The young man has diabetes mellitus. Features of diagnosing diabetes mellitus in adolescents and young people. Why does "sweet" disease occur?

Diabetes in young people does not arise spontaneously, there are prerequisites for it. It is mainly associated with genetic mutations (MODY), can be hereditary, and is also often detected in obese people. It can be either type 1 or type 2. By age, it occurs in children, adolescents, pregnant women, up to 25 years. How diabetes manifests itself in young people, its diagnosis and treatment, read further in our article.

A special type of diabetes in young people is MODY. It is associated with genetic mutations. They disrupt the activity of the cells that produce.

The risk factors for the disease have been identified:

young age, adolescents, newborns and children also get sick;
the period of pregnancy - appears, it persists after childbirth;
close relatives (parents, grandmother, grandfather, brothers, sisters) have type 1 or 2 diabetes, disorders of carbohydrate metabolism (prediabetes, metabolic syndrome);
during intrauterine development, the child had hypoxia (lack of oxygen), since the expectant mother suffered from coronary heart disease, bronchial asthma, and hypertension.

The prevalence of the disease has not yet been precisely established, since genetic tests for the diagnosis of diabetes are rare. Presumably, it occurs in every tenth diabetic under the age of 35 years.

Types of disease

Discovered 13 types of genes that are involved in reducing the formation of insulin. Several types of MODY diabetes have been identified depending on the variant of chromosome structure disorders. The most common is the third with a progressive course of the disease and manifestations at a young age. The second variant of the disease is mild and does not cause complications; it is enough for its treatment.

Relatively rare forms include:

diabetes in newborns or occurring before 2 years of age;
combined with congenital underdevelopment of the pancreas;
proceeds with severe kidney damage, more often polycystic disease is detected;
disturbances in the synthesis of insulin and the functions of neurons in the brain;
mutations contribute to a decrease in the number of working cells, adipose and connective tissue grows in the pancreas (steatosis and fibrosis);
due to a significant decrease in insulin levels, patients appear (ketone bodies in the blood and urine) with nausea, vomiting, impaired consciousness, the smell of acetone in the exhaled air;
obesity-related diabetes (an extremely rare form);
the work of the carrier of potassium ions in the cells of the pancreas changes;
the progression of the disease is associated with liver failure.

Due to the rarity of certain forms of pathologies, their clinical manifestations remain not fully understood.

Signs and symptoms in women and men

The second type of MODY diabetes can begin in adolescents or at the age of 7-11 years. Its development usually does not give obvious symptoms, so it is found by chance when examining a child during a medical examination. Often the reason for the diagnosis is the registration of a pregnant woman or emerging gestational diabetes in the second trimester.

In the third variant of the disease, the manifestations are similar to type 1 diabetes, but they are distinguished by a smoother onset in patients with genetic abnormalities. The most common signs are:

increased thirst;
copious flow of urine;
sleep disturbance;
twitching of the leg muscles;
hot flashes;
periodic increase in blood pressure;
decrease in body weight (not always).

In most fasting patients, blood glucose can remain normal. This explains the milder course of the disease. When eating, due to a lack of insulin, its absorption is impaired. For a long time, a diet and small doses of antihyperglycemic tablets are enough to correct such an increase in sugar.

Then there is a progression of symptoms due to the destruction of pancreatic cells. The reason and mechanism for the development of this phenomenon are still unknown. Patients develop ketoacidotic conditions that require use. Over time, lesions of small and large vessels appear - (visual impairment), (kidney damage), (changes in the functions of internal organs,).

Differential diagnosis with late type 1 diabetes

It is extremely difficult to make a correct diagnosis without a genetic examination, especially at the stage of the initial detection of the disease. For MODY diabetes, the most typical are:

family history - blood relatives have diabetes;
the first manifestations were not associated with ketoacidosis;
general condition is satisfactory;
body weight is close to normal;
fasting glucose is normal or slightly increased;
reveals the rise in blood sugar after exercise, characteristic of diabetes;
glycated hemoglobin has values close to the upper limit of the norm;
insulin and within normal limits or slightly reduced;
in the blood and ketone bodies are not found;
no antibodies to pancreatic cells, enzymes, insulin;
genetic analysis revealed mutations in the chromosome regions responsible for the formation of insulin.

