Swelling of the legs - the most common ailment with diabetes. Therefore, for those who suffer from this disease, it is recommended to conduct daily inspection of the limbs. Ignoring the swelling can lead to serious consequences up to amputation. A diabetic patient needs to clearly know why leg swelling occurs and how to eliminate them.
Swelling of the legs in diabetes mellitus is usually caused by two reasons:
- The development of nephrotic syndrome arising from the protracted course of the disease.
- Trauma to the blood vessels due to poor circulation in the legs.
Both factors with the same power affect the sensitivity of the legs, disrupt blood circulation and lead to prolonged healing of wounds. Even a slight scratch in the presence of diabetes mellitus can cause purulent inflammation, develop into gangrene and cause amputation of the leg. Treat with due attention to the emerging edema.
In addition to the main two causes of swelling of the extremities, there are other factors that affect fluid accumulation. This may be a violation of water-salt metabolism, kidney problems, poor diet, pregnancy, heart failure, varicose veins, or wearing uncomfortable and cramped shoes.
Among the reasons listed for the most dangerous, doctors call venous thrombosis, accompanied by an uneven swelling of the extremities, painful sensations and redness when standing. The edema caused by thrombosis does not subside even at night: in the morning the swollen leg remains enlarged. In the presence of blood clots, massage is prohibited, as it can lead to blockage of the pulmonary arteries and, as a result, death.
In order to avoid the negative effects caused by swelling of the legs of a patient with diabetes mellitus, it is important to recognize in time signs of a violation of blood circulation in the extremities. Among these symptoms are:
- Increase the size of the legs. When pressing on the swelling of the finger on the skin for some time there is a fossa.
- Numbness of the feet.
- Changing the shape of the fingers, deformation of the feet (shortening and expansion).
- Desensitization, goosebumps, burning or coldness in the limbs.
Swelling of the legs with diabetes do not pass by themselves. They need to be treated. Methods and methods of therapy depend on the cause of the pathology.
Neuropathic edema in diabetes mellitus should be removed with the help of normalization of blood glucose and proper nutrition. It is recommended to abandon fast carbohydrates, fatty and salty foods. Smoking diabetics should give up the bad habit: nicotine also leads to the accumulation of fluid.
If the swelling of the legs is caused by heart failure, they should be removed with special preparations. The most effective in this case are the following groups of drugs.
- Blood pressure lowering agents and blocking the angiotensin-converting enzyme. For example, Valsartan.
- Drugs that prevent kidney problems and act as angiotensin-converting enzyme inhibitors, such as Captopril.
- Diuretics: Furosemide, Veroshpiron and others.
Leg edema caused by hormonal imbalances in the presence of type 2 diabetes should be resolved with the help of maintenance therapy. It involves taking vitamins, minerals and dietary supplements.
To eliminate the pain caused by nephropathy, analgesics are recommended. Ketorol, Ketorolac and other drugs are most effective in this case.
In the treatment of edema of the legs caused by diabetes mellitus on the background of renal failure, it is necessary to combine several methods: antihypertensive therapy, control of the level of glycemia and intake of metabolic means that have a vasodilating effect. In the case of advanced forms of renal failure, hemodialysis is recommended.
In old age, swelling of the extremities is recommended to treat folk remedies. Anti-edematous properties have such medicinal plants as primrose, St. John's wort, oats, burdock, ginseng root and hydrasti. It is best to eliminate the accumulation of fluid in soft tissues helps cayenne pepper. It restores the performance of blood vessels and nerve endings.
Many diabetics prefer to use a special ointment, which includes honey and eucalyptus tincture, to relieve foot edema. It is rubbed into swollen extremities 2-3 times a day.
The most delicious remedy for removing leg edema in type 1 diabetes is considered to be a fig compote. It is boiled from sliced fruit. In this case, at the end of cooking, add some food water to the finished drink. The tool take 1 tbsp. l 5–6 times a day.
Edema is only a small step towards health. It is much more important to prevent its occurrence. To do this, you must comply with certain actions. In the first place among the preventive measures to eliminate puffiness - daily moderate exercise. Thanks to physical therapy, vessels are strengthened, excess water is removed from the body, glycemic indicators are normalized and the immune system is strengthened.
