Type 2 diabetes in young people.

Golovna Osvita

Blood diabetes - one of the most widespread illnesses today. This, like many others, is called a non-infectious epidemic - such a large scale of illness.

Why is there any concern about diabetic diabetes, since it is not good to understand that there are a lot of patients? Various variants of this disease are widely spread among people of active working age, and also, what’s worse, among children and toddlers. Severe disabilities that lead to a wheelchair, the necessity of living while receiving expensive medicinal drugs, early mortality is a given in young patients diagnosed with diabetes.

The statistics are disappointing: over the past two decades, the incidence of diabetes among children and children has doubled! Mova go about type 1 diabetes, which is most common in this age group.

This type of diabetes is due to illness, in which the immune system shows aggression against its own cells (doctors call such illnesses autoimmune) - β-clitis in the islets of the subslute, leading to They are dead. Absolute insulin deficiency develops in the body, so the best way to treat type I diabetes is not to administer insulin drugs. with a diagnosis of cardiovascular diabetes is placed within the proper framework. The basic rules include early childhood, adequate physical exercise, continued use of medications, and not the use of insulin or sedatives - medication also conveys stagnation. іків for the prevention of unsafe folding on the side Cardiovascular system

, low, organic vision and in. We respect the serious problems with diabetes angiopathies (vessel disease), which itself is the cause of disability and high mortality in patients. Yes, diabetic retinal angiopathy lead to blindness, changes in the network develop in most patients already 3 days after the onset of illness. The result urazhennya sudin nirok

There is a chronic nitric deficiency that will require serious medical care to preserve the patient’s life. Angiopathy of the lower ends can lead to gangrene and amputation. There are many patients who are recovering from traditional treatment (medicinal treatments), but it is not known that other methods of preventing the development of important complications will be discovered. So,

garni results Likuvannya judiciary complications of cervical diabetes are already stretching out a lot of fates to be removed from

TOV "Klinika Epifanova"

This is the belief of Oleksiy Gerasimovich Yepifanov, the creator of the polymagnetic installation “Epifanov’s Spacesuit” and new medical technologies for the treatment of sick people.

The clinic, developed in Ryazan, uses a unique technology for the treatment of damage to arterial and venous blood flow from the frozen polymagnetic installation “Epifanov’s Spacesuit”.

Epifanov’s technology allows patients with severe vascular diseases to undergo amputation in 96% of cases.

UDC 616.379-008.64-07-053.81

PROBLEMS OF DIAGNOSTICS OF CHURCH DIABETES TYPE 2 IN YOUNG VICTORS

E.B. Bashnina, V.M. anamnestic, clinical and metabolic indicators of illness in two groups of patients from 14 to 30 years of age.

For type 2 CD, the priority, but not absolute criteria for diagnosis in a young person may include a family history of diabetes, a body mass index (BMI) above the 50th percentile, and the presence of specific autoantibodies in the blood. However, verification of the diagnosis of CD type 2 in young patients is possible with dynamic monitoring.

Key words

: blood diabetes type 2, differential diagnosis, family history, specific autoantibodies, verification.

Different diagnosis type 2 and type 1 diabetes mellitus in patients under 30 years of age sems to become difficult problem because the clinic presentation of type 2 diabetes mellitus in youth is heterogeneous.

More follow-up is needed to compare anamnestic, clinic and metabolic data in two groups of patients from 14 to 30 years of age.

Family history of diabetes mellitus, body mass index more than 50 percentile, negativity for specific diseases auto-antibodies is priority, but not absolute diagnostic criteria for type 2 diabetes mellitus in youth.

The greatest difficulty in diagnosing the type of CD, which can be encountered by a doctor of advanced practice, lies in episodes of manifestation of illness with mild clinical manifestations due to diabetic ketoation dose.

Materials and methods.

A comprehensive analysis of the main characteristics of the two types of CD was carried out in patients aged 14-30 years at the onset of illness.

The patients were treated at the Moscow Diabetology Center for children and children in St. Petersburg, as well as at the Interdistrict Diabetology Center for patients with CD type 2 in St. Petersburg.

The caution group included 36 patients with type 2 CD.