Treatment of diabetes mellitus at a young age

Diet, exercise and medication are used to lower blood sugar.

Diet

For many patients, adherence to dietary rules is sufficient to normalize carbohydrate metabolism. A fractional meal is recommended - three main meals, two snacks in between and a fermented milk drink 2 hours before bedtime. You need to exclude from the diet:

sugar and all products that contain it, and stevia, Jerusalem artichoke syrup are recommended as a sweetener;
flour products made from white flour;
a source of carbohydrates are whole grain cereals in water or with the addition of milk, bread made of 2 grade flour, unsweetened fruits, berries;
proteins are obtained from chicken, turkey without fat, eggs (1 per day), fish, seafood, 2-5% cottage cheese, fermented milk drinks without added sugar;
animal fats should be limited, butter is permissible up to 15 g per day, vegetable oil - up to 25, 30-50 g of nuts or seeds are allowed;
vegetables are the basis of the diet, they are recommended to be steamed, baked, prepared from fresh salads with olive oil, lemon juice, supplemented with fresh herbs;
under a strict ban - alcohol, fast food, snacks, chips, sweet soda, canned meat, fish and fruit preserves, semi-finished products, preserves, honey, jams, sweets.

Physical activity

It is extremely important to set aside at least 30 minutes daily for therapeutic exercises, swimming, walking or jogging. Since most patients feel well enough, you can choose any type of physical activity in accordance with your own preferences. Weightlifting is an undesirable sport.

Medications

If with the help of nutrition and physical activity it is not possible to maintain the desired glucose level, then they are supplemented with tablets. In patients with young diabetes, there is a 4 times greater reaction to drugs than in type 2 classic diabetes mellitus, therefore, therapy is started with the minimum dosages of Siofor, Pioglar or Novonorm.

In adolescents, due to the action of counterinsular hormones (growth, cortisol, sex), the effect of insulin decreases. Therefore, they may need to be given small doses of the hormone in addition to the pills. This is justified when ketoacidotic conditions occur.

Pregnant women with MODY-diabetes, as well as in the presence of the gestational type of the disease, have an increased risk of having a large fetus. Since the use of tablets during this period is contraindicated, insulin therapy is prescribed if the diet is ineffective. The patient can be transferred to hormone injections even with a long course of the disease.

Watch the video about what MODY diabetes is:

Methods for preventing diabetes in young people

Since the disease is caused by genetic changes, the methods of its specific prevention have not been developed. If there are cases of increased blood glucose levels in relatives, then it is recommended to undergo an examination by an endocrinologist regularly, at least once a year. It is important to take blood tests for glucose and glycated hemoglobin, even if there are no symptoms at all.

Diabetes in young people can occur in the form of 1 and 2 types of disease, as well as a hereditary disease - MODY. It is caused by a change in the structure of chromosomes, which disrupts the formation of insulin. There are completely asymptomatic forms that are detected by blood tests.

Some patients in childhood, adolescence or young age have thirst, frequent urination, weight loss. Genetic tests are needed to confirm the disease. In most cases, diet, exercise, and small doses of sugar-lowering pills are sufficient for treatment.

Similar articles

A pathology such as diabetes mellitus in women can be diagnosed against a background of stress, hormonal disruptions. The first signs are thirst, profuse urination, discharge. But diabetes, even after age 50, can be latent. Therefore, it is important to know the rate in the blood, how to avoid it. How long do people live with diabetes?

There is an alarming increase in diabetes mellitus 2 among young people, which, according to experts in the field of diabetes mellitus, will be the main problem in the course of this disease in the next decade. It is predicted. that by 2050 the number of children with type 2 diabetes will quadruple.

Type 2 diabetes mellitus (T2DM) in young people is increasingly being diagnosed in children, due to signs of insulin resistance, β-cell dysfunction and relative insulin deficiency, but the absence of diabetes-related immune markers.

