Urinary urgency, intense thirst and dry skin: There are many symptoms that make diabetes noticeable. Around six million people in Germany suffer from the metabolic disease. Read here how diabetes develops, what forms it takes and how it is treated.
What is diabetes?
Diabetes mellitus, colloquially known as diabetes, refers to a chronic metabolic disorder with elevated blood sugar levels (hyperglycemia).
The term "diabetes derives from the Greek and stands for "flow through", the latin word mellitus means "sweet as honey. Together, the two terms describe a clinical picture that was already recognized in ancient times: an increased excretion of sugar in the urine.
Diabetes: What you should know
Causes and risk factors
The hormone insulin, which controls carbohydrate, fat and protein metabolism, plays a decisive role in the development of diabetes. Insulin is a vital hormone that is produced by the body itself. It ensures that glucose (sugar) from the blood reaches the cells, where it serves as an energy supplier for metabolism. Insulin thus lowers the level of sugar in the blood. This mechanism is disturbed in diabetics. The reasons for this depend on which type of diabetes it is.
Why some people develop type 2 diabetes, while others are spared, has not yet been adequately researched. It is certain, however, that an unfavorable lifestyle and a hereditary predisposition play an important role. Obesity is considered one of the greatest risk factors. Fat cells in the abdomen in particular produce inflammatory substances that can cause insulin resistance. Therefore, as the abdominal girth increases, so does the risk of developing type 2 diabetes. Factors such as smoking. Lack of exercise increases the risk of diabetes.
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Types of diabetes: Types of diabetes
There are several forms of diabetes: the most common is type 2 diabetes. It affects about 90 percent of all cases. Five to ten percent of diabetics suffer from type 1 diabetes . Gestational diabetes is another form of diabetes.
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Type 1 diabetes
Type 1 diabetes is an autoimmune disease that can be hereditary or caused by environmental factors and infectious diseases. It often occurs in childhood or young adulthood and affects 0.3 to 0.4 percent of the population. In type 1 diabetes, the immune system turns against its own body by destroying the insulin-producing cells in the so-called islets of Langerhans (beta cells) of the pancreas. The body therefore no longer produces insulin. Insulin deficiency causes blood sugar to rise. Since this process cannot be reversed or cured, patients have to take insulin artificially for the rest of their lives.
Detailed: Causes, symptoms and treatment of type 1 diabetes
Type 2 diabetes
At Type 2 diabetes the insulin produced in the pancreas, which regulates blood glucose levels, loses its effectiveness. In the early stages of the disease, the pancreas counteracts the increasing insulin resistance of the body's cells by producing more insulin. This leads to an overload of the organ. This can lead to a situation where the pancreas stops producing insulin altogether. This causes blood glucose levels to rise even further.
In contrast to type 1 diabetes, type 2 usually occurs at an advanced age. Since the disease is promoted by an unhealthy lifestyle, poor diet, obesity and lack of exercise, it is increasingly affecting younger people and even children. It is therefore no longer a disease of old age.
Type 2 diabetes or its precursors often occur as a result of the metabolic syndrome. More than 80 percent of this form of diabetes is associated with obesity. However, a hereditary predisposition also plays an important role in the development of the disease.
In detail: Causes, symptoms, and treatment of type 2 diabetes
Type 3 diabetes
The term Type 3 diabetes Comprises various rare special forms of the metabolic disease. Develops in a different way than type 1 and type 2 diabetes. These include, among others, diseases of the pancreas, genetic defects of the beta cells or hormonally induced diseases. This form of diabetes occurs during pregnancy. Usually disappears again after the birth of the child. Risk factors are obesity, late pregnancy in women over 35, and a genetic predisposition. Risk of premature birth. Complications during birth. The newborns of affected mothers are often larger than average and heavier than average.
Gestational diabetes: These facts you should know
This graphic illustrates how insulin produced in the pancreas is released into the bloodstream to bind glucose. Diabetes mellitus usually develops gradually. Often does not initially cause acute symptoms. In the long term, however, the elevated blood glucose levels trigger certain symptoms that occur in all forms of diabetes. This is mainly due to changes in the water-. Mineral balance as well as the lack of energy in the body cells. The most common diabetes symptoms for type 1 and type 2 are:
– Strong urge to urinate, often at night (polyuria) – Urine has a sweet odor – Strong thirst – Feeling of weakness and fatigue – Difficulty concentrating – Visual disturbances that can last for hours – Itching and dry skin – Susceptibility to infectious diseases due to weakened immune defenses – In type 1 diabetes: marked weight loss within days to a few weeks
Unlike type 1 and type 2 diabetes, gestational diabetes is largely asymptomatic. Feeling of thirst, frequent urination and fatigue are usually only weakly pronounced and are interpreted differently in connection with pregnancy anyway. Nevertheless, there are signs that may indicate gestational diabetes. These include increased amniotic fluid, high blood prere, frequent urinary tract infections, and excessive growth of the unborn baby.
