Diabetes is a metabolic disorder characterized by an excess of sugar in the blood. In France, more than three million people are supported for this disease, or 4.6% of the population. While their number is constantly increasing (+ 5.4% per year between 2000 and 2011), a diabetic on six would not be diagnosed.
The most common diabetes is type 2 diabetes which affects 90% of diabetics and usually occurs in overweight more than 50 years. Conversely, the type 1 diabetes appears rather in children, in whom it causes weight loss. Pr Jean-François Gautier, endocrinologist-diabetologist, precise symptoms and risk factors related to each of these two types.
Type 1 or type 2, diabetes is an excess of sugar in the blood
Diabetes is related to insufficient or improper use ofinsulin, a hormone that helps glucose (sugar) to enter the cells. That it remains so in the blood in excessive amounts, it is hyperglycemia. In France, more than three million people are treated for diabetes.
The most common types of diabetes are type 1 diabetes, said “insulin-dependent”, and type 2 diabetes, “non-insulin-dependent”. Type 1 diabetes occurs in general before 35 years, mainly in children and adolescents. For some yet unexplained reason, the immune system no longer recognizes the insulin-producing cells and destroys them. Type 2 diabetes occurs rather adult, most often between ages 55 and 65. It is linked to two mechanisms: insufficient secretion of insulin and the insensitivity of its cells (she has as much effect).
There are also intermediate forms (of type 1 diabetes in late-onset, type 2 diabetes in obese children), diabetes secondary to another disease…. Therefore, this disease can appear at any age.
Diabetes support aims to regulate blood glucose levels to avoid metabolic and longer-term complications, vascular and neurological disorders that can affect the whole body. It is based on rules of hygiene of life, often associated with oral orinsulin.
Type 1 diabetes, the symptoms
Signs of type 1 diabetes are identical regardless of the age, and occur suddenly, usually within a few days or weeks. Those of hyperglycemia, as explained in the Pr Gautier: “there is frequent urination, an intense thirst desires and an increased appetite which, paradoxically, is associated with weight loss, sometimes a breath that smells of acetone, stomach aches and vomiting.” “The fatigue can be very important.” Let continue the situation exposes the risk of ketoacidotic coma.
Ketoacidotic coma, sometimes revealing urgent
When there is any more insulin to move glucose into the cells, the body cannot use it as an energy source. Instead, it uses fatty acids, producing acetone, which acidifies the blood and intoxicate the brain. It is the Ketoacidosis.
The signs preceding the coma are more marked dehydration, stomach aches that intensify (suspicion ofappendicitis), noisy breathing and disorders of consciousness. Ketoacidotic coma is treated by rehydration and insulin intake. If it continues, it can lead to death.
Ketoacidotic coma revealed 10% of type 1 diabetes or, much more rarely, a type 2 diabetes. It can also occur when stopping insulin therapy and should not be confused with the hypoglycemic coma preceding instead of a fall in blood glucose levels.
Typically, the child can recover to pee the bed while it was clean and have eyes surrounded by fatigue and dehydration. The adult also complains of being dehydrated. On a forum, SwOOn tells that at the time of the diagnosis, he drank 5 to 7 litres of water per day, had the mouth constantly dry and doughy, very violent cramps and an enormous fatigue.
Regarding risk factors, Pr Gautier recalls that diet and physical inactivity are not in question. On the other hand, the weight of genetics remains relatively small: “the child of a parent a 3% risk of also be if it comes to his mother, 5 to 7% if it was his father. In 85% of cases, not family history found.”
Type 2 diabetes, the importance of screening
Type 2 diabetes often evolves silently because it may take more than ten years between the early hyperglycemia and its diagnosis. Pr Gautier details: “there may be signs of hyperglycemia, as in type 1 diabetes. “However, they are rare and, in the absence of screening, type 2 diabetes is usually discovered due to its complications (heart attack, pain in the legs, decrease in Visual acuity, erectile dysfunction…) or following an event décompensant.” That is, in a situation increasing insulin needs. It can be a pregnancy, some medications, infection…
Genetics plays an important role. “If one of the parents is a diabetic type 2, the child will also in 40% of cases. If both have the disease, the risk rises to 60%, said doctor. On the other hand, we know that certain ethnic minorities are most concerned.”
Overweight, excess fats in the blood (triglycerides, ‘bad’ cholesterol),hypertension and cardiovascular risk factors are often associated with type 2 diabetes. And have made a gestational diabetes or given birth to a large baby for a woman.
The influence of lifestyle (sedentary, unbalanced diet) is not negligible. The Pr Gautier note that type 2 diabetics can also be a person in a precarious situation, dedicating a budget reduced to its power, as a good living rather easy social class.
For the specialist, of type 2 diabetes should be screened from the age of 40 has risk factors:Plus the assumption is early, the rate of complications decreases. However, it is difficult for people who do never felt sick, to accept the hygiene of life and treatment required”.