Type 2 diabetes mellitusIn type 2 diabetes, the sugar levels in the blood are elevated. If left untreated, the disease can cause acute metabolic disorders. Result in long-term health problems. A change in lifestyle and treatment with medication can prevent it
Diabetes mellitus type 2: The disease briefly explained
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What is type 2 diabetes??
Type 2 diabetes is a chronic metabolic disorder. Characteristic of the disease is an elevated level of sugar in the blood. The reason is usually a combination of hereditary predisposition, unhealthy diet and lack of exercise, which subsequently lead to insulin resistance. Insulin resistance means that the body's cells respond less effectively to the hormone insulin. Insulin has the task of transporting sugar (glucose) from the blood into the cells that need it as an energy source. In the case of insulin resistance, this is only achieved to an insufficient extent. The sugar therefore accumulates in the blood.
In treatment, on the one hand, medications prescribed by the doctor are important in order to lower the blood sugar level. At the same time, the patient plays a key role: with a change in lifestyle – especially a healthy diet, weight loss and plenty of exercise – the metabolic situation can be improved again and the dangerous long-term consequences of diabetes can be prevented.
Why is type 2 diabetes dangerous?
Elevated blood glucose levels often cause no symptoms for a long time. Inside the body, however, they cause long-term damage to the blood vessels, nerves and numerous organs. Above all, cardiovascular diseases such as a heart attack are typical complications of type 2 diabetes.
Type 2 diabetes is often diagnosed with initial damage, as the disease is only discovered after many years. Regular routine examinations by a doctor are therefore important in order to detect possible secondary diseases at an early stage and to take appropriate countermeasures.
The most important secondary diseases are heart attacks, strokes, kidney weakness, retinal damage, nerve disorders and circulatory problems in the legs and feet, including diabetic foot syndrome, which in the worst case can lead to amputation. These diseases usually develop gradually over a long period of time.
What happens in the body with type 2 diabetes
The pancreas produces insulin. It enters the blood and attaches to the insulin receptor in the cell wall. The receptor opens the gate to the cell for the sugar. Sugar enters the cell. The blood glucose level remains constant.
Type 2 diabetes
The beta cells in the pancreas initially still produce insulin. But the receptor does not react (insulin resistance). The cell gate remains closed. The sugar remains in the blood. The blood sugar level rises.
How common is type 2 diabetes?
There is no reliable data on the incidence in Germany, as diabetes is not a notifiable disease. Probably at least 7.5 million people nationwide currently live with diabetes that is treated with medication – the vast majority (about 95 percent) have type 2 diabetes. In addition, there are probably as many as two million people who have diabetes but do not know about it. Every day in Germany, around 1.300 people newly diagnosed with type 2 diabetes.
Does type 2 diabetes only occur in old age??
In the past, type 2 diabetes was often referred to as "adult-onset diabetes" designates. In fact, it is primarily older people who develop the disease. However, younger people are also increasingly suffering from type 2 diabetes. The reason for this is that more and more people are already heavily overweight at a young age and take little exercise. Doctors are increasingly finding the disease in children and adolescents as well. In the USA, about a quarter of young people have diabetes or a precursor of it. The term "adult-onset diabetes is no longer correct.
Can type 2 diabetes be cured by losing weight??
Type 2 diabetes can be made to disappear in many people by weight loss. That's according to the British DiRECT study, published in 2017: Nearly half of the participants were able to reverse their diabetes within a year by following a severely calorie-restricted diet followed by nutritional counseling. Among those who had managed to lose 15 kilos, the success rate was as high as 86 percent. However, this effect is only permanent if a healthy lifestyle is maintained. If those affected fall back into old habits, the diabetes also returns.
Difference between type 1 and type 2 diabetes
Type 2 diabetes is based on insulin resistance. This means that the body's cells respond less and less to insulin until they finally become insensitive – resistant. The hormone can then no longer transport the sugar into the cells. As a result, the blood glucose level rises. In the beginning, weight loss, exercise, and tablets are usually sufficient for treatment. In the course of the disease, insulin treatment is often necessary.
Type 1 diabetes is an autoimmune disease. The body's defense system destroys the insulin-producing cells in the pancreas. This leads to an insulin deficiency. Why the autoimmune reaction occurs in type 1 diabetes is not yet clear. Those with type 1 diabetes have to inject insulin from the start to control their blood glucose levels. The disease often develops in childhood and adolescence. Here you can learn more about this disease.
In addition to type 1 and type 2 diabetes, there are a number of other forms of diabetes, which are, however, very rare. You can read more about these forms here.
Professor Dr. med. Dr. h. c. Diethelm Tschope is a physician for internal medicine, endocrinologist, diabetologist DDG, gastroenterologist and health economist and, as clinic director, heads the diabetology/endocrinology department at the Heart and Diabetes Center North Rhine-Westphalia in Bad Oeynhausen. He teaches at the Ruhr University in Bochum and is chairