Latent (hidden) diabetes is quite difficult to detect, because the disease does not make itself felt for a long time. Obvious symptoms appear only when the pathology passes into the next form. Prior to this, it is possible to suspect something was wrong only by minor changes in the body and by the results of tests. In this case (even in the absence of alarming signs), the disease destroys the body. Possible symptoms and principles of treatment of latent diabetes mellitus will be discussed below.
The essence of the disease
Diabetes mellitus is a very dangerous disease characterized by impaired glucose metabolism. Sugar does not enter the cells and accumulates in the bloodstream due to insufficient production of insulin, which increases the concentration of glucose, which is necessary to provide the body with energy. Cells feel the lack of this substance. The disease is especially dangerous for the body if treatment is ignored.
There is a special form of diabetes - latent, or pre-diabetes. The disease does not manifest itself in any way, proceeds secretly, no clinical picture is observed. It is quite difficult to determine the disease in a latent form. A person with DS may feel normal. The only way to determine the disease is to undergo a comprehensive diagnosis. Latent diabetes can be suspected by the presence of sugar in the patient's urine or blood.
Even without obvious signs of pathology, the disease can cause serious harm to the body of a patient who is not even aware of the presence of a problem. The disease damages the walls of blood vessels, they become more fragile, and the internal organs too. As a result, a heart attack, hypertension, stroke may develop, vision problems or disturbances in the central nervous system may appear. You can avoid complications if you regularly take tests and pay attention to the slightest possible manifestations of the disease.
Risk factors
Symptoms of diabetes can appear in people who are at risk. Such patients need to be more attentive to their own he alth and not to ignore preventive examinations. Pathology can begin to progress with physical inactivity, frequent stress, decreased immunity, due to genetic predisposition or hormonal disorders, low levels of potassium in the blood, frequent pressure surges, consumption of large amounts of sweet and alcoholicbeverages, pancreatic diseases and so on.
Age is of great importance for people who are prone to disease. According to statistics, about 85% of elderly patients suffer from this disease or have certain signs of latent diabetes mellitus. Most often, the genetic factor makes itself felt. If any of the relatives had diabetes, then you should definitely take tests from time to time in order to notice the onset of the disease in time.
Often, diabetes can cause excess weight. Poor diet, unhe althy diets and unhe althy eating habits can lead to metabolic disorders and obesity. Every fourth patient with an elevated body mass index has signs of latent diabetes. This indicator can be calculated independently to determine belonging to a risk group.
Body mass index can be calculated by the formula: body weight in kilograms divided by height (in meters) squared. If BMI in adults is below 18.5, this indicates body weight is below normal, 18.5 - 24.9 - normal weight, 25.0 - 29.9 - overweight, above 30 - obesity.
Reflects the risk of developing dangerous diseases and waist circumference. So, for a woman, an indicator of up to 79 cm is optimal. With a circumference of 80 to 87 cm, it has an increased risk of pathologies, and an indicator of 88 cm indicates a high risk. For men, the optimal waist circumference is up to 93 cm. Indicators above 94 cm and 102 cm are associated with an increased and, accordingly, high risk of developingcomplications.
Pregnant women are at risk. While waiting for a child, serious hormonal changes occur in the body, weight increases. In this regard, all women in the position from time to time without fail take blood tests in order to prevent or detect dangerous diseases in a timely manner. If diabetes is suspected, the doctor will prescribe a special diet for the patient.
Any diseases that affect the pancreas or disturb the hormonal balance can also be a provoking factor for the development of latent diabetes. There is a high risk of developing the disease in women with polycystic ovaries, as well as patients who have had diseases of viral etiology or infection. Patients with such diagnoses are often diagnosed with pancreatic disease.
Main danger
Symptoms of a latent form of diabetes mellitus are quite difficult to distinguish. This is the main danger of this form of the disease. Latent diabetes can occur in both adults and children. Significant changes in the human body will already be taking place, while he himself will not feel unwell.
Latent diabetes most often affects the vessels, resulting in a significantly increased risk of cardiovascular pathologies. For example, the probability of death in a heart attack is several times higher if the patient has latent diabetes mellitus. Also often there are problems with nerve endings and reduced vision.
