The causes of diabetes are the factors that provoke the emergence and development of this pathology in the body of a particular person. Such a pathology is accompanied by high blood sugar levels due to insufficient insulin production in the body. Insulin in the normal state produces β-cells of the pancreas, whose function under the influence of internal and external factors may be impaired. As a result, insulin deficiency or diabetes mellitus occurs.
About 150 million people with diabetes are living in the modern world. These statistics have led to the fact that diabetes in our days is no longer considered a disease, and is regarded more as a specific metabolism, in which you should lead a certain lifestyle. Having learned to control one’s own condition with the help of diet and medications, the patient can lead a normal life without any difficulty due to illness.
Mechanism of disease
What contributes to type I diabetes
The basis of type 1 diabetes is a genetic predisposition to this disease with a recessive mode of inheritance. The developmental pathology has an autoimmune nature, in which β-cells are damaged by their own immune system, which leads to their inability to produce insulin. Also identified are antigens for the development of diabetes, a certain combination of which leads to an increase in the risk of pathology manifestation. Diabetes mellitus type I very often occurs in combination with other autoimmune diseases, namely rheumatoid arthritis, toxic goiter, autoimmune thyroiditis.
Typically, type 1 diabetes occurs in childhood or adolescence. The most dangerous age is considered to be from 20 to 29 years, when stress, alcoholism and the use of narcotic substances come to the forefront as factors provoking the pathology. The risk group consists of children whose birth weight was more than 4.5 kg, in which obesity or endocrine pathologies are diagnosed at the time of the manifestation of the disease, as well as those who have close relatives with diabetes mellitus in the family history.
Often the cause of an autoimmune failure is a postponed viral infection. The human immune system responds most strongly to infections characteristic of childhood (chickenpox, parotitis, and other childhood infections). In Britain, a study was conducted according to which a large percentage of diabetics were born here during the period of intensification of the influenza epidemic. Viral infections invade the pancreas and impair the function of the beta cells of the pancreas. Insulin is not enough, it needs to be introduced from the outside, so this type of diabetes is often called insulin-dependent diabetes mellitus. To compensate, constant injections of insulin are needed, which become part of the life of any diabetic forever.
The emergence of type II pathology
The second type of diabetes is transmitted at the gene level through the dominant pathway. Insulin continues to be produced in the pancreas, but in a smaller amount, or in sufficient, but the body ceases to recognize it.
The second type pathology develops after the age of 40-50 years. Insulin therapy is not used to correct excess blood glucose, but medications are prescribed to lower blood sugar levels.
Diabetes mellitus of the second type is detected in the vast majority of cases of detection of the disease - in 85-95% of all cases. A dangerous tendency in recent years is the fact that this pathology, which is more characteristic of mature people, is increasingly manifesting at a fairly early age.
Disease during pregnancy
Diabetes mellitus, first occurring during pregnancy, is called gestational. It occurs due to insulin resistance - the insensitivity of cells to insulin, which is triggered by a high dose of hormones produced by the placenta. They block the action of maternal insulin and gestational diabetes occurs.
After childbirth, such insulin resistance most often disappears on its own. However, there is also the likelihood that in the period of gestation of the fetus, a woman develops type 1 diabetes or a clinically existing non-manifesting type II diabetes that manifests itself previously.
The placenta is a special organ designed to bring all the necessary nutrients and oxygen to the fetus from the mother's body. In the placenta, hormones are also produced that are necessary to preserve a pregnancy for a certain period. Estrogen, placental lactogen, cortisol can block the functionality of its own insulin in the body, causing an increase in blood glucose levels.
This effect usually occurs after 20-24 weeks of pregnancy. At the same time, the pancreas of the mother continues to produce insulin, and if it ceases to cope with this task, it manifests gestational diabetes. After birth, the production of pregnancy hormones is stopped and gestational diabetes is resolved, the blood glucose level returns to normal. Gestational diabetes may have a hereditary basis.
However, the following factors may affect its occurrence in each specific case:
- obesity, overweight;
- pregnancy after the age of 25 years;
- the presence of pathology in the next of kin;
- burden obstetric history;
- the occurrence of gestational pathology during previous pregnancies;
- the weight of the previous child is more than 4 kilograms;
- numerous spontaneous abortions in women (more than 3) in the first and second trimesters of previous pregnancies;
- high water flow;
- the presence of malformations in previous children.
MODY-diabetes or adult-type diabetes in young people represents several types of autosomal dominant inheritance of diseases. Earlier, this term was understood as early manifesting diabetes of the second type with a mild course without reducing insulin sensitivity in the body. In modern medicine, the term "MODY-diabetes" refers to a monogenic disease that is associated with genetic defects in the functionality of beta cells. It has its subtypes, which are determined by specific genes affected in a particular organism with a diagnosed disease.
The most frequent subtype of MODY-diabetes is the type of MODY 2. It is a consequence of heterozygous gene mutations that encode glucokinase and its control function of insulin release by beta cells and glucose metabolism.
