.
It is normal for normal people to increase blood sugar after meals, but the increase should be controlled within 2.8mmol/L or 50mg/dL, and 2 hours after eating, normal people's blood sugar should return to 6.7mmol/L or below 120mg/dL. These All are brought about by the hypoglycemic effect of insulin and are the result of normal physiological effects.
The hypoglycemic process of insulin is rough as follows: when the blood sugar rises rapidly, the pancreas needs to secrete a large amount of insulin to lower the blood sugar level.
It is precise because of the large amount of insulin that the blood sugar drops rapidly. When the blood sugar drops too fast, the pancreas also secretes glucagon to raise the blood sugar, thus forming a blood sugar shock. To ensure that the body's blood sugar is in a stable normal range.
When too much insulin causes blood sugar to drop too quickly, if the pancreas cannot effectively secrete glucagon or the adrenal glands cannot effectively produce cortisol and epinephrine, blood sugar cannot be raised in time, This person will have symptoms of low blood sugar.
Low blood sugar is very dangerous!
Low blood sugar will directly lead to the insufficient blood supply to the human brain, resulting in syncope, and even brain death. Therefore, when encountering low blood sugar, be sure to replenish foods with high sugar content such as candy in time. It is best to keep a few pieces of sugar in your pocket.
Conversely, high blood sugar is also bad.
Even for a normal person, if he does not pay attention to his diet for a long time and often eats high-sugar foods, the blood sugar level will continue to remain high, which is a dangerous signal, because the viscous and high-glycemic blood will cause chronic damage to the blood vessels.
At the same time, the sugar in the blood combines with the proteins in the blood vessels to form glycated proteins (also called AGES). The glycated proteins are harmful proteins, which cannot fulfill the function of proteins, cannot be metabolized normally in the body, are prone to Injuries to the blood vessels, and can easily lead to arteriosclerosis.
The most dangerous thing, of course, is insulin resistance.
Meaning: Everyone knows that insulin is hypoglycemic. For example, 1ul of insulin can reduce blood sugar by 10mg. If insulin resistance occurs, now 1ul can only reduce blood sugar by 1mg. To put it bluntly, insulin is slow.
The consequence of insulin resistance is that the blood sugar that rises after a meal cannot be lowered in a short time.
But the body has a self-protection mechanism. In order to maintain the balance of blood sugar, the pancreas will work hard to secrete more insulin to lower blood sugar.
The more insulin, the more resistant the cells become to it, leading to more sustained insulin resistance, and the vicious cycle begins.
This is also the first step toward diabetes.
What are the symptoms of insulin resistance?
It's often easy to get drowsy after a meal, and you may even need to take a nap.
At the same time, there may also be a frantic and relentless craving for sugar after a meal, making dessert a necessity.
These phenomena show that although there is a lot of glucose in the blood after meals, it cannot enter the cells and cannot be used.
Once you have insulin resistance and you don't pay attention to changing your diet and living habits, it is easy to develop diabetes.
In the long run, it will induce the occurrence of diabetes.
In one sentence, for most type 2 diabetics, the path from normal to diabetic experience is as follows:
Normal people —> insulin resistance —> hyperglycemia —> diabetes.
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"Diagnosis"
How is Diabetes Diagnosed?
First, a single increase in blood glucose cannot be used as a clinical basis for diabetes.
Diabetes is clinically identified in two ways:
Method 1. Generally, multiple blood glucose measurements at different time points are required.
Normal fasting blood glucose is 3.9 - 6.1 mmol/L.
When the fasting blood sugar value is greater than 6.7mmol/L, and the blood sugar value of 2 or more repeated measurements is higher than the normal range, it can be judged that the blood sugar is too high, but diabetes cannot be diagnosed, and it is necessary to continue to observe and measure multiple times.
When the fasting blood sugar exceeds 11.1mmol/L, diabetes can be diagnosed and no other tests are required!
Postprandial blood sugar level, there are 3 clinical standards -
One hour after the meal, the blood sugar is 6.7-9.4 mmol/L, and the maximum value does not exceed 11.1 mmol/L;
2 hours postprandial blood glucose should be lower than 7.8mmol/L;
Blood glucose should return to normal levels 3 hours after meals, that is, 3.9 to 6.1 mmol/L.
Mode 2, by measuring the glycated hemoglobin index.
