The severity of diabetes mellitus: classification and criteria

Statistics show that every third person in the world can be affected by diabetes. This disease is considered one of the most dangerous, along with oncology, tuberculosis and AIDS.

Diabetes is a well-studied disease, but it requires a complete examination of the body. Medicine distinguishes several degrees and types of diabetes.

When evaluating the severity of the disease, it is important to consider several criteria. Among them, the level of glycemia, the need to use external insulin, the reaction to the use of antidiabetic drugs, the presence of complications.

Symptoms of diabetes

The disease never appears suddenly, it is characterized by the gradual formation of signs and long-term development. The main symptoms: constant thirst, dry skin and frequent itching, which in many cases is considered nervousness, dry mouth, regardless of the volume of fluid consumed.

Increased sweating - hyperhidrosis, in particular, on the palms, weight gain and weight loss, muscle weakness, prolonged healing of abrasions and wounds, suppuration for no apparent reason.

It should be noted that if there is at least one of the listed manifestations, then it is necessary to consult a doctor without delay. He will prescribe a series of necessary tests to confirm the diagnosis.

If the wrong treatment was carried out, or it was absent, complicated diabetes can form. Its symptoms are:

  1. persistent migraine and vertigo,
  2. high blood pressure, at some critical moments,
  3. violation of walking, pain in the legs,
  4. discomfort in the heart,
  5. enlarged liver
  6. severe swelling of the face and legs
  7. a significant decrease in the sensitivity of the feet,
  8. rapid drop in vision
  9. The smell of acetone emanates from the human body in diabetes mellitus.

Diagnostic measures

If there is suspicion of the presence of type 2 diabetes or another type of disease, it is important to undergo several tests using instrumental methods. The list of diagnostic measures includes:

  • fasting blood test,
  • sugar tolerance test,
  • monitoring disease change
  • urine analysis for sugar, protein, leukocytes,
  • Acetone urine test
  • blood test for glycated hemoglobin,
  • blood chemistry,
  • Reberg test: determination of the extent of urinary tract and kidney damage,
  • blood test for endogenous insulin,
  • Consultation of an ophthalmologist and performing a fundus examination,
  • Ultrasound of the state of the abdominal organs,
  • cardiogram: control of cardiac work on the background of diabetes.

Analyzes that are aimed at identifying the level of vascular lesions of the legs, prevent the development of diabetic foot.

People diagnosed with diabetes or suspected of it should be examined by such doctors:

  1. ophthalmologist,
  2. vascular surgeon,
  3. endocrinologist,
  4. neuropathologist,
  5. cardiologist,
  6. endocrinologist.

Hyperglycemic factor is investigated on an empty stomach. This is the ratio of sugar level one hour after the glucose load to the level of glucose in the blood. The normal rate is 1.7.

Hypoglycemic coefficient refers to the ratio of the volume of glucose in the blood on an empty stomach two hours after the glucose load to the level of glucose in the blood. The normal figure does not exceed 1.3.

Determining the extent of the disease

There is a classification of diabetes by severity. This separation allows you to quickly determine what happens to a person at different stages.

Doctors use the classification to determine the best treatment strategy.

1 degree of diabetes is a condition in which the volume of blood glucose does not exceed 7 mmol / l. There is no glucose in the urine, blood counts are within normal limits.

A person has no complications of diabetes mellitus, the disease is compensated by diet and medication.

Grade 2 diabetes involves only partial compensation and some signs of complications. Target organs in this situation:

  • vessels
  • kidneys,
  • vision.

In case of diabetes mellitus grade 3, there is no effect from medication and dietary treatment. Sugar is detected in the urine, the level is 14 mmol / l. Diabetes mellitus grade 3 is distinguished by such complications:

  1. blurred vision in diabetes
  2. swelling of the arms and legs begin,
  3. there is constantly increased blood pressure.

Diabetes mellitus grade 4 is the most difficult stage of diabetes. At this time, the highest glucose level is diagnosed (up to 25 mmol / l). In the urine protein and sugar are found, the state can not be adjusted drugs.

This stage is fraught with the development of renal failure. Gangrene of the legs and diabetic ulcers may also appear.

The most common are the first three severity of diabetes.

Degrees of type 1 diabetes

Insulin-dependent diabetes is a type 1 disease. In this disease, the body can no longer produce its own insulin.

This disease is differentiated into severe, moderate and mild.

The severity of the disease depends on several components. First of all, it is considered how much the patient is prone to hypoglycemia, that is, a sharp decrease in blood sugar levels. Next you need to determine the likelihood of ketoacidosis - the accumulation of harmful substances, including acetone in the body.