For the first time the term "MODY-diabetes" was applied in 1975 as a designation of low-progression family diabetes in young people. This included a whole group of genetic pathologies affecting the functions of the beta cells of the pancreas, which produce insulin. There is no exact statistics on the prevalence of this type of disease, but it is known that about 5% of all modern diabetics suffer from it.
Obesity as a factor
In people without excess weight, the pathology in question is found up to 12 times less often. With obesity in the body, there are processes that promote insulin resistance. This leads to the fact that the pancreas begins to produce more and more insulin, and over time, this function weakens or stops.
However, losing weight at a fast pace is not the norm in a healthy body. Positive can be considered the dynamics of a smooth weight loss of up to 2 kilograms per week. With more extensive weight loss, it is not the fatty tissue that is reduced, but the muscle tissue, which is involved in glucose utilization, and in addition, numerous health problems appear. For healthy weight loss, you need to reduce the amount of fast carbohydrates consumed - sweets, muffins, cereal on sugar, because about 30% of carbohydrates from their composition in the body are deposited as fat reserves. It is also not recommended to consume large amounts of animal fats contained in dairy products and fatty meats.
Predisposing factor to the onset of diabetes is poor diet. When a person wants to eat, the stomach sends a signal to the brain. This occurs at the stage of complete emptying of the stomach and redistribution of food debris in the intestine. At the same time the blood is still full of nutrients, but the appetite is already beginning to play out. If you start eating at the very first symptoms of hunger, you can eat a small portion of food that will protect against overeating and greatly reduce the likelihood of developing diabetes.
When suppressing the first signals of hunger, it becomes dull, and then completely ceases to remind of itself.
The second signal of hunger arises at the very moment when there are no nutrients left in the blood. In this case, sitting at the table, it is very easy to overeat, the level of glucose in the blood begins to fluctuate and breaks the physiological schedule of the pancreas that produces insulin. There are situations when insulin in the pancreas is not produced at all, and this is fraught with the development of real diabetes.
The best eating regimen is regular five daily balanced meals, with daily caloric intake, complemented by regular moderate physical activity.
At night, the pancreas should rest, so that insulin reserves are not exhausted prematurely. Therefore, night food is a direct prerequisite for the development of diabetes. To distract from thinking about food, various distracting ways are recommended, one of which is a ten-second stretch, in which you should turn to face the wall, inhale raise your hands up and rest your palms on the wall, and then begin to move backwards until your palms will begin to break away from the vertical surface.
Cardiovascular diseases and pathologies of the pancreas
In patients with cardiovascular diseases, as a rule, there is always a history of metabolic disorders. This process in itself is practically the guarantor of the fact that in a certain period of time against its background it will begin to manifest type 2 diabetes. Arterial hypertension in the patient's history and such vascular diseases as strokes and heart attacks are provoking factors for the pathology in question.
It is also important to remember that the relationship of diabetes and cardiovascular diseases is reciprocal. As diabetes can be caused by vascular lesions, so the pathology of the cardiovascular system can be a consequence of the development of diabetes.
All possible causes of pancreatic dysfunction (cancer, pancreatitis, damage to all organs of internal secretion) will contribute to the development of diabetes in the body. In some cases, pancreatic function is impaired due to physical injuries suffered, which should be taken into account in the treatment and prevention of the disease in question.
Any infectious processes, including parotitis, rubella, chicken pox, epidemic hepatitis, influenza, increase the risk of diabetes in the patient's body. Each infection can act as a specific trigger mechanism, which will lead to the manifestation of this serious disease. In most cases, the usual flu does not lead to the development of diabetes, but, with the assistance of additional aggravating factors, can lead to endocrine dysfunction.
These aggravating factors include overweight, aggravated heredity of diabetes, poor diet and so on.
In the absence of a family history of cases of diabetes, the risk of developing this pathology during the transfer of various infections is significantly lower than in those whose relatives suffer from insulin resistance. The combination of several provoking factors can lead to the fact that the slightest infection can cause an irreversible process in the body and form a chronic disease.
Psychosomatics of diabetes
In modern medicine, a symptomatic approach to the treatment of diabetes is not the only possible one. Psychosomatics suggests considering the development of this pathology from a different angle. It proceeds from the theory of the unity of mental and physical factors in a person, which makes it possible to identify the dependence of the psychological characteristics of the person with the onset of her diabetes.
In special studies, specialists in psychosomatics revealed that the following psycho-emotional states can provoke the occurrence of diabetes in a patient:
- Posttraumatic depression. After severe psychological upheavals, long-term depression develops in a person’s life and the person “gets stuck” under stress. This is the natural state of affairs, if a person is able to control the boundaries of universal grief and knows when it is time and it is necessary to leave it. The endocrine system during such periods functions at the limit of its capabilities, therefore in this situation the thyroid gland, the pancreas or the adrenal glands are hit, which can lead to the development of diabetes.
- The presence of unsolved problems. For years accumulating, such problems drag their master into a shaped pit. The person either cannot or does not want to solve them once and for all. Thus, the constant patience of the alcoholic spouse, infidelity affects the normal function of the pancreas. Especially negative impact on this body has a constant expectation of the collapse and poor end of any events taking place.
