ETIOLOGICAL FACTORS AND TREATMENT PRINCIPLES OF DIABETES MELLITUS

Аннотация

Diabetes mellitus (DM) is a long-standing, complicated, and non-transmissible endocrine ailment that is growing rapidly and has posed clinical challenges globally, often linked with threats related to complicated metabolic development in patients. It is marked by elevated glucose and lipids in the blood as well as oxidative stress, which culminate in chronic complications involving diverse organs, mainly the kidneys, eyes, nerves, and blood vessels, among others, in the body. The article provides a comprehensive overview of the underlying causes and management strategies of diabetes mellitus. It explores both genetic and environmental factors contributing to the development of type 1 and type 2 diabetes, including autoimmune processes, insulin resistance, obesity, and lifestyle influences. The article also outlines current treatment principles, emphasizing individualized care that integrates lifestyle modifications, pharmacological interventions, and patient education. Special attention is given to the role of emerging therapies and the importance of glycemic control in preventing complications. This article is valuable for healthcare professionals and students seeking a foundational understanding of diabetes etiology and evidence-based management. Keywords: hyperglycemia, Diabetes mellitus, insulin, MODY, insulin resistance. ЭТИОЛОГИЧЕСКИЕ ФАКТОРЫ И ПРИНЦИПЫ ЛЕЧЕНИЯ САХАРНОГО ДИАБЕТА Аннотация. Сахарный диабет (СД) — это хроническое, сложное и неинфекционное эндокринное заболевание, которое быстро распространяется и представляет собой клиническую проблему во всём мире. Оно часто связано с рисками, обусловленными сложными метаболическими нарушениями у пациентов. Заболевание характеризуется повышенным уровнем глюкозы и липидов в крови, а также оксидативным стрессом, что приводит к хроническим осложнениям со стороны различных органов, в первую очередь почек, глаз, нервной системы и кровеносных сосудов. Статья предоставляет всесторонний обзор причин возникновения и стратегий лечения сахарного диабета. Рассматриваются как генетические, так и экологические факторы, способствующие развитию диабета 1 и 2 типа, включая аутоиммунные процессы, инсулинорезистентность, ожирение и образ жизни. Также изложены современные принципы лечения с акцентом на индивидуальный подход, включающий 1788 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 4 изменение образа жизни, медикаментозную терапию и обучение пациентов. Особое внимание уделено новым методам лечения и значению контроля уровня глюкозы в крови для предотвращения осложнений. Данная статья будет полезна медицинским специалистам и студентам, стремящимся получить базовые знания об этиологии сахарного диабета и его лечении, основанном на доказательной медицине. Ключевые слова: гипергликемия, сахарный диабет, инсулин, MODY, инсулинорезистентность Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Several distinct types of DM are caused by a complex interaction of genetics and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. It also predisposes to cardiovascular diseases. With an increasing incidence worldwide, DM will be a leading cause of morbidity and mortality for the foreseeable future. As reported by World Health Organization (WHO), DM is an outbreak prone to high malaise and death. Globally, approximately 387 million persons are affected by this disorder and it is estimated to be more than 640 million by 2040. Etiologic Classification of Diabetes Mellitus: I. Type 1 diabetes (beta cell destruction, usually leading to absolute insulin deficiency) A. Immune mediated B. Idiopathic II. Type 2 diabetes (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly insulin secretory defect with insulin resistance) III. Other specific types of diabetes A. Genetic defects of beta cell function characterized by mutations in 1. Hepatocyte nuclear transcription factor (HNF) 4α (MODY 1) 2. Glucokinase (MODY 2) 3. HNF-1α (MODY 3) 4. Insulin promoter factor-1 (IPF-1; MODY 4) 5. HNF-1β (MODY 5) 6. NeuroD1 (MODY 6) 7. Mitochondrial DNA 8. Subunits of ATP-sensitive potassium channel 1789 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 4 9. Proinsulin or insulin B. Genetic defects in insulin action 1. Type A insulin resistance 2. Leprechaunism 3. Rabson-Mendenhall syndrome 4. Lipodystrophy syndromes C. Diseases of the exocrine pancreas—pancreatitis, pancreatectomy, neoplasia, cystic fibrosis, hemochromatosis, fibrocalculous pancreatopathy, mutations in carboxyl ester lipase D. Endocrinopathies acromegaly, Cushing’s syndr