According to WHO, every year in the worldApproximately two million people die from diabetes and complications from the disease. In the absence of proper support for the body (drug therapy, a special diet and regular monitoring by a specialist), the disease quickly and asymptomatically leads to various complications that destroy the human body.
The most common complications are trophic ulcers, gangrene, nephropathy (bilateral kidney tissue damage, acute or chronic kidney failure), hypoglycemia (an endocrine disorder characterized by low plasma glucose levels), ketoacidosis (a life-threatening condition, at which a high level of acetone in the blood is determined). Diabetes often leads to the development of tumors. In most cases, the patient either dies after a long struggle with a serious illness, or becomes disabled.
Possible symptoms
How does hidden diabetes manifest itself? In most cases, there is no clinical picture of the disease, that is, the patient feels well, and the disease is diagnosed by chance during a routine examination.
Some patients still note disturbing changes and sound the alarm. But this rarely happens. Most diabetics with a latent form live for many years, completely unaware of a serious illness.
Some characteristic symptoms help to recognize latent diabetes mellitus. The skin begins to peel off, itching appears. These signs appear due to the fact that with elevated blood sugar, certain microorganisms develop extremely quickly. On the skindiabetics also lack special protection that can prevent the development of such symptoms.
Persistent thirst, dry mouth are symptoms that occur with any form of diabetes. But many patients do not pay attention to this sign, especially during the summer heat.
Symptom of latent diabetes is a sudden change in body weight. At the same time, the diet remains the same as it was before. Usually a person first loses weight sharply, and then rapidly gains extra pounds. All this is accompanied by increased appetite and desire to eat sweets.
Additional signs of latent diabetes are dizziness, pain in the chest, decreased visual acuity, mood swings, sleep disturbance, increased irritability. But these are not specific symptoms that accompany many diseases.
How to detect hidden diabetes? Most often, women begin to sound the alarm, who notice that the skin has become dull. Pigmentation appears, severe itching in the perineum, hair splits, and nails become brittle.
Symptoms of latent diabetes mellitus indicate a pre-diabetic state, which, under the influence of favorable factors, quickly turns into an open form. For a long time, the disease does not manifest itself in any way, but the pathology can be recognized by the following signs: a feeling of bitterness in the mouth, skin irritation, poor healing of wounds and cuts, decreased visual acuity, periodic bouts of hunger, sudden weight gain, constant thirst,decrease in concentration and performance, frequent mood swings, decreased immunity, numbness of the extremities.
How to identify hidden diabetes? Symptoms may not appear for a very long time, so that the disease can often be identified only by chance. In order to start treatment on time, it is recommended to regularly take a sugar test and listen to your body. It is especially important to undergo diagnostics from time to time for those people who are at risk of developing the disease.
Diagnostic Methods
Diagnosis of latent diabetes mellitus is complicated by the lack of a clinical picture. The disease proceeds without causing any changes. The usual analysis may not show the presence of pathological changes in the endocrine system. The only truly reliable way to determine diabetes is a glucose tolerance test.
True, at the first visit to the therapist, the doctor most often refers the patient to a routine blood sugar test. Biological material is taken on an empty stomach (after the last meal, at least 8 hours must pass). You can only drink plain water 8 hours before taking a blood test for diabetes. Alcohol is not recommended to be consumed for two days, so as not to distort the results. The result may be incorrect after physiotherapy procedures, during an infectious disease, when taking certain medications.
A blood test for latent diabetes mellitus can be done independently (using a glucometer). This is the express method. It is enough to place a drop of blood on the test strip - and the test will show the result. No need to visit the hospital, it is possible to track blood sugar throughout the day, but the result will be inaccurate. If you need to get an accurate result, then it is better to use one of the diagnostic methods. Usually they take blood from a finger, but sometimes it is taken from a vein.
For men and women, the decoding of the results is the same. The norm is from 3.3 to 5.5 mmol / l in blood taken from a finger, from 3.7 to 6.1 mmol / l in blood from a vein. If the score is above 5.5, a pre-diabetic condition is diagnosed, and if the result is above 6.1, then we are talking about diabetes mellitus.
To confirm the diagnosis, the doctor may prescribe a second test or refer the patient to a test for glucose tolerance. This is the most accurate way to diagnose. The procedure is carried out in three stages. First you need to donate blood from a finger on an empty stomach, and then take a solution of 75 g of glucose. After that, you need a break for one hour. Then they draw blood again. The study is carried out again in an hour. The results obtained allow us to conclude what is the reaction to incoming sugar.