The povnyannya group included 50 sick people on type 1 CD. The groups were behind the scenes. The data were analyzed based on three aspects: medical history, clinical symptoms at the time of diagnosis of illness, metabolic markers of CD.

To verify the diagnosis of CD of 1 or 2 types, patients were dynamically monitored for 1-3 days after diagnosis with repeated measurements of basal glycemia, HbA1 c and stimulated secretion of C-peptide.

The level of glycosylated hemoglobin (HbA1c) was determined using the additional device DCA2000.

Instead of blood serum, immunoreactive insulin, C-peptide, as well as autoantibodies ICA and GAD were determined by enzyme-linked immunosorbent assay.

Clinical symptoms of illness at the time of manifestation are small in both groups, but at different levels of severity.

The main clinical symptoms during the manifestation of CD were narrower in both caution groups.

However, the symptoms of CD type 2 are less significant for the diagnosis of illness.

The cardinal symptom in the differential diagnosis was the loss of the vagina, which is characteristic of type 1 CD at the same time as type 2 CD, if the vagina became stable during the manifestation of the disease (Fig.).

Statistically significant differences between groups were revealed in the body mass index (BMI).

24 patients with CD

2 types (66.7%) small BMI above 97 percentile for HIV, 12 patients

Small

1. Frequency of clinical symptoms during the manifestation of type 1 and type 2 diabetes in young patients

(33.3%) the indicator met the parameters of the 50th percentile.

In the case of a patient with CD type 2, BMI was not assigned below the 50th percentile.

At once, it is far from all-out of the 1st type of Central Center of Mali IMT Nizhde Srednich behind Vike, 12% ailments on the Central House of Top 1 Masi Tіla, with a CLOINICHICIC Symptoms of Zakhoruvannya Buli, poorly viravezhy.

The literature discusses the presence of acanthosis in CD type 2, as well as typical symptoms< 0,05

I'm sick.< 0,05

For tributes C.R.< 0,05

Scott, 86% of patients with type 2 CD suffer from this symptom, while those with type 1 CD do not get worse.< 0,001

In this case, the presence of acanthosis is accompanied by hyperinsulinemia and obesity.

A mild stage of hyperglycemia due to a decrease in the level of insulin in the blood and the presence of signs of ketoacidosis is the most common option for the progression of type 2 CD in young patients.

At the same time, according to studies by a number of authors, in type 2 CD there is no risk of developing ketoacidosis.

In two patients out of 36 (5.6%) during the surveillance process, signs of the early stage of diabetic ketoacidosis were recorded.

The frequency of various anamnestic and clinical-metabolic characteristics of CD types 1 and 2 in patients of the groups is equal, which may be important for the differential diagnosis of illness when it manifests in a young person , presented in table 2. The peculiarities of type 2 CD in young adults include moderate expression of metabolic disturbances despite the absence of characteristic clinical symptoms of illness.

In this case, the most common signs include excess body weight or obesity, and the presence of diabetic ketoacidosis.

Significant official

the presence of autoantibodies up to p-clin in the blood, a body mass index above the 50th percentile, as well as a family history of diabetes.

Prote, according to medical literature from this diet, it is impossible to talk about the pathological-monicity of any of the listed signs of this or that type of illness.

With a designated type of CD that appears in a young person, it is insane, it is necessary to take into account a number of the signs we have listed and, if in doubt, carry out more intensive treatment of the patient.

Varto indicate what is in action

In such cases of congestion of the patient, even at the very beginning of illness, it is still not possible to reliably determine the type of CD.

Priority is given to dynamic monitoring of repeated measurements such as basal glycemia, HbA1c and stimulated secretion of C-peptide.

Actively detected illness means a favorable prognosis until compensation for the damaged carbohydrate metabolism is achieved using non-invasive methods of treatment and long-term management of the central nervous system.

