Diabetes

The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: " Why not self-medicate?". Diabetes mellitus is a chronic disease, which is based on a metabolic disorder in the human body due to a deficiency in the production of its own insulin and the resulting high level of glucose in the blood. The main clinical manifestations of diabetes mellitus are considered to be intense thirst, increased urination, high appetite, weakness, dizziness, and so on.

Diabetes mellitus is a chronic disease that is constantly progressing. This disease provokes complications such as strokes, liver and kidney failure, myocardial infarction, gangrene, blindness. Also, fluctuations in blood glucose levels can provoke hypoglycemic or hyperglycemic coma.

The heterogeneity of the nature of diabetes mellitus is explained by the fact that it is not one, but a whole complex of metabolic diseases that are very different in etiology, clinic and pathogenesis.

However, all cases of diabetes have such a manifestation, as hyperglycemia, which, in the absence of therapy, constantly develops and, in contrast to the situationally conditioned picture, does not return the person's sugar level to the normal range.

Classification of diabetes

Based on the heterogeneity of the disease, the classification of diabetes mellitus is very important in medicine, for which physicians around the world try to apply a unified approach based on the classification of the World Health Organization. WHO in 1980 and 1985 offered other classifications of pathology, but today they have completely lost their relevance.

Modern medicine uses the etiological classification of diabetes mellitus, which was developed by the American Diabetes Association and has been used by WHO since 1999. According to this classification, diabetes mellitus can be of type 1 or 2, specific or gestational. Type 1 diabetes is considered to be a disease that arose due to a violation of the structure of most of the body's beta cells, which led to a sharp deficiency of insulin. Type 2 diabetes is characterized by insulin resistance and some relative insulin deficiency or impaired insulin secretion with or without insulin resistance. Other specific forms of diabetes that are fully understood in medical science include pathologies of the exocrine pancreas, genetic defects in the functioning of β-cells, endocrinopathies, genetic pathologies of insulin exposure, drug-induced or chemical diabetes, infectious pathology, some types of immune-mediated diabetes. Gestational diabetes mellitus is a pathological condition of intolerance to glucose in the body, which is detected for the first time during pregnancy.

Types of diabetes mellitus

Type I pathology

insulin glands (so-called β-cells). Such deficiency is caused by the destruction of β-cells due to viral infections, autoimmune aggression, stress conditions and other factors.

The prevalence of diabetes of this type among the population reaches 10-15% of all registered cases of this pathology. This type of disease is characterized by the manifestation of the main symptoms in adolescence or even childhood, the rapid progression of complications due to decompensation of carbohydrate metabolism. The first type of diabetes mellitus is treated with insulin injections, which allow you to normalize metabolic processes. Insulin is injected subcutaneously with the help of a special dosing pump, insulin syringe, syringe pen. This type of diabetes requires constant therapy, because without it it develops very quickly, progresses, causing all sorts of complications such as ketoacidosis or diabetic coma.

Type II diabetes

The basis of the pathogenesis of type II diabetes is a decrease in the sensitivity of tissues dependent on insulin to its effects, that is, the formation of insulin resistance. At the start of the disease, insulin is able to be synthesized in the required or even increased amount. Weight loss and dieting at the initial stage of the disease can normalize the process of carbohydrate metabolism, restore tissue sensitivity to insulin, and reduce hepatic glucose synthesis. But, if the pathology begins to progress, pancreatic β-cells reduce insulin synthesis, which leads to the need to prescribe insulin hormone replacement therapy.

The second type of diabetes occurs in 85-90% of all persons suffering from this pathology in adulthood. Manifestation most often occurs after the age of 40 and is usually accompanied by obesity. The development of this pathology is slow, it proceeds quite easily. The clinical picture is usually accompanied by concomitant symptoms, and ketoacidosis rarely develops. The stability of hyperglycemia over time provokes various complications in the form of: angiopathy, nephropathy, neuropathy, retinopathy and others.

Gestational diabetes mellitus

Gestational diabetes mellitus occurs in women during childbearing, and after childbirth it either completely disappears or is greatly alleviated. The mechanism of development of gestational diabetes is similar to a similar mechanism in the pathology of the second type.

Gestational diabetes can occur in up to 5% of pregnant women. In the course of bearing a child, this pathology brings a lot of harm to both the woman and the fetus. Also, women who have had gestational diabetes have a high chance of developing type II diabetes in the future.

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The influence of the gestational type of the disease on the child is most often expressed in his excessive body weight at birth, congenital deformities and malformations. All these symptoms are described in medical sources in the form of diabetic fetopathy.