As soon as it is possible to identify latent diabetes mellitus by symptoms and confirm the diagnosis with laboratory tests, treatment is immediately prescribed to help reduce the adverse effects of glucose on the body.
Self-medication with such a disease is unacceptable and extremely dangerous not only for the state of he alth, but also for the life of the patient. The slightest delay could result inprediabetes will turn into full-fledged sugar.
Treatment regimen
Symptoms of latent diabetes will help eliminate complex treatment. Prediabetes needs therapy in full compliance with all the recommendations of the attending physician. Only in this way the condition will not turn into a full-fledged disease and will not cause serious complications.
Assume a comprehensive treatment of the symptoms of latent diabetes, diet, active lifestyle, taking medications, giving up bad habits and remedies that restore normal metabolic processes in the body.
Eating habits need to change immediately. The success of the treatment directly depends on this. A special diet will allow you to normalize your metabolism and saturate the body with a sufficient amount of potassium. This is necessary to maintain the normal functioning of the cardiovascular system. Restore metabolism will help and feasible physical activity. Muscles absorb some of the glucose, which normalizes the concentration of the substance in the blood.
Be sure to take all the drugs prescribed by your doctor. Usually, with such a pathology, drugs are prescribed that bind and remove glucose. You should give up bad habits that reduce immunity. It is recommended to take multivitamin complexes regularly so that the body does not need nutrients.
Usually, doctors use the following table when prescribing therapy. In the absence of symptoms of latent diabetes mellitus, treatment with potent medications is not immediately prescribed. Within three months, the patient is advisedchange lifestyle. This refers to diet and exercise.
Further therapy depends on test results. If fasting glycemia (mmol / l) is more than 8 units, then insulin is needed. If there is insulin resistance, then metformin or glitazone + insulin is prescribed, if there is no resistance, then insulin + SM (sulfonylurea) is prescribed.
At 6 - 8 mmol/l, the further course of therapy depends on BMI. If the patient's BMI is greater than 27, then metformin and/or glitazones are needed; if the BMI is equal to or below 27, then meglitinides or SM are prescribed. If, according to the results of glycemia, less than 6.0 mmol / l is found, then an additional analysis is performed two hours after eating. In any case, exercise and a special diet are shown next. If the result of the repeated analysis is more than 8 mmol / l, then acarbose or meglitinides are additionally prescribed.
Therapy
Drug treatment of latent diabetes mellitus should be aimed at improving the activity of the insular apparatus and reducing peripheral insulin resistance. Medications are prescribed and lifestyle changes need to be made. It is best to take a holistic approach. Most patients need medication.
Initial therapy depends on symptoms. Currently, three subgroups of drugs are actively used. These are insulin sesitizers, which improve insulin sensitivity without stimulating its secretion, secretagogues, that is, secretion stimulators, and inhibitors.glucosidases, which slow down the absorption of carbohydrates.
Tableted hypoglycemic drugs (TSP) are prescribed, as well as insulin therapy. The use of TSP is contraindicated in severe forms of diabetes mellitus, during pregnancy and lactation, in severe kidney damage with impaired function, blood diseases, the presence of vascular diseases, a significant decrease in body weight, surgical interventions and acute inflammatory diseases. The use of TSP is undesirable for patients with chronic inflammatory processes.
Sulfonylurea drugs are prescribed when physical activity and diet are ineffective, if insufficient insulin secretion is diagnosed. Contraindications are pathologies of the kidneys and liver, pregnancy and lactation, as well as ketoacidosis. Meglitinides are necessary for the ineffectiveness of therapeutic nutrition and exercise in severe hyperglycemia after a meal. Contraindications are the same as when taking sulfonylurea.
Biguanides may be given if the patient has fasting hyperglycemia and a significantly elevated BMI. In addition to pathologies of the kidneys, pregnancy and lactation, as well as ketoacidosis, such drugs are contraindicated in alcoholism, anemia, heart failure, or in old age. Thiazolidinediones are indicated for the predominance of insulin resistance against the background of the lack of results from physical exertion. α-glucosidase inhibitors are needed with the predominance of hyperglycemia after eating, but are contraindicated in diseases of the gastrointestinal tract, during pregnancy andlactation, with ketoacidosis.
