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Diabetes make you tired: Causes, management, and when to see a doctor

Causes, management, and when to see a doctor

Fatigue is a common symptom of diabetes. There are many reasons why diabetes can cause fatigue, including:

  • changes in blood sugar levels
  • other diabetes symptoms
  • complications of diabetes
  • mental and emotional issues resulting from diabetes
  • being overweight

Changes in blood sugar levels

Diabetes affects the way the body regulates and uses blood sugar.

When a person eats, the body breaks down food into simple sugars, or glucose. In people with diabetes, the pancreas does not produce enough insulin, or the body does not use insulin effectively. Cells need insulin to absorb glucose from the blood.

If the cells do not take in enough glucose, it can build up in the blood. The cells need glucose to provide energy.

Fatigue and weakness might result when the cells do not get enough glucose. Diabetes medications, such as insulin or metformin, help more of this sugar to move into the cells and prevent it from building to harmful levels in the blood.

A potential side effect of diabetes medications is low blood sugar, or hypoglycemia.

Low blood sugar can also cause fatigue, especially in people who do not get enough warning that their blood sugars levels are dropping. A person can also feel fatigued after treatment of low blood sugar.

Other diabetes symptoms

Other symptoms of diabetes can also contribute to a person experiencing fatigue, including:

  • frequent urination
  • excessive thirst
  • extreme hunger despite eating
  • unexplained weight loss
  • blurred vision

While not all of those symptoms account for feelings of fatigue directly, many of them may contribute to an overall feeling of being unwell. These persistent and uncomfortable sensations may have severe mental and physical effects that can lead to the development of fatigue.

Some of the symptoms of diabetes might also disrupt a person’s sleep pattern. For example, a person with the condition may find themselves waking up several times every night to use the bathroom or get a drink.

Similarly, discomfort in the limbs, hands, and feet may make it difficult for a person with diabetes to fall asleep and stay asleep.

This disruption to a person’s sleep cycle can lead to them feeling increasing fatigue.

Diabetes complications

Share on PinterestManaging diabetes can help prevent complications, such as heart disease.

People with diabetes might develop complications that contribute to feelings of fatigue.

These complications typically develop in a person who has the condition when their blood sugar levels remain too high.

Possible complications include:

Here, we explain the complications of diabetes.

Adverse effects of diabetes medication

Certain medications that a person might use to treat the complications of diabetes and other health problems may also cause adverse effects that contribute to fatigue.

Medications that can lead to fatigue include the following:

Corticosteroids: A person with diabetes might need to take corticosteroids, such as prednisone, to treat the inflammation, pain, and discomfort that develop due to other conditions and diseases.

  • Statins: A doctor might prescribe statins to reduce levels of low-density lipoprotein (LDL), or “bad” cholesterol, in the blood.
  • Diuretics: People mainly use diuretics to treat high blood pressure. These lead people to pass more urine than they normally would.
  • Diabetes sometimes increases urinary frequency, so this side effect can be particularly potent for people who have the condition.
  • Beta blockers: Doctors recommend beta blockers for people who have high blood pressure and anxiety. However, their slowing effect on a person’s heart rate might lead to chronic fatigue as an adverse effect.

Alongside the diabetes symptoms that contribute to fatigue, beta blockers can have particularly potent side effects in people who have diabetes.

Learn more about the relationship between steroids and diabetes here.

Mental and emotional health

Living with diabetes can often impact a person’s mental and emotional health.

According to a 2016 study of 90,686 participants, people with diabetes may be around two to three times more likely to experience depression than people who do not have the condition.

The same study found that anxiety was more prevalent in people who were aware they had diabetes due to their health concerns.

Both depression and anxiety can also cause increased feelings of fatigue due to sleep disruption.

Depression can also adversely affect blood sugar control, which may increase the risk of fatigue.

In fact, many of the symptoms of depression relate directly to fatigue, including:

  • changes in sleeping patterns
  • waking too early or being unable to go back to sleep
  • loss of energy

Learn more about the effect diabetes can have on relationships.

Being overweight

Many people with diabetes, especially those with type 2 diabetes, are overweight or obese. Excess body weight might also contribute to fatigue.

Reasons for the association between being overweight and fatigue may include:

  • Lifestyle choices that may lead to weight gains, such as lack of exercise or a diet that contains too much processed or junk food.
  • The increased energy a person uses up when moving the extra body weight.
  • Sleep disruption from some complications of being overweight, such as sleep apnea.

People with diabetes commonly experience persistent fatigue.

Causes of fatigue can include high or low blood sugar levels, depression, being overweight, certain medications, and coinciding medical conditions.

While fatigue can interfere with a person’s daily life, controlling blood sugar levels and putting in place lifestyle changes can improve energy levels and reduce tiredness and lethargy.

It can be helpful for a person to connect with people who understand what they are going through. T2D Healthline is a free app that provides support through one-on-one conversations and live group discussions with others living with type 2 diabetes. Download the app for iPhone or Android.

Read the article in Spanish.

Why Does Type 2 Diabetes Make You Feel So Tired?

When fatigue is a concern, Zonszein will also screen for anemia. Anemia is not caused by diabetes, but it frequently occurs in people with diabetes and is a common cause of fatigue.

He will also check the thyroid hormone level. People with diabetes are at increased risk for thyroid diseases, especially hypothyroidism. “A sluggish thyroid together with diabetes can be another cause,” says Zonszein.

Medications should also be reviewed, as fatigue can be a side effect in some, especially those used to control blood pressure like beta blockers.

Type 2 diabetes is a complex disease that is associated with numerous co-morbidities, including obesity, high cholesterol, high blood pressure, and high blood sugar. People with diabetes who neglect their health because of fatigue and other symptoms put themselves at greater risk of developing complications, according to a review of literature focused on diabetes-related fatigue that was published in the July 2010 issue of the Journal of Psychosomatic Research. Often neglected are psychological factors, such as depression or feeling overwhelmed by their diagnosis or complexity of medical care, that can contribute greatly to feeling “low energy.

To reduce fatigue and your risk of other symptoms and complications, it’s important to work with your health care team to make sure you’re properly managing your diabetes and any co-morbid conditions — and that includes making healthy lifestyle choices.

“People who have a healthy lifestyle — who exercise every day, eat well, drink a lot of water, and take their medications properly — tend to feel well,” says Zonszein. “It is the ones who are a little bit sluggish with exercising, or they over-eat, or they don’t eat all day and then they eat too much at night, and they forget their medications, those are the ones who often start to get complications.” Fatigue and headaches are the most common complications of patients who are not well-treated, he says.

If you’re feeling abnormally tired in between your regular doctor visits and you don’t seem to be getting better, call your doctor and make an appointment to get examined sooner.

6 Tips to Help if You’re Tired of Your Diabetes

When you have diabetes, your daily to-do list can seem like a lot. You track your blood sugar, take medicine, watch your diet, and exercise.

It can make you feel overwhelmed and burned out. If you’re there:

1. Know that no one is perfect.

There are no vacations from diabetes. Even the most diligent people can’t keep their blood sugar or diet or physical activity on target all the time.

“Diabetes is unique because [you’re] actually making medical decisions, day-to-day, minute-to-minute,” says Alicia McAuliffe-Fogarty, PhD, a clinical health psychologist.

This can be stressful, says David Nathan, MD, director of the Diabetes Center at Massachusetts General Hospital.

“If people are always stressed out about diabetes, they’re miserable,” Nathan says.

He says people need to forgive themselves if they miss their goals for a day, a week, or even more.

“Chill a little bit,” Nathan says. “We’re going to do the best we can. We need to recognize no one is perfect.”

2. Pay attention to what stresses you out.

Living with diabetes can cause fear, anger, worry, and sadness.

Lawrence Fisher, PhD, director of the Behavioral Diabetes Research Group at the UCSF School of Medicine, has studied what doctors call “diabetes distress” in people with type 1 and those with type 2  diabetes. He learned that during any 18-month period, from a third to a half of people with diabetes will feel a good bit of it.

He cites seven common sources of diabetes distress among people with type 1 diabetes. The most common is a feeling of helplessness.

“The [blood sugar] numbers have a life of their own. They go up. They go down. You’re constantly making adjustments,” Fisher says. “There’s a feeling of powerlessness that is really hard to tolerate.”

Other common sources of diabetes distress among people with type 1 diabetes include:

  • Worry about what those around them assume
  • Concern about access to good health care
  • Perceived lack of support from family or friends, or feeling like they’re the “diabetes police”
  • Fear of dangerously low blood sugar
  • Stress over managing blood sugar levels
  • Bother over what to eat and when

Fisher says people with diabetes should pay attention to what stresses them out and try to address those things. He suggests programs or workshops that focus on what gets you down.

“There are things you can do,” he says.

He found that people with type 2 diabetes also had a feeling of helplessness. A sense of failure and negative social perceptions were other common sources of bother among type 2 folks, he says.

Paying attention to what gets to you about your diabetes is important. The less spun-out you are, the better you’ll be able to manage your disease.

3. Set realistic goals.

That’s important to avoid burnout. It can mean taking a big goal and breaking it into more manageable pieces.

“Taking small steps to achieve a larger goal often makes sense,” says McAuliffe-Fogarty, who has type 1 diabetes.

If you need to lose 50 pounds, shoot for 2 pounds a month, she says. If you drink regular soda, try switching to diet. If you normally eat a pint of ice cream, switch to a half a pint.

“You should adapt your treatment plan to your lifestyle rather than the other way around,” says McAuliffe-Fogarty, who is also vice president of the lifestyle management team at the American Diabetes Association.

4. Ask for help.

Build a support network — and use it.

In addition to your doctors, look for counselors or family friends who can be there for you when you feel down. Sharing stories as part of a diabetes support group can be very helpful.

Ask those closest to you for specific help you need. This can be anything from asking a family member to remind you to take your medication to asking a friend to go for a walk with you a few times a week, McAuliffe-Fogarty says.

“Without that support, people often get down,” she says.

5. Know transitions can be hard.

Change can be a challenge for anyone. Going through it while you manage your diabetes can be really tough.