MODY diabetes as a form of the disease

MODY diabetes is a heterogeneous group of autosomal dominant pathologies that are caused by genetic defects that contribute to the deterioration of the secretory function of pancreatic β-cells.

This type of disease may occur in up to 5% of all patients undergoing pathology. A feature of MODY-diabetes is the start of its development at an early age. The need for insulin in such patients is, however, unlike patients with the first type of diabetes, it is quite low and quite successfully compensated. Ketoacidosis in this type of disease is not observed, and the C-peptide values ​​are within the normal range.

MODY diabetes is conventionally considered an intermediate type of disease between the first and second type of disease, since it has features of both diseases.

Indeterminate type

Indeterminate type of diabetes is a relatively new concept in medicine. In recent years, more and more cases have begun to occur when it is impossible to determine the studied type of disease in a patient. Experts from the World Health Organization have proposed introducing a new category in the classification of diabetes mellitus with an “indeterminate type” indicator in order to accelerate the development of an effective method for treating this disease.

A distinctive feature of indeterminate type of diabetes mellitus is the set of clinical manifestations of pathology that can be present in all previously studied types of diabetes combined.

Causes

Pathology of the first type is most often manifested in patients under the age of 30 years. Insulin synthesis is impaired due to autoimmune lesions of the pancreas and, as a result, due to the destruction of insulin-producing β-cells. In many people, such a disease begins to develop after viral infections such as mumps, hepatitis, rubella or from the toxic effects of pesticides, nitrosamines, and certain drugs, the immune response to which leads to the death of pancreatic cells. glands. When 80% of insulin-producing cells are affected, type 1 diabetes mellitus develops. With its autoimmune nature, this form of diabetes is very often combined with other pathologies of an autoimmune nature - autoimmune thyroiditis and others.

In the second type of diabetes mellitus, tissue insulin resistance develops, that is, the process of losing their sensitivity to insulin produced in the body begins, which at the time of development of the pathology in the cells is sufficient or even excessive.

Diabetes mellitus type 2, as mentioned above, is the predominant form of this pathology among all patients. In obesity, insulin resistance occurs due to blockage of insulin sensitivity by adipose tissue cells in the body. Older people with age-related loss of glucose tolerance are more susceptible to this type of disease.

The occurrence of type II diabetes can be influenced by such external factors as:

  • genetics, which in 3-9% of cases predetermines the occurrence of pathology in a person if his close relatives suffered from it;
  • obesity, which leads to the fact that adipose tissue significantly reduces the sensitivity of healthy cells to the effects of insulin;
  • malnutrition based on carbohydrates and lacking fiber ;
  • cardiovascular pathologies leading to loss of insulin resistance;
  • chronic stress, which increases the concentration of catecholamines and glucocorticoids, which provoke diabetes;
  • drugs with diabetogenic properties, such as glucocorticoids, antihypertensives, diuretics, cytostatics, and others;
  • chronic insufficiency of the adrenal cortex.

When insulin resistance or insufficiency develops, much less glucose enters the cells, which increases its concentration in the blood. The body begins to look for alternative ways of utilizing glucose, leading to the accumulation of sorbitol, glycosaminoglycans, and glycated hemoglobin in tissues. An increase in the concentration of sorbitol can lead to cataracts, neuropathy and various microangiopathies, and glycosaminoglycans provoke the processes of joint damage. To get the proper level of energy, the body provokes the breakdown of protein tissue, which leads to dystrophy, skeletal weakness and weakness of the heart muscle. The processes of fat oxidation are activated in the body and toxic metabolic products - ketone bodies - begin to accumulate.

Hyperglycemia in diabetes mellitus causes increased urination, which helps to eliminate excess sugar, but in addition to glucose, the kidneys also remove a large amount of the necessary fluid, which can cause dehydration. With the loss of glucose, energy reserves in the body are also lost, due to which patients with this type of pathology lose weight dramatically and greatly.

Elevated glucose levels, dehydration, and accumulated ketone bodies can cause diabetic ketoacidosis. With the progression of the disease due to high glycemic levels, the nerves, kidneys, eyes, brain, heart of the patient are damaged.