Most common among non-whites of European descent, for example, black African descent, originally from North America, Hispanics (especially Mexicans), Asian, South Asian (Indian Peninsula), and natives of the Pacific Islands. In the US: only 6% for non-Hispanic whites and 22% for Hispanics, 33% for blacks, 40% for Asians / Pacific Islanders, and 76% for Native Americans. In Hong Kong,> 90% of young people have T2DM, in Taiwan 50%, almost 60% in Japan.

Technological advances in entertainment, small-scale mechanization and transportation, together with the economic environment that make high-calorie food more and more affordable and affordable, have led to T2DM in children and are making it more difficult to treat.

T2DM in North America and Europe mostly affects people with lower incomes, less educated parents, less insured. This socioeconomic bias has not been described for Asian T2DM patients.

Diabetes inheritance in 75% or more children with T2DM. The impairment of these family members in weight and glucose control is common, as a result of relationship complications in family members, feelings of fatalism and submissiveness in the child. ...

Criteria for the diagnosis of type 2 diabetes mellitus in children and adolescents, ISPAD (2000) are currently being updated.

Clinical:

Paraclinical:

compulsory laboratory tests - moderate fasting hyperglycemia (up to 10 mmol / l), postprandial hyperglycemia 10-14 mmol / l, possibly the presence of traces of glucosuria;
additional laboratory - the level of HbA1c at the time of examination> 6.4%;
lack of autoimmune signs - autoantibodies to β-cells, GAD, insulin-associated protein - 2.
Normal or even elevated C-peptide and insulin levels. But the decrease in B-cell function progresses 3-4 times faster than in adults, as a rule, over the next 3 years.
arterial hypertension and dyslipidemia are widespread among youth with T2DM. Elevated triglycerides (65%), decreased HDL (60%), increased ap (36%), and dense LDL (36%).

Severe insulin resistance is accompanied by severe β-cell deficiency, a violation of the first (<75%) и второй фазы секреции инсулина (< 55%) у подростков с СД 2. Функция β-клеток по отношению к чувствительности к инсулину составляла < 85% среди молодежи с СД2.

According to Canadian researchers, 9% of 51 patients with manifestation of type 2 diabetes in childhood died by the age of 18–33, 6% were on dialysis, 2% of patients had toes amputated, and 2% developed blindness. Sometimes severe dehydration (hyperosmolar coma, hyperglycemia, and hypokalemia) can be fatal.

Albuminuria testing should be done at the time of diagnosis and annually thereafter. Elevated urinary albumin levels should be confirmed in two out of three samples.

Blood pressure (BP) should be monitored at each visit according to standardized methods for children. Increased blood pressure must be confirmed on two additional days.

Testing for dyslipidemia should be performed only after a diagnosis has been established and under follow-up and annually thereafter.

An assessment of non-fatty liver disease should be done at the time of diagnosis and annually thereafter.
Questions about puberty and menstrual irregularities should be assessed at the time of diagnosis and then regularly.
Retinopathy should be screened at diagnosis and thereafter annually.

Eliminate large quantities of sugar-sweetened soft drinks and juices. Complete elimination of these drinks and replacement with water.
Avoiding overly strict diets, do not use food for reward.
meals should be taken on schedule, in one place, no other activity (TV, study, reading, and play), preferably with the family.
Food and snacks should be served in a plate or bowl, not eaten straight out of the box.
Limiting access to high-fat, high-calorie foods, reading labels and controlling purchases.

Such an extremely aggressive course of type 2 diabetes with respect to vascular complications, diagnosed in childhood and adolescence, requires timely, pathogenetically grounded effective treatment.

The treatment used metformin to minimize gastrointestinal discomfort, metformin should be titrated slowly, starting at 500 mg daily at bedtime for a week, and if tolerated without side effects, the dose can be increased to 500 mg twice daily with meals. and then 500 mg / day every week. Effective doses are about 2000 mg / day with a maximum recommended daily dose of 2550 mg.