Heading to college, being diagnosed with a complication, and trying a new treatment are types of adjustments that can bring worry, McAuliffe-Fogarty says.

To ease stress, try to anticipate and prepare for big changes in your life. That’ll lessen the impact on how you manage your diabetes.

6. Tell your doctor all about it.

See him regularly. When you go, make sure to share your physical symptoms, and how you’re feeling about things. Your diabetes can make it more likely for you to be depressed or anxious. What’s more, how you feel plays a big role in your ability to control your diabetes.

“That’s a component that’s often forgotten or left out,” McAuliffe-Fogarty says of mental well-being. “It’s equally important as eating right and exercising.”

It’s important that you take an active role in communicating with your doctor. He’s trained in managing diabetes. But he may not be as knowledgeable about the emotional toll the disease can take, McAuliffe-Fogarty says.

Tired all the time? Here’s why

Ever wonder if your diabetes can cause fatigue? Sure we all experience fatigue from time to time, especially after exerting ourselves too much. But if you’re constantly mentally or physically tired, your diabetes may have something to do with it. Diabetes Fatigue Syndrome is a condition commonly seen in people with diabetes. It can affect your ability to do daily tasks and manage your disease properly. Left untreated, fatigue will wreak havoc on your quality of life too.

Why does my diabetes cause fatigue?

 Diabetes affects blood sugar levels: 

There’s no question that fluctuations in your blood sugar levels can cause fatigue. When your blood sugars are too high, for example, the blood can’t circulate as efficiently and your cells don’t get the oxygen and nutrients they need to function optimally. High blood sugar can also cause inflammation. This in turn, releases cells called monocytes into the brain causing fatigue. Similarly, if your blood sugars are too low, your cells aren’t getting enough fuel to work well either, which affects your energy levels.

Diabetes affects sleep:

Blood sugar fluctuations can also disrupt sleep. High blood pressure can trigger headaches at night, as well as thirst and frequent urination. Nerve damage, or neuropathy, caused by your diabetes can cause tingling and burning in your legs and feet which can affect your sleep too. Read more about how diabetes can impact your sleep. 

Dealing with diabetes is stressful:

Managing your diabetes means tracking blood sugar levels, paying attention to your diet and taking medication in a timely manner—every day! All of this can be overwhelming and stressful. As well, research shows that people with diabetes are twice as likely to suffer from depression than people without. Feeling tired and easily fatigued are key symptoms of depression. Find more on the symptoms that may signal depression.

What else causes fatigue?

 Lifestyle factors:

Being overweight and getting little exercise when you have diabetes can also contribute to fatigue. Lots of research points to the positive effects of regular exercise in alleviating symptoms of fatigue. In fact, moderate to vigorous exercise has been proven to enhance energy and improve your mood. Find out how even standing or light walking can be beneficial when you have diabetes.

Other medical conditions and medications:

Keep in mind that fatigue can also be a symptom of other underlying conditions such as:

  • Anemia
  • Anxiety disorders or depression
  • Sleep apnea
  • An under-active thyroid
  • An infection or inflammation
  • Heart disease
  • Kidney problems

Some of the medications may be contributing to your lack of energy too. These include:

  • Corticosteroids, which are used to treat inflammation and pain
  • Statins for cholesterol
  • Diuretics for high blood pressure
  • Beta blockers for high blood pressure and anxiety

How do I treat diabetes-related fatigue?

Improve your lifestyle: Making changes in your day to day life can help reduce fatigue. Here are some lifestyle changes to consider:

  • Lose some weight or maintain a healthy weight
  • Engage in moderate to vigorous exercise multiple times a week
  • Make healthy food choices
  • Limit stress as much as possible and find ways to unwind
  • Develop good sleep habits, such as regular bedtimes and no screen time at night

Manage your blood sugar levels: Monitoring your blood sugar levels regularly will ensure you’re not experiencing the highs and lows that will negatively impact your sleep.

Seek professional advice: Be sure to check in with your diabetes healthcare provider to help you monitor your diabetes and determine if there are underlying conditions that could be contributing to fatigue.

Remember that feeling fatigue on occasions is normal when you have diabetes, but feeling exhausted all the time is not. Getting to the bottom of the issues contributing to your fatigue will mean you can get on top of staying healthy.

Type 2 Diabetes Symptoms and Early Warning Signs

The symptoms of type 2 diabetes (also called type 2 diabetes mellitus) develop gradually—so gradually, in fact, that it’s possible to miss them or to not connect them as related symptoms. Some people are actually surprised when they are diagnosed with type 2 diabetes because they’ve gone to the doctor for something else (eg, fatigue or increased urination).

The symptoms develop gradually because, if you have the insulin resistant form of type 2, it takes time for the effects of insulin resistance to show up. Your body doesn’t become insulin resistant (unable to use insulin properly) overnight, as you can learn about in the article on causes of type 2 diabetes.
 

If you’re not insulin resistant—and instead your body doesn’t produce enough insulin to process glucose well—the symptoms also develop gradually. Your body will be able to “make do” with lower insulin levels for awhile, but eventually, you will start to notice the following symptoms.

Common symptoms of type 2 diabetes

  • Fatigue: Your body isn’t getting the energy it needs from the food you’re eating, so you may feel very tired.
  • Extreme thirst: No matter how much you drink, it feels like you’re still dehydrated. Your tissues (such as your muscles) are, in fact, dehydrated when there’s too much glucose (sugar) in your blood. Your body pulls fluid from the tissues to try to dilute the blood and counteract the high glucose, so your tissues will be dehydrated and send the message that you need to drink more. This is also associated with increased urination.
  • Frequent urination: This is related to drinking so much more in an attempt to satisfy your thirst. Since you’re drinking more, you’ll have to urinate more. Additionally, the body will try to get rid of the excess glucose through urination.
  • Extreme hunger: Even after you eat, you may still feel very hungry. That’s because your muscles aren’t getting the energy they need from the food; your body’s insulin resistance keeps glucose from entering the muscle and providing energy.  Therefore, the muscles and other tissues send a “hunger” message, trying to get more energy into the body.
  • Weight loss: You may be eating more but still losing weight. Since your body isn’t getting energy from food, it turns to muscles and fat and starts to break them down in order to create energy. That will cause you to lose weight.
  • Infections: The effects of type 2 diabetes make it harder for your body to fight off an infection, so you may experience frequent infections. Women may have frequent vaginal (yeast) and/or bladder infections.  That’s because bacteria can flourish when there are high levels of glucose in the blood.
  • Slow wound healing: Similar to the body’s inability to fight off infections, it might take longer for wounds (even small cuts) to heal. The high blood glucose level affects how well the white blood cells (which are in charge of healing wounds) work.
  • Blurry vision: In an attempt to get more fluid into the blood to counteract the high blood glucose level, your body may pull fluid from the eyes.  You may have trouble focusing then, leading to blurry vision.

 These are some of the more common symptoms associated with type 2 diabetes, but you may not experience all of them. If you’re concerned about your health and think you may have diabetes, make an appointment with your doctor to be tested.

Updated on: 07/03/19

Type 2 Diabetes Causes

Diabetes symptoms: When diabetes symptoms are a concern

Diabetes symptoms: When diabetes symptoms are a concern

Diabetes symptoms are often subtle. Here’s what to look for — and when to consult your doctor.

By Mayo Clinic Staff

Millions of people in the United States have diabetes but don’t know it. Early symptoms of diabetes, especially type 2 diabetes, aren’t always obvious. In fact, signs and symptoms can come on so gradually that people may have type 2 diabetes for years before they’re diagnosed with the disease.

But if you notice the following signs and symptoms, make an appointment to see your doctor:

  • Increased thirst and urination
  • Fatigue
  • Blurred vision
  • Unexpected weight loss
  • Increased hunger
  • Slow-healing sores and frequent infections
  • Red, swollen gums
  • Tingling or numbness in your hands or feet

Understanding possible diabetes symptoms can lead to early diagnosis and treatment, which can help you prevent the complications of diabetes and lead to a lifetime of better health.

Here are more details about the signs and symptoms of diabetes:

Excessive thirst and increased urination

Excessive thirst and increased urination are common diabetes signs and symptoms. When you have diabetes, excess glucose — a type of sugar — builds up in your blood. Your kidneys are forced to work overtime to filter and absorb the excess glucose.

When your kidneys can’t keep up, the excess glucose is excreted into your urine, dragging along fluids from your tissues, which makes you dehydrated. This will usually leave you feeling thirsty. As you drink more fluids to quench your thirst, you’ll urinate even more.

Fatigue

Diabetes can make you feel tired. High blood glucose impairs your body’s ability to use glucose for energy needs. Dehydration from increased urination also can leave you feeling fatigued.

Weight loss

When you lose glucose through frequent urination, you also lose calories. At the same time, diabetes may keep the glucose from your food from reaching your cells — leading to constant hunger. The combined effect can potentially cause rapid weight loss, especially with type 1 diabetes.

Blurred vision

Diabetes symptoms sometimes involve your vision. High levels of blood glucose pull fluid from your tissues, including the lenses of your eyes. This affects your ability to focus.

Left untreated, diabetes can cause new blood vessels to form in your retina — the back part of your eye — and damage established vessels. For most people, these early changes don’t cause vision problems. However, if these changes progress undetected, they can lead to vision loss and blindness.

Slow-healing sores or frequent infections

High levels of blood glucose can lead to poor blood flow and impair your body’s natural healing process. Because of this, people with diabetes may notice slow-healing sores, especially on the feet. In women with diabetes, bladder and vaginal yeast infections may occur more often.

Tingling hands and feet

Too much glucose in your blood can affect the function of your nerves. You may notice tingling and loss of sensation (numbness) in your hands and feet, as well as burning pain in your arms, hands, legs and feet.

Red, swollen, tender gums

Diabetes may weaken your ability to fight germs, which increases the risk of infection in your gums and in the bones that hold your teeth in place. Your gums may pull away from your teeth, your teeth may become loose, or you may develop sores or pockets of pus in your gums — especially if you have a gum infection before diabetes develops.

