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The Latin name “Diabetes mellitus” (diabetes) is a condition characterized by a constant increase in blood sugar (hyperglycemia) with the simultaneous existence of disorders in the circulation of fats and proteins (proteins). Diabetes occurs due to reduced or complete cessation of insulin hormone secretion and due to decreased sensitivity of the liver, muscle and adipose tissue to the effects of insulin. Insulin is produced in the pancreas. The pancreas is a gland located in the upper abdomen. It is laid transversely. This gland is divided into head, neck, body and tail. The length of the pancreas is 15 centimeters, the width is 3-5 cm and the thickness is 2-3 cm, the weight is 60-160 grams. This gland has a dual function of exocrine (secretes enzymes to digest food in the intestines) and endocrine (it synthesizes several hormones, the most important of which are insulin and glucagon). Insulin synthesis is performed in special cells of the pancreas. These cells are called beta cells. They are grouped into the so-called “Langerhans Islands” (the number of these islands in a healthy pancreas varies from 250,000 to 2,000,000).
A direct stimulus for insulin secretion is the concentration of sugar (glucose) in the blood (glycemia). The amount of insulin secreted directly depends on the amount of glycemia. Little insulin (base secretion) is constantly secreted from the pancreas. After the intake of carbohydrates (sugar) through food, the amount of insulin secretion increases sharply. This amount is constantly adjusted according to the current needs of the organism. Insulin reaches cells in various tissues through the bloodstream. It binds to special creations on cell membranes. These substances are called insulin receptors. This allows glucose to pass inside the cell. Insulin is therefore necessary for the transfer of glucose from the blood to the cells in which it is broken down and used to create the energy needed for the body to function. If not enough insulin is produced in the pancreas (or there is a disorder in the cell membranes where the number of insulin receptors is reduced), then blood sugar cannot be consumed. Cells literally “bathe” in blood full of glucose. At the same time, there is a lack of sugar inside the cells, so the energy needed for their survival cannot be created. The main problems in diabetes are glucose consumption and glycemic control. The concentration of glucose in the blood increases because the glucose from the blood cannot get into the cells. Then the possibility of burning sugar in the cells is reduced, which leads to disorders in the circulation of proteins and fats (fats burn on the fire of sugar). These disorders cause certain problems in patients (symptoms of diabetes). At the same time, conditions are created for the accelerated process of sclerosis on the blood vessels of the eyes, heart, kidneys, nerves, lower legs and feet.
Diabetes through history
Diabetes is probably as old as the human race. In 1550 BC Diabetes was first mentioned in the Ebers Papyrus. It is described as a disease characterized by “urine flooding”. In the 3rd pre-Christian century, Demetrius of Apamea first used the term “diabetes” to denote a disease that is not characterized by the appearance of swelling but “water passes through the human body as through a tube.” English physician Thomas Willys found in the 17th century that the urine of some patients was miraculously sweet (as if soaked in honey or sugar). This is how the name “mellitus” comes about.
In his doctoral dissertation in 1869, Paul Langerhans described in detail the specific groups of cells in the pancreas. These groups of cells were later shown to produce insulin. 1889 Minkowski and von Mehring prove that experimental animals after removal of the pancreas show typical diabetic signs: strong thirst and excretion of a large amount of urine. 1921 Banting and Best performed the removal of the pancreas of the dog Marjory (whom they later successfully kept alive with pancreatic extract). This experiment enabled the extracted insulin to be administered for the first time to a thirteen-year-old boy, Leonard Thompson, on January 11, 1922, whose life-saving insulin. In 1954, Franck and Fuchs from Berlin first used a preparation from the group of sulfonylureas (in the form of tablets) for the treatment of diabetes in the elderly. In 1958, the Englishman Frederick Sangher clarified the structural formula of insulin in Cambridge.
Diabetes is a common health problem
Diabetes mellitus is a common health problem in people around the world. The number of patients is growing rapidly worldwide, especially in the newly industrialized countries. This disease has great social and economic significance. The number of people suffering from diabetes has risen from 1990 (80 million) to 150-160 million by the year 2000. Diabetes is a global epidemic. The largest increase in patients is recorded in developing countries. There are so-called Centers and Counseling Centers for Diabetics in many countries around the world. It is considered to be larger representation of patients in northern, lowland and industrialized areas. There is a lower prevalence of patients with diabetes in mountainous and underdeveloped countries. There are patients with unidentified disease whose number is approximately 1% of the total population. It is also estimated that about 10% of the total world population has a “subclinical” (asymptomatic) stage of diabetes which under the influence of certain factors (infections, stress, improper diet, insufficient physical activity) can turn into a manifest form. It is important to detect asymptomatic forms of diabetes because even at this stage of the disease, atherosclerotic processes in the blood vessels in a person’s body progress.
The most important factors that increase the number of diabetic patients are:
-possibility of inheriting genes for diabetes (offspring of patients)
-frequent exposure to stressful situations (infections, mental and physical stress)
-improper diet and obesity
-reduced physical activity
-extension of human life and the like.
Modern methods for early detection of the disease and better organization of the health service help to detect and treat diabetes as early as possible. In that way, acute and chronic complications in people are prevented.