Sulfonylurea use is associated with an increased risk of hypoglycemia in adolescents

UDC 616.379-008.64-07-053.81

PROBLEMS OF DIAGNOSTIC DIABETES TYPE 2 IN YOUNG AGE

E.B. Bashnin, V.N. Gonchar St. Petersburg Medical Academy of Postgraduate Education, Russia

TYPE 2 DIABETES MELLITUS IN YOUTH: DIAGNOSTIC CHLLENGE

E.B. Bashnina, V.N. Gonchar St. Petersburg Medical Academy of Postgraduate Studies, Russia

Differential diagnosis of type 1 and type 2 diabetes mellitus (DM) before the age of 30 is very difficult at the onset of the disease. A comparative analysis of anamnestic, clinical and metabolic parameters of the disease in two groups of patients from 14 to 30 years old was carried out. For type 2 diabetes, the priority, but not absolute, diagnostic criteria at a young age can be considered a family diabetic history, body mass index (BMI) above the 50th percentile, and the absence of specific autoantibodies in the blood. However, verification of the diagnosis of type 2 diabetes in young patients is possible with dynamic observation.

Key words: type 2 diabetes mellitus, differential diagnosis, family history, specific autoantibodies, verification.

The differential diagnosis of type 2 and type 1 diabetes mellitus in patients at the age up to 30 years seems to become difficult problem because the clinical presentation of type 2 diabetes mellitus in youth is heterogeneous. Further research is needed to compare anamnestic, clinical and metabolic data in two groups of patients at the age from 14 up to 30 years. Family history of diabetes mellitus, body mass index more than 50 percentile, negativity for specific blood auto-antibodies are priority, but not absolute diagnostic criteria for type 2 diabetes mellitus in youth. However, type 2 diabetes mellitus in youth can be verified while case monitoring.

Key words: diabetes mellitus type 2, differential diagnosis,. family history, specific autoantibodies, verification.

Introduction. Type 2 diabetes mellitus (DM) is considered a disease of patients over the age of 40. Improvement of methods for early diagnosis of carbohydrate metabolism disorders revealed a significant increase in the number of patients with non-immune forms of diabetes mellitus at a young age. An increase in the number of patients with type 2 diabetes among adolescents is associated with obesity and physical inactivity; an increase in the number of sick children has been noted in populations with a high prevalence of the disease among adults. Verification of the type of diabetes at the onset of the disease determines the choice of a treatment method, namely, the need for insulin administration. This is of particular importance in young patients. Since in most cases it is assumed that diabetes develops before the age of 30

Type 1, the drug of choice in this case is insulin. At the same time, insulin therapy for type 2 diabetes in young patients leads to an increase in body weight, the development of obesity and insulin resistance, stable metabolic

disorders, despite the effectiveness of insulin in the treatment of hyperglycemia.

The greatest difficulty in diagnosing the type of diabetes that a general practitioner may face is in cases of manifestation of the disease with moderate clinical manifestations in the absence of diabetic ketoacidosis.

Materials and methods. A comparative analysis of the main characteristics of the two types of diabetes in patients aged 14-30 years at the onset of the disease was carried out. Patients were followed up in the city diabetes center for children and adolescents in St. Petersburg, as well as in the interdistrict diabetes center for patients with type 2 diabetes in St. Petersburg. The observation group consisted of 36 patients with type 2 diabetes. The comparison group consisted of 50 patients with type 1 diabetes. The groups were comparable in age. The obtained data were combined in three aspects: history, clinical symptoms at the time of diagnosis of the disease, metabolic markers of diabetes.

In order to verify the diagnosis of type 1 or type 2 diabetes, patients were dynamically monitored for 1-3 years after the diagnosis was made with repeated studies of basal glycemia, HbA1c, and stimulated secretion of C-peptide.

The level of glycosylated hemoglobin (HbA1c) was determined using a DCA2000 instrument. The content of immunoreactive insulin, C-peptide, and autoantibodies ICA and GAD in blood serum was determined by enzyme immunoassay.

To process the results of the study, the methods of biomedical statistics were used, implemented in the applied programs Statistica for Windows.

Results and its discussion. Among patients with type 2 diabetes, female patients predominated (62%), the ratio of female to male sex was 1.6: 1. The comparison group was formed in a similar ratio. The average age of patients with type 2 diabetes at the time of diagnosis was 23.9 ± 4.1 years, the minimum - 14 years, the maximum - 30 years.

