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Endocrinology

Diabetes mellitus 2 types

Table of contents
Diabetes mellitus 2 types
Treatment
Medicines
Insulin therapy

In the general structure of a diabetes mellitus of 90-95% 2 types make a diabetes mellitus, at the same time it is known that the actual prevalence by 2-3 times exceeds registered on negotiability. This type of a disease is associated with modern "epidemic of diabetes". Increase in prevalence of a diabetes mellitus 2 types is caused, first of all, by sharp changes in way of life of the modern person (an overeating, a hypodynamia) and the social and economic processes which are their cornerstone. The most rapid growth of incidence is observed among the population of developing countries, and also among ethnic minorities with a low income level in industrially developed countries.

Historical name: non-insulin-dependent diabetes mellitus. 2 types are the cornerstone of a diabetes mellitus resistance to insulin and/or its insufficiency (relative more often than absolute). At the beginning of a disease, and it is frequent and throughout life such patients do not need an insulin therapy according to vital indications. The diabetes mellitus reasons 2 types are various. Possibly, in the future allocation of the specific pathogenetic processes and genetic defects which are the cornerstone of this disease will allow to allocate options (subtypes) of a diabetes mellitus 2 types. Specific cytologic characters of this form of a diabetes mellitus are not established, however it is known that autoimmune destruction of beta cells does not happen. Most of patients with a diabetes mellitus 2 types have the excess body weight or obesity as a result of which the insulinorezistentnost develops. The Insulinorezistentnost is also possible at people with normal body weight, but with the raised abdominal adiposity. In spite of the fact that patients with a diabetes mellitus 2 types can have normal or even the increased insulin level in blood, the insufficient insulin answer to a hyperglycemia is characteristic of them. Therefore secretion of insulin at these patients is defective and cannot compensate an insulinorezistentnost. Resistance to insulin can decrease as a result of weight reduction and/or pharmacotherapy of a hyperglycemia, however it is seldom recovered to normal. The risk of development of a diabetes mellitus 2 types increases with age, and also at increase of surplus of body weight and insufficient physical activity. This disease develops at women with a diabetes mellitus of pregnant women in the anamnesis and at people with an arterial hypertension and a dislipidemiya also more often. Genetic predisposition is noted at a diabetes mellitus 2 types more often than at a diabetes mellitus of 1 type. However the genetics of this form of a diabetes mellitus is difficult and is still accurately not defined.

Clinical picture

Diabetes mellitus 2 types quite often make the diagnosis accidentally as the disease develops gradually, the symptoms caused by a hyperglycemia and deficit of insulin demonstrate late and can be combined with clinical manifestations of complications of a diabetes mellitus. In the presence of symptoms they correspond to that at a diabetes mellitus of 1 type. Besides, at patients with a diabetes mellitus 2 types quite often note: obesity or excess weight - in 80-90% of cases, an arterial hypertension, decrease in sight, neurologic disturbances, an ischemic heart disease.
These manifestations micro and makroangiopatiya, and also a skin itch, a furunculosis, a fungal infection, onychalgias, impotence can become the reason of the first address of the patient to the doctor.
Quite often 2 types for the first time reveal a diabetes mellitus at patients with a myocardial infarction or a stroke.
2 types can appear the first manifestation of a diabetes mellitus a giperosmolyarny coma. Spontaneous development of diabetic ketoacidosis is noted seldom; usually it is a consequence of a stress (an intercurrent disease).
Rather often at the time of diagnosis of a diabetes mellitus 2 types come to light specific complications from eyes, kidneys or the lower extremities.



 
"Diabetes mellitus of 1 type   Syndrome of Kushinga"