Take your body’s hints seriously

If you notice any possible diabetes signs or symptoms, contact your doctor. Diabetes is a serious condition, and the earlier it’s diagnosed, the sooner treatment can begin. With your active participation and the support of your health care team, you can manage diabetes and enjoy an active, healthy life.

June 03, 2021

Show references

  1. Diabetes overview. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview. Accessed April 22, 2019.
  2. Diabetes symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/symptoms.html. Accessed April 22, 2019.
  3. American Diabetes Association Standards of Medical Care in Diabetes
    — 2019. Diabetes Care. 2019;42:S1.
  4. Diabetes mellitus (DM). Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dm. Accessed April 22, 2019.
  5. Stern SC, et al. Diabetes. In: Symptom to Diagnosis: An Evidence-Based Guide. 3rd ed. New York, N.Y.: McGraw-Hill Education; 2015. https://accessmedicine.mhmedical.com. Accessed April 29, 2019.
  6. Papadakis MA, et al., eds. Diabetes mellitus and hypoglycemia. Current Medical Diagnosis & Treatment 2019. New York, NY: McGraw-Hill; 2019. https://accessmedicine.mhmedical.com. Accessed April 23, 2019.
  7. Jameson JL, et al., eds. Diabetes mellitus: Diagnosis, classification, and pathophysiology. In: Harrison’s Principles of Internal Medicine. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2018. https://accessmedicine.mhmedical.com. Accessed April 23, 2019.
  8. Eye complications. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/eye-complications/. Accessed April 22, 2019.
  9. Preventing diabetes problems. National Institute of Diabetes and Digestive and Kidney Disease. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems. Accessed April 22, 2019.
  10. Complications of diabetes mellitus. Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/complications-of-diabetes-mellitus. Accessed April 22, 2019.

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10 Signs of High Blood Sugar to Be Aware Of

But when someone has diabetes, this finely tuned system gets thrown out of whack. In type 2 diabetes—which accounts for 90% to 95% of diabetes in adults, according to the CDC—the body either can’t make enough insulin or can’t utilize insulin well, according to the NIDDK. If someone has prediabetes, their blood glucose will be higher than normal but not quite in the type 2 diabetes range yet, per the NIDDK. And in type 1 diabetes, the body does not make insulin or makes very little.

In any case, the result is extra sugar hanging around the bloodstream, making you feel like total crap in the short term and putting your health at risk in the long term.

Signs of High Blood Sugar

Someone who has been diagnosed with diabetes will be familiar with how it feels to have hyperglycemia. (If you have diabetes, you can also keep tabs on your blood sugar by testing it regularly.) But for the millions of people who have diabetes or prediabetes and are unaware of it, knowing the signs of high blood sugar could prompt them to seek care and get a diagnosis as soon as possible.

While type 1 diabetes symptoms can come on suddenly and severely, it’s important to note that type 2 diabetes symptoms can creep up gradually and be so mild that they’re not noticeable, the NIDDK explains. And most people with prediabetes actually have no symptoms, per the NIDDK. So it’s extremely important to get screened if you have risk factors, like having a family history, being overweight, or being over age 45, the NIDDK says.

Still, there are many potential signs of high blood sugar in the short and long term that it doesn’t hurt to be conscious of, especially if you are at elevated risk.

Early on, hyperglycemia can make you feel off in a variety of ways:

1. Fatigue

Feeling tired may be the most common early sign of high blood sugar, Dr. Hatipoglu says. It’s also one that can occur, to a mild degree, with even the mild and normal blood sugar fluctuations that happen in people without diabetes (or with prediabetes) when they consume a large amount of simple carbs, like sugar, she says.

Of course, tiredness is a pretty nonspecific symptom (and can even be a sign of low blood sugar, as Dr. Adimoolam points out). If you notice fatigue regularly occurring right after you eat, though—especially a carb-heavy meal—it may have to do with rising blood sugar levels. “People will say, ‘I want to nap after lunch,’ or ‘I just cannot open my eyelids after dinner,’ often after eating something like a lot of pasta or potatoes or sweets,” Dr. Hatipoglu says. To be clear, there’s nothing wrong with eating these foods. But if you notice that they always affect you in a very specific way that you find troubling, like always making you incredibly sleepy, it’s a sign you may want to talk to a medical professional.

2. Frequent urination

When you have too much sugar in your blood, “your kidneys start trying to pour out more sugar to get rid of it. And as they excrete the sugar, they pull out water with it,” Dr. Hatipoglu explains. This makes you have to visit the bathroom more than usual.

3. Increased thirst

This is a natural effect of peeing more, Dr. Adimoolam explains, because your body becomes dehydrated. “People start feeling thirsty all the time,” Dr. Hatipoglu says. The dehydration also becomes cyclical, the Mayo Clinic explains: The more you pee, the thirstier you are, the more you drink, the more you pee, and so on.

4. Headaches

Dehydration from any cause can trigger headaches, Dr. Hatipoglu says. Of course, headaches can be a sign of many different things, but it’s worth getting checked out if it’s something new or coupled with other symptoms here. (The dehydration can also worsen your fatigue in addition to your headaches, by the way.)

5. Blurred vision

When there is excess sugar in the blood, it can affect some unexpected areas in the body, like your eyes, according to the Cleveland Clinic. Essentially, extra sugar (along with a little water) gets trapped in the lens in the middle of the eye, causing a blurred effect, Dr. Hatipoglu explains. (This is temporary and not the same as the damage to the eye that can occur in the long term with a condition like diabetes.)

6. Nausea, vomiting, confusion, and more

These seemingly disparate symptoms are all signs of a rare and life-threatening state called diabetic ketoacidosis (DKA), according to the U.S. National Library of Medicine. DKA can cause the symptoms above, as well as stomach pain, trouble breathing, dry or flushed skin, fruity-smelling breath, or difficulty paying attention. It usually occurs in people with type 1 diabetes and is sometimes the first sign they are sick, according to the U.S. National Library of Medicine. (More rarely, DKA can occur to a milder degree in type 2 diabetes.) 

DKA happens when the liver is unable to use the sugar in the blood for energy without insulin and begins to break down body fat into a type of fuel called ketones at such a high rate that they become toxic and make the blood acidic, the U.S. National Library of Medicine explains. DKA can be fatal if left untreated, so anyone experiencing these symptoms should seek care immediately.

90,000 Empty Calorie Disease

In the USA, they say goodbye to the famous American blues guitarist BB King. The musician’s cause of death is complications associated with diabetes, a disease that has taken a special place in the list of chronic disease pandemics in the past ten years. The International Diabetes Federation recognizes: “The fight against this disease is lost.” Why is the diabetes pandemic rampant?

Since 1980, the number of diabetics in the world has quadrupled, and treatment of such patients on this scale is becoming increasingly expensive.According to Olga Martin , head of the Alliance Against Diabetes Clinical Research Center in Las Vegas, if the pandemic of this chronic disease is not stopped, then in 20 years the world community will face catastrophic consequences.

What is diabetes?

Diabetes is a group of diseases of the endocrine system associated with metabolic disorders, which begins with disruptions in carbohydrate metabolism. The biological nature of such a violation is as follows. Of all sources of energy, carbohydrates are the fastest converted to sugar and broken down, providing the body with “fuel”.In a healthy person, between meals, the liver releases some glucose into the bloodstream, which we need for normal life. For sugar to be absorbed by cells, the body needs a “password” – the hormone insulin, which is synthesized by the beta cells of the pancreas and reaches the insulin receptors of the remaining cells. Without the presence of insulin on the surface of the cell and “enveloping” it with this hormone, the absorption of the necessary sugar is impossible.

BB King in Moscow. 2004 year

After a meal, the level of sugar in the blood rises, and the amount of insulin increases, which helps the cells to assimilate this sugar.The liver begins to accumulate excess glucose from the blood, storing it for next use. When this process ends, insulin is broken down and excreted from the body, so that the body constantly renews its stores of insulin by the beta cells of the pancreas.

Diabetes patient in Azerbaijan hospital

In diabetes, this harmonious system of glucose metabolism breaks down and, depending on these disorders, diabetes is divided into two types – 1st and 2nd. The relatively rare type 1 diabetes develops when the beta cells of the pancreas are destroyed and cannot produce insulin, or only produce minimal amounts of it.A much more common form of diabetes, about ten times more common (in 2-10 percent of the population), is type 2 diabetes (diabetes mellitus), in which glucose metabolism is impaired due to a lack of insulin. Patients with type 2 diabetes have high blood sugar levels, since insulin activity decreases – insulin resistance occurs, although the beta cells of the pancreas produce more and more of it at the initial stage of the disease. Over time, the worn-out beta cells are depleted, even if doctors can track the diabetic at the very beginning of the disease, half of the patient’s B cells, as a rule, no longer function, and it is impossible to restore them. In this case, a violation of the metabolism of carbohydrates leads along the chain and to a violation of the metabolism of proteins and lipids. The patient’s condition may deteriorate gradually (subtle symptoms) or, conversely, rapidly. Although diabetes has always been considered a disease of older age, it is now increasingly common in young people and children.

Diabetes is associated with a complex of factors, both genetic and lifetime. However, the main one is being overweight. “High-calorie foods rich in simple carbohydrates lead to overweight and obesity, which is a risk factor for diabetes.Obese people are three times more likely to become diabetic than people of normal weight, ”explains Olga Martin. Actually, the threatening spread of diabetes on the planet is connected with a gradual change in the predominant diet.

Diabetes and junk food

Olga Martin notes that the prevalence of diabetes depends to a large extent on the geographic region and the state of the economy – this is associated with the predominant lifestyle of people and their diet. It is logical that the incidence increases with urbanization, 77 percent of diabetics live in underdeveloped and moderately developed countries.However, in rural areas of developing countries, the incidence of type 2 diabetes continues to be low.

Eating high-calorie foods with a predominance of simple carbohydrates, which dramatically increase blood sugar levels, using foods that do not contain vitamins and trace elements, which protect us from oxidative stress – another important risk factor for disease, leads to the development of diabetes. Conversely, a low-calorie diet that uses complex carbohydrates, which are absorbed much more slowly and do not cause a sharp rise in blood sugar levels, significantly reduces the risk of diabetes.