Do not forget about the precautions and every day carefully examine the legs, feet and fingers for defects and deformation. It is important to observe personal hygiene: wash your feet daily with soap and dry them with a towel.
Be sure to walk in comfortable and high-quality shoes. Sometimes it is tight shoes or shoes that cause deformation of the foot. To avoid such problems, it is recommended to buy orthopedic shoes.
In order to avoid unnecessary problems, it should be remembered that in the presence of edema of the legs with diabetes, it is prohibited to treat skin wounds with iodine and green paint. For these purposes it is better to use hydrogen peroxide or drugs such as Betadine and Miramistin.
In diabetes, heat sensitivity is often impaired. That is why it is not recommended to warm the feet with a hot-water bottle or mustard plaster. Otherwise, you can get burned.
To reduce the likelihood of wounds, apply a moisturizing or nourishing cream to your feet daily.
Despite the fact that swelling of the legs can occur in a patient with diabetes, it is not worth despondent. You can get rid of the disease. The main thing - to find the cause and purposefully deal with it.
Swelling due to limb lesions
Describing the complications of diabetes, leg edema can be called the most common consequence of the disease.
The cause of edema of the lower extremities is "diabetic foot" - a whole complex of changes in the tissues, which include angiopathy (vascular lesion), arthropathy (lesion of the joints) and neuropathy (lesion of nerve fibers).
The direct mechanism of the appearance of edema is expressed in fluid retention in the tissues of the limbs. Altered vascular walls pass blood plasma into the extracellular space, where it accumulates. At the same time, due to impaired conduction of nerve endings, the patient may not notice the discomfort and pain from the resulting edema.
An unpleasant effect that edema can cause in diabetes mellitus is venous thrombosis of the lower extremities due to obstructed blood flow. In addition, swelling of the legs causes the tissues and skin of the affected limbs to become even more vulnerable to injuries and infections. And infectious diseases of the legs for a diabetic patient are a big problem because wound healing and skin regeneration are slow.
Swelling of the legs as a result of kidney damage
Another cause of lower limb edema is diabetic nephropathy, or kidney damage. As a result of the fact that the filtration of blood in the capillaries of the renal glomeruli and tubules is disturbed, the body does not cope with the removal of fluid. Excess non-released fluid provokes the development of edema.
Diabetic nephropathy develops gradually over a long time. At first, it is asymptomatic. Therefore, in patients with diabetes, this pathology is detected using routine screening.
Diabetic nephropathy is a terrible complication of diabetes mellitus, which can lead to the death of the patient. With any course nephropathy significantly impairs the patient's quality of life. Only compensation of diabetes is the basis for the prevention and treatment of renal pathology. Therefore, it is important to conduct proper treatment in order to prevent the development of serious complications.
What is swelling?
More than half of all cases of edema in diabetes mellitus occur in the lower and upper extremities, only a third in the internal organs.
Many patients are interested in whether there can be differences between the edema in different types of diabetes. In type 1 pathology, general malaise is present, the swelling is uneven, on the left side of the body more than on the right side. Often affects the legs. With type 2 diabetes, pain is added. In women, the stomach, face and upper limbs swell.
Symptoms of edemaSymptoms of pathology vary, depending on the location of the lesion:
|Localization of edema||Related symptoms|
|Legs and arms||Soreness, tingling in the limbs, burning, redness of the skin, loss of hair, deforming changes in the feet and toes, heal skin lesions for a long time. A strong pulsation is felt, the sensitivity of the affected limbs is reduced|
|Kidney||Swelling of the face, localized mainly in the upper part of it, paleness of the skin, the formation of pits on the skin during palpation, which is quickly smoothed, diuresis|
|Hearts||Swelling of the lower limbs, thighs, internal organs, abnormal heart rhythm, feeling tired and weak. Cyanotic skin becomes cold, the hole on the skin that is formed during palpation is smoothed out slowly|
Drug treatment of edemaTherapy should carry out a comprehensive support of the body, perform many functions at the same time. Standard treatment for edema in diabetes may look like this:
|purpose||Group of drugs||Title|
|Lower blood pressure||Angiogenesis Receptor Blockers||Valsartan|
|Remove excess fluid||Diuretic drugs||Veroshpiron, Furosemide|
|Help the kidneys work||Angiotensin Converting Enzyme Inhibitors||Captopril|
|To expand the vessels||Metabolic drugs||Riboxin|
|Disinfect skin lesions||Antiseptic external use||Furacilin, Miramistin|
|Saturate the body with vitamins and minerals||Biologically active food supplements, vitamin and mineral complexes||Olidhim|
If ulcers, wounds, cracks due to edema have formed on the skin, it is strictly prohibited to disinfect them with drying agents. Alcohol, iodine, brilliant green under a strict ban!