Diagnosis: Recognizing diabetes
When diagnosing diabetes mellitus, the doctor first takes a thorough medical history, during which risk factors and symptoms are discussed. In order to be able to make a reliable diagnosis, various test procedures are available:
Determination of the glucose of opportunity: The measurement can be done at any time of the day, you do not have to be sober for it. Determination of fasting blood glucose: The patient should not have eaten anything for eight hours beforehand. The patient should have been fasting for ten hours. Have eaten a high-carbohydrate diet for at least three days previously. Smoking is prevented. Not allowed during the test. Determination of HbA1c (long-term blood sugar)HbA1c (glycohemoglobin) is the pigment in red blood cells (hemoglobin) that is linked to sugar residues. The value indicates how high the concentration of blood sugar was in the last six to eight weeks. If the HbA1c is ≥ 6.5 percent (48 mmol/mol), this is called "manifest" diabetes mellitus diabetes mellitus. A value ≤ 6.5 percent does not exclude the presence of diabetes! Further diagnostics by means of fasting glucose or oGTT is necessary. Test for antibodies (for type 1 diabetes)
Consequential diseases and late complications
If the blood glucose of diabetics is incorrectly adjusted, this can have serious health consequences. If the values are permanently too high, blood vessels, nerves and organs are damaged. Common concomitant diseases in diabetes type 1 and 2 are:
– High blood prere – coronary heart disease – diseases of the retina/diabetic retinopathy (risk of blindness) – nerve damage (polyneuropathy) – damage to blood vessels – lipid metabolism disorders – diabetic kidney disease (risk of dialysis) – diabetic foot syndrome (amputation in severe cases) – arterial occlusive diseases of the leg arteries – skin infections and poor wound healing – erectile dysfunction in men – increased risk of stroke and heart attack – depression
Regular check-ups with the doctor help diabetics to reduce the risk of secondary diseases. The doctor can detect and treat existing diseases at an early stage.
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A young diabetes patient with an insulin pump: Insulin is delivered to the bloodstream via an implant. The pump itself is in the trouser pocket. (Source: Thinkstock by Getty-Images)
Treatment of diabetes
Diabetes treatment includes several options that can be combined with each other. Treatment depends on the type of diabetes, the course of the disease and the patient's general state of health.
Type 1 diabetesSince insulin deficiency is the cause of the metabolic disease, it can only be treated with insulin. Type 2 diabetesTreatment follows a step-by-step plan. The first step is to try to normalize blood glucose levels by changing the diet, normalizing body weight and exercising. If these measures are unsuccessful, the doctor usually prescribes oral antidiabetic tablets after three to six months. If the measures in step two are not sufficient, two medications are combined (dual combination), and therapy with insulin is also possible. If the blood glucose values are still not within the normal range, an intensified insulin therapy takes place in stage four, which can also be combined with tablets if necessary. Gestational diabetes: Here, too, an initial attempt is made to normalize blood glucose levels by changing the diet. Insulin is injected only if this approach is unsuccessful.
Regular check-ups with the doctor
Even if diabetes mellitus is well controlled, a medical check-up should take place at least once a year in order to assess the course of the disease and thus prevent dangerous secondary diseases. If acute complaints occur or the blood glucose values show abnormalities during the measurement, more frequent control appointments are advisable.
As part of the check-up appointments, the general practitioner checks not only blood glucose control, but also possible signs of changes in the vessels. Vascular calcification (arteriosclerosis) is common in diabetics. Is the cause of many cardiovascular diseases. Kidney function is also more often impaired in diabetics. With a urine test, the doctor can detect early signs of diabetic kidney disease. Changes in nerve function also often occur in diabetics.
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A physical examination, during which the doctor checks the reflexes and the sensitivity of the skin, provides indications of a possible diabetic neuropathy (nerve disease). Irrespective of the control appointments with the family doctor or diabetologist, patients should also have their eyes examined once a year to prevent visual disorders.
– Professional Association of German Internists e.V.