Part 1: Concept of diabetes

(Baonghean) -To meet the needs of readers who are concerned about their health, especially issues related to Diabetes Mellitus (DM). Starting from 2013, Nghe An Endocrinology Hospital will cooperate with the Editorial Board of Nghe An Newspaper to publish the column "Diabetes - What you need to know". This column is published every Tuesday and Friday, with the desire to convey to readers all issues related to DM.

Nowadays, diabetes, especially type 2 diabetes, has truly become a pandemic worldwide. It is a group of non-communicable diseases, but the consequences of the disease are quite severe. So, what are the characteristics of diabetes, how do you know if you are at risk of getting the disease or have already had the disease? How to prevent it? What are the consequences of the disease? We will clarify these concerns in turn:

• According to the American Diabetes Association (ADA)-2006: “Diabetes is a chronic disorder with the following attributes: One is: increased blood glucose; Two is: combined with abnormalities in carbohydrate, lipid and protein metabolism; Three is: the disease is always associated with the tendency to develop kidney, eye, nerve and other cardiovascular diseases”.

• About the cause and pathogenesis:

The most important feature in the pathophysiology of type 2 diabetes is the interaction between genetic factors and environmental factors. This is a complex relationship.

*) Genetic factors: Up to 60% to 100% of identical twins have type 2 diabetes. If a child has diabetes, the parents (or vice versa - that is, the next generation) have a 40% chance of having the disease. If the mother has diabetes, the child is more likely to have the disease than the father. If both parents have diabetes, the child has a 70% chance of having the disease;

Other factors: Obesity or overweight; Sedentary lifestyle; Special factors in history (Children born with low birth weight under 2500 grams; Women with a history of gestational diabetes or giving birth to a child weighing over 4000 grams; History of being diagnosed with impaired glucose tolerance or impaired fasting glucose; Family history of parents or biological children, siblings (immediate generation) with diabetes; Essential hypertension; Changes in living environment).

Age ≥ 40: The older you are, the higher your risk of getting the disease. In Vietnam, up to 80% of people with type 2 diabetes are between the ages of 40 and 65.

*) Stress: These stresses often occur in both family and society.

*) Beta cell dysfunction:

- At the time of diagnosis of diabetes, the secretory function of beta cells is only about 50%.

- Imbalance of glucose in the blood and in cells, due to: Reduced insulin secretion; Due to insulin resistance (there is still a lot of insulin in the blood but it is resistant so it has no effect); ...

- Consequences: The liver continues to produce glucose and release it into circulation, causing the already high postprandial blood glucose level to increase even higher; Skeletal muscles have a reduced ability to absorb glucose.

*) Insulin resistance: Has the following main characteristics: Decreased glucose tolerance; Increased blood insulin; Increased triglycerides; Decreased HDL - Cholesterol levels; Increased blood pressure...

Doctor:Nguyen Van Hoan(Director of Nghe An Endocrinology Hospital)