- Feeling of anxiety. Anxiety body begins to burn sugar reserves more actively, while insulin production cannot be maintained at the same level as it leads to hormonal disruption. This easily explains the fact that many people under stress begin to actively consume sweets. Sometimes this situation gives rise to the habit of constantly eating sweets, there is a psychological dependence. At the same time, development of diabetes mellitus of the second type with impaired insulin production is quite possible.
There are some personal characteristics of a person, which are a prerequisite for the development of diabetes at any age. So, at risk are those who are prone to obesity.
Obesity often has a psychosomatic basis, such as impressionability, mood swings, hypersensitivity. They are, as a rule, good-natured people, who are able, however, to manipulate their close surroundings. Often patients of this type are in need of constant attention and continuous communication.
Causes of diabetes in children
The main factor that can provoke type 1 diabetes in a child is genetic predisposition. Therefore, if there are cases of this type of diabetes in the family, the risk of becoming ill with other family members is higher than that of others in the population.But at the same time, heredity is not enough for diabetes, for its manifestation other provocative factors of autoimmune nature are required from the external environment. Chronic lymphocytic insulitis with destructive changes of beta cells and insulin deficiency can most often be caused by viruses of Coxsackie, Epstein-Barr, rubella, mumps, measles, rotavirus, herpes, cytomegalovirus, enterovirus and other pathologies.
Also, if a family predisposition occurs in children, the toxic effect of some chemical compounds, some nutritional factors, such as artificial feeding, feeding with cow's milk, carbohydrate mono-diet and others, stress and surgery, can trigger the onset of the disease.
The risk group for the development of diabetes includes those children whose birth weight exceeded 4.5 kilograms, which subsequently were diagnosed with obesity, leading an inactive lifestyle, often suffering colds, suffering from various allergic reactions.
All kinds of endocrinopathy (Itsenko-Cushing syndrome, acromegaly, diffuse toxic goiter, pheochromocytoma), pancreatic diseases such as pancreatitis can also provoke the development of symptomatic or secondary forms of diabetes in young children.
Immunopathological processes, for example, scleroderma, systemic lupus erythematosus, periarteritis nodosa, rheumatoid arthritis, can provoke the development of type 1 diabetes in childhood. The association of diabetes mellitus with genetic syndromes (Klinefelter syndrome, Down syndrome, Prader-Willi, Lawrence-Moon-Barde-Beadle, Shereshevsky-Turner, Friedreich ataxia, Huntington chorea, and others) is also not uncommon in children.
What causes complications and exacerbations
The main cause of the formation of complications in diabetes mellitus is prolonged decompensation, in which vascular damage occurs. At the same time, both micro- and macrovascular beds are affected, followed by the occurrence of vascular insufficiency. In this regard, in medicine it is considered that the age of the vessels of a patient suffering from diabetes is 10 years older than the passport age.
It is dangerous that diabetes complications develop slowly, gradually and often - completely unnoticed by the patient.
For the prevention of these processes in modern medicine, the only solution has been found - quality compensation of the underlying disease, which provokes comorbidities. Proper blood sugar levels, supported by diabetes therapy, can practically guarantee the absence of severe irreversible complications. In addition to the need to daily measure the level of glucose in the blood, there is the need to control the level of glycated hemoglobin at least 1 time per quarter. This indicator will reflect the average blood sugar level over the study period, that is, for the previous 3 months.
Is diabetes mellitus transmitted?
Most people mistakenly think that diabetes is transmitted through the hereditary line. This is not quite true. There is a genetic predisposition to the disease, but without concomitant provoking external factors, it may never manifest itself.
Among the main factors that can positively affect the manifestation of diabetes, doctors call the propensity to be overweight, overeating, stress, hypertension and atherosclerosis, alcoholism, disruptions in the body's metabolic processes, the development of various autoimmune diseases, pancreatic disease, the use of a number of pharmacological drugs, strong physical overload and insufficient rest for the body.
Also, diabetes of the first type may occur in a child in whom both parents are completely healthy and do not suffer from such pathology. This is due to the existing pattern of transfer of genetic susceptibility through the generation - from grandmother or grandfather to grandchildren. If we talk about the prevention of type 1 diabetes, which develops as a result of the destruction of the insulin-producing beta cells of the pancreas by its own immune system, then, unfortunately, medicine is currently powerless to prevent this disease. In the case of type 2 diabetes, it is enough to know about the factors that increase the risk of the disease, and try to make every effort to eliminate them.
Specialty: therapist, nephrologist.
Total experience: 18 years.
Place of work: Novorossiysk, medical center "Nefros".
Education: 1994-2000 Stavropol State Medical Academy.
- 2014 - "Therapy" full-time advanced training courses on the basis of the State Budgetary Medical Educational Institution of Higher Professional Training "Kuban State Medical University".
- 2014 - "Nephrology" full-time refresher courses on the basis of the Stavropol State Medical University.