Queue to the first McDonald’s in the USSR

Olga Martin gives a curious example: in agrarian Mexico in 2010, the incidence of diabetes mellitus was 10% of the total population, but among Mexican immigrants in the United States, 35 percent were already ill. The reason is a different diet, primarily fast food, soda instead of natural water, processed foods such as canned food, white flour, and polished rice. But in the Mexican countryside, people mainly eat more wholesome unprocessed foods: dark rather than polished rice, coarse flour, fresh vegetables and fruits.

Here’s another hilarious confirmation of the correlation between junk food and diabetes: Stanford University biologist Robert Sapolsky, studying one of the primate species, African baboons, found that those who lived near hotels and ate the remains of food discarded by tourists grew faster and reached maturity than their savannah counterparts, but also more often acquired symptoms of diabetes.

Being overweight increases your risk of diabetes

The relationship between excess weight, as well as oxidative processes caused by an improper diet and diabetes is beyond doubt.Obviously, the increasingly widespread spread of this disease is one of the costs of modern civilization. The dietary pandemic is gaining more menacing momentum: The International Diabetes Federation reports that there were 387 million registered diabetics worldwide in 2014, of which 5 million died. The global cost of treating diabetics is growing rapidly: last year it amounted to $ 612 billion, while in 2007 it was almost four times less, 174 billion. The three leaders in the number of people suffering from diabetes are as follows: India, China, the United States (in the United States over the past 20 years, diabetes has increased from 14.9 million to 26.1 million cases, that is, by 75 percent).Russia is in fourth place with 10 million patients. However, if you look at the relative number of patients with diabetes to population size, Russia is only 89th, and Ukraine is one of the last 219th, while the world leaders include the Pacific island states and the countries of the Arabian Peninsula (data for 2013).

Symptoms and diagnostics

In reality, the statistics can be even more depressing: diabetes develops slowly and imperceptibly, and patients do not always go to the doctor right away. IDF estimates that out of two people with diabetes, one is unaware of this. How to recognize the first manifestations of a developing disease? Milan Kvapil , chairman of the Czech Diabetes Association, names the following symptoms: excessive fatigue, constant thirst, shortness of breath, blurred vision, itching, nausea, rapid uncontrolled weight change, frequent urination, slow wound healing. A set of several of these symptoms is a reason to get tested without delay: Milan Kvapil reminds that an elevated blood sugar level after a few years leads to irreversible changes in blood vessels, deterioration of vision, kidney function, and disorders in the nervous system.

Although until recently it was believed that diabetes is an age-related disease, today it is not only the elderly who need to worry: associate professor of the Internal Medicine Clinic at Charles University in Prague Martin Prazdny notes that type 2 diabetes is rapidly getting younger, all people are at risk over 40, and the disease threatens one in three.

To test yourself for diabetes, you need to do a blood test.

A promising development – a contact lens that measures glucose in tears

The norm of blood glucose for a healthy person before meals is from 3.5 to 5.5 mmol per liter.For greater accuracy, blood is taken from the patient twice, on an empty stomach, and two hours after ingestion of 75 grams of glucose dissolved in a glass of water. If a fasting blood test shows 7.0 or more mmol per liter, and after two hours the concentration has reached 11.0 or more, a diagnosis is made – diabetes mellitus (its type is determined by additional research).

Olga Martin notes that the American Diabetes Association’s diabetes diagnosis criteria are likely to be lowered, and then the number of cases will increase by about four times: “Recent studies show that cardiovascular diseases (heart attack and stroke) and diabetes begin to develop when the fasting blood sugar exceeds 4.7 mmol per liter, and after eating 6.6 mmol per liter, ”comments Olga Martin.

Treatment

Diabetes is one of the chronic diseases that cannot be completely cured. However, you can achieve a significant slowdown in the development of the disease and save the patient from most of the unpleasant symptoms. Direct drug treatment of diabetes is mainly reduced to the use of drugs that either replace insulin or stimulate its secretion by the pancreas. For example, with moderate hyperglycemia of type 2 diabetes, sulfonylureas are recommended (they increase insulin secretion by stimulating beta cells), biguanides (oral hypoglycemic drugs), insulin therapy, which normalizes the condition of a patient with type 2 diabetes.According to the Czech diabetologist Marcela Shabo , a new class of effective drugs has recently appeared: antidiabetic glyflozins affect the functioning of the kidneys, allowing excess glucose to be excreted in the urine. However, an undesirable side effect of these drugs can be an increased risk of urinary tract infections.

Diet and an active lifestyle are necessary to stabilize the condition of the diabetic

It is important to understand that it will not be possible to achieve positive results only with the help of medicines: the prerequisites for stabilizing the state of a diabetic are diet and regular physical activity.Milan Kvapil, President of the Czech Association of Diabetologists, tells about a typical success story of complex treatment: a Czech patient (now 70 years old) was diagnosed with diabetes 5 years ago, while the woman was overweight. The patient complained of poor sleep, constant thirst, excessive fatigue. Laboratory tests of blood and urine showed type 2 diabetes. The woman began to take antidiabetic medications, changed her diet, and began seeing a doctor every six months. When the patient lost 16 kilograms, it turned out that she no longer needed to take medications, but rather follow a diet (five small portions of food during the day, the last one no later than 6 pm), completely abandon sweets and maintain an active lifestyle (30 minutes of brisk walking daily).

Prevention

Diabetes cannot be completely cured, but it can be prevented by eliminating the main risk factors as much as possible. Professor Jaroslav Rybka , a leading diabetologist in the Czech Republic and the EU, believes that this should be done starting from childhood: computer games and social networks, instead of outdoor games and cheap sweets, lay the foundation for a future illness. Children become overweight, the pancreas cannot produce enough insulin to lower blood sugar, and diabetes is only a matter of time.Children’s endocrinologist from California Dr. Robert Lustig from the University of California (San Francisco) in his book The Fat Chance Cook-Book insists that sugar, in principle, should be excluded from the diet of any person and that it is no less harmful than alcohol or tobacco smoking …

Yaroslav Rybka advises avoiding fried foods, eating only high-quality protein products, giving preference to fish, especially seafood, or white chicken meat, and trying not to buy ready-made meals in supermarkets.You can eat vegetables and herbs in unlimited quantities, but you should be careful with fruits: they contain a lot of fructose.

Greens and vegetables are the basis of nutrition for the prevention of diabetes

Olga Martin, like many other experts, advocates the complete exclusion of junk food from the diet, and also advises to intelligently supplement the diet with food additives containing trace elements: “The modern Western diet leads to a deficiency of essential trace elements, such as magnesium, chromium, potassium , as well as B vitamins, vitamin C and so on, so it is necessary to replenish the diet with special dietary supplements.The body’s natural ability to control blood glucose levels is influenced by several factors: food composition, the state of the digestive and excretory systems, pH imbalance, and pharmacological drugs taken. This explains why diabetics have low levels of several essential micronutrients and vitamins. ”

Future diabetes

Will Humanity Ever Beat Diabetes? On the one hand, a pandemic can be stopped by approaching diet in a systemic manner.

Olga Martin is sure that the most drastic measures are needed here, up to the introduction of protective taxes on the production and sale of harmful food products. But is there any hope that diabetes can be cured in the future simply by taking a pill? Martin urges not to count on it. “Society needs to be very skeptical about the words of doctors and pharmacologists who promise to take control or even cure diabetes by using the latest drugs,” warns Olga Martin.- If diabetes was caused by a specific bacterium or virus, then it would be possible to influence the cause of the disease and cure the patient. However, diabetes is a physiological response of the body to a complex of factors: lack of essential micronutrients, excessive consumption of “empty calories” in combination with a sedentary lifestyle. Thus, type 2 diabetes can be cured only by excluding the complex of causes, and not by treating the effect. About 12 years ago, the American journal Diabetology posed a quite logical question: will you seriously fight the disease that feeds doctors and brings huge profits to pharmaceutical companies? Diabetes is a multi-billion dollar business, ”concludes Olga Martin .

Diabetes mellitus – a disease of civilization | Krasniykut.ru

In the Krasnokutsk region, there is a slight, but still growth of this insidious disease. If in 2016 the number of patients registered with “D” was 821 people, then at the moment of the current year it is 848.

What is diabetes mellitus? This is a disease of the endocrine system that occurs due to a lack of insulin and is characterized by a violation of the metabolism of carbohydrates in the body, as well as other metabolic disorders.Insulin is essential for maintaining normal blood sugar levels, it promotes the entry of glucose into cells, regulates protein processes, blood glucose levels, and a number of other functions. Therefore, the normal functioning of the body is impossible without a sufficient amount of insulin.

Currently, there are two types of diabetes mellitus: the first type – insulin-dependent, which occurs at a young age under 30, and the second type of diabetes – insulin-independent, diabetes of the elderly.In such patients, insulin is produced, but its activity is reduced. If the diagnosis is not made on time, the disease progresses, the formation of insulin decreases, which requires the transfer of the patient to injectable insulin.

If we talk about the reasons for the development of type 2 diabetes mellitus, then it is, first of all, heredity, moreover, with a probability of up to 80%, both maternal and paternal, and if such diabetes in both parents, the likelihood of manifestation in children is approaching to 100%.Obesity is also the cause of the disease.

If a “war” is declared against overweight, then diabetes can be defeated. Next comes nervous stress as a predisposing factor and, of course, age. The older a person is, the more you need to be afraid of diabetes.

What are the symptoms of the disease to watch out for? Dry mouth, thirst, weight loss for no apparent reason, frequent urination, weakness, itching in the external genitals. Diabetes mellitus is dangerous with vascular complications.Myocardial infarction, stroke – lesions of large vessels. Retinopathy is a lesion of the small vessels that feed the eyes. In case of non-observance of a balanced diet, taking the necessary medications, renal failure may develop. The defeat of the legs and feet. These complications are associated with damage to blood vessels and nerve endings.