Symptoms of the disease

Type 1 diabetes develops very rapidly, while type 2 diabetes develops gradually. Very often, this pathology is asymptomatic (hidden). The disease is detected randomly during studies of various pathologies, for example, the fundus of the eye, or by analyzing the level of sugar in the urine or blood. And although the clinical picture of type I and type II diabetes is different, many of the symptoms of these pathologies are the same and can be used to conclude that the disease is present:

  • dry mouth, severe thirst, leading to polydipsia (increased fluid intake up to 8-10 liters per day);
  • frequent and profuse urination (polyuria);
  • increased appetite (polyphagia);
  • itching and dryness of the mucous membranes and skin, pustular infections;
  • loss of strength and working capacity, weakness, interruptions in sleep;
  • calf cramps;
  • visual impairment.

Symptoms of type 1 diabetes are always nausea, thirst, weakness, increased urination, hunger, weight loss, irritability. In children, this type of pathology is expressed by the occurrence of enuresis, which has never happened before. Very often, such diabetes causes hyperglycemic and hypoglycemic conditions, when blood sugar levels are either critically high or very low. At the same time, patients urgently require rehabilitation emergency measures.

The clinical picture of type 2 diabetes is manifested by thirst, pruritus, visual disturbances, fatigue, drowsiness, slow wound healing, skin infections, leg numbness, paresthesia. Also, patients with this disease are very often obese.

It happens that with diabetes, hair growth on the face increases, and on the legs they begin to actively fall out. Also, xanthomas (small yellow growths) can occur on the body, balanoposthitis develops in men, and vulvovaginitis in women. With the development of the disease, human immunity is sharply reduced, which leads to a deterioration in resistance to infections. With long-term treatment, bone tissue damage in the form of osteoporosis is possible. There are pains in the lower back, joints, bones, there is a high probability of dislocations and subluxations, bone deformities, fractures, which can provoke the patient's disability.

Course of the disease

Grades

Mild

The first degree or form of diabetes mellitus is the most easy. It is characterized by a low level of glycemia (not higher than 8 mmol per liter on an empty stomach), the absence of pronounced fluctuations in blood sugar during the day, and slight glucosuria. Pathology compensation can be easily supported by diet therapy. However, with a mild form, patients may already suffer from functional or preclinical angioneuropathy.

Moderate

At the second or moderate severity, glycemia in diabetes mellitus increases on an empty stomach to 14 mmol per liter, daily fluctuations in glycemia are observed, while glucosuria does not very large, ketosis or ketoacidosis is rarely possible. A compensated form in the second stage is possible with the right diet, which is supplemented by taking oral hypoglycemic drugs or subcutaneous insulin at a dosage of up to 40 IU per day. In patients with the second stage of diabetes mellitus, angioneuropathy of various stages and localization may occur.

Severe

The third, most severe degree of diabetes, is manifested by high levels of glycemia, exceeding 14 mmol per liter in a fasted state, pronounced fluctuations in blood glucose levels during the day, high glucosuria. Patients require continuous insulin therapy, which is equal to or greater than 60 units in a dosage. The list of diabetic complications detected in this case is very extensive.

Stages of the disease

The stages of diabetes mellitus are understood as successive stages in the development of the disease. The chronic nature of the course of the pathology implies the progression of symptoms over time. A feature of the disease is the fact that with once diagnosed diabetes, the patient will never be able to recover from the disease completely, his diagnosis will remain on a lifelong basis.

Initial stage

As a rule, even in the early stages of the disease, hyperglycemia can affect the functionality of many organs and systems at once. Symptoms of the initial stage of diabetes can be expressed by:

  • feeling of thirst;
  • increased urination;
  • constant fatigue and headaches;
  • decreased visual acuity;
  • numbness of limbs;
  • long wound healing process;
  • the occurrence of various skin rashes.

Most patients with diabetes suffer from reduced immunity, which leads to a high risk of developing various infections with a long and complicated course.

The latent stage

The latent stage is understood as such a stage of diabetes mellitus in which there are no clinical manifestations of the disease yet, but if you undergo an examination, then the results will contain a violation of tolerance to glucose. At the same time, on an empty stomach, the sugar level can remain normal or close to the upper limit of the norm, and a couple of hours after taking glucose, this indicator will rise to the range of 7.8-11.1 mmol per liter. With a latent stage of the disease, it is urgent to begin to carry out preventive measures that will help to exclude the development of the disease. In the absence of timely therapy, the latent stage of diabetes mellitus manifests soon into an explicit one.

The last stage

In the last stage of the disease, all clinical manifestations of the pathology are present, and the blood sugar level is significantly higher than normal. Patients experience thirst, frequent urination,121 dry mouth, weakness, with type 1 diabetes the patient rapidly loses weight, and with type 2 diabetes, obesity may occur.

