Complications of type 2 diabetes mellitus
Among modern diseases, endocrine pathology is more and more frequent. The most widespread diabetes mellitus and its complications.
Diabetes is a disease of the endocrine nature, associated with either a lack of insulin, or its ineffectiveness in relation to the splitting of glucose. Disease due to insulin deficiency is referred to type 1 diabetes. If insulin is produced in excess, but it can not communicate with specific receptors, then in this case they speak of type 2 diabetes buy metformin online.
The first type is characteristic mainly for young people and children. The development of type 2 diabetes is most often observed in older people.
With competent and timely treatment, diabetes can manage to reduce and reduce its negative impact on organs and blood vessels. If delayed with treatment or to conduct it incorrectly, complications of diabetes mellitus are often observed.
They can develop directly when the first symptom of the disease is detected, or a few tens of years after the diagnosis is made. Everything depends on the course of the ailment and the attitude of the patients towards it. Thus, the emerging pathological conditions can be divided into early and late complications of diabetes mellitus.
Early, or acute, complications pose an immediate threat to human life. For their development is characterized by a rapid beginning, taking no more than two to three hours, less often - a few days. Acute complications of diabetes mellitus in the absence of appropriate medical support often lead to the death of the patient. Because of this knowledge of the algorithms of emergency care for the development of a particular coma is simply necessary, both for the relatives of the patient and for the medical staff.
As mentioned above, coma are acute complications of diabetes. This term means a life-threatening condition in which there is no activity of the patient, unconditioned reflexes either completely or completely disappear, the heart rhythm and respiratory activity are disturbed. They occur as a result of the predominance of inhibition processes in the cerebral cortex.
Such complications have a tendency to rapid development, so it is extremely difficult to assume their occurrence. Treatment of patients with this pathology should be carried out in a hospital (first in intensive care before removal of the patient from coma, and then in a specialized department).
Ketoacidosis. This condition often occurs with type 1 diabetes (the second type never occurs). This complication is usually provoked by malnutrition, a violation of the schedule for taking medications, a decrease in immunity after the trauma and operations that have been suffered. The condition is characterized by a sudden loss of consciousness, a violation of the functions of vital organs, such as the heart, lungs, brain.
The most characteristic sign of the development of this coma in the patient is the sensation of the smell of acetone from the mouth (due to the formation of ketone bodies in the blood plasma - the products of lipid metabolism). Diagnosis of coma is based on the determination of high concentrations of ketone bodies and glucose in the blood. Treatment of this complication of type 1 diabetes must be carried out with the help of detoxification solutions and short-acting insulin in the intensive care unit.
Hypoglycemic coma. Can develop in patients with any form of diabetes mellitus. Usually, the condition is provoked by excessively large amounts of insulin taken, although cases of coma develop with intense physical exertion (for example, after a long run) or after drinking alcohol.
The condition is characterized by complete loss of consciousness, increased separation of sweat and glandular secretion, the absence of pupillary responses to light. Usually the development of coma can begin with the appearance of harbingers, felt by the patient: sudden weakness, shortness of breath, sharp dizziness. Patients sometimes have time to warn others that now they will lose consciousness.
The first aid for the development of this complication of diabetes is given when 40% glucose is administered to the affected person. This procedure is also diagnostic, as it allows to distinguish hypoglycemic coma from hyperglycemic. Usually after this, patients immediately regain consciousness. With frequent cases of development of such complications of diabetes mellitus, correction of metabolism in hospital conditions is necessary.
Hyperosmolar coma. Among all the listed species, this state differs somewhat in its course and causes of development. They are affected by older people, but the most common is a coma for patients with an insulin-dependent form of a disease.
Typical clinical signs that occur in these patients are polydipsia (severe thirst) and polyuria (increased urination by increasing the concentration of sodium and glucose in the blood). The condition can develop gradually, over several days or weeks. Treatment is based on the correction of metabolism and intravenous transfusions of crystalloids (not containing sodium and glucose).
Lactacidotic coma. This condition is most susceptible to patients over the age of 50 years (that is, those people who have the prerequisites for the development of type 2 diabetes). The pathogenesis of lactic acid coma is the accumulation of lactic acid in the body. This changes the composition of the buffer systems of plasma, which leads to the development of severe acidosis. The factors that provoke this condition are the presence of chronic cardiac, renal or hepatic insufficiency.
The manifestations of such complications of type 2 diabetes are the following: impairment of consciousness, inhibition of reflexes, complete anuria, disturbances in the work of the respiratory and vasomotor centers, which leads to a drop in arterial pressure and depression of inspiration.
Treatment consists in the use of detoxification solutions in parallel with diuretics and insulin preparations. Simultaneously, it is necessary to conduct and therapy of the underlying disease, which led to the development of coma. Treatment - only in intensive care units.