Swelling of the feet and feet with diabetes
The most dangerous consequence of leg edema is deep vein thrombosis. This condition is often fatal.
Puffiness does not occur spontaneously, it is always preceded by symptoms, which can be suspected of stagnant fluid in the tissues, which is still imperceptible visually. If you find the following signs, you should immediately seek medical advice:
- discomfort in the limbs when standing,
- burning sensation, itching, tingling, throbbing in the legs,
- discoloration of the skin around the ankle and foot: pallor is replaced by redness,
- causeless hair loss on the limbs,
- dry skin, blisters, calluses.
If casual shoes suddenly become rubbed or hard to wear, this indicates the beginning of the disease. Should consult a doctor.
What to do to prevent edema?
Distribute the total amount of water per day evenly. Last drink no later than 1-2 hours before bedtime.
Swelling in diabetes can not be ignored. This is not an ordinary symptom of the disease, but a serious signal of ongoing pathological processes in the body. Only timely, comprehensive treatment can reduce the risk of complications and return a full, comfortable life to a person.
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Why are there swelling in diabetes?
Disorders of carbohydrate metabolism lead to an increase in the concentration of sugar in the blood. The progression of diabetes affects the nutrition of tissues and often leads to the development of edema. Liquid accumulates in the internal organs and tissues, worsening the health of the patient. The person begins to experience difficulties with movement, strong discomfort appears in the limbs.
In diabetes, swelling of the extremities is observed due to circulatory disorders and nervous regulation.
There are many causes of fluid accumulation. Often this leads to the development of neuropathy, which appears on the background of chronic hyperglycemia, because of which the nerve endings begin to die off. Often swollen legs with lesions of blood vessels.
Other causes of fluid accumulation in tissues include:
- varicose veins,
- heart failure
- kidney disease
- failure to follow a diet
- violation of water-salt metabolism,
- wearing tight shoes.
Depending on which organ is affected, the following symptoms are distinguished:
- Swelling of the hands and feet: redness of the skin, tingling, burning, pain, deformity of the thumb, slow healing of wounds, the occurrence of diabetic foot.
- Puffiness of the kidneys: the face swells up, the process begins to spread from top to bottom, when you press on the skin, a fossa appears, which quickly smoothes. There is a diuresis.
- Edema of the heart: legs swell up, the process spreads to the internal organs and thighs, fatigue is observed, the heartbeat is disturbed. The skin becomes bluish, cold to the touch, the fossa is smoothed slowly.
Insulin swelling in type 1 diabetes occurs only at the beginning of insulin therapy. Signs of pathology include temporary visual impairment, swelling of the face, perineum, hands, feet. After a while, such unpleasant symptoms disappear on their own.
What are dangerous neuropathic edema?
Distal sensory neuropathy develops in type 1 and type 2 diabetes due to lack of treatment. As a result, the nerve endings are damaged. A person may have numb legs, he no longer feels pain from burns, wounds. Due to the loss of sensation when the skin is damaged, an infection may join, which in severe cases leads to amputation of the injured limb.
The disease in diabetes develops over a long time. Its main stages are:
- the initial symptoms are practically absent, and the pathology is diagnosed using special procedures,
- acute - legs go numb, then the limbs begin to burn and tingle,
- final - ulcers, tissue necrosis and gangrene with further amputation are formed.
Neuropathic swelling in diabetes leads to deep vein thrombosis. With such a violation of unevenly swollen legs, there is pain, a person feels discomfort in a standing position. Massage procedures are prohibited for this diagnosis.This often contributes to the development of acute blockage of the pulmonary artery vessel with a blood clot, which in most cases is fatal.
Neuropathic swelling in diabetes leads to deep vein thrombosis.