Table 2

Frequency of occurrence of other characteristics of dietary diabetes in young people

Characteristics of CD type 1 n = 50 CD type 2 n = 36

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

Basal secretion of insulin:

Reduced;

36 (72%) 0 (0%)

Normal;

14 (28%) 12 (33%)

Moved 0 (0%) 24 (67%)

Sensitivity to insulin:

Normal;

50 (100%) 0 (0%)

Reduced 0 (0%) 36 (100%)

- < 50 перцентили; 40 (80%) 0 (0%)

Autoantibodies in serum:

- ISA;

36 (72%) 0 (0%)

GADA;

10 (20%) 0 (0%)

ICA+GADA;

2 (4%) 0 (0%)

Ні 2 (4%) 36 (100%)

Ketoacidosis at debut 34 (68%) 2 (5%)

BMI at CD debut:

6. Schober, E. What type of diabetes is diagnosed in young subjects?

Multicenter analysis in Germany and Austria is based on 27,008 patients with diabetes onset during the first 3 days of life / E. Schober, A. Thon, B. Rami // Diabetologia.

– 2004. – Vol. 47. – Suppl.

1. -A 114. - P. 298.

8. Brooks-Worrel, W.M.

Autoimmunity to islet proteins in children diagnosed with new-onset diabetes / V.M. Brooks-Worrel, C.J.

Greenbaum, J.P.

Palmer, C. Pihoker //J. Clin.

Depending on the type of diabetes on the cob, illness is important for the choice of therapy methods, then.

the needs and requirements of insulin therapy.

This is especially important for young patients, since in most cases it is important that patients under 30 years of age most often develop the first type of diabetes, which is supported by insulin treatment .

And at the same time, with stagnant insulin therapy during the treatment of another type of diabetes, young people experienced an increase in body weight, changes in fat metabolism, and the resistance of cells to insulin. persistent changes in tissue metabolism.

These effects were insignificant and unimportant for successful and effective correction in the blood.

The greatest complexity in the type of diabetes diagnosed by a clinician may occur in these episodes, if the onset of illness is accompanied by moderately expressed clinical symptoms and which is characterized by the absence of toacidosis.

The most important in the first group was the female status (60%), the ratio of males and females became 1.5 to 1. The equal group had a similar warehouse.

The youngest child with other types of diabetes was fourteen years old, the oldest was thirty years old.

The middle age of young patients of the first group became 24 years plus or minus 4. When analyzing the main somatic illnesses in both groups, significant symptoms were revealed. When specifying the family factor, severe slumpiness was revealed in 85% of patients who may

other type of blood diabetes

: 60% had an illness in their mother, 40% had an illness in their father, and one of the young people had an illness in their father.

In contrast, patients in the other group had fathers who suffered from type 1 diabetes, only in 10% of cases.

Analysis of the main clinical symptoms present at the time of manifestation of illness, revealing their presence with varying degrees of severity in all groups.

However, the symptoms of type 2 diabetes did not play such a significant role in the diagnosis of pathology. An important criterion for differentiation was a decrease in body weight (), characteristic of CD 1 option, while in case of diabetes of another type, body weight was lost unchanged. We also analyzed changes in the body mass index (BMI) in both groups and found that 65% of patients with type 2 diabetes were above the 97 percentile, and 35% of patients were within the 50 percentile range. percentiles, and there was no lower value in a very young man from a group who is careful.

The most characteristic and partial variant of type 2 diabetes in patients of the age-old category was the presence of a mild stage in patients with increased levels of insulin in the blood and on a daily basis. I have ketoacidosis. However, according to the thoughts of some authors, other type of diabetes This is accompanied by the presence of ketone bodies in the seed. U

this report

Signs indicating early stage diabetic ketoacidosis were found in 5% of patients.

Visnovki For another type of diabetes that occurs in adolescents and young people, it is characteristic that there are moderate manifestations of metabolic disorders in the absence of clinical symptoms that are most typical for this pathology. In this case, the most important signs are excess body weight (or obesity) and the presence of ketone bodies in the body.

Another significant factor that promotes the possibility of developing another type of diabetes is depression, which is associated with this pathology.
It has long been established that the most characteristic and specific sign of type 1 CD is the autoimmune antibodies to antigens found on the membrane of p-clitis.

In addition, a number of studies have confirmed the fact that when CD of another type is diagnosed in young people due to a combination of obvious clinical signs (excess body weight, acanthosis, illness in close relatives), then up to 40% x patients have autoantibodies in their blood.

Thus, if you are aware of the type of CD that appears in a young person, it is necessary to take into account all the signs of illness that have been observed and the signs of illness, and for obvious doubts, to cover the sick person more carefully.

