Diabetes mellitus


Diabetes mellitus
Diabetes mellitus said (or modus) is a disease linked to a failure of the biological mechanisms for regulating blood sugar, concentration of glucose in the blood. The disease manifests itself through a significant increase in blood sugar, and can be caused by genetic factors (see hereditary disease) or develop following an unhealthy life. However, the causes of diabetes in the vast majority of cases have not yet logical explanation.

Several failures exist and characterize different forms of diabetes. The symptoms and complications may vary depending on the mechanisms or defaulting.

In France, an estimated 3.5% of the population has diabetes (10-20% of type 1 diabetes and 80-90% of type 2 diabetes). (2007: International Diabetes Federation estimated that 1 in Belgium on 12 with diabetes (7.8%). In 20 years, this figure is expected to reach 1 in 10)

Different types of diabetes
there is 3 types of diabetes. Either type 1, type 2 and type 3. Type 1 and 2 being the most common.

The regulation of blood sugar by the body is largely linked to the ability of cells to absorb glucose, thereby lowering its concentration in the blood. Insulin is a hormone secreted by the pancreas, whose function is to increase the entry of glucose into cells (hence its action hypoglycemic). This is the only substance in the body capable of eliminating glucose, while many contrary to participate independently in its manufacture. There are two types of diabetes according malfunctions present.

Diabetes type 1
Formerly known as insulin-dependent diabetes (or juvenile diabetes), diabetes is most often brutal manner in children or young adults.

It is characterized by:

* A blood glucose (blood sugar in the blood) greater than 1.26 g / l fasting or 8.8 mmols (normal value is understood by 0.8 and 1.10 g / l, 1.10 to 1 , 25 speaks of glucose intolerance) and sometimes a acétonurie (presence of acetone in the urine, the threshold for passage of the acetone in the urine is a blood sugar of 2.5 g / l) accompanied by a breath "apple reinette" feature and presence of sugar in the urine (glycosuria, the threshold for passage of sugar in the urine is 1.8 grams).
* By an emission of excessive urine (polyuria) resulting in intense thirst (polydipsia)
* Abnormal appetite increased (polyphagie). It has also resulted in a weight loss despite an abundance of food.

Type 1 diabetes is an autoimmune disease resulting in a total destruction of beta cells (which produce the hormone insulin) of the islets. These cells are responsible for verifying the rate of glucose in the blood and produce more or less insulin based on blood sugar: in the event of hyperglycemia, insulin is produced in greater quantity in the event of 'hypoglycemia is the glucagon, which is secreted in large quantities. Located in the pancreas, their destruction has resulted in a lack of insulin in the blood. The type 1 diabetes must inject insulin several times a day throughout their life and eat a balanced manner. This balance is precarious blood sugar, food processing and vary from day to day depending on the circumstances (activities, emotions, schedules, diseases, etc.).. The diabetic must therefore be autonomous in its management of the disease.

Type 2 Diabetes
Formerly called non-insulin diabetes (diabetes or middle age), diabetes typically occurs in adults over 40 years showing in 80% of cases, obesity or at least overweight. It is sometimes preceded by the type 1 diabetes. At the beginning of the disease, the production of insulin by the pancreas is normal (or excessive). But the body's cells responsible for capture and use glucose become insensitive to insulin, resulting in an increase in blood sugar.

Until recently, diabetes affected mostly adults, from the thirties. Because of the increase in juvenile obesity, it is now more and more teenagers and even children.

Diabetes and heredity
The risk of transmission of diabetes is not the same in the type 1 or type 2. It is widely believed that this risk is 5% in insulin-dependent diabetes (type 1). In diabetes, non-insulin-dependent (type 2), this risk is 30% if one parent is reached, and 50% if both parents are diabetic.

Diabetes Cases particular type MODY
Five MODY type of diabetes (type Maturity Onset Diabetes of the Young) were highlighted, with five mutated genes:

* MODY-1: HNF4 alpha (Hepatocyte nuclear factor 4)
* MODY-2: Glucokinase (Hexokinase liver)
* MODY-3: alpha HNF1
* MODY-4: IPF-1 (Insulin Promoter Factor)
* MODY-5: HNF-1 beta (rare form)

Polyuro-polydipsia Syndrome (you drink a lot and a lot on urine)

A blood sugar (glucose levels) outside a certain standard very quickly causes symptoms:

* Malaysian hypoglycemic and hyperglycemic (Malaysian acid-cétosiques).

* Emerging sometimes fungal infections (including the entrecuisse).

The long-term complications of diabetes can be divided into complications of small vessels (microangiopathy) and complications of large vessels (macroangiopathie).

* Cardiovascular disease due to atherosclerosis. There are often angina or myocardial infarction passing sometimes unnoticed, stroke as ischemic and the arterial obliterans of the lower limbs. It is recommended for diabetics to an electrocardiogram once a year.

* On the mucocutaneous, there are difficulties of healing wounds in the form of ulcers, they are common among diabetics suffering from arterial obliterans of the lower limbs.

* On the immune mid sweet benefits to many infectious agents such as candidiasis by an attack of cellular immunity.

The complications of small vessels affect:

* All eyes on ischemic diabetic retinopathy (untrained neo-vessels) or hemorrhagic (with formation of neo-vessels) that can cause blindness, microanévrisme, macular edema. It is recommended for diabetics to a background of eye once a year.

* The diabetic neuropathy is a disorder of the sensitivity and deep épicritique sometimes accompanied by neuropathic pain mainly in the lower limbs, these disorders sensitivity can lead to a delay care wounds of the foot. The diabetic does not realize he had an injury by the absence of painful stimuli, it leaves evolve an injury that may lead to an ulcer, even a genuine evil plantar piercing. Diabetics are testing their sensitivity distal annually with the test called monofilament.

* The diabetic kidney disease may progress to kidney failure. Various injuries may reach the diabetic kidney, especially glomerular kidney and kidney disease.

The word diabetes comes from the Greek dia-baïno pass through. The ancient Greek physicians had observed this syndrome: the sick seemed to urinate as soon as they came to drink, as if they were "permeated by the water" without being able to retain it. Then they maigrissaient, despite abundant food, and died a few weeks or months.

The polyuria - polydipsia (literally: many urinate and drink a lot) is a consequence of hyperglycemia (increased blood sugar). The kidneys can not recover all the glucose filtered, which passes through the urine and by osmosis drew water from primary urine and leads to a loss of water in urine, which leads to dehydration and a permanent thirst. Patients drink therefore too because they urinate and not vice versa.

Read also Diabetes type 2