This stage of the disease requires urgent medical attention to an endocrinologist who will be able to select an effective individual treatment. In the first two stages of diabetes, treatment can lead to stable compensation, but when the last stage is detected, it is almost impossible to achieve such an effect.

Complications and consequences

Diabetic retinopathy

Among all possible complications due to diabetes mellitus, multi-organ disorders such as diabetic retinopathy are the most difficult to treat. Diabetic retinopathy refers to the process of destruction of the capillaries, veins and retina of a person's eyes, a decrease in visual acuity, which can lead to retinal detachment and complete blindness. In the case of type 1 pathology, this complication may occur 10-15 years after the onset of manifestation, and with type 2, much earlier. Moreover, such a complication occurs in 90% of cases of all diagnosed pathologies.

The conclusion about the occurrence of such a pathology in a patient is given by an oculist after an indirect or direct ophthalmoscopy of the fundus. Moreover, this complication has 3 stages. The first stage is diabetic non-proliferative retinopathy, the second is proliferative, and the third is terminal retinopathy. The non-proliferative and proliferative stages of the disease are treated by compensating for the patient's diabetes itself.

Diabetic encephalopathy

Diabetic encephalopathy refers to the process of diffuse degenerative damage to the human brain due to diabetes mellitus. The main signs of the occurrence of this complication in a patient are memory impairment, a decrease in the intellectual level, all kinds of neurosis-like changes, asthenia, dysfunction of the vegetative-vascular system, and other symptoms.

The diagnosis of diabetic encephalopathy is made by a neurologist during a neurological examination of the patient, during an analytical review of the results of REG, EEG, and cerebral MRI. It is necessary to treat this complication exclusively with parallel antidiabetic therapy with various vascular, metabolic, antioxidant, vitamin, psychotropic and antisclerotic drugs.

Diabetic coma

A severe condition in diabetes mellitus, which is provoked by a lack of insulin in the body, is called diabetic coma. With an insufficient amount of insulin in the blood, the concentration of glucose and the "hunger" of peripheral tissues, dependent on the intake of insulin and not capable of utilizing glucose without its participation, increase. The response to this process is the start of gluconeogenesis in the liver (glucose synthesis) and the development of ketosis (the synthesis of ketone bodies from acetyl-CoA). If the body also develops a lack of utilization of ketone bodies, then ketoacidosis occurs. With accumulations of metabolic underoxidized products (lactate, for example), lactic acidosis is provoked. With gross metabolic disorders, hyperosmolar coma can also develop.

A diabetic coma can last for years. In the practice of doctors, a case is known when a diabetic coma in a patient lasted more than 40 years.

Diabetic Nephropathy

Capillary damage to the glomeruli that leads to glomerulosclerosis is called diabetic nephropathy. At its terminal stage, the excretory functionality of the kidneys is disturbed, and chronic renal failure occurs.

To date, such stages of diabetic nephropathy are known as:

  • microalbuminuria is a preclinical stage without severe symptoms, with a possible transient increase in pressure, sometimes it can be provoked by other factors;
  • proteinuria - stage with persistent arterial hypertension, severe renal edema, increased amount of protein in the urine, including general analysis;
  • uremia is a severe stage in which severe edema and complex hypertension cause intoxication symptoms based on poisoning by metabolic products.

Other complications

Among other multiple organ disorders that can complicate the course of diabetes mellitus, diabetic angiopathy, polyneuropathy, and diabetic foot should be mentioned.

In diabetic angiopathy, vascular permeability increases, vascular fragility, thrombosis, atherosclerosis, coronary heart disease, intermittent claudication, and diabetic encephalopathy develop. Polyneuropathy is a lesion of the peripheral nerves in a large percentage of patients with diabetes mellitus, due to which sensitivity is disturbed, swelling and chilliness in the limbs, burning, goosebumps, and so on occur. A similar pathology occurs many years after the manifestation of diabetes mellitus, most often its first type. Under the diabetic foot in medicine, it is customary to understand the violations of the circulatory process in the lower extremities, which leads to soreness of the calf muscles, trophic ulcers, destruction of bones and joints in the feet.

In order to prevent all kinds of complications when a disease is detected, it is necessary to constantly treat and control the amount of sugar in the patient's blood.

