Diabetes mellitus (diabetes)
Lack of exercise, obesity and poor diet are the main causes of diabetes.
Diabetes is a metabolic disease with a chronic elevation of blood sugar (hyperglycemia). Basically, a distinction is made between diabetes mellitus type 1, an autoimmune disease triggered by a viral infection, and diabetes mellitus type 2, the so-called adult-onset diabetes, since it used to occur mostly in people of advanced age.
Type 2 affects about 90% of all diabetics. Due to progressive lifestyle changes, the age of onset of the disease has dropped significantly in recent years: Young people are also increasingly suffering from this form of diabetes.
With every meal, our body converts parts of the ingested food into sugar (glucose), which is transported from the blood to the ties. There, the body's cells use it as an energy supplier. The pancreas produces insulin, a hormone that "opens" the doors of the cells so that the glucose can enter.
At least 30 percent of all Germans are diagnosed with what is known as prediabetes, or insulin resistance, in the course of their lives: Over time, muscle, liver and fat cells become insensitive to insulin. The blood glucose level (glucose level) rises, but does not yet reach the levels seen in type 2 diabetes. Insulin resistance cannot be recognized by symptoms. However, they can lead to elevated blood cholesterol levels and high blood prere. In addition, the risk of heart disease or stroke is increased. Once you have prediabetes, you are likely to develop type 2 diabetes within ten years.
In insulin resistance, the cells do not respond normally to insulin; the transfer of glucose from the blood into the cells is disturbed. The glucose level in the blood keeps rising, the pancreas tries to compensate for the apparent lack of insulin – and keeps producing insulin. Over time, the body's cells become more resistant to insulin. Eventually, the body can no longer cope with the continued production of insulin: Blood glucose levels continue to rise, and type 2 diabetes develops.
These factors favor type 2 diabetes:
– Obesity due to improper diet and physical inactivity, which mainly increases the fat tie of the abdominal cavity and increases the amount of free fatty acids in the blood; – Genetic predisposition: If a family member already has diabetes, you have an increased risk of developing the disease yourself. If you have a parent with the disease z. B. this risk is 50 percent; – certain medications, z. B. Statins (cholesterol synthesis enzyme inhibitors), which are designed to lower blood cholesterol levels. Also cortisone, diuretics (thiazides), antihypertensives (beta-blockers), ovulation inhibitors, antidepressants; – Pregnancy (gestational diabetes); – Liver diseases; – Stress factors for the body (infections, injuries, operations); – Hormone disorders. – Since diabetes mellitus develops over years, it is often detected too late. The first non-specific signs may be fatigue, weakness, impaired vision and a tendency to infection (repeated bladder infections). Poorly controlled diabetes also results in secondary damage that is often irreversible: – cardiovascular disease (heart attack, stroke) because of the increased risk of developing arteriosclerosis; – kidney disease and renal insufficiency; – eye disease, even blindness; – worsened wound healing and diabetic foot syndrome due to nerve and vessel damage and, as a result, arterial circulatory disorders.
Have your personal diabetes risk determined
Various values provide information about the risk of developing diabetes mellitus. Basically, if you reduce your body fat, you reduce your risk of diabetes. The cells respond more strongly to insulin – especially if you do not have a fatty liver. The determination of the liver fat content therefore allows statements to be made about the individual risk.
From a body mass index (BMI, kg/m2) of 27, the risk also increases. For fasting blood glucose (mg/dl), a value below 110 is considered normal. This is referred to as abnormal fasting glucose, and values above 126 are referred to as diabetes. Regardless of age and body weight, it is recommended to have a glucose load test done if fasting blood glucose is elevated before starting lifestyle changes such as diet or exercise training.
Hemoglobin A1c (HbA1c), also known as long-term blood glucose, is important for statements about the individual risk of diabetes. Its value provides information about the blood glucose level of the last eight to twelve weeks. For diabetics, the blood glucose level is determined regularly and should be below seven to eight percent; for frail elderly people, somewhat higher values are also acceptable in individual cases in order to prevent hypoglycemia with the risk of falling and thus fractures (fracture of the neck of the femur). A value above 8.5 percent indicates that blood glucose levels have averaged above 200 milligram percent in the past two to three months. Normal values are between 70 and 140.