If the legs are swollen, then to remove the edema, a diabetic needs to adhere to some recommendations:
- blood sugar should be normalized to avoid damage to peripheral vessels,
- you need to quit smoking because nicotine leads to the development of vasospasm,
- it is necessary to follow a diet, especially with edema, which developed on the background of type 2 diabetes, for this reducing the consumption of fast carbohydrates and animal fats.
Treatment of edema is:
- Conservative. With the help of medicines and folk remedies, normalize the concentration of glucose in the blood, remove the accumulated fluid from the tissues.
- Surgical. Remove small areas of the skin with necrotic lesions. Carry out angioplasty (vascular repair). With severe complications, the foot is partially or completely amputated.
If the legs swell, then treat this condition with the use of the following drugs:
- pressure reducing angiotensin receptor blockers (Valsartan),
- diuretics, which remove excess fluid from the body due to an increase in the amount of urine (Veroshpiron, Furosemide),
- ACE inhibitors that do not allow complications to develop in renal disease (Captopril),
- analgesics that relieve pain (Ketorolac, Ketorol),
- metabolites, vasodilators (Riboxin),
- antiseptics, which are used to disinfect ulcers and wounds (Furacilin, Miramistin),
- Supplements that restore the balance of minerals and vitamins (Oligim).
The most effective medicines for the treatment of diabetic edema are:
- Valsartan - normalizes blood pressure, reduces the risk of heart failure.
- Actovegin - improves cell metabolism, increases capillary blood flow.
- Thiogamma - improves the condition of peripheral nerve fibers, increases the concentration of glycogen in the liver.
If diabetic swelling occurs cracks, abrasions or abrasions, they can not be treated with iodine, alcohol or brilliant green. This exacerbates the situation, because such agents dry the skin even more. For this it is best to use Betadine. To prevent skin injury, feet should be moistened with ointments and nourishing creams every evening.
Why there is swelling in diabetes
Swelling of the legs in diabetes can occur for several reasons:
- diabetes can be accompanied by pathologies of nerve endings (diabetic neuropathy),
- arthropathy - joint damage,
- nephropathy - renal diseases,
- cardiovascular diseases,
- problems with water-salt balance,
- damaged, weakened vessels
- improper diet, enriched with plenty of salty foods, liquid,
- improper footwear that leads to impaired blood circulation,
- overweight, passive lifestyle, pregnancy, lack of sleep.
What is the danger of neuropathic edema
Swelling of the legs develops in diabetes of 1.2 degrees, especially if a person does not consult a doctor for medical care. As a result, there is damage to the nerve endings, due to which the limbs may swell. Such states are accompanied by:
- numbness of the legs
- foot enlargement
- sensitivity decreases with the appearance of wounds, burns,
- there is a feeling of discomfort when wearing shoes.
Complete loss of sensation in the limb increases the likelihood of its amputation.
The swelling does not occur immediately - the development of the disease takes a certain time and is divided into 3 main stages:
|Initial||There is no pronounced symptomatology; special diagnostic methods help to detect the problem.|
|Sharp||Increased pain, there are feelings of tingling, burning. In elderly patients, the disease may be accompanied by a critical loss of muscle mass.|
|Heavy||Observed education: |
Usually, this form of the disease requires amputation.
One of the dangers of the disease is deep vein thrombosis. This condition is accompanied by uneven swelling of the lower extremities, pains that are aggravated while standing. It is important to note - massage procedures in this state are categorically not recommended - there is a high likelihood of blockage of the pulmonary arteries, which causes a fatal outcome.
Swelling in the presence of diabetes leads to modification of the legs - there is swelling, redness of the skin, deformation of the fingers. Common symptoms of the disease include:
- burning sensation, tingling in the legs,
- redness of the skin,
- there are stratifications of the skin on the feet,
- there is a strong pulsation,
- leg sensitivity gradually decreases,
- numbness occurs
- goose bumps on the skin
- feet become rough,
- on the limbs disappears hair,
- the process of wound healing slows down significantly
- regular formations of calluses, water bodies,
- pain in the lower leg, stop.
For self-detection of edema of the legs, it is necessary to press a finger on the swollen area and immediately remove it. If the appeared fossa does not disappear immediately, but after a few seconds (about 10), you need to contact a specialist for diagnostic measures.