Diagnosis of diabetes mellitus

Diagnostic methods

When diagnosing the first and second types of diabetes, it is easy for a doctor to make a diagnosis based on the pronounced specific symptoms of the disease - polyphagia, polyuria, a sharp loss of body weight. However, the main diagnostic method is to detect the concentration of glucose in the patient's blood. To determine the degree of decompensation of carbohydrate metabolism, a glucose tolerance test is used.

For the diagnosis to be made, the clinical picture must match such signs as fasting blood sugar concentration of more than 6.1 mmol per liter, and 2 hours after eating and during glucose tolerance testing - more than 11.1 mmol per liter, glycated hemoglobin exceeded the level of 5.9%, sugar and acetone were detected in the urine.

EEG of the brain, ultrasound examination of the kidneys, rheoencephalography, rheovasography of the lower extremities are also used to diagnose the disease and its complications.

What kind of tests are done

So, for the diagnosis of diabetes, it is necessary to pass a number of laboratory tests. To do this, doctors necessarily refer patients to donate blood from a finger or a vein, in which it is required to monitor the level of glucose, a general urine test, in which ketone bodies and sugar are detected, the determination of glycated hemoglobin (in pathology much higher than normal), insulin, C-peptide and for a stress test that demonstrates glucose tolerance. All of the above analyzes have their own range of normal indicators, so it is practically impossible to make a mistake when making a diagnosis, having the results of laboratory tests.

Methods of treatment

To slow the progression of pathology and prevent the development of complications, patients are required to follow all the recommendations of a diabetologist on a life-long basis. Any treatment for diabetes is aimed at lowering the glycemic index, normalizing metabolic processes in the body, and preventing complications.The text is for informational purposes only. We urge you not to use diets, do not resort to any medical menus and fasting without medical supervision. Recommended reading: " Why you can't go on a diet on your own". The main thing in the treatment of this pathology is an individually selected diet, which takes into account the age, gender, weight of the patient and those physical activities that he regularly performs. Patients are taught to count the calorie content of their own diet and take into account the amount of proteins, carbohydrates, fats, vitamin and mineral composition.

In the case of insulin-dependent type of diabetes, the patient is recommended to consume carbohydrates always strictly at the same hours of the day, so that it is easier to correct blood glucose with administered insulin. In the pathology of the first type, it is required to limit the intake of fatty foods, as this leads to ketoacidosis. If the patient has an insulin-independent type of disease, then any type of sugar should be excluded from the diet, and the total caloric content of food per day should be reduced.

Meals in diabetes should be divided, while it is necessary to distribute the daily intake of carbohydrates in order to stabilize glucose and maintain basic metabolic processes. It is important to use sweeteners, which are found in many diabetic foods, instead of regular sugar. With a mild degree of pathology, correction with the help of a diet is sufficient to maintain the disease in a compensated form.Medical products (preparations, medicines, vitamins, medicines) are mentioned for informational purposes only. We do not recommend using them without a doctor's prescription. Recommended reading: " Why can't you take medications without a doctor's prescription?". Drug treatment is always selected taking into account the type of specific pathology. So, in the first type of the disease, patients are prescribed insulin therapy, and in the second - hypoglycemic agents in combination with a diet, and insulin can be shown only with the ineffectiveness of tablet preparations, ketoacidosis, pre-coma, renal or hepatic insufficiency.

Insulin administration should be carried out with systematic monitoring of glucose in urine and blood. At the same time, insulins themselves can be prolonged, intermediate and short-acting. Long-acting insulin is injected into the body once a day and its administration does not depend on food intake. Sometimes prolonged insulin is prescribed to patients along with intermediate and short injections in order to approximate the compensation of diabetes.

However, the use of insulin can lead to a sharp drop in blood sugar and a state of hypoglycemia or coma. Therefore, it is constantly required to monitor and change the dosage of drugs, depending on physical activity, changes in sugar levels throughout the day, caloric content of the daily menu, frequency of meals, drug tolerance and other factors. With insulin therapy, general and local allergic reactions often occur, and this treatment can also be complicated by lipodystrophy - the occurrence of failures of adipose tissue in those places where insulin is injected.

In case of non-insulin-dependent type of the disease, tablets with a hypoglycemic effect are prescribed in combination with a diet. Such drugs, according to the mechanism of action, are divided into sulfonylureas, biguanides, meglitinides, alpha-glucosidase inhibitors, thiazolidinediones.

Sulfonylureas, which include glibenclamide, gliquidone, carbutamide, chlorpropamide, help stimulate the production of insulin by ß-cells of the pancreas, promote better penetration of glucose into tissues. With the optimal selection of the dosage of these drugs, the glucose level will be in the range of up to 8 mmol per liter, and in case of an overdose, hypoglycemic coma may occur.

