Doctors were already talking about the "honey-sweet flow" more than 2 years ago.000 years ago, when they discovered by taste test that their patient had too much sugar in the urine. "Diabetes mellitus" has become a Greek-Latin technical term in medicine. Unfortunately, diabetes has now become a widespread disease. 1 advanced: Over six million people in Germany alone have diabetes.
What is diabetes mellitus?
Diabetes mellitus is a metabolic disease. Its hallmark: elevated sugar levels in the urine. Not by chance one speaks therefore also of the
What are the symptoms of diabetes mellitus?
Elevated sugar levels in the urine are only one of several possible diabetes symptoms; the body also draws attention to this metabolic disorder in other ways. The most common signs of diabetes are present:
– Strong thirst – ravenous appetite – weight loss – frequent urination – itching – visual disturbances – dullness – susceptibility to infections (e.g., gum infections).B. gum infections)
Whether diabetes type 1 (autoimmune disease) or diabetes type 2 (causes lie u.a. The symptoms are only mild at the beginning of the disease. Therefore, diabetes mellitus is often an incidental finding. It takes months for the excessively high blood glucose levels to cause damage in the body, z.B. to the retina (diabetic retinopathy), to the kidneys (diabetic nephropathy), to the nerves (diabetic neuropathy) or until erectile or menstrual disorders occur due to diabetes.
What are the causes of diabetes mellitus?
Sugar in the urine – how does it actually get there?? And why are the blood sugar levels so high in diabetes mellitus?? The hormone insulin is behind it. It ensures that blood sugar levels in the body are as balanced as possible. Insulin is a cab for the sugar that is in the blood. Insulin binds the sugar molecules and transports them from the sugar into the cells of the body, where it is stored or converted into energy.
If someone gets diabetes, the cab transport of insulin stops, sometimes completely, sometimes only "jams" occur, so that the blood sugar is not transported into the cells, but remains in the blood. This is fatal, because in the long term it clogs the arteries and makes people ill: blindness, heart attacks or strokes can be the consequences. The kidneys work hard to get the blood sugar out of the body – but can be damaged in the long run by all the blood sugar themselves.
Small type theory of diabetes mellitus: diabetes type 1, 2 or 3?
Depending on the cause of the faltering blood sugar transport, different types of diabetes mellitus are distinguished:
diabetes type 1: Insulin is missing in the body – the blood sugar cab – because it is simply not produced or no longer produced. The reason: the pancreas is attacked by its own immune system (autoimmune disease). The function of the insulin-producing cells is massively disturbed. This is the so-called "juvenile or juvenile diabetes", because this type of diabetes mostly affects young people (before the age of 20). affected by the age of 65). In Germany, there are around 300.000 people who suffer from this form of diabetes.
For this type of diabetes, insulin injections are usually the treatment of choice. Those affected can do little here with the right diet. However, they also need to know how many carbohydrates are in their food, because they need the appropriate amount of insulin to avoid hyperglycemia or hypoglycemia.
Type 2 diabetes: Here, the insulin is present, but it is not recognized by the body's cells, which should take the blood sugar or. Rejected. This resistance means that the insulin axes do not get rid of their charge. The insulin loses its effect and at some point the pancreas produces less and less insulin and later none at all.
Because this form of diabetes is actually only diagnosed after the age of 30. If diabetes occurs before the age of 60, it is also known as adult-onset diabetes. But in the meantime, more and more young people are also suffering from type 2 diabetes. A consequence, scientists say, of a lifestyle determined by obesity and lack of exercise. Genetic factors also play a role in type 2 diabetes.
With this type of diabetes, insulin injections are not mandatory. Sometimes a change in lifestyle is all that is needed. More exercise, the right diet and giving up tobacco and alcohol can help just as well.
type 3 diabetes: This type is actually a German neologism, because internationally it is referred to as "other, specific types of diabetes" (of which there are eight types).
Type 3 diabetes is the term used to describe diabetes when its cause is z.B. in a drug treatment (z.B. The cause of insulin deficiency can be cortisone or diuretics, alcohol abuse or chronic inflammation of the pancreas. Autoimmune diseases or impaired hormone production can also trigger type 3 diabetes.