For an accurate diagnosis, you must visit a surgeon or an endocrinologist. The doctor will examine the clinical manifestations, examine the limbs, prescribe tests and direct the patient to undergo diagnostic measures. Diagnosis of pathology occurs in stages:
- palpation and inspection of the feet,
- control of various types of susceptibility,
- if there is no extensive swelling, pulse measurements in the legs,
- check reflex reactions,
- prescribe an ultrasound,
- passage of ENMG to determine the state of nerves and muscles.
What to do when developing swelling from diabetes, and how to treat such a disease? Usually, therapy is carried out in a comprehensive manner, subject to certain rules:
- first you need to normalize the condition - to level the blood sugar level, since elevated rates lead to damage to the blood vessels,
- An important treatment condition is diet. It is important to eliminate or reduce the consumption of fatty foods, because they adversely affect the health of blood vessels,
- give up bad habits (tobacco products, alcoholic beverages).
Treatment is of two types:
- conservative - aimed at normalizing the state, preventing exacerbations,
- surgical - removal of damaged skin that is not treatable leads to the development of serious pathological conditions.
Drug treatment of edema is comprehensive with the use of drugs from different groups:
- angiotensin receptor blockers to reduce pressure,
- diuretics for excretion of excess fluid,
- ACE inhibitors to normalize the functioning of the kidneys and prevent the development of pathological conditions,
- analgesics help eliminate pain,
- metabolites for vascular dilation
- antiseptics to combat pathogenic microorganisms that develop in wounds, ulcers,
- Dietary supplements - saturate the body with all useful minerals, vitamins.
Exercises for physiotherapy exercises are selected by the doctor, taking into account contraindications. Physical education should be given daily for about 20 minutes.
|The first set of exercises is performed up to 15 times, being in the initial position (standing, resting your hands on the back of the chair).|
|The second complex is also 15 times. Starting position, lying with legs straightened.|
|The last stage is performed while sitting on the chair.|
Folk therapy will help eliminate negative symptoms, relieve pain and relieve swelling of the legs.
It is important to take into account that any treatment methods, including folk ones, have a number of contraindications, while ignoring which adverse symptoms develop, and the patient's condition worsens significantly. Therefore, before using a particular prescription, you should consult with your doctor.
For treatment, use a variety of infusions, decoctions of herbs. They can be used as compresses, baths. In some cases, massage with the use of essential and vegetable oils is allowed.
Why legs swell in diabetes?
There are many factors that can cause edema in diabetes. Neuropathy should be considered as the most common, because under the influence of the ailment nerve endings are gradually damaged, and then die completely. This leads to the fact that the diabetic does not feel not only puffiness, but also sores and other injuries. Another important point is that neuropathy can cause damage to the macula, which aggravates the course of the underlying disease.
Angiopathy is the next factor that causes this pathology. The state of all vessels is aggravated, but it is the vessels of the legs that most quickly face changes. In addition, the skin of the legs loses elasticity, as a result of which cracks and ulcerative areas rapidly progress. With diabetes mellitus, edema appears on the legs due to:
- fluid accumulations in tissue structures due to destabilization of water and salt metabolism,
- kidney disease (usually in the last stages),
- overweight, which can lead to diabetic macular edema,
- errors in the diet.
After receiving an answer to the question of why legs swell in diabetes, it is necessary to understand the symptoms of this condition.
Symptoms of the disease
An increase in the size of one or both limbs is noted if the feet become swollen in diabetes. A characteristic sign should be considered the presence of dimples in the point of the skin, which is pressed with a finger. Swelling of the legs can also be associated with symptoms such as numbness of the foot, hair loss and the formation of blisters directly in the area of the swelling.
No less rarely, swelling of the legs is associated with a decrease in the degree of sensitivity in swelling of the foot. There may be a change in the shape of the fingers, which visually increase. If a person's legs swell strongly in diabetes, it is about shortening or expanding the foot. It is necessary to understand in more detail what the dangerous state is.
What is dangerous swelling of the lower extremities?
If the swelling of the legs in diabetes is not treated on time, the development of adverse events, such as pain and burning, is likely. The skin, in turn, becomes more fragile and depleted, which increases the likelihood of an infectious lesion. However, the most serious complication of the disease should be considered deep vein thrombosis in the lower extremities.