If you notice at least one of the listed symptoms, you should immediately contact your local doctor who will prescribe the necessary examinations. Diabetes is insidious in that it can be hidden, i.e.That is, on an empty stomach, sugar is normal, but during the day you are worried about dry mouth, fatigue. Here it is already necessary to prescribe a sugar curve, but this is decided by the endocrinologist. It is necessary to monitor blood pressure, lipid profile, because in diabetes mellitus, all blood vessels are affected and cholesterol and its derivatives should be normal. In addition, you should pay special attention to your balanced diet and exercise self-control of blood sugar at home.

But even if the diagnosis has already been made, do not worry: following the diet and doctor’s recommendations, leading an active lifestyle, you can ensure that the sugar level will be normal for a rather long time, and complications can be safely avoided.

Diabetes psychology. Fear of living alone with diabetes

Good or bad, no one will be treated for us. It would be great: someone measures sugar, someone injects insulin, and I eat. But this is unreal. I think thank God. Because who knows my body better than me and what I want? Who better than me will take care of me?

And yet, even when I know how to take care of myself, sometimes I am overwhelmed by the feeling that I am alone with my disease.That all this “idiot” every day. And I am the one who has to live with it and cope with it. Nobody can help. And then a thought and fear creeps in: I live alone, what if what?

“What” is, in most cases, hypoglycemia, feeling unwell, nausea, vomiting, calling an ambulance, ketoacidosis, fear, fear, fear. Fear of helplessness, fear of being alone in a difficult situation, fear of dying. Let’s see how we can help ourselves if we feel “one on one” with diabetes.To do this, consider two situations:

When I really do not live alone, but my feeling “one on one with diabetes” is a feeling of burnout and devastation from treatment.

Whether you live alone or with a family, it is important to understand for yourself that this feeling of devastation reflects the process of burnout from the disease. This happens not only with diabetics, but also with other people who have to undergo constant treatment. What to do?

    • Visit your endocrinologist and discuss what can be changed during your treatment.Perhaps you are on a too rigid diet and it tires you too much. You may not see any treatment results at all. In this case, it is important to find new ways for yourself to diversify your daily routine.
    • Contact the community for advice and support.
    • See a psychologist.
    • Look for variety, novelty, interest, even in non-diabetic moments.

    When I really live alone and am afraid of the fact that I will be alone with diabetes in difficult times.

    In this situation, it is important to understand what exactly you are afraid of. Most often it is the fear of hypoglycemia.

    • Learn the mechanism of hypoglycemia and the “Rule 15”: if the glucose level is low, we eat 15 grams of fast-acting carbohydrates, after 15 minutes we measure the sugar again. If it stays low, eat another 15 grams of carbs. We repeat the algorithm until the sugar returns to normal.
    • Let your home always have on hand means of suppressing hypoglycemia: dextrose, juice, honey.Consciously pay your attention to the fact that all these funds are there. Put it straight in your brain: I have everything to deal with this situation .
    • Measure sugar before bed.
    • Visit your endocrinologist if you have frequent hypoglycemia. It may be time to adjust your insulin dose or you need to pay attention to physical activity.
    • Remember if there were real hypo situations. If so, the best thing you can do is see a psychologist.He knows how to professionally work with fears and phobias. If there were no such episodes, concentrate on the fact that it is just fear. Which may not be confirmed.
    • Look for your own relaxation methods that help you: meditation, walks, sports, communication.
    • Remember, you can always reach out to our community for support!

    Diabetes mellitus and alcohol | Tambov Regional Clinical Hospital named after V.D. Babenko

    Humanity learned to make wine about 8 thousand years ago and since then alcoholic beverages have firmly entered the life of all peoples, they accompany us in joy and sorrow.The influence of alcohol on the functions of various organs and systems is being actively studied; there are many conflicting data on its harm and health benefits. Undoubtedly, excessive consumption of alcoholic beverages is a great evil for the physical and mental health of a person, his relatives and society as a whole. Alcohol abuse leads to various diseases, contributes to the more rapid development and malignant course of cardiovascular diseases, such as hypertension. Alcohol has the most dramatic effect on the nervous system and liver, aggravates the severity of diabetes mellitus and accelerates the development of its late complications – encephalopathy, polyneuropathy, hepatosis.

    In all countries of the world, doctors recommend that diabetic patients refrain from drinking alcoholic beverages. Looking at them as a tonic for weakened people is fundamentally wrong. In the initial stage of intoxication, the drunken person’s own strength seems to be increased, in fact, even the smallest amounts of alcohol significantly reduce a person’s ability to physical and mental work. The presentation loses its clarity and sharpness, attention is dulled, fatigue sets in faster, and the risk of injury in everyday life and at work increases.
    People with diabetes should be aware of the hypoglycemic effect of alcohol. But in no case can it be used as a remedy, because alcohol lowers blood sugar levels not in the same way as insulin, but by affecting the liver, causing toxic effects. The liver contains a store of sugar in the form of glycogen, which is broken down into glucose and enters the bloodstream. Thus, the liver is involved in the regulation of blood glucose levels, preventing hypoglycemia , t.e. a sharp decrease in blood sugar, even with a prolonged absence of food intake. Alcohol for a long time (up to two days) blocks the breakdown of glycogen and, as it were, “closes” all sugar reserves in the liver, which, in combination with antihyperglycemic drugs, can lead to severe hypoglycemia up to coma. Moreover, hypoglycemia can be delayed, that is, it does not occur immediately after drinking alcoholic beverages, but after a few hours (3-5 hours). The signs of intoxication and developing hypoglycemia are very similar: the patient himself cannot adequately assess his condition and take timely measures to stop hypoglycemia, and people around, due to the smell of alcohol, attribute inappropriate behavior and deterioration of the condition to intoxication and also do not take any measures.As a result, the patient is left without any help in a life-threatening condition. Therefore, if you have a feast with alcoholic beverages, you need to reduce the dose of antihyperglycemic drugs by half, and if the dose is small, you can skip taking the medicine on the day of the celebration. As a snack, carbohydrate-rich foods (potatoes, bread, fruits, vegetables) must be present on the table. Alcoholic drinks should be taken not before meals, but during or after meals.
    If a person with diabetes has drunk a lot of alcohol, hypoglycemia may develop at night.Therefore, before going to bed, you need to check your blood sugar and additionally eat foods containing carbohydrates and proteins. Careful self-control will also be required the day after the meal. Drinking alcoholic beverages (in moderation!) Is permissible only with good compensation for diabetes, a stable course without a tendency to hypoglycemia and ketoacidosis, and in the absence of vascular complications. They are undesirable if you are overweight. have a high calorie content: 1 gram of alcohol contains 7 kcal, which is comparable to the calorie content of fat (1 gram contains 9 kcal).All alcoholic beverages are conventionally divided into two groups. The first group includes spirits: vodka, cognac, whiskey, rum, gin, etc. The alcohol content in them is 40%, and there is almost no sugar. “Dose of risk”, i.e. the dose, the excess of which threatens the development of hypoglycemia, is 50 g for these drinks. The second group includes drinks that contain less alcohol, but they contain sugar: wines, champagne, liqueurs, liqueurs, etc. Of this group, dry wines and champagne with a sugar content of no more than 5% are preferable.The “risk dose” for these drinks is 150g. With diabetes, dessert and fortified wines, sweet champagne, liqueurs and liqueurs are undesirable, because they have a high sugar content. Separately, it must be said about beer. It can be attributed to the group of “allowed”, tk. it contains carbohydrates that compensate for the effect of alcohol. Light varieties are preferable in moderate quantities (no more than 300g.). Perhaps the only healthy drink is dry red natural grape wine. It is noted that its moderate consumption reduces the risk of cardiovascular disease.Science has solved this secret of grape red wine: it contains special substances – procyanidins and procyanidols, which act as traps for harmful free radicals that damage the walls of blood vessels and contribute to the development of atherosclerosis and aging of body cells. These substances pass into wine from the skins of red and black grapes and are not found in other drinks. It is the presence of these substances that explains the antioxidant effect of dry red wine. On a birthday or on the occasion of a holiday, you can drink a glass of wine with a meal, but you should not do it for no reason and turn it into a habit.

    Contraindications to the use of alcoholic beverages in diabetes mellitus:
    1. Chronic pancreatitis. Alcohol abuse is one of the main causes of damage to the pancreas with the development of chronic pancreatitis with impaired production of digestive enzymes, and then insulin. Specific secondary diabetes mellitus occurs.
    2. Chronic hepatitis or cirrhosis of the liver associated with diabetes mellitus, caused by viruses, alcohol or other reasons.
    3. Kidney damage – progressive diabetic nephropathy with renal failure.
    4. Diabetic neuropathy. Alcohol is the main cause of peripheral neuropathy. Diabetes mellitus ranks second in this row. Hence the danger of a combined effect on the peripheral nerves of alcohol and metabolic disorders in diabetes.
    5. Gout concomitant to diabetes mellitus.
    6. Disorders of lipid metabolism in the form of a sharp increase in the content of triglycerides in the blood.
    7. Reception for type 2 diabetes mellitus metformin (Siofor) – a hypoglycemic drug. With a significant consumption of alcohol while taking metformin, the risk of developing a special violation of the acid-base state of the body – lactic acidosis, increases.
    8. Increased tendency of a patient with diabetes mellitus to hypoglycemic conditions.

    The presented list does not exhaust all diseases and conditions in which patients with diabetes mellitus should refrain from alcoholic beverages.

    Endocrinologist, Diabetes Center

    Galina Sergeevna Kaporikova

    Tel. 71-55-02

    September 24, 2014

    90,000 Diabetes is different

    Something begins to tire the modern way of presenting information, especially of a medical nature.
    Now there are a great many blogs, everyone writes something – who can and who can not, actively accompanying the text with photographs of themselves in “different poses”.Medical information is often “corresponded (copied)” with each other, as a result – nothing new and interesting, and most importantly, little reliable and truthful.
    Therefore, in this article they will not write a theory, they talk and write about diabetes so much, as a result, they are not only not cured, but often they cannot even compensate for blood sugar decently. I would like to present and describe all the variety of forms of diabetes encountered, to try to reflect that not everything is so simple and that diabetes is divided not only into types 1 and 2… And the best way to present it is clinical cases from practice.

