Insulin is a pancreas hormone the main function of which is regulating the blood sugar level. On the one hand, insulin helps body cells to absorb glucose and to turn it into energy. On the other hand, if glucose level is excessive, insulin causes liver and muscles cells to take up glucose from blood, transform it into glycogen and store it, thus enabling the body to receive glucose later. If insulin production or function disturbances occur, glucose concentration in the blood grows (hyperglycaemia), and the body cells lose their main source of energy. The only exception is insulin-independent cells, i.e. those cells that do not need insulin to supply glucose into a cell, for example, brain cells.

Underlying mechanism of diabetes taken into consideration, DM falls into two main types: type 1 and type 2 diabetes mellitus. 85-90% cases of diabetes belong to type 2 DM. There are other diabetes types as well, but their course is similar to that of the above mentioned diabetes types.

Type 1 diabetes mellitus

Type 1 diabetes, also called pancreatic endocrine insufficiency, occurs when the body fails to produce insulin due to destruction of the insulin-producing β-cells in the pancreas. Pancreatic insufficiency starts with mass loss of insulin-producing cells leading to the drastic decrease of insulin. Type 1diabetes mellitus is caused mostly by autoimmune attack against β-cells in the pancreas. Mass destruction of these cells can occur either without known cause or as a response to virus infections, toxins, pancreas inflammatory diseases, traumas, tumors, or stress.

Risk of developing type 1 diabetes also depends upon genetic predisposition. Due to the defects of some genes the body may start autoimmune aggression towards the cells of the pancreas; moreover, regenerative ability of β-cells decreases.

Most affected are children, young people and middle-aged people (under 40). Type 1 diabetes mellitus symptoms develop with time. Traditional treatment consists in insulin injections. If diabetes is not treated, acute severe complications such as ketoacydosis and diabetic coma may develop that can lead to a patient’s death.

Type 2 diabetes mellitus

In type 2 diabetes mellitus, also known as nonpancreatic insufficiency, insulin is produced in normal or even high amounts but response of the body cells to insulin is defective, which leads to insulin resistance. Sometimes, insulin resistance is accompanied by an insulin deficiency.

Decrease of sensitivity of insulin-dependent tissues to insulin is either due to reduced number of insulin receptors on the membrane of insulin-dependent cells, or change in the quality of the receptors. Also, insulin structure can be damaged due to some genetic defects.

Genetic predisposition increases the risk of developing type 2 diabetes two to six times. Excessive weight is one of the key factores of type 2 diabetes development. 80% of type 2 DM patients are stout. The risk of type 2 diabetes onset is two-fold higher in grade I obesity, five-fold higher in grade II obesity, and more than ten-fold higher in grade III obesity. Some other factors that can give raise to type 2 diabetes include advanced age, hypertension, sedentary life and bad habits. Unlike type 1 diabetes affecting mostly children, young and middle-aged people, type 2 diabetes develops mostly after 40.

The disease progresses slowly. Chronic complications develop slowly, too. There is a very little risk of ketoacidosis development occurrence in type 2 diabetes mellitus, but being poorly compensated, type 2 DM can lead to diabetic coma.

In some cases, proper diet and normalization of body weight allow for normalization of carbohydrate metabolism and decrease of glucose synthesis in the liver. If the above is not effective, tableted sugar-lowering drugs are usually prescribed. As diabetes develops, β-cells produce less and less insulin that requires insulin injections.

Symptoms of diabetes

Clinical manifestations of diabetes type 1 and 2 are similar but their intensity is different. In type 1 diabetes mellitus, the symptoms are more distinct and may develop quite rapidly over a few weeks. On the opposite, type 2 diabetes is often diagnosed accidentally.

Among the main symptoms of diabetes are frequent urination, persistent thirst due to significant water loss with urination, dryness in the mouth, increased hunger, weight loss (and even cachexy) – in type 1 diabetes, or weight gain in type 2 diabetes.

Secondary symptoms develop gradually and include itching of skin and mucous coats, general weakness, headaches and dizziness, inflammatory skin involvement, susceptibility to infectious diseases, eyesight impairment, decreased libido and sexual potency, etc.

Intensity of symptoms varies in each case. It depends on the duration of the disease, extent of insulin secretion decrease as well as on the individual peculiarities of the sufferer.

Diabetes-related complications

Stable blood sugar increase and impaired nutrition of body tissues c ause a range of serious complications. Described are acute and chronic complications.
Among acute complications are diabetic ketoacidosis and diabetic coma.

Chronic complications include diabetic macroangiopathy (damage of the large vessels), diabetic microangiopathy (damage of the small vessels such as arterioles, venules, and capillaries), and diabetic neuropathy (nerve damage).

Other complications include retinopathy that can result in blindness, renal damage – nephropathy with gradual development of renal insufficiency, damage of the major arteries – atherosclerosis of cardiac and cerebral arteries, as well as of the lower extremities arteries, soft tissues involvement such as trophic ulcers, and decreased immunity resulting in increased incidence of infectious-inflammatory processes.

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