Diabetes mellitus diabetes causes symptoms diagnosis treatment prognosis prevention g

In case of diabetes mellitus (diabetes) the Blood sugar level permanently too high (hyperglycemia) as long as the disease is not properly controlled. Caused by insulin deficiency or insulin resistance (insulin is present but cannot act). Insulin is a hormone produced in the pancreas. It accelerates the absorption of sugar (glucose) from food into various cells of the body and thus regulates the blood sugar level. Two main types of diabetes mellitus are distinguished: Type 1 and Type 2.

In diabetes mellitus type 1, the pancreas no longer produces insulin. The cause is probably an autoimmune reaction in which the body's own immune cells destroy the insulin-producing cells of the pancreas. This leads to a permanent insulin deficiency; doctors also speak of insulin-dependent diabetes. Type 1 diabetes usually begins in children. Adolescents or young adults.

The cause of type 2 diabetes mellitus is impaired insulin production and/or congenital or acquired insulin resistance. This means that the pancreas is either no longer producing enough insulin or that the cells are no longer responding properly to the effect of the insulin. As a result, the cells do not absorb enough sugar from the blood. The blood glucose level remains elevated. Type 2 diabetes occurs mainly in middle or older adulthood. In the past, this was therefore also referred to as "adult onset diabetes". Since obesity and lack of exercise promote the disease, type 2 diabetes mellitus can also occur in younger, overweight adults and even in children.

Complaints: How does diabetes mellitus manifest itself??

Typical signs of diabetes mellitus (diabetes), especially in type 1, are chronic fatigue, decreased performance, general fatigue and weight loss, as well as abnormally increased thirst, increased urination and increased urination. These symptoms appear quite quickly.

In contrast, diabetes mellitus type 2 often progresses insidiously. Type 2 diabetics, in contrast to people with type 1 diabetes, are often overweight. The elevated blood glucose level is often only noticed during a routine check-up with the doctor. Previously, the affected person may not even have noticed for a long time that they were ill. This is dangerous because untreated diabetes can lead to Consequential damage such as circulatory problems, eye damage, kidney disease and severe foot problems causes.

Diagnosis: How diabetes mellitus is diagnosed?

After discussing the symptoms and the course of the disease, the doctor performs a thorough physical examination to diagnose diabetes mellitus (diabetes). This is followed by blood tests and urine tests. The blood glucose level is determined either when the patient has not yet eaten anything (fasting blood glucose) or at any time of the day (casual blood glucose).

From a glucose value of over 126 mg/dl (7.0 mmol/l) in fasting blood one ames diabetes mellitus. The normal value is below 100 mg/dl (5.6 mmol/l). If the glucose concentration at any time of day is over 200 mg/dl (11.1 mmol/l), this is also a sign of diabetes.

If the blood glucose values are in the borderline range (i.e. above 100 mg/dl and below 126 mg/dl), a so-called oral glucose tolerance test (OGTT) can confirm the diagnosis of diabetes mellitus. People who have an increased risk of developing diabetes – for example, due to a family predisposition – should also take an oral glucose tolerance test if their blood glucose levels are normal. For this purpose, after an initial measurement of the fasting blood glucose level, the patient drinks a concentrated sugar solution (glucose solution). After two hours, the doctor measures the blood glucose level again. If the value is above 200 mg/dl (11.1 mmol/l), this is a sign of diabetes mellitus. The HbA1c value is often used to monitor the course of the disease-. Therapy control in case of already known diabetes mellitus. In simple terms, this blood value enables the doctor to detect whether increased sugar molecules have attached to the red blood cells. This "saccharification" occurs when blood glucose levels are permanently high – the HbA1c value rises accordingly. From an HbA1c level of 6.5 percent (48 mmol/mol) if diabetes mellitus is present. With a value below 5.7 percent (39 mmol/mol) the disease can be ruled out. If the HbA1c level is 5.7 to 6.4 percent (39 to 47 mmol/mol), further tests are necessary, for example measurement of the blood glucose level or the glucose tolerance test.

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In some cases, the HbA1c value is not suitable for determining diabetes mellitus, because the value can be falsified in some situations. These include various forms of anemia, for example as a result of iron deficiency, liver and kidney diseases, the use of certain medications, and pregnancy. If symptoms of diabetes mellitus are already present, the HbA1c value is not suitable for diagnosis. This is then determined by blood glucose measurement or a glucose tolerance test.