    Male, 65 years old .
    Diabetes mellitus type 2 for more than 15 years, was on therapy with PADS (oral sugar-reducing drugs) for a long time, first on therapy with 2 types of drugs, then with 3 types of drugs, over time – PADS stopped “restraining” the increasing glycemia, was transferred to insulin therapy , but also a combination, selection of different insulins poorly compensated for the high blood glucose.As a result, intestinal carcinoma was revealed, after the operation he lost weight, returned to therapy with 2 types of PSSP, insulin therapy was canceled. Keep blood sugar in the range of 6-7 mmol / l.
    Conclusion: in case of symptoms of long-term uncompensated diabetes, especially with an active change in therapy (its complication), especially in young people 45+, it is necessary to exclude oncopathology of any nature.

    Female, 45 years old.
    Diabetes mellitus type 2 (?) Developed against the background of normal weight.Antibodies to GAD (an autoimmune marker of pancreatic inflammation were negative). Received 2 types of PSSP. She rarely came to the reception, 1. once a year. At the 5th year of the course of diabetes, she began to actively lose weight, blood sugar increased – she was transferred to insulin therapy, weight did not recover, blood sugar continued to rise, on ultrasound of the OBP – a pancreatic tumor, confirmed later by MRI of OBP, the tumor was detected at a late stage. With active questioning of relatives – in two direct relatives in the family – pancreatic cancer with an early outcome up to 55 years.
    Conclusion: as in the first case.

    Female, 37 years old.
    Increase in blood sugar gradually over the course of a year, the maximum figure is 11 mmol / l. There is no diabetes mellitus in the family.
    Normal weight, not actively losing weight. During the examination, a high titer of antibodies to GAD (GAD) was revealed, confirmed 2 times and a decrease in the reserve of the pancreas (by a decrease in insulin and blood c-peptide 1 hour after meals). the diagnosis was confirmed. LADA – diabetes. The decision was made to lead on PSSP, so there is no ketoacidosis.Within 4 months without insulin therapy, blood glucose is maintained at 5-6 mmol / l.
    Conclusion: all young people need to take antibodies to pancreatic cells (antibodies to GAD, insulin, etc.) to make a diagnosis.

    Female, 37 years old.
    Gestational diabetes mellitus was revealed in pregnancy, according to the words, which could not be compensated for with high doses of Lantus (more than 22 units / day) and Novorapid (more than 12 units / day), after childbirth, blood sugar continues to rise above 8 mmol / L on an empty stomach against the background withdrawal of insulin!
    During examination, antibodies to pancreatic cells were not detected, but the reserve of the pancreas was sharply reduced (the increase in insulin and c-peptide h / z 1 hour after meals was not more than 30%).Diagnosis: Type 1 diabetes mellitus, antibody-negative, detected during pregnancy! Further insulin therapy was prescribed, given the low reserve of the pancreas.
    Conclusion: during pregnancy, it is necessary to carefully control blood sugar – in this case, the debut of type 1 sugar took place, mistaken for gestational diabetes mellitus.

    Male, 60 years old.
    From anamnesis, was admitted to hospital 3 years ago with blood sugar 25 mmol / l, mild ketosis (urine acetone +), diagnosed with type 2 diabetes mellitus, prescribed combination therapy – prolonged + short insulin.Who canceled on his own h / z 3 months after hospitalization, continuing to adhere to table number 9, for 3 years therapy with PSP and insulin does NOT receive !!! Blood sugar is kept at 5-6 mmol / l, and does not lose weight. The diagnosis is unclear.
    Conclusion: in the analyzes carried out earlier and presented at the reception, there are no tests for antibodies to the pancreas, c-peptide, insulin, not to mention the genetic test for the type of diabetes. Missing
    examinations assigned.

    Male, 28 years old
    Fasting blood sugar up to 8.0 mmol / l, after eating within normal limits, an increase was recorded several years ago.On a diet, glycemia is 4-5 mmol / l.
    When examining, antibodies to the pancreas are negative, the pancreas reserve is preserved (insulin and c-peptide h / z 1 hour after meals are normal). That is, there is no data for either type 1 or 2 diabetes mellitus and no LADA. It was decided to take tests to exclude MODY-diabetes.
    Conclusion: MODY diabetes is a rare, but still occurring form of diabetes, is a consequence of a point genetic mutation of a different type, is divided into more than 13 subtypes, Is a copy of type 2 diabetes (but in young people)

    Boy 22 years old.
    Blood sugar increased gradually, weight is low (initially). There was no ketoacidosis and no diabetes mellitus. When examining the function of the pancreas, a decrease in its function is gradual, without an increase in the titer of antibodies to GAD and insulin. He started treatment with DDP4 preparations, which is a type of PSSP. Gradually he was switched to prolonged insulin, then short 3-4 times a day for food jokes.
    Pancreatic function has declined sharply in 4 years. Presumptive diagnosis: slowly progressive type 1 diabetes mellitus, without antibodies (seronegative).
    Conclusion: the diagnosis of diabetes mellitus can sometimes be made only retrospectively, by assessing the course of diabetes “in time”.

    Female, 33 years old.
    Examined with the aim of planning pregnancy for obesity, metabolic abnormalities were not identified. But the pregnancy was postponed by 1.5 years. After 1.5 years, she was re-directed by gyneclog: a sharp increase in liver transaminases (ALT, AST, GGTP) by more than 3-4 times and an increase in blood sugar above 7.0 mmol / L, during the absence she gained weight.A detailed examination revealed – Type 2 diabetes mellitus, insulin resistance, fatty hepatitis. Taking into account the planning of pregnancy, insulin therapy was prescribed to compensate for type 2 diabetes mellitus.
    Conclusion: when diagnosing type 2 diabetes mellitus at a young age, pregnancy can only be managed with insulin therapy, PAD in Russia is not allowed for pregnancy management.

    Male, 72 years old.
    Suffering from type 1 diabetes mellitus since the age of 23 !!!!!!
    At his age from folded has only:
    diabetic retinopathy 1st stage, nephropathy at the stage of proteinuria, no data for chronic renal failure, diabetic seromotor neuropathy (the most pronounced of all complications).Acute cardiovascular accidents
    (heart attack, insulin) could not stand !!
    Conclusion: Type 1 diabetes mellitus does not imply an “early outcome” (life expectancy may be normal, as in people without diabetes), complications can be prevented by satisfactory diabetes compensation.

    Male, 48 years old
    A history of acute pancreatic necrosis (acute inflammation – “melting” of the pancreas), which suggests the death of more than 70% -80% of pancreatic cells.Survived. He was discharged from the hospital on combined insulin therapy, later, within 8-12 months after an acute condition, he was completely withdrawn from insulin therapy, and for 3 years he has been receiving only pill forms of PSSP.
    Conclusion : there is always an exception from any statistics, pancreatic necrosis, which implies high mortality and lifelong insulin therapy, is NOT a verdict yet!

    … and that’s not all ..

    10 Pregnancy and diabetes mellitus

    LECTURE No. 9

    Pregnancy and diabetes mellitus.

    Extragenital pathology – these are all somatic diseases that a pregnant woman has.

    If these diseases are in the stage of compensation, the childbirth can proceed normally.

    Problems that need to be solved if a pregnant woman has diabetes mellitus:

    1) the question of the feasibility of pregnancy

    2) family planning for diabetes

    3) questions of contraception:

    – with an IUD there is a high risk of development inflammatory complications

    therefore – better sterilization

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    The mortality rate of pregnant women, women in labor at the beginning of the 20th century was 50%, and 0.2-0.7% is maternal mortality from diabetes.

    Now the incidence of diabetes has increased, and the frequency of complications has increased (the risk of their development in diabetes is 5-6 times higher than in pregnant women without diabetes).

    Characterized by a high perinatal mortality in the presence of a woman with diabetes mellitus – 250-150 ppm.

    Pathogenesis of diabetes mellitus.

    Diabetes mellitus develops absolute or relative insulin deficiency , which leads to the development of disorders of all types of metabolism.

    In this case, pathological changes occur in internal organs and tissues:

    1. hyperglycemia
    2. violation of the synthesis of proteins, fats and carbohydrates
    1. severe oxide stress (generalized tissue hypoxia)
    2. organs in any, even normally proceeding, pregnancy are similar to the changes that occur in diabetes mellitus.

      During normal pregnancy the pituitary gland enlarges 10 times .

      In this case:

      – an increase in the synthesis of tropic hormones

      – an increase in adrenal activity.

      In addition, a new endocrine organ appears in the body of a pregnant woman – placenta , in which a large number of counterinsular hormones are synthesized.

      Thus, pregnancy is diabetogenic factor .

      Diabetes mellitus that occurs or is first diagnosed during pregnancy is gestational diabetes mellitus.

      It occurs at 24-28 weeks of gestation .

      Transient impairment of glucose tolerance is characteristic.

      Gestational diabetes mellitus may disappear after pregnancy ends.

      Classification of diabetes mellitus in pregnant women:

      1) Gestational diabetes mellitus

      – occurs in 1.5% of cases

      2) Pre-gestational diabetes mellitus

      (that is, diabetes mellitus women before pregnancy):

      Insulin-dependent

      Non-insulin-dependent

      Insulin-dependent diabetes mellitus – type 1 diabetes mellitus:

      1) juvenile type

      – occurs in adolescence 20005 and

      is genetically determined

      3) antibodies to the cells of the islets of Langerhans are detected in the blood

      4) this is a severe form of diabetes mellitus

      5) acute onset

      6) insulin deficiency develops

      7) tendency to frequent development of etoacidosis

      8) complications:

      microangiopathy

      macroangiopathy

      neuropathy.