Biguanides are commonly referred to as drugs that reduce the absorption of glucose in the intestine and contribute to the saturation of peripheral tissues with it, such as buformin, metformin, and others. Biguanides increase uric acid in the body, lead to severe lactic acidosis in patients over 60 years of age and those who suffer from renal or hepatic insufficiency or chronic infectious processes. Drugs of this group are prescribed for non-insulin-dependent type of pathology and parallel obesity in young patients.

Meglitinide drugs such as Repaglinide or Nateglinide help lower blood sugar by stimulating the pancreas to produce insulin. This group of drugs always acts, depending on the blood sugar content at the time of administration, so it does not cause hypoglycemia.

Acarbose, miglitol and other alpha-glucosidase inhibitors inhibit the process of increasing sugar, block enzymes that are involved in the assimilation of starch. This group of drugs often leads to diarrhea and flatulence as a side effect.

Thiazolidinedione drugs are contraindicated in severe heart failure patients. They lower blood sugar and increase insulin sensitivity of fat cells in the body.

Also, the treatment of diabetes mellitus includes teaching patients and their relatives the skills to control sugar levels, the patient's well-being, first aid measures in case of a pre-coma.

The course of the disease is beneficially affected by a decrease in excess body weight and moderate physical activity. Muscular efforts during physical education increase the oxidation of glucose, reducing its concentration in the blood. You can’t play sports at a sugar level of more than 15 mmol per liter, in this case you need to wait for it to decrease under the influence of drugs. It is also important that physical activity in the case of the disease in question be redistributed evenly to all muscle groups.

How not to get sick

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Preventive measures for type I diabetes mellitus boil down to ensuring that a person takes all measures to increase the resistance of his own body to various infectious processes and eliminate the toxic effects of harmful agents on the pancreas.

To prevent the onset of type II diabetes, it is necessary to carefully monitor one's own body weight, prevent obesity, and adjust nutrition. It is especially important to monitor these parameters if a person has had diabetes in hereditary history.

In order to prevent decompensation or complications of the disease, it is necessary to treat the pathology in a timely manner, follow all the prescriptions of doctors and monitor your lifestyle.

Life expectancy of diabetics

Type 1 diabetes is insulin dependent, so the patient must use insulin on a daily basis to ensure a fulfilling life. In this case, the life expectancy of such patients directly depends on how well and responsibly a person approaches his diet, physical activity, and taking medications that alleviate the disease. Usually, after diagnosing a pathology, patients live for at least 30 years, during which people develop other serious chronic pathologies that reduce life expectancy. Typically, type 1 diabetes manifests itself at an early age (up to 30 years), so with a competent lifestyle, you can live with it at least up to 60 years. In recent years, according to statistics, the life expectancy of patients with the diagnosis in question has increased to an average of 70 years. All people who were able to live with type 1 diabetes longer than the standard period had the right lifestyle, they controlled their blood glucose levels in a timely manner, went in for sports and took all the necessary drugs.

When considering the statistical data on the life expectancy of diabetics depending on gender, we can conclude that, on average, with this disease, life expectancy is reduced by 20 in women and 12 years in men. However, each case of the disease is individual, the body has its own defense mechanisms, so these statistical indicators in private can differ significantly from reality.

In type II diabetes mellitus, which is much more common than the insulin-dependent type, the manifestation of pathology occurs more often in people over the age of 45-50 years. Death in this case can occur not only from diabetes itself, but also from complications in the heart and kidneys that it causes. However, according to statistics, people with the second type of the disease live much longer than those with the first, and their life expectancy in comparison with healthy peers is reduced by only 5 years. But in the second type of diabetes, disability occurs more often, since the progression of the pathology is usually quite fast, causing complications.

Whether disability is allowed

Disability in diabetes is supposed if the pathology has led to significant complications in various organs and systems.

Diabetes itself is not a reason for disability.

Functional impairment due to diabetes of any type is the basis for disability in a patient. The severity of complications determines the group of disability that can be assigned to a patient whose ability to work is reduced due to illness. Children who suffer from diabetes from an early age are assigned a lifetime disability without reference to a specific group.

In the most severe forms of diabetes and severe functional complications to which it leads, patients are assigned the first group of disability. The mild course of the pathology can become the basis for the appointment of the third group, while the second is assigned to those patients who partially lose their ability to work due to complications, but are still able to independently provide themselves with a normal life.

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