SYMPTOMATOLOGY AND DIAGNOSTICS OF DIABETES, HYPERTHYROIDISM AND HYPOTHYROIDISM
Diabetes is a state of chronic or re hyperglycemia which is caused by absolute
— «course», melli ney».
of impairments of glycemia alth Organization, 1999)
: а) autoimmune; b) idiopathic.
e (impairment of sensitivity of insulin receptors, synth
iabetes) — the most often variants are: а
traum ocytoma, hypercorticoidism, thyrotox or chemicals
(adrenoblockers, glucocorticoids); d) infections (rubella, parotitis). r fac f diabe
uperfluous m the b
fee e of ea ilable carbo tes, fat
—Inactive mode of life. ce of a hyp
tral an f diab
regnancy p hydram ultiple preg during ei is mo 4 kg.
h a
and others central cympatholytics, p ves
—Often stressful situations
«Big symptoms of diabetes»
— General and muscular weakness.
—Thirst (polydipsia).
—Dryness in mouth.
lative deficiency of insulin in the organism and leads to pathological changes in various organs and tissues of the organism and to impairment of ex-change of proteins, fats and carbohydrates. The name of this disease arose from Latin words diabetes
tus — «sweet», «ho
Etiological classific
ation
(World He
1.Diabetes of the 1st type
2.Diabetes of the 2nd typ esis of abnormal insulin).
3.Other specific types of diabetes (secondary d
) diseases of the exocrine pancreas (pancreatitis, tumours, hemochromatosis,
as, etc.); b) endocrynopathy (pheochrom
icosis, acromegalia); c) diabetes induced by medicines
4. Gestational diabetes (diabetes in the pregnant).
Majo
tors of risk o
tes
—S ass of ody.
—Irrational ding (us
sy assim hydra food).
—Presen
rterial ertension.
— Ances
amnesis oathology: etes. nion, m
—P nancy pregnancy.
—Child’s w
ght at birth re than
—Smoking. use wit
—Ab— Regular reception of clophelinum lcohol.
eroral contracepti
.
.
—Autoimmune diseases.
—Often and abundant emic
—
—Risi
—Cau
—Poly
ohydrate metabol
Table 16 — Laborator ents of carbohydrate meta
toluidin method, mmol/l tion.
Thinness (it is typical of diabetes of the 1st type).
ng of appetite (polyphagia).
«Small symptoms of diabetes» — Causeless dedentition, parodontosis, alveolar pyorrhea — pyoinflammatory lesion of small cavities of teeth. — Generalized dermal itching with pr
imary localization in the area of per-ineum. — Parkinsonism.
seless trophic disorders, furunculosis. hypovita
minosis, etc.
Laboratory diagnostics of diabetes
In biochemical analysis of blood the determination of glucose is carried on with the following standard methods:
—glucosooxidase — normal contents of glucose in capillary blood — 3,5–6,1 mmol/l; — orthotoluidin
—3,3–5,5 mmol/l (it is used more often); — iit’s 0,1 mmol/l lower in venous blood. The laboratory criteria of diagnostics of impairments of carb
ism in shown in the table 16.
y criteria of diagnostics of impairm bolism
Glycemia in capillary blood, determined with orthoDiagnosis
On empty stomach In 2 hours after carrying out of load with glucose
Imp stom
airment of glycemia on empty ,6 Less than 7,8 ach More or equal to 5
Diab More or equal to 6,1 More or equal to11,1 etes
Impa More or equally 7,8
irment of tolerance to glucose Less than 6,1 and less than 11,1 Complications of diabetes
—microangiopathy(retinopat
—macroangiopathy
combination microangiopathy and macroangiopathy. diabetic comas, a hypoglycemic coma.
Late complications:
hy, nephropathy); (atherosclerosis of arteries);
—neuropathy;
—universal angiopathy —
Acute complications —
Diabetic nephropathy
,nephrotic syndrome, chron
Clinical rule
If in unitary analy epeatedly reveal more than
,and it is proved in the analyses of urine renephropathy. ic) comas
2. Hyperosmolar
3. Lactacidemic. erglycemic comas patient or abandonin
.
s, traumas, operations, burns and scalds.
—Pregnancy.
—Impairment in diet (abuse with ea
—Reception of diuretics.
of glucose level in blood
below 2,8 mmol/l or sharp differe el m ses o ia
—Superfluous dose of insulin.
—The patient has int ad meals.