Analysis of case histories did not reveal differences in the groups for major somatic diseases. However, among patients with type 2

Diabetes mellitus was a 14-year-old girl with She-Reshevsky-Turner syndrome and a 16-year-old boy with Prader-Willi syndrome.

An analysis of the family history showed that 86% of patients with type 2 diabetes were burdened with heredity for this disease: 59% of them had type 2 diabetes from their mother, 38% from their father, and one of the patients we observed had both parents. In contrast, in the comparison group, only 10% of patients had parents with type 1 diabetes.

By the time of manifestation, clinical symptoms of the disease occurred in both groups, but with varying degrees of severity. The main clinical symptoms during the onset of diabetes were found in both observation groups. However, the symptomatology in type 2 diabetes was less significant for the diagnosis of the disease. The cardinal symptom in the differential diagnosis was weight loss, characteristic of type 1 diabetes, in contrast to type 2 diabetes, when the weight remained stable during the onset of the disease (Fig.).

Statistically significant differences between groups were found in the body mass index (BMI). 24 patients with diabetes

Type 2 (66.7%) had a BMI above 97 percentiles for the corresponding age, in 12 patients

Rice. 1. The frequency of clinical symptoms in the manifestation of type 1 and 2 diabetes mellitus in young patients

(33.3%) the indicator corresponded to the parameters of the 50th percentile. None of those examined with type 2 diabetes had a BMI below the 50th percentile. At the same time, not all patients with type 1 diabetes had BMI values below the average for age, 12% of patients with type 1 diabetes had moderate excess body weight, while the clinical symptoms of the disease were mild.

The literature discusses the presence of acanthosis in type 2 diabetes as a typical symptom.

me disease. According to C.R. Scott, 86% of adolescents with type 2 diabetes have this symptom, with type 1 diabetes it does not occur. Moreover, the presence of acanthosis is accompanied by hyperinsulinemia and obesity. When examining 36 patients in the present study, acantosis negricans was detected in only 3 patients (8.3%).

The most significant diagnostic differences between patients of the two groups were revealed in the study of metabolic parameters of diabetes (Table 1).

Table 1

Metabolic characteristics of diabetes mellitus in young patients

with manifestation of the disease (M ± m)

Indicator of type 1 diabetes n = 50 type 2 diabetes n = 36 level of statistical significance of differences (p)

HbA1c (%) 11.0 ± 0.9 7.3 ± 0.6< 0,05

Basal glycemia (mmol / L) 25.5 ± 0.9 8.7 ± 0.5< 0,05

Immunoreactive insulin in blood serum (pmol / L) 63.4 ± 1.6 185.6 ± 1.9< 0,05

Serum C-peptide (ng / ml) 0.8 ± 0.2 4.0 ± 0.5< 0,001

Typical for type 2 diabetes at a young age are moderately pronounced signs of impaired carbohydrate metabolism with significantly higher levels of insulin and C-peptide in the blood serum compared with diabetes.

A mild degree of hyperglycemia with an increase in insulin levels in the blood and the absence of signs of ketoacidosis is the most frequent variant of the progression of type 2 diabetes in young patients. At the same time, according to studies by a number of authors, with type 2 diabetes, the possibility of developing ketoacidosis is not excluded. In two out of 36 (5.6%) patients, signs of the initial stage of diabetic ketoacidosis were recorded during the observation process.

The incidence of individual anamnestic and clinical and metabolic characteristics of type 1 and 2 diabetes in patients of the comparison groups, which are important in the differential diagnosis of the disease at manifestation at a young age, are presented in Table 2.

The peculiarities of type 2 diabetes at a young age are moderately pronounced metabolic disorders against the background of the absence of characteristic clinical symptoms of the disease. In this case, the most significant signs can be considered overweight or obesity, the absence of diabetic ketoacidosis.

A significant risk factor for the development of type 2 diabetes should be considered a disease burdened heredity.

