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Endocrinology

Diabetes mellitus of 1 type

Diabetes mellitus - group of the metabolic (exchange) diseases which are characterized by a hyperglycemia which is result of defects of secretion of insulin, effect of insulin or both of these factors. The chronic hyperglycemia at a diabetes mellitus is associated with damage, dysfunction and insufficiency of various bodies, especially an eye, kidneys, nerves, heart and blood vessels.

The destruction of beta cells of a pancreas which is usually leading to absolute deficit of insulin is the reason of a diabetes mellitus of 1 type. Distinguish two main subtypes:

Autoimmune diabetes mellitus.

This form was called insulin-dependent diabetes earlier. It is result of autoimmune destruction of beta cells of a pancreas. Markers of immune destruction of beta cells include autoantibodies to insular cells (ICAs), autoantibodies to insulin (lAAs), autoantibodies to a decarboxylase of glyutaminovy acid (GAD65) and some other autoantibodies. Existence of the genetic contributing factors, in particular communication of a disease with the HLA system does not raise doubts. At an autoimmune diabetes mellitus destruction of beta cells can happen to various speed, usually this process happens fast at children and slower at adults. Anyway insulin secretion sharply decreases or completely stops that is shown by the low level of S-peptide in blood.

Idiopathic diabetes mellitus.

The etiology of some forms of a diabetes mellitus of 1 type is unknown. At many of such patients constantly note insufficiency of insulin and bent to ketoacidosis, but signs of autoimmune process are absent. Most of patients with an idiopathic diabetes mellitus - the African or Asian origin. This form of a diabetes mellitus has the expressed family character, communication with HLA is not revealed. The absolute need for a replaceable insulin therapy at patients can appear that, disappear.

Clinical picture of a diabetes mellitus of 1 type

Beginning of a disease acute. The clinical picture at the time of detection of a disease is a consequence of absolute deficit of insulin which leads to the expressed hyperglycemia and a glucosuria that in turn causes characteristic symptoms of a diabetes mellitus. Treat them:

  1. polyuria (including at night) - a consequence of osmotic diuresis;
  2. thirst; dryness in a mouth;
  3. decrease in body weight, despite the increased appetite and a polyphagia;
  4. skin manifestations, including skin itch (the itch mucous, - at women in a vulva is possible), tendency to bacterial and fungal infections of skin and mucous membranes (furunculosis, candidiasis);
  5. glucose and ketonic bodies in urine.

Nonspecific symptoms are also characteristic: weakness, fatigue.
If in time not to begin treatment, at patients diabetic ketoacidosis with the progressing disturbances of consciousness up to a diabetic coma develops.
The patients receiving sakharosnizhayushchy therapy, can have erased even at the remaining hyperglycemia clinical signs. At development of chronic complications of a diabetes mellitus (a diabetic retinopathy, a diabetic nephropathy, diabetic polyneuropathy) the corresponding clinical picture will be observed.

 
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