Another diagnostic procedure for diabetes mellitus is the determination of sugar (glucose) in the urine. If glucose is detected by urine test strips, this indicates an elevated blood glucose level, because sugar is not normally excreted in the urine. So-called ketone bodies can also be detected in the urine, which are also indicative of diabetes mellitus. However, the possibility of measuring blood glucose has made the determination of urine glucose less important.

If diabetes mellitus is diagnosed, further tests are useful to determine the extent and progression of the disease. This includes, for example, the determination of blood values (HbA1c, C-peptide, autoantibodies if necessary, blood lipid values) and blood prere, as well as specialist clarification of possible consequential damage (for example, eye examination, foot ambulance, etc.).).

Treatment: How can diabetes mellitus be treated??

The basis of the therapy of diabetes mellitus (diabetes) is comprehensive patient education. This includes how to deal with the disease in everyday life, such as self-medication, diet, blood glucose meters, and information about possible consequential damage. Diabetics have to measure their blood glucose several times a day and watch what they eat. The aim of diabetes therapy is to keep blood glucose levels within a certain range and thus, above all, to prevent severe secondary diseases. A distinction is made between the treatment of type 1 and type 2 diabetes:

– People with type 1 diabetes are in any case Insulin are dependent (insulin requirement). – Affected persons with Type 2 diabetes can often control their disease by changing the Nutrition and to provide HealthierLifestyle with plenty of exercise and Weight normalization Getting to grips with the disease. When changing the diet, counseling is advisable, if necessary as part of a diabetes training course. If these measures are not sufficient, type 2 diabetics must also take blood sugar-lowering tablets (oral antidiabetics). These include: – Biguanides (metformin) – Sulfonylureas – Glitazones – Alpha-glucosidase inhibitors – Glinides – SGLT-2 inhibitors (gliflozines) – Incretins (z.B. GLP-1 receptor agonists) – DPP-4 inhibitors

The first-choice antidiabetic drug is the Metformin. It effectively lowers blood glucose, reduces the risk of secondary diseases and improves the quality of life of those affected. Sulfonylureas are particularly recommended for type 2 diabetics who cannot tolerate metformin. Because of various side effects, for example possible weight gain, they play only a minor role in modern diabetes treatment. Newer agents whose efficacy is still being studied in detail include glitazones, alpha-glucosidase inhibitors and glinides. If the diabetes medications do not help to lower blood glucose and relieve symptoms, people with type 2 diabetes mellitus are dependent on insulin.

Because the pancreas in people with type 1 diabetes mellitus no longer produces any insulin at all, sufferers must take a daily supply of this vital hormone. Because insulin is sensitive to stomach acid, it is currently not possible to take the hormone in tablet form; instead, it must be injected. However, alternative dosage forms, for example tablets, are currently being investigated in clinical trials.

People with diabetes mellitus can use different insulins. Some act very quickly, for example within a few minutes (short-acting insulins), others very slowly but for many hours (long-acting insulins). There are also mixed insulins, which combine long- and short-acting variants. In the past, diabetics mostly used insulin from the pancreases of cattle or pigs. However, the majority of insulins used today are artificially produced. There is so-called human insulin, which chemically corresponds to human insulin, and so-called insulin analogues, which differ slightly in their structure from human or animal insulin. The effects of long-term use of insulin analogues have not yet been fully clarified scientifically.

Regardless of the type of insulin used, it is advisable for every diabetic who requires insulin to undergo training to learn how and when to measure their blood glucose and inject themselves with insulin. In the course of the training, the person affected also learns what he or she has to bear in mind as a diabetic in everyday life – above all with regard to diet, exercise and sport, alcohol consumption and possible concomitant diseases.

Prognosis: What is the prognosis for diabetes mellitus??

The earlier diabetes mellitus (diabetes) is diagnosed and treatment is started, the better consequential damage can be avoided. Poorly controlled blood glucose levels lead to vascular and nerve damage with serious sequelae, for example in the eye (up to blindness), kidneys and feet (diabetic foot with the risk of amputation). Also the risk of heart attacks. Strokes (apoplexy) is increased.

Prevention: How to prevent diabetes mellitus?

Preventing type 1 diabetes is not possible. Type 2 diabetes can usually be controlled with normalization of weight. Avoiding a healthy lifestyle. Since overweight children and adolescents are increasingly affected by type 2 diabetes, it is advisable to consult a doctor as soon as possible, who can work out a weight reduction concept suitable for children. If you suffer from diabetes, you should have regular medical check-ups and aim for a blood glucose level in the target range in order to avoid serious secondary diseases.

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