It is known that the most specific diagnostic feature for type 1 diabetes is the presence of autoantibodies to β-cell antigens. At the same time, a number of studies have shown that in the case of a diagnosis of type 2 diabetes in young people based on clinical signs (obesity, aca ^ 0818 negricans, family history of the disease), from 10 to 35% of patients have autoantibodies in their blood. This is attributed to a number of factors. Due to the fact that autoantibodies in the blood can also be detected in the healthy population, one cannot exclude the possibility of their presence in patients with type 2 diabetes, in which case insulin resistance is the main link in the pathogenesis of the disease. In addition, there may be so-called latent autoimmune diabetes in adults, which develops as a result of slowly progressive autoimmune destruction of β-cells. Insulin resistance is not expressed, therefore, in a typical case, the disease is not accompanied by obesity.

The results of our study indicate a very high significance in the differential diagnosis of type 1 and type 2 diabetes of such criteria as weight loss at the onset of the disease, decreased insulin sensitivity,

the presence in the blood of autoantibodies to β-cells, a body mass index above the 50th percentile, as well as a family diabetic history. However, given the literature data on this issue, it is not possible to talk about the pathogenicity of any of the listed signs to a particular type of disease. When determining the type of diabetes that appeared at a young age, of course, it is necessary to take into account several of the signs we have listed and, if in doubt, conduct a deeper examination of the patient. It should be noted that in some

In some cases, examination of the patient only at the very beginning of the disease still does not allow to reliably determine the type of diabetes mellitus. In this case, the priority is dynamic observation with repeated studies of not only basal glycemia, but also HbA1c and stimulated secretion of C-peptide.

Timely active detection of the disease determines a favorable prognosis regarding the achievement of compensation for impaired carbohydrate metabolism by non-invasive methods of treatment and long-term management of diabetes mellitus.

table 2

Frequency of occurrence of certain characteristics of diabetes mellitus at a young age

Characteristics of type 1 LED n = 50 Type 2 LED n = 36

Insulin requirement at manifestation 50 (100%) 10 (28%)

Basal insulin secretion:

Reduced; 36 (72%) 0 (0%)

Normal; 14 (28%) 12 (33%)

Increased 0 (0%) 24 (67%)

Insulin sensitivity:

Normal; 50 (100%) 0 (0%)

Reduced 0 (0%) 36 (100%)

Serum autoantibodies:

- ICA; 36 (72%) 0 (0%)

GADA; 10 (20%) 0 (0%)

ICA + GADA; 2 (4%) 0 (0%)

No 2 (4%) 36 (100%)

Ketoacidosis at the onset 34 (68%) 2 (5%)

BMI at the onset of diabetes:

- < 50 перцентили; 40 (80%) 0 (0%)

50th percentile; 8 (16%) 9 (25%)

-> 50th percentile 2 (4%) 27 (75%)

Presence of ace ^ 08І8 negricans 0 (0%) 3 (8.3%)

Literature

1. Dedov, I.I. Diabetes mellitus in children and adolescents / I.I. Dedov, T.L. Kuraeva, V.A. Peterkova. - M.: GEOTAR-Media, 2007. -S.112-119.

2. Cronenberg, G.M. Diabetes mellitus and disorders of carbohydrate metabolism / G.M. Cronenberg, Sh. Melmed, K.S. Polonski, P.R. Larsen; per. from English ed. I.I. Dedova, G.A. Melnichenko. -M. : GEOTAR-Media, 2010. - S. 75-85.

3. American Diabetes Association. Type 2 diabetes in children and adolescents // Pediatrics. - 2000. -Vol. 105. - P. 671-680.

4. Palik, E. Idiopathic Type 1 or ketosis-prone Type

2 diabetes? / E. Palik, N. Hossufalusi, A. Vatay // Diabetologia. - 2004. - Vol. 47. - Suppl. 1. - P. 116.

5. Rocchini, A.P. Childhood obesity and Diabetes Epidemic / Rocchini A.P. // NEJM. - 2002. -Vol. 346. - P. 802-810.

6. Schober, E. Which type of diabetes is diagnosed in young subjects? Multicenter analysis in Germany and Austria based on 27,008 patients with diabetes onset during the first 3 decades of life / E. Schober, A. Thon, B. Rami // Diabetologia. - 2004. - Vol. 47. - Suppl. 1. -A 114 .-- P. 298.