      Non-insulin dependent diabetes mellitus – type 2 diabetes mellitus:

      1) occurs after the age of 30-40

      2) often – against the background of obesity

      3) there are no antibodies to the cells of the islets of Langerhans

      4) metabolic disorders – insignificant

      5) often patients do without insulin therapy

      6) treatment – diet therapy and hypoglycemic drugs (biguanides)

      During pregnancy in women with non-insulin dependent diabetes mellitus , the use of hypoglycemic drugs is categorically contraindicated, since they have a pronounced effect.

      Therefore, during pregnancy, insulin is used to correct non-insulin dependent diabetes mellitus.

      7) complications – vascular.

      Complications of diabetes mellitus, which progress with the development of pregnancy:

      1) hypoglycemic coma

      2) hyperglycemic coma:

      – ketoacidotic coma

      – ketoacidotic coma 9305

      – ketoacidotic coma

      305

      – ketoacidotic coma

      30

      diabetic angiopathy:

      diabetic glomerulosclerosis

      retinopathy.

      Hypoglycemic coma.

      There is a sharp drop in blood glucose levels.

      Occurs when:

      – insulin overdose

      – incorrect selection of the insulin dose

      – no carbohydrate intake at the time of maximum insulin action

      Clinic.

      1) pallor

      2) anxiety

      3) a sense of fear

      4) general weakness

      5) a sharp feeling of hunger

      6) sweating

      7) tremor

      8) paresthesia

      10) blurred speech

      11) aphasia

      12) convulsions

      11) clouding of consciousness

      12) coma, which develops very quickly.

      Hyperglycemia.

      Ketoacidosis.

      In the blood there is an increase in the level of glucose, acetone, acetoacetic acid, beta-hydroxybutyric acid.

      The precom is developing.

      Clinic.

      1) thirst

      2) vomiting

      3) drowsiness

      4) weakness

      5) the smell of acetone in the exhaled air.

      If ketoacidosis is not compensated, then it develops:

      – significant dehydration

      – loss of electrolytes

      – acute renal failure develops

      – acute liver failure.

      Ketoacidotic coma.

      1. oliguria

      2. soft eyeballs

      3. decreased skin turgor

      4. dry skin and mucous membranes

      5. decreased tendon reflexes

      6. adynamia

      7. increased heart rate

      8. decrease in blood pressure

      9.noisy breathing (like Kussmaul)

      10. loss of consciousness

      11.coma

      12.rarely – abdominal pain.

      Hyperosmolar coma.

      1. a sharp increase in glucose levels

      2. increased osmolarity

      3. dehydration

      4. normal content of ketone bodies in the blood.

      Diabetic angiopathy.

      Generalized changes occur in the basement membranes of small vessels, which contain many mucopolysaccharides.

      Damage to the renal glomeruli is especially characteristic.

      Diabetes mellitus most often affects:

      1. fundus vessels

      – diabetic retinopathy

      2. renal vessels

      – diabetic glomerulosclerosis

      3. nerve fibers and endings

      – polyneuritis In addition , the vessels of the muscles, gastrointestinal tract, skin and other organs are also affected.

      Diabetic retinopathy.

      There are three stages of diabetic retinopathy:

      Stage 1:

      Retinal vein dilatation

      Microaneurysms

      Stage 2:

      At this stage retinal hemorrhage

      decrease pregnancy is already contraindicated.

      Stage 3:

      Proliferative retinopathy (irreversible process)

      Retinal detachment may occur and amovrosis (blindness) may develop

      Diabetic glomerulosclerosis.

      The following changes are characteristic:

      Proteinuria

      Increased blood pressure

      Hypercholesterolemia

      Uremia

      Severe forms of late gestosis develop against the background of glomerulosclerosis.

      The course of pregnancy and childbirth in diabetes mellitus.

      Diabetes mellitus during pregnancy is very labile .

      The alternation of periods of improvement and deterioration of the condition of the pregnant woman is characteristic.

      There is an increased tendency to develop ketoacidosis and hypoglycemia.

      Characteristically, the fetus tolerates hypoglycemia better than ketoacidosis, in which there is a risk of intrauterine fetal death.

      The course of diabetes mellitus in the first half of pregnancy.

      The course of diabetes mellitus is unchanged (as before pregnancy) or even an improvement in the general condition

      This is due to the fact that there is an improvement in carbohydrate tolerance due to the synthesis of chorionic gonadotropin

      The dose of insulin must be reduced

      The course of diabetes mellitus in the second half of pregnancy.

      the course of diabetes mellitus is labile

      there is a sharp deterioration in the general condition, diabetic complaints appear :

      – polydipsia

      – polyphagia

      – polyuria

      – skin itching – especially in the area of ​​genital itching

      organs

      · This is due to the fact that a large amount of contrainsular hormones are synthesized at 24 weeks of gestation

      · the dose of insulin must be increased

      The course of diabetes mellitus in the third trimester of pregnancy .

      the course of diabetes mellitus – there is an improvement in the general condition

      This is due to the fact that there is an improvement in carbohydrate tolerance due to the synthesis of fruit insulin

      the fetus develops hyperinsulinism – hyperplasia of the islets of Langerhans

      dose of insulin it is necessary to reduce

      The course of diabetes mellitus during labor.

      Childbirth is stress, in which there is an increase in energy costs, increased muscle work, and rapid fatigue develops.

      A state of hyperglycemia or hypoglycemia occurs quickly.

      With prolonged labor, the pregnant woman develops ketoacidosis.

      Therefore, during childbirth, dynamic control of blood sugar levels is necessary – every 2 hours .

      The presence of an endocrinologist during childbirth is mandatory.

      The course of diabetes mellitus in the postpartum period.

      In the first week after childbirth, the blood glucose level decreases, but then its level rises rapidly, and hyperglycemia develops.

      This is due to the fact that there is no fetal insulin in the mother’s body, therefore the insulin dose must be increased , and the postpartum woman must be transferred to the endocrinology department .

      Complications of pregnancy proceeding against the background of diabetes mellitus.

      Complications arising in the first half of pregnancy:

      1) Early gestosis

      – since a woman is dehydrated, hyperglycemic coma may develop

      2) Spontaneous termination of pregnancy

      with the development of angiopathy

      3) Anomalies of fetal development

      – therefore, it is necessary to perform screening ultrasound at a period of 22 weeks.

      Complications arising in the second half of pregnancy:

      1) Late gestosis

      – these are combined gestosis

      – develop in 50-80% of cases

      – early onset is characteristic – after 18 weeks of pregnancy

      – the level of perinatal mortality rises sharply

      2) Polyhydramnios

      – develops in 30-50% of cases

      its development is due to :

      a) fetal polyuria

      (since glucose has a diuretic effect)

      b) the reaction of the amnion to an increased content of

      sugar in amniotic fluid

      (violation of water transport and an increase in its

      synthesis)

      3) Gestational pyelonephritis

      – developing occurs in 5% of cases

      – the enlarged uterus compresses the bladder

      – therefore it is necessary to recommend that pregnant women periodically take the knee-elbow position

      – in addition, the content of progesterone increases, which reduces the tone of the ureters

      – all this contributes to urinary stagnation , and with the addition of a bacterial infection, an inflammatory process develops in the renal pelvis and calyces

      4) Candidal colpitis

      5) Late miscarriage

      6) premature pregnancy and premature pregnancy.

      Complications arising in the third trimester of pregnancy:

      1) Late gestosis

      2) Polyhydramnios

      3) Undermaturity

      4) Diabetic fetopathy.

      Complications arising during childbirth:

      Reasons:

      1) Late gestosis

      2) Polyhydramnios – complications develop as often as possible

      3) Large fetus.

      Complications arising in the first stage of labor:

      1) premature rupture of amniotic fluid

      2) loss of umbilical cord loops, small parts of the fetus

      3) infection

      – development of chorionamnionitis

      labor activity

      4 since the uterus is overstretched

      – hormonal disorders

      5) premature detachment is normally

      located placenta

      – due to the rapid outflow of water

      – fragility of the vessels

      6) fetal hypoxia

      complications arising from the second 1) Clinics narrow pelvis

      – inconsistency of the fetal head with the size of the pelvis, so

      as:

      a) there is a transversely narrowed pelvis

      b) large fetus

      2) Weakness of attempts

      3) Injuries of the birth canal

      4) Long standing of the fetal head in one plane

      5) Acute fetal hypoxia

      6) Difficulty in the birth of the fetal shoulder girdle

      7) High level of fetal trauma:

      – craniocerebral trauma

      – peripheral paralysis

      – limb fractures

      An increase in the frequency of surgical interventions is characteristic:

      – caesarean section is performed in more than 50% of cases.

      Complications in the third stage of labor:

      – bleeding.

      Complications developing in the postpartum period:

      1) Hypotonic bleeding

      2) Severe hypogalactia or agalactia (lack of breast milk)

      3) Purulent-inflammatory endometrial 9000 – 9000 – 9000 – 9000 – 9000 – 9000 postpartum ulcers

      – suppuration of a postoperative wound, etc.

      · due to microcirculation disorders

      · metabolic disorders

      Features of children born to women with diabetes mellitus.

      Diabetic fetopathy is a complex of changes that occur in the fetus’s body under the influence of the mother’s diabetes mellitus.

      With diabetic fetopathy, triad changes (DON) are observed:

      1) disproportion

      2) edema

      3) fetal immaturity

      Characteristic:

      1. High frequency
      2. High frequency
      3. High frequency malformations (2 times more often than in pregnancy without diabetes mellitus)
      1. Deviations from the normal course of the perinatal period
      1. Large weight and large size of the fetus – macrosomia

      If there was a developmental delay syndrome fetus, then there may be microsomia.

      1. Characteristic appearance.

      Fetal malformations arising in diabetes mellitus:

      1) heart defects

      2) underdevelopment of the caudal spine

      3) spina bifidum – the presence of spinal hernia (the spinal cord is open behind)

      CNS

      Appearance of the fetus.

      – resembles Itsenko-Cushing’s syndrome.

      1) excessive development of subcutaneous fatty tissue

      2) large, moon-shaped face

      3) cyanoticity

      4) a large number of petechiae on the skin of the face and mucous membranes

      5) pronounced hypertrichosis

      – long hair

      disproportion between the size of the head and body

      (the circumference of the shoulder girdle is much greater than

      head diameter)

      7) large fetal mass

      Immaturity of all systems is characteristic.