Diabetes prevention: lifestyle changes work
Since diabetes develops over a longer period of time, it can be effectively countered with the right preventive measures. Lifestyle changes are just as important as medical measures, not only as prevention, but in every phase of the disease. The biggest challenge is to establish a new, healthier lifestyle over the long term.
Along with high-calorie diets, lack of physical activity is the main cause of obesity and type 2 diabetes. Overweight occurs when more energy is taken in than consumed. There are basically two ways to achieve an improvement: by eating fewer calories or by doing more physical activity. In addition, obesity can also be caused by mobility impairments, such as osteoarthritis in hip or knee joints.
If there is an increased risk of diabetes, weight loss of five to seven percent should be the goal. Reducing body weight favors the transport of glucose from the blood into the cells. The more you move, the less glucose remains in the blood, the cells' responsiveness to insulin improves. As a guideline, 30 minutes of endurance sports (aerobic training: walking, swimming, cycling, etc.) are recommended.) for adults on at least 5 days per week. In addition, you should aim to take 10.to take 000 steps a day.
The type of physical activity is secondary. In addition to endurance sports, gardening or dancing may also be considered. It is important to make an effort and sweat as much as possible. However, exercise should only be pushed to the point where you are able to say a sentence out loud at any given time without having to gasp for air in between. Anyone who has been physically inactive or not very active for a long time should only put weight on their body after consulting a doctor. The ideal is a gradual approach to the 30-minute goal. Also moderate strength training two to three times a week. Daily gymnastic exercises to increase flexibility are useful. However, caution is advised with regard to the individual vascular situation: Changes in the back of the eye may make. an adjustment of strength training is necessary. Here, too, you should seek medical advice beforehand.
A sensible diet prevents diabetes
The components of our diet have a direct influence on the development of type 2 diabetes. High levels of sugar and (animal) fats as well as high-protein diets, such as low-carbohydrate or low-carb diets, promote the disease. Conversely, a diet emphasizing plant-based, high-fiber foods protects the body.
If a diet is indicated, it should be carried out with an accompanying muscle program so as not to impair the body's functionality. A diabetic who is to reduce his weight must also pay attention to his protein intake. Because proteins are essential for building muscle mass. A balanced Mediterranean diet makes sense. Basically, the following dietary recommendations apply:
– Avoid industrially processed foods as much as possible and instead eat vegetables, legumes, beans, berries and whole grain products because of their numerous nutrients and high fiber content, which quickly saturate and increase insulin sensitivity.
– Avoid saturated fats (red meat, fatty dairy products) because of their high caloric density. In addition, they favor insulin resistance, fish fats and vegetable oils (z. B. Rapeseed or olive oil), on the other hand, do not. In moderation, low-fat dairy products, fish and other protein sources.
– Largely avoiding sweets, baked goods and sugared drinks – they contain too much sugar, fat and calories and have little nutritional value.
– Eat smaller portions slowly to give the brain time to signal a feeling of fullness. Focus exclusively on the meal when eating. Do not watch TV or work at the same time.
– Moderate consumption: one to two cups of coffee, one bar of dark chocolate, one alcoholic drink per day can improve insulin sensitivity.
Once you have diabetes mellitus, you need to measure your blood glucose regularly. Blood glucose meters for everyday use now achieve considerable accuracy. Whereas about ten years ago average deviations of 15 to 20 percent compared to a laboratory analysis were the order of the day, today these deviations are only five to ten percent. However, inexpensive models are often based on older technologies. Show correspondingly inaccurate results.
Good devices now have numerous additional functions. In addition to the storage of the values with measurement time and date, many devices offer complete evaluation programs, integrated or for the computer. With some, the data can be sent via cell phone to another computer, for example in the doctor's office. Necessary adjustments in the therapy can thus be implemented at short notice.
Take advantage of the comprehensive diabetes check-up at the Bornheim Clinic
We can tell whether you are at risk of diabetes or have type 2 diabetes by measuring blood glucose, hemoglobin HbA1c, and sugar and protein in your urine. The thorough check-up in our practice clinic also includes the measurement of arterial blood prere, the determination of cholesterol values and blood fat values (triglycerides). We also examine whether characteristic organ damage has already occurred in the eyes, kidneys, nervous system or blood vessels.