8. Brooks-Worrel, B.M. Autoimmunity to islet proteins in children diagnosed with new-onset diabetes / B.M. Brooks-Worrel, C.J. Greenbaum, J.P. Palmer, C. Pihoker // J. Clin. Endocrinol. Metab. - 2004. - Vol. 89. - No. 5. -P. 2222-2227.

Gonchar Victoria Nikolaevna Tel. 8-921-415-3747 e-mail: [email protected]

7. Scott, C.R. Characteristics of youth-onset noninsulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus at diagnosis / C.R. Scott, J.M. Smith, M.M. Cradock, C. Pihoker // Pediatrics. - 1997. - Vol. 100. -P. 84-91.

In 2016, the number of patients with diabetes increased to 500 million. At the same time, many scientists say that diabetes is getting younger and by 2030 may become the main cause of death.

It should be noted that only 10% of diabetics suffer from the first type of disease, the remaining 90% fall on the second type. It is believed that the first type of diabetes is common in patients at a young age, and the second - in the older generation (40-45 years and older).

Diabetes mellitus is a very tricky disease because it can develop almost unnoticed. Therefore, early diagnosis of the disease can prevent the manifestation of complications.

Types and signs of diabetes

Diabetes mellitus is an endocrine disease. It develops for two main reasons. The first is associated with dysfunction of the beta cells of the pancreas. These cells make insulin, a hormone that lowers blood sugar levels. Their dysfunction causes the hormone to stop being produced and glucose begins to build up in the blood.

Due to the lack of energy, the cells and tissues of the body "starve". As a result, the body begins to break down fats in order to get enough energy. By-products of this synthesis are ketone bodies - toxins, due to which the brain and other organs of a person suffer. It is they that cause dizziness and headache in a diabetic.

The second reason is related to the sensitivity of peripheral cells to insulin. In this case, beta cells produce the necessary hormone in the right amount. But the receptors in the cells do not perceive it correctly. As a result, glucose, as in the first case, accumulates in the patient's blood. It should be noted that the second type of disease often develops as a result of overweight and a sedentary lifestyle in people of age.

Diabetes mellitus has a complex clinical picture, therefore, with its development, not a single symptom appears. If you suspect at least one of them, you need to immediately consult a doctor, because the sooner the diagnosis is made, the less harm the disease will bring to the body. And so, the following signs of diabetes are possible:

insatiable thirst and constant desire to visit the restroom;
increased fatigue, drowsiness, poor sleep, dizziness;
digestive disorders (nausea, vomiting, diarrhea);
swelling, tingling, or numbness in your limbs;
constant feeling of hunger;
deterioration of vision (blurry picture with defects);
rapid weight gain or loss;
high blood pressure.

Another sign of diabetes is long-term healing of scratches and wounds.

Features of diabetes in childhood and young age

Sugar level

Previously, it was believed that children and young people mainly get the first type of diabetes, but nowadays the second type is also slowly getting younger. This is due to obesity, which affects 60% of the world's population.

Now the schools do not give much physical activity, children do not play on the school playground, preferring computer games to this. Instead of wholesome food, they are increasingly consuming fast food, which is a high-calorie product. In addition, genetics also affects the development of the disease. If one of the parents has diabetes, then the child is more likely to have it.

Childhood and juvenile diabetes is treated in the same way as an adult. When treating a disease in children, their parents play a very important role. It is they who should monitor the child's diet: do not cook fatty and fried foods, do not give the baby sweets and pastries, offer him more vegetables and fruits, as well as foods containing easily digestible carbohydrates (for example, juices without sugar).

Exercise is an important part of diabetes management. To support your baby, you can involve the whole family in an active lifestyle. It can be anything: a visit to the pool, all kinds of team games (football, volleyball, basketball, etc.), walking and much more.

In the first type of diabetes, insulin therapy is required. It is performed 3-4 times a day, before each injection of the hormone, the blood glucose level is measured. In this case, medications are rarely used.