      During the neonatal period:

      1) belated, defective adaptation mechanisms

      2) often – asphyxia

      3) hemodynamic disturbances

      4) violation of cerebrospinal fluid circulation

      – may develop cerebral edema

      ) hypodynamia

      6) there is often a tendency to hypoglycemia

      – this is due to the presence of hyperinsulinism in the fetus

      In the first hours after childbirth, the blood glucose level is 1.2-2.6 mmol / l, and then rises.

      Therefore, immediately after childbirth, it is necessary to determine the level of sugar in the blood and to correct the carbohydrate metabolism.

      Medical tactics of pregnancy management in diabetes mellitus.

      1) It is necessary to seek compensation for diabetes mellitus one year before the onset of pregnancy

      and throughout pregnancy

      2) Early detection of explicitly and latent forms of diabetes mellitus

      identification of risk groups for the development of gestational diabetes mellitus:

      1. family history of aggravated
      2. history of gestational diabetes
      1. glucosuria or clinical symptoms of diabetes during pregnancy
      1. if fasting blood glucose is more than
      2. 6 90-8359 9000 L blood 2 hours after eating more than 7.8 mmol / l, then it is necessary to monitor the glycemic profile during the day :

        – determination of blood glucose level every 3-4 hours – 5 times during the day

        – determination sugar level in 5 servings x urine

        5.body mass index (body weight / height squared)

        more than 27 (obesity)

        1. a history of a large fetus

        (a newborn weight more than 4 kg)

        1. a history of unexplained intrauterine fetal death
      3. polyhydramnios
      4. malformations in children

      10. malformations in the fetus

      Prevention and treatment of complications of pregnancy.

      1) Rational choice of time and method of delivery

      2) Careful nursing and treatment of the newborn

      3) Organization of endocrinological monitoring of children born to diabetic mothers.

      Tactics of pregnancy management in diabetes mellitus.

      A pregnant woman should be hospitalized at least three times (during critical periods).

      First hospitalization.

      Hospitalization is made in the endocrinology department at the first visit to the antenatal clinic – at a gestational age of to 12 weeks .

      Purpose of hospitalization:

      1. Thorough examination of the pregnant woman
      1. Establishing a detailed diagnosis

      – indicating the type, severity and presence of complications of diabetes

      1. 13 Determining the possibility of maintaining pregnancy optimal dosage of insulin
      1. carrying out a course of preventive treatment

      Contraindications to maintaining pregnancy in diabetes mellitus:

      1) the presence of rapidly progressing vascular complications

      2) the presence of diabetes mellitus in both parents

      3) combination of diabetes mellitus with rhesus – incompatibility

      4) combination of diabetes mellitus with active tuberculosis

      – as the process aggravates quickly

      5) the presence of labile or insulin resistance uncompensated diabetes mellitus, tendency to ketoacidosis.

      Preventive treatment of diabetes mellitus.

      1) Vitamin therapy

      – vitamins C, E

      – askorutin

      – B vitamins

      2) lipotropic therapy

      – methionine

      3) oxygen therapy.

      Second hospitalization.

      Produced at 24-28 weeks pregnancy first in the endocrinology department, and then in the department of pathology of pregnant women.

      In the endocrinology department , the optimal dosage of insulin is determined.

      In the department of pathology of pregnant women:

      1) diagnosis, prevention and treatment of late gestosis

      2) determination of the state of the fetus

      3) diagnosis of fetal malformations

      Third hospitalization.

      is produced at 32-36 weeks of pregnancy with the aim of:

      1) treatment of late gestosis

      2) compensation of diabetes mellitus

      3) deciding on the timing and method of delivery.

      Outpatient observation.

      First half of pregnancy:

      – 2 times a month

      Second half of pregnancy:

      – weekly observation by an obstetrician-gynecologist and endocrinologist.

      Choice of term and method of delivery.

      According to WHO criteria, it is necessary to deliver at 38 weeks of pregnancy (that is, at full-term pregnancy).

      But diabetes mellitus should proceed without complications or serious complications.

      Indications for early delivery (delivery at 36-37 weeks of gestation):

      1) burdened obstetric history

      2) many complications of pregnancy

      3) severe fetal hypoxia

      4) diabetic

      fetopathy 2) diabetic

      if there are no conditions for daily monitoring of the fetus (cardiotonography, ultrasound)

      Methods of delivery.

      1. Vaginal delivery
      2. Caesarean section.

      Vaginal delivery.

      Principles of conservative management of labor:

      1) adequate pain relief

      2) the duration of labor should not exceed 8-10 hours

      3) continuous monitoring of the state of the fetus and labor

      4) prevention and treatment of intrauterine hypoxia fetus

      5) control of blood sugar levels and its correction

      6) prevention of bleeding

      7) prevention of the development of pyoinflammatory diseases in the postpartum period

      8) treatment of diabetes mellitus after childbirth.

      Indications for caesarean section in diabetes mellitus:

      1) obstetric indications

      2) the presence of vascular complications of diabetes mellitus, progressing during pregnancy

      3) a labile course of diabetes mellitus with a tendency to develop ketoacidosis (even if only one ketoacidosis has developed times for the entire pregnancy)

      4) severe late gestosis

      5) breech presentation of the fetus

      6) giant fetus

      7) progressive fetal hypoxia.

      PREGNANCY IN THYROID DISEASES.

      Complications of pregnancy proceeding against the background of thyroid diseases:

      1) early abortion

      2) severe early gestosis

      3) high frequency of fetal malformations

      – since thyroid hormones are necessary for normal differentiation processes all body tissues.

      4) accession of infection, fetal death from sepsis

      5) rapid discharge of amniotic fluid

      People are also interested in this lecture: 6.2. Monetary reform of Elena Glinskaya and its significance.

      6) bleeding in the postpartum period

      Medical tactics.

      Pregnancy can be saved with unexpressed thyrotoxicosis – goiter 1 degree.

      Pregnancy is contraindicated with severe thyrotoxicosis – goiter 3 degrees .

      With hypothyroidism (myxedema), there is a violation of the ovarian-menstrual cycle (anovulation, amenorrhea), infertility often develops.

      But if pregnancy has come, then it is allowed to preserve it , provided that the pregnant woman takes thyroid preparations – thyroxine, thyronine.

      Burnout and Diabetes | DiaNika

      Emotional burnout is a mental phenomenon that is a state of emotional, mental exhaustion, physical fatigue.

      Such a state occurs in a person when he spends emotional energy for a long time, being, for example, in prolonged and / or intense stress, while not replenishing his resources.

      A person with diabetes mellitus, a parent of a child with diabetes mellitus knows firsthand what burnout is: the daily responsibilities associated with compensating for diabetes mellitus drain emotional resources. Added to all this is the fear of diabetes complications, worries about the health and life of a loved one with diabetes.

      Emotional burnout affects not only people with chronic diseases, but also specialists in helping professions, managers and workers working on assembly lines.

      It is important to understand that burnout in diabetes is normal, understandable and understandable. However, it greatly reduces the quality of life and the ability to effectively treat diabetes.

      If you feel yourself getting caught up in your “diabetic routine” and is being hit or about to get burned out, please know:

      you are not alone: ​​emotional burnout occurs in all people with diabetes mellitus and their caregivers to one degree or another;

      you are not a weak person: emotional burnout can happen to any person whose daily activities are associated with routine and high responsibility;

      your situation is solvable: burnout can be defeated.

      How to beat burnout?

      1. Understand that this is normal.

      It is important to understand that burnout occurs in everyone. It’s a feeling when everything is tired and you don’t want anything. I want to forget that I / my child has diabetes, to stop taking all these measurements, to calculate the doses of insulin, but I want to get a good night’s sleep at last.
      We must remember that we are not robots. We can be very strong and productive, but sometimes we exhaust our resources, a period of weakness comes, it comes for everyone, sooner or later.And our task is to live and survive it, preferably by making the most of ourselves.

      2. Learn to identify burnout.

      Burnout can be different. It can be of low intensity – when there is still some vital resource, there is a desire to help yourself with something, there is a little strength, then you definitely need to please yourself, no matter what, the main thing is that it gives you joy and pleasure.
      What do you like? Go dancing, meet friends, practice vocals, take a walk, ride a bike, lie on the couch, watch a movie, read, take a bubble bath?
      Everything that allows you to restore the resource, fill up faster and bounce back.Always remembering that diabetes is not so scary, we can live with it and cope with it.

      Burnout happens – more serious, when it seems that no one can help, that you only want to lie down, and so that no one touches. It is during this period that you need to see a specialist.

      3. Get help.

      It is important to know that there are situations when you should see a psychologist. And he can help. This is a specialist who will gladly talk with the patient about him, about his personality, interests, social circle, about diabetes, if he is interested in it.

      The psychologist will help:
      – to deal with the cause of burnout;
      – define further steps to exit from this state to the resource;
      – to understand what to do so that emotional burnout “does not come back”.

      4. Share control and responsibility.

      It is important and necessary to control diabetes mellitus, compensation for the disease, the state and quality of life of a person with diabetes depends on it, but it is impossible to live in this control permanently, we all get tired of it.

      For example, if a teenager has already taken responsibility for himself and controls his diabetes, and suddenly at some point feels: I am tired, I can’t take it anymore, then you need to rest. There is no need to be afraid to seem irresponsible and drive yourself into burnout, you must definitely turn to relatives / friends / friends for help and ask them to help today / tomorrow / this week, when a person has less strength – ask, for example, to remind about measurements, about injections etc.

      You can share this control with someone from your family.
      This, first of all, will remind you that a person with diabetes is not alone or alone, that there is someone who can help. It can be a relative, a friend – you need to find these opportunities in your circumstances.
      And secondly, it very much unites, makes it possible for the person who helps to feel important and needed again, as in childhood.

      Dear friends, I wish you traditionally normal sugars, as well as be in the resource and avoid emotional burnout)

      Source: Ivanovo Diabetes Society

      .