Therapeutic diet
Effective treatment of latent diabetes mellitus is impossible without a diet. You should eat in small portions (about five times a day), exclude s alty, fatty, spicy, fried and sweet, semi-finished products, marinades from the menu. It is important to include fruits and vegetables (unsweetened), nuts, beans, dairy products with a low percentage of fat in the menu. It is advisable to choose fish and meat of low-fat varieties. Replace sweets with special ones and limit the consumption of bread. Dishes are best consumed boiled or baked, you should drink enough water. Such dietary rules for latent diabetes must be observed constantly.
DM during pregnancy
Gestational diabetes can occur even in relatively he althy women. In addition, pregnancy worsens type 1 (insulin-dependent) or type 2 (non-insulin) diabetes. During childbearing, the disease can occur in women who are overweight or relatively deficient in insulin. Pathology is observed in approximately 5% of pregnancies, in some ethnic groups it is more common. Asians, Indians, American Indians, Mexican Americans, and Pacific Islanders are more likely to suffer from this condition.
Gestational diabetes increases maternal and child mortality. In newborns whose mothers had diabetes of this form, the risk of hypoglycemia, hyperbilirubinemia, increased blood viscosity, distress syndrome, hypocalcemia increases. Weak medical supervisionthe condition of a woman with gestational diabetes increases the likelihood of serious birth defects of the fetus or spontaneous abortions. In the later stages or with a large fetal weight, the risk of miscarriage also increases.
Symptoms of diabetes during pregnancy
Symptoms of latent diabetes during pregnancy may not be. A potential predisposition to the disease appears in cases where both parents of the patient suffered from diabetes, previously the woman gave birth to children weighing more than 4.5 kg, the pregnant woman is obese, eczema, neurodermatitis, allergic diseases, polyhydramnios or sugar in the urine is diagnosed. Latent diabetes mellitus is determined only with the help of tests. During pregnancy, the symptoms of an obvious illness already require special attention to the patient. These signs include:
- large amount of urine;
- dry mouth and intense thirst;
- skin itching;
- unquenchable hunger;
- exhaustion;
- visual impairment;
- decrease in performance;
- insomnia;
- headaches;
- irritability;
- muscle pain;
- pain in the region of the heart.
Diagnosis and treatment of gestational diabetes
An analysis for latent diabetes mellitus during pregnancy is mandatory if, according to the results of a general laboratory blood test, the doctor suspected a pathology. Treatment consists in careful monitoring and strict control of glucose levels by a doctor, as well as timely therapy in case of complications. This reduces the risk to the mother andfetus.
To minimize risks, the gynecologist should involve an additional team of specialists (nutritionists, general practitioners, nurses and pediatricians) in monitoring the woman, eliminate pregnancy complications (even minor ones) in time, plan childbirth and ensure the presence of an experienced neonatologist and also to make sure that medical therapy is really impossible. Specialists in the treatment of diabetes in pregnant women are located in regional perinatal centers.
With gestational diabetes, diet and exercise are selected on an individual basis. The weight of a woman during the gestation period should not increase by more than 9 kg in order to avoid complications. For obese women, the maximum weight gain is 7 kg. Moderate exercise is recommended after meals.
Starting from the 32nd week, it is necessary to carry out weekly antenatal diagnostics. At earlier stages, the diagnosis is carried out according to indications. The procedure includes non-stress tests, fetal movement counts, and a diophysical profile. Insulin treatment is prescribed only for progressive hyperglycemia after a diet with latent diabetes mellitus for two weeks. The dose is selected individually.
Planned childbirth for women with diabetes
With gestational diabetes, natural delivery is possible if the disease is well controlled and there are documented due dates. Cesarean section is performed according to indications. It could be an obstetric complicationin previous pregnancies, poor adherence to therapy, inaccurate date of delivery, inadequate prenatal care. Delivery recommended at 39 weeks gestation.
Disease prevention
Prevention of the symptoms of latent diabetes mellitus in women and men is based on the same principles. It is necessary to eat he althy food, engage in feasible sports, get rid of bad habits and keep body weight under control. Individuals who fall into the risk group, it is advisable to take tests from time to time or measure their sugar levels daily. If any alarming symptoms appear, you should consult your doctor to stop the development of the disease.