Moreover, it was noted that more specific investigation of the patient does not allow one to correctly determine the type of pathology except in some cases of early stage diabetes.

In this option, the development of this priority will be given to the prevention of the disease in the dynamics of continuous measurements of basal glucose in the blood, instead of HbA1c and peptide C after stimulation.

Based on the current and active diagnosis of diabetes, a further favorable prognosis is achieved, as soon as compensation for the damaged carbohydrate metabolism is achieved using non-invasive methods of treatment, and the prospects for troublesome and successful management of the central nervous system. Endocrine diabetes is a disease of the endocrine system, which is caused by a lack of insulin and is characterized by impaired metabolism of speech, excretion, and carbohydrate metabolism. In case of cervical diabetes, the subcutaneous phallus loses its ability to secrete the necessary amount of insulin and produce insulin of the necessary amount.

The name "blood diabetes", according to the decision of the World Health Organization in 1985, is the name of a whole series of illnesses that loom

baked rice : due to various factors, the level of sugar (glucose) in the blood rises in the patient, be it any of these ailments. Diabetes can progress to illness, which is rarely diagnosed. Start row factors What to do before the onset of diabetes In the first place there is a decline in weakness; Another important cause of diabetes is obesity; the third reason is certain illnesses, which result from the level of beta-clitsin, which vibrates insulin (these are diseases of the pancreas - pancreatitis, cancer of the pancreas, congestion of other tissues internally ї secretion). The fourth reason is diversity

In some cases, diabetes is caused by hormonal imbalances, and in some cases, diabetes is caused by inflammation of the subpillar gland, which occurs after the use of certain medications or as a result of heavy alcohol abuse.

Depending on the reasons for the rise in blood glucose, blood diabetes is divided into two main groups: cervical diabetes type 1 and cervical diabetes type 2.

Type 1 diabetes of the blood- insulin dependent.

It is associated with infections of the subpillar, an absolute lack of insulin, and requires insulin administration. Type 1 diabetes usually occurs in young people (this form of diabetes mainly affects young people under 30).

Other type of diabetes

- insulin-independent, due to the connection with insulin deficiency.

In the early stages of illness, insulin administration is usually not required.

For people with type 1 diabetes, it is characterized by a decrease in self-esteem and a greater manifestation of symptoms of dehydration in the body. Such diseases require a term for the use of insulin drugs. Without proper treatment, you may end up in a life-threatening condition - a diabetic coma.

Because of type 2 diabetes, the loss of vaginal energy is significant in all types physical importance help to overcome progressing diabetes and normalize blood sugar levels. In order to install diagnosis

In case of blood diabetes, it is necessary to consider rhubarb instead of blood sugar. If your blood level is less than 7.0 mmol/l, or more than 5.6 mmol/l, it is necessary to conduct a glucose tolerance test to clarify carbohydrate metabolism. Procedure given to the test

This is due to the immediate effect: after the presence of sugar in the blood, immediately (fasting period of at least 10 years) it is necessary to take 75 g of glucose.

It is firmly established that diabetes cannot be contracted like the flu or tuberculosis.

Diabetes is rightly attributed to the disease of civilization, since the cause of diabetes in many forms is excess, rich in carbohydrates that are easily digested, “civilized” hedgehogs.

Blood diabetes is the most widespread endocrine disease in the whole world.

According to the World Health Organization (WHO), diabetes is the fourth leading cause of death and, according to forecasts, there will be 10 more deaths due to diabetes. by 50%, so that no unprofitable entries will be made.

Regardless of all the efforts of health care organizations and national programs to combat these diseases, which are being implemented in rich countries around the world, the number of patients with such a diagnosis is steadily increasing .

The incidence of diabetes is increasing not only in the age group over 40, but among the sick, more and more children and teenagers are being identified. According to the International Diabetes Federation and WHO, there are more than 200 million diabetic patients in all countries of the world. Based on expert assessments, until 2010. This figure will grow to 239.4 million, and until 2030. - up to 380 million. Over 90% of cases in this case fall on type 2 diabetes.

Estimated values may turn out to be greatly underestimated, with up to 50% of patients with diabetes today going undiagnosed.

These people do not refuse any kind of circulatory therapy and maintain stable hyperglycemia, which creates a receptive mind for the development of cardiovascular and other complications.