Glycated hemoglobin index (also called GHb) is the product of the combination of hemoglobin in red blood cells and sugars in serum. GHb is composed of HbA1a, HbA1b, and HbA1c, of which HbA1c accounts for about 70%, and the structure is stable, so it is used for diabetes control It can effectively reflect the blood sugar control of patients with diabetes in the past 1 to 2 months): the standard normal value of glycated hemoglobin is 4% to 6%, and if it is higher than 6%, diabetes can be determined.
"Symptom"
What are the symptoms of diabetes?
Diabetic patients are clinically characterized by hyperglycemia, and symptoms of "three more and one less" may also appear in typical cases——
The phenomenon of polyphagia, polydipsia, polyuria, and weight loss.
1. Polyuria: It is the result of increased blood sugar and the body's efforts to eliminate sugar through urine;
2. Polydipsia: It is the result that the body needs to replenish the lost water because of excessive urination;
3. Eat more: the result of the body's inability to use sugar well;
4. Physical strength and weight loss: This is caused by insufficient energy, fat, and protein consumption.
Why do diabetics urinate more and drink more?
Diabetic people's blood sugar rises, and high blood sugar does great damage to the human body. In order to protect itself, the human body has to urinate more to excrete sugar the urine, resulting in a significant increase in urine output.
In fact, it is the body's self-protection mechanism.
If a person urinates too much and loses a lot of water in the body, they will feel unbearable thirst.
The clinical manifestations of polyuria and polydipsia are dry lips, sticky tongue, more than one 5-pound thermos of water per day, and frequent and frequent urination during the day and night, especially at night.
Some people drink a lot of water, their stomachs are full, and they still feel thirsty.
The above symptoms can also be used for self-examination diagnosis. If you find the above symptoms, please check your blood sugar in advance to confirm whether you have diabetes.
"Harm"
What are the dangers of diabetes?
I don't want to talk about the dangers of diabetes, I know, and you don't want to hear it either.
But who said that diabetes is harmful? Sometimes I think, if diabetes is a good disease, it would be great.
Everyone greets you. It's not what you have eaten, but how much your blood sugar is today. My 16, oh, my 17, how good it is.
OK, back to the topic.
The harm of diabetes is not diabetes itself, but a series of possible complications brought by diabetes.
The hazards of diabetes are mainly divided into the following 7 points:
1. Cardiovascular and cerebrovascular complications (the most deadly): microvascular diabetic lesions manifested in aortic and cerebral atherosclerosis, extensive small vessel endothelial hyperplasia, and thickening of capillary basement membranes.
In an easy-to-understand way, diabetes can easily lead to strokes such as cerebral infarction, cerebral congestion, heart disease, myocardial infarction, heart disease, etc. Once these complications are acquired, they are basically either dead or discarded.
Therefore, patients who have been diagnosed with diabetes must (must) pay attention to controlling their blood sugar and do regular physical examinations. If they have chest tightness, headache, dizziness, etc., seek medical attention in time to find out the cause.
Many sudden deaths reported in the news are basically strokes (also known as strokes, cerebrovascular accidents) and sudden cardiac arrests.
2. Renal complications (the main cause of death): Due to the high sugar in blood sugar, the glomerular microcirculation filtration pressure in the kidney is abnormally increased, which will promote the occurrence and development of diabetic nephropathy for a long time.
The early manifestations are proteinuria and edema in the physical examination results, which then develop into abnormal renal function and eventually lead to renal failure, which is the main cause of death in type 2 diabetes.
3. Peripheral vascular complications (diabetic foot and diabetic extremity): The influence of diabetes on peripheral blood vessels is mainly extremity arteries. Due to the high blood sugar in the blood vessels of the extremity arteries, high blood sugar will cause vascular lesions, resulting in damage to local tissues. The sensitivity to factors is reduced and blood perfusion is insufficient. When external factors damage local tissues or local infections, local foot and limb tissue ulcers are more likely than ordinary people. The most common part of this risk is the feet, so it is called a diabetic foot. If the ulcer occurs in the lower extremity, it will lead to an ulcer, and the lack of blood supply will lead to necrosis of the extremity, which will lead to disability. The general hospital treatment method is amputation.
4. Neuropathy (the main cause of death and disability): High blood sugar can also cause fatal damage to the nerves in the long run. Diabetic neuropathy is one of the most common chronic complications of diabetes and the main cause of death and disability in diabetes.
Peripheral neuropathy and autonomic neuropathy are the most common types of diabetic neuropathy. The clinical symptoms of peripheral neuropathy are numbness and cold tingling in the extremities. Autonomic neuropathy is mainly manifested in no sweat, less sweat, or more sweat. inflammation. According to symptoms, pay attention to self-examination and seek medical attention in time to control sugar.
