Diabetes is a group of metabolic diseases characterized by hyperglycemia. Hyperglycemia is caused by defective insulin secretion or impaired biological effects, or both. Long-term high blood sugar causes chronic damage and dysfunction of various tissues, especially eyes, kidneys, heart, blood vessels and nerves
1. genetic factors
Both type 1 and type 2 diabetes have obvious genetic heterogeneity. Diabetes has a family history, and 1/4 to 1/2 patients have a family history of diabetes. There are at least 60 genetic syndromes that can be accompanied by diabetes in clinical practice. There are multiple DNA sites involved in the pathogenesis of type 1 diabetes. Among them, the DQ site polymorphism in the HLA antigen gene is most closely related. A variety of clear gene mutations have been found in type 2 diabetes, such as insulin gene, insulin receptor gene, glucokinase gene, mitochondrial gene, etc.
2. environmental factor
Obesity caused by excessive eating and reduced physical activity is the most important environmental factor for type 2 diabetes, which makes individuals with genetic susceptibility to type 2 diabetes prone to the onset of disease. Patients with type 1 diabetes have an abnormal immune system. Some viruses such as the Coxsackie virus, rubella virus, mumps virus, etc., cause an autoimmune response and destroy insulin β cells.
1. Polydipsia, polyuria, polyphagia, and weight loss
The typical symptoms of "three more and one less" appear in severe hyperglycemia, which is more common in type 1 diabetes. The symptoms of "three more and one less" are more obvious when ketosis or ketoacidosis occurs.
2. Fatigue, weakness, obesity
More common in type 2 diabetes. Obesity is common before the onset of type 2 diabetes. If not diagnosed in time, the weight will gradually decrease.
Diabetes is generally not difficult to diagnose. The fasting blood glucose is greater than or equal to 7.0 mmol/L, and/or the blood glucose is greater than or equal to 11.1 mmol/L two hours after a meal. Types should be performed after the diagnosis of diabetes:
1. Type 1 diabetes
The age of onset is light, mostly <30 years old, the onset is sudden, the symptoms of polydipsia, polyuria, polyphagia, weight loss are obvious, blood sugar levels are high, many patients have ketoacidosis as the first symptom, serum insulin and C-peptide levels are low, ICA, IAA Or GAD antibody can be positive. Oral medication alone is ineffective, and insulin treatment is required.
2. Type 2 diabetes
It is common in middle-aged and elderly people. The incidence of obesity is high, and it is often accompanied by diseases such as hypertension, dyslipidemia, and arteriosclerosis. Insidious onset, no symptoms in the early stage, or only mild fatigue, thirst, and insignificant increase in blood sugar need to undergo a glucose tolerance test to confirm the diagnosis. The serum insulin level is normal or increased in the early stage, and low in the late stage
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