The development of such a state may indicate unevenness of swelling, with one leg being larger. In addition, the state during the night does not lose its intensity, with the result that by the morning the limbs remain more than the norm. Experts pay attention also to the fact that:
- painful sensations are formed even with short standing,
- redness and discomfort in the legs are observed more and more often
- increases the likelihood of pulmonary embolism. This is the most dangerous condition in which there is a possibility of death.
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The first symptom should be considered the separation of a blood clot and its movement into the region of the lungs, as a result of which shortness of breath and soreness in the sternum are formed. Given all this, we should not neglect the diagnosis and timely treatment.
What does pathology diagnosis include?
Diagnosis should include a range of measures to ensure correct and complete treatment in the future. There should be a visual inspection, collection of information about the main manifestations, blood analysis (both general and biochemical). In addition, in type 2 diabetes, a urinalysis, hormone identification and an ECG analysis are recommended (electrocardiographic examination).
Swollen limbs are recommended to be examined at each stage of treatment, as well as after the recovery course is completed. This will eliminate the likelihood of complications, as well as allow you to choose the most effective method of treatment.
Treatment of leg edema in diabetes
Treatment of leg edema in diabetes should include a whole range of activities. Diuretics (diuretic names) are used for kidney disease. However, such treatment should be as correct as possible to eliminate the excretion of potassium from the body, so it is prescribed after consulting a specialist.
In diabetes mellitus type 2, names are used that inhibit the production of steroid hormone - aldosterone. Also necessary may be protein tools that are used to normalize blood pressure. Special attention deserves:
- the use of gels and ointments, namely venotonic, which strengthen the walls of blood vessels and improve blood flow,
- diuretic herbs, which, like other means for edema of the legs, should be applied three to four hours before sleep. This will eliminate insomnia during the night, but their use should never be permanent, because addiction can develop.
- The use of compression knitwear is special knee-highs and tights. It is advisable to purchase them in pharmacies and special stores, which will effectively treat the causes of the condition in the elderly and younger diabetics.
Swelling of the legs with diabetes mellitus and their treatment simply cannot be effective without moderate physical exertion. One of the most useful sports in this case is swimming, as well as water aerobics. This is due to the fact that water is characterized by a gradual effect on the skin, excluding the expansion of blood vessels and swelling of the limbs. To prolong the swelling of the legs will help long walks, as well as, for example, jogging.
Can be applied pressure therapy, or lymphatic drainage apparatus foot massage. As part of the procedure, the lymphatic system will be affected, due to which excess amount of fluid is removed from the human body.At the same time, the procedure should not be carried out during pregnancy, in the presence of malignant neoplasms and during menstruation. For treatment of diabetic macular edema, it is recommended to consult with your doctor in a separate order.
Prevention for diabetics
For preventive purposes, it is recommended to inspect the limbs every day. Special attention should be paid to the feet and the spaces between the fingers. This will allow time to detect any small sores, blisters, as well as cuts. It is very important to wash the limbs daily, while choosing neutral grades of soap. It is recommended to wipe them with an exceptionally clean towel.
We should not forget about careful cutting of the nails so that they do not grow into, and you could avoid injury to the soft part of the legs. At the very first signs of redness, ingrowth and other defects, it is recommended to contact a specialist as soon as possible.
When itching and redness of the skin of the foot also requires a visit to the doctor. In addition, shoes are recommended to inspect every day, which will allow to identify gaps and damage. As you know, they can hurt the foot and provoke an infectious lesion. It should be remembered that:
- for warming the limbs it is better to use warm socks, rather than dry heat. For example, heating pads are contraindicated due to the high likelihood of a burn,
- Do not use brilliant green and iodine solution. In order to successfully treat wounds, such agents as hydrogen peroxide, Miramistin, Betadine,
- in order to cope with the dryness of the skin, it is best to smear it with a cream with a high percentage of fat.
Shoes should be extremely comfortable. In the event that the feet are deformed, it is recommended to wear special shoes or shoes that are orthopedic. It is very important to walk on foot as much as possible. Such walks will improve the general condition of the body, blood circulation and provide faster recovery. It is strictly forbidden to smoke because it aggravates the work of blood vessels and blood circulation.
It is also important to normalize the sugar level and exclude the development of other complications in diabetes mellitus. As a result of such a complete prevention, we can talk about the elimination of limb swelling in diabetics and the development of severe unpleasant symptoms. The most effective such activities, as well as methods of treatment, will be at the initial stage of development of the state.