5. Eye disease (can lead to blindness): It is still because excessive blood sugar that damages the blood vessels of the eye, resulting in problems with the blood supply to the eye and the blood vessel wall. In mild cases, it can cause vision loss, glaucoma, or other eye diseases, and in severe cases, it can cause blindness.
Diabetic patients must pay attention to whether the eyes are uncomfortable and whether the vision is blurred.
6. Substance metabolism effects (ketoacidosis): Because diabetes is a disorder of glucose metabolism, fat and protein decomposition is accelerated, ketone bodies are produced in large quantities, tissues are not oxidized in time, and lungs and kidneys are too late to excrete ketone bodies, which will lead to a significant increase in blood ketone concentration. , there will be ketoacidosis and hyperosmolar nonketotic coma, the mortality rate is extremely high, and emergency treatment is required.
7. Infection (prone to lesions): Frequent skin infections occur repeatedly, which can sometimes lead to sepsis.
Vaginal itching, onychomycosis, tinea pedis, urinary tract infection (nephritis and cystitis) caused by fungal vaginitis, in addition, it is easy to contract tuberculosis.
Do many people wonder why diabetes brings so many concurrent diseases?
It is very simple, the blood sugar in the blood of diabetics exceeds the normal blood sugar level. You must know that blood vessel are present in the whole body, and every organ and cell needs blood transportation to transmit nutrients and wastes.
Because blood vessels are all over the body, problems with blood components will cause chronic damage to various tissues and organs in the body.
Abnormal blood composition, just like the water in your water pipe becomes turbid and bad, not only does it take a lot of effort to pump the water, but the "contaminated water" will be "contaminated" wherever it flows. The most common contaminated organs are the above-mentioned hearts, kidneys, eyes, lower limbs, feet, etc.
This is why diabetes can bring a series of complications.
"Treatment and Sugar Control"
How to treat diabetic patients?
Type 1 diabetes is usually treated with insulin injections.
The majority of diabetic patients are obesity-induced patients, namely, type II diabetes patients.
Type II diabetes mainly controls blood sugar through hypoglycemic drugs, which often require lifelong medication.
Decreased or low insulin secretion, also need to consider injecting insulin therapy.
At the same time, the non-drug adjuvant treatment of type II diabetes is mainly based on diet control and exercise.
Most type II diabetes is caused by obesity, and fat metabolism can be regulated by losing weight, thereby affecting glucose metabolism and repairing lipid metabolism to achieve the purpose of balancing glucose metabolism.
In view of the variety of weight loss methods on the market, I will only say one thing:
Fat is the problem of eating out, and it needs to be solved by eating back.
This determines that a truly healthy and scientific weight loss plan must be non-drug and non-surgical, but a diet + exercise weight loss plan. Please pay attention to screening, don't be deceived and hurt your body.
For patients who have been diagnosed with diabetes, in addition to necessary drug treatment, it is very important to maintain a good mood. The diet is mostly low-glycemic (mainly foods such as whole grains and coarse grains), small and frequent meals, balanced nutrition, a combination of work and rest, and appropriate Do cardio.
By the way, you also need to check your blood sugar regularly, have regular physical examinations, and have a good idea of your own body.
"Prevention"
How can ordinary people prevent diabetes?
1. Diet, reduce fat and sugar control
It is an old saying that my country has entered the ranks of countries with a moderate prevalence of diabetes (3% to 10%), among which type 2 diabetes patients account for 85% to 90% of the total, and obesity is the main culprit of type 2 diabetes, because obese people Abnormal distribution of fat, excessive accumulation, etc., will lead to insulin resistance. At this time, the pancreas will be overloaded to synthesize a large amount of insulin to maintain the balance of glucose metabolism. This is hyperinsulinemia. The overloaded islets will definitely have problems for a long time. The function of the pancreas to synthesize insulin gradually fails, which leads to diabetes.
Obesity and diabetes are mutually causal.
Obesity is an independent high-risk factor for type 2 diabetes. 85% to 90% of type 2 (non-insulin-dependent) diabetic patients are overweight or obese. Obesity is the origin of the natural history of type 2 diabetes.
Therefore, eliminating obesity is the most effective measure to treat and prevent diabetes.
All knowledge is used to serve, and knowledge is to become better. I hope everyone will become better after understanding diabetes.
The unity of knowledge and action can make change possible, and the next thing to do is to act:
Start with reducing fat and sugar control, starting with balanced nutrition, starting with early going to bed and getting up early, starting with proper exercise, starting with a smile every day, and of course, the most important thing is starting now.
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