What is gestational diabetes?
Sometimes it occurs as a result of the Hormone changes during pregnancy to diabetes. Around five percent of all pregnant women have elevated blood glucose levels, which are reduced again after birth. This form of diabetes is largely asymptomatic, but does require treatment (e.g.B. through an adequate diet and an exercise program such as swimming, gymnastics or even just going for a walk).
Gestational diabetes endangers both the pregnant woman and the child. In fact, children whose mothers developed diabetes during pregnancy have a higher risk of developing diabetes themselves later in life. About 50 percent of women who have had gestational diabetes are also at risk of developing type 2 diabetes later in life.
How diabetes mellitus is diagnosed?
Sometimes the patients are lucky and the doctor finds out by chance that their blood glucose levels are elevated. Diabetes is present when
– the blood glucose value at/above 11.1 mmol/l resp. 200 mg/dl – the fasting blood glucose value at 7.0 mmol/l or. 126 mg/dl – the long-term value (HbA 1 c) at 48 mmol/l
In the case of a potential type 2 diabetic, the so-called "diabetic foot" is still present. oral glucose tolerance test (oGTT): for this, the patient drinks a fixed amount of a sugar solution on an empty stomach. Before that. One and. two hours later, the blood glucose is determined. If the two-hour value is 11.1 mmol/l (or. 200 mg/dl) or above, diabetes is present.
You can do a self-test at regular intervals. The risk of developing diabetes can be quickly checked on the Internet: diabetesde.org/risk test. Test strips can be purchased just as quickly and it only takes a few minutes to find out whether you have too much sugar in your urine.
What happens if diabetes is left untreated?
Too much sugar in the blood damages the blood vessels in the long run. Their walls become permeable, so that bleeding can occur. In addition, the vessel walls thicken due to scarring, so that vascular occlusions and circulatory disorders can occur.
The small vessels are particularly at risk, z.B. in the retina or in the kidneys and nerves. Therefore, vision problems and even blindness can be a consequence of untreated diabetes, as can kidney dysfunction or insensations (tingling, pain, burning) caused by the nerve damage.
But large vessels also suffer from the sugar load that flows through them. This increases the risk of hardening of the arteries (arteriosclerosis).
The organ damage caused by undetected diabetes does not appear until long after the insulin metabolism has been disturbed. In type 1 diabetes, the insulin-producing beta cells of the pancreas are bspw. almost 80 percent destroyed before symptoms appear! Sometimes it is a diabetic coma that first raises suspicion of diabetes.
What is diabetic coma?
The most severe consequence of hyperglycemia is the Diabetic comas: a deep unconsciousness. The breath of the affected person smells of acetone (nail polish remover). It is imperative to call the emergency doctor!
What is diabetic foot?
The damage that untreated diabetes causes to the vessels and the circulatory disturbances can lead to wounds, especially on the feet, that heal poorly or are even covered with ulcers. The cause are u.a. also the nerve disorders: Injuries or too much prere (z.B. Affected persons not even aware of it. Develop into large wounds. Affected diabetics should have regular inspection of the feet, if necessary. also examine the foot by mirror, so that the sole of the foot can also be viewed.
How is diabetes mellitus treated?
Diabetes mellitus is a serious disease, whose consequences can be really massive, but it is also well treatable. Type 2 diabetes in particular, the most common form, cannot be cured, but thanks to good therapy, the consequences of severe disease can be largely prevented or reduced.
Not everyone needs insulin injections right from the start. This applies more to type 1 diabetics, but many type 2 diabetics also need to take insulin from outside at some point. 1.5 million diabetics require insulin on a regular basis. Decisive for the use of insulin are the blood glucose levels. One value in particular, the HbA 1c, is especially meaningful here, because it is the body's blood glucose memory, so to speak.
– The long-term blood glucose value (HbA 1c) in type 1 diabetics should be below 7.5 % (or. 58 mmol/mol) are present. – In type 2 diabetics, the HbA 1c value should be between 6.5 and 7.5 % (or. are between 48 and 58 mmol/mol).