And in the second type, if exercise and diet cannot reduce glucose to normal levels, hypoglycemic drugs are used, for example, Metformin or other analogues, the use of which is allowed in childhood.

Diabetes mellitus in young women

In young women, the course of type 1 diabetes mellitus has certain characteristics.

In addition, this disease develops more often in females, which has been scientifically proven.

The girl can feel not only the symptoms mentioned above, but also the signs of diabetes mellitus associated with the reproductive system.

These include:

Genital candidiasis, or thrush.
Infectious diseases of the genital organs.
Hormonal disruptions and menstrual irregularities.

If a little girl has been diagnosed with diabetes, then, most likely, the disease at an early age will have a negative impact on the endocrine and reproductive system. First, menstruation in adolescents with diabetes occurs 1-2 years later than in healthy peers. Secondly, the menstrual cycle for most girls is irregular: the delay in menstruation can range from several days to several weeks. In addition, the nature of the course of menstruation also changes, it becomes more painful, both small and large volumes of blood can be released.

Sometimes menstruation may stop altogether, and in adult women menopause occurs much earlier. Because the ovaries are dysfunctional, not every menstrual cycle ovulates. Therefore, many gynecologists recommend that young girls plan pregnancy as early as possible. Irregular ovulation over time can lead to infertility.

In the case when hormonal disruptions occur, for example, testosterone production increases, girls begin to grow facial hair, voice coarsens, and reproductive function worsens. An increase in estrogen and a decrease in progesterone, affecting the thickness of the uterine layer, lead to endometriosis or hyperplasia.

Conversely, a decrease in estrogen levels and an increase in progesterone lead to the fact that the layer of the uterus becomes very thin, and menstruation becomes scarce.

The course of diabetes in young men

The development of the disease has some characteristics in young men.

The earlier a guy fell ill with diabetes, the faster his reproductive system would be disturbed.

Of course, the condition can be improved by those who lead a healthy lifestyle, are not overweight and follow the correct drug therapy.

In addition to the basic symptoms common to all people, men with diabetes have special characteristics:

sharp baldness;
itching in the groin and anus;
impotence;
violation of reproductive function.

It can also cause hormonal imbalances. A decrease in testosterone levels leads to a decrease in blood flow to the genitals, as a result of which potency decreases. There are other disorders in the reproductive system, such as dysfunction of ejaculation, decreased libido and erection, lack of orgasm. But the use of drugs that induce an erection is highly discouraged, since it worsens health and is not advisable in diabetes.

When metabolic disorders occur in young men, sperm count and DNA changes can be reduced, which can lead to infertility.

Diabetes mellitus is not a sentence

Even if a young patient has been diagnosed with diabetes, don't panic.

After all, stressful conditions also negatively affect the condition of a diabetic.

It must be remembered that you can live with this pathology even longer than other healthy people.

The main components of a successful diabetes treatment are:

doing physical exercise;
adherence to a special diet;
insulin therapy or medication;
constant monitoring of glucose and blood pressure.

Fulfillment of all of the above points is the key to successfully maintaining normal blood sugar, as a result, preventing all kinds of consequences. In addition, it is very important to support loved ones and moderate emotional stress in a diabetic.

Many people are interested in the problem of life expectancy in cases of diabetes mellitus. Firstly, it depends on the type of pathology, and secondly, many other factors affect it. In patients with the first type of diabetes, it is rather difficult to predict life expectancy. Many observations indicate that many patients die after 40 years of illness.

In addition, after 20 years of illness, atherosclerosis and stroke may appear. Type 2 diabetics often have a longer life expectancy. Although, in fact, everything depends on the person himself. There was evidence that a patient with type 1 diabetes mellitus, which began at the age of five, lived to be 90 years old.

Since at present, diabetes mellitus has managed to "rejuvenate", children and young people need to adhere to a healthy lifestyle and engage in or in the absence of it. In the presence of the main pathology that accompanies diabetes - obesity, it is necessary to solve the problem of overweight. In this way, an increase in blood sugar levels and severe consequences of the disease can be prevented.

The video in this article talks about diabetes prevention.