The severity of the disease is also affected by the presence of vascular complications that have provoked diabetes and are now exacerbating the situation.

Due to timely therapy and systematic control over the level of glucose in the blood, complications are excluded. With a compensated form of the disease, you can lead a normal life, perform physical activity, however, you should constantly follow a diet.

Speaking about the severity of the disease, it is theoretically possible several options, depending on the neglect. Each person has diabetes in its own way, it can be decompensated or compensated. In the first case, it is difficult to cope with the disease even with the help of strong drugs.

Diabetes moderate has the following symptoms:

  • almost complete cessation of insulin synthesis by pancreatic cells,
  • periodic state of ketoacidosis and hypoglycemia,
  • dependence of metabolic processes and diet on the supply of external insulin.

Severe diabetes can cause:

  1. wounds
  2. discontinuation of insulin production
  3. the formation of complete insulin deficiency,
  4. conditions of ketoacidosis and hypoglycemia up to coma,
  5. late complications: nephropathy, retinopathy, nephropathy, encephalopathy.

Known yet another form of diabetes when the disease gets out of control. We are talking about labile diabetes. It has the following characteristics:

  • spikes in sugar throughout the day for no reason
  • difficulties in choosing the dosage of insulin,
  • persistent ketoacidosis and hypoglycemia,
  • rapid formation of diabetic coma and various complications.

The severity of diabetes mellitus is determined not only by the indicated signs, but also by the results of laboratory tests prescribed by the doctor.

The severity of type 2 diabetes

Type 2 diabetes is of great interest among representatives of formal and informal medicine. There are many more people with this disease than with type 1 diabetes.

Previously, type 2 diabetes was called obesity disease in adults. Usually this disease appears after 40 years and is associated with the presence of excess weight. In some cases, the symptoms of diabetes are associated with poor nutrition and a passive lifestyle. This disease is inherited in 50-80% of cases.

This type of illness is considered insulin-independent. At the beginning of the disease, insulin treatment is not necessary. But most patients eventually need insulin injections.

This type of diabetes is treated and proceeds much more easily. But the disease can also have a severe form, if you do not carry out the necessary treatment and do not change your lifestyle. The second type of diabetes, or insulin-independent diabetes, most often develops in middle and older age.

As a rule, women over 65 are exposed to this disease, in many cases it is associated with obesity at various stages. Often, all family members suffer from this disease. The disease does not depend on the weather and the season, diabetes is pretty easy. Only when complications form, does a person consult a doctor.

Despite the slow course of the disease, it has a great influence on other diseases that a person already has, for example, atherosclerosis. In addition, this type of diabetes provokes the formation of other ailments, namely:

  1. brain stroke,
  2. myocardial infarction,
  3. gangrene of the extremities.

It is extremely important to know the degree of development of the disease and to distinguish them from each other. Sugar non-insulin dependent diabetes can occur in:

  • easy
  • moderate
  • severe form.

According to the results of laboratory tests and the human condition, the doctor decides what degree of the disease is present and what treatment is necessary.

Diabetes mellitus type 2 moderate severity is characterized by a violation of carbohydrate metabolism, the main task is its normalization. But it is not always possible to achieve maximum results, especially if the ailment is running, or a person forgets to control the condition and use medicines.

In diabetes, carbohydrate metabolism may be different. The compensated form of the disease is considered an acceptable condition. Through treatment with this form, it is possible to achieve the rate of glucose in the blood and its absence in the urine.

With a subcompensated form of the disease, it is impossible to achieve such results. In humans, the level of sugar is not much higher than normal, in particular, it is 13.9 mmol / l. The daily loss of glucose in the urine is not more than 50 g. At the same time, there is no acetone in the urine.

The decompensated form of the disease is the worst of all, because in this case it is not enough to lower the blood glucose and improve the carbohydrate metabolism. Despite its therapeutic effects, the glucose concentration begins to exceed 13.9 mmol / l. During the day, the loss of sugar in the urine exceeds 50 g, acetone appears in the liquid. Hypoglycemic coma is often formed.

All these forms of the disease have a different effect on the state of health. Compensated diabetes does not cause a malfunction of organs and systems, while at the same time, insufficiently compensated or not compensable causes an increase in pressure, cholesterol and other important indicators. The video in this article will continue the topic of degrees of diabetes.

Watch the video: Diagnosis and Management of Diabetic Foot Infections (April 2020).