For many type 2 diabetics, therapy with tablets or. oral antidiabetic drugs are perfectly adequate. The so-called oral antidiabetics lower the blood sugar. Some also have a protective effect on the kidneys or heart. Oral antidiabetic medications include.B.
1. Metformin or glitazones, which increase the sensitivity of cells to insulin 2. sulfonylureas or glinides, which increase insulin production 3. DPP4 inhibitors or GLP-1 analogues, which boost metabolism 4. SGLT-2 inhibitors, which increase sugar excretion in the kidneys 5. Alpha-glucosidase inhibitors, which ensure that sugar is absorbed more slowly in the intestines
In many cases, however, it is not possible without a Insulin therapy.
How does insulin therapy work??
To keep blood glucose levels in check, many sufferers need to take (v.a. Type 1 diabetics) inject insulin. Sometimes they use a so-called pen, a kind of "fountain pen," to do this; sometimes they use an insulin pump that is worn on the body and delivers insulin regularly.
In intensified insulin therapy (ICT), patients inject long-acting insulin once or twice a day and – at mealtimes – another injection of short-acting insulin. rapid insulin.
Insulin administration depends on what, when and how much food the diabetic eats. For hyperglycemia (high blood glucose). Hypoglycemia must also be avoided.
– Rapid pulse – thirst – strong urge to urinate – nausea – weakness – dizziness – headache – tremor – pallor – restlessness, anxiety – difficulty concentrating – sudden heavy sweating
Rapid treatment is now important. Dextrose or a sugary drink quickly bring blood sugar back up again. Important: The blood glucose levels at which these symptoms occur vary from person to person with diabetes. Sudden hypoglycemia can also occur during sleep. Occur during physical exertion/sport.
– Strong thirst and urge to urinate – Fatigue – Lack of drive – Nausea – Dizziness – Visual disturbances – Abdominal pain, nausea, vomiting – Loss of appetite – Acetone odor of the breath
Diabetes mellitus – what can you do?
Diet in diabetes mellitus – what to watch out for?
It used to be on the shelves: diabetic chocolate. In the meantime, experts have proven that many alleged "diet foods" contain no sugar but a lot of fat. So instead of relying on diet products, the advice today is: eat a healthy, varied diet with lots of fresh fruit and vegetables, little meat and, above all, lots of unsaturated fatty acids, such as those found in the.B. found in oils, fish or nuts.
Dietary fiber (z.B. Whole-grain products, legumes) ensure that blood sugar levels rise less sharply after a meal. In addition, dietary fiber makes you feel fuller longer – and this is beneficial if you also need to reduce weight.
Plenty of exercise for diabetes mellitus
Obesity is a risk factor for diabetes. A plus of exercise supports the normalization of body weight. It also brings even better body awareness, forces to go outside, meet with others and perhaps even complete joint walking rounds.
Alcohol and tobacco in diabetes mellitus
Alcohol and tobacco affect the blood vessels, increase blood prere and can cause many diseases (u.a. Trigger cancer). Both stimulants are not recommended with diabetes. Just cutting back on food can make those affected feel fitter and more likely to enjoy regular exercise again.
Diabetes mellitus – Regular doctor visits are important
Every diabetic should see his or her family doctor regularly. There, the protein excretion in the urine is determined, the feet are checked for prere points or wounds, and blood prere and blood lipid values are also measured.
A regular visit to the ophthalmologist to check the retina for any damage is also part of living with diabetes.
Say yes to your diabetes!
In the treatment of diabetes mellitus, it is not only important that those affected receive insulin, but also that they first accept their disease! It's no use lulling yourself into a sense of security thanks to insulin injections. All diabetes mellitus requires a lifestyle that takes it seriously. This also includes regular blood glucose monitoring.
Diabetes mellitus: Support groups can help
Patient education and support groups can help if you may have just been diagnosed with "diabetes". This is scary, but use this fear as an impetus to really deal with the disease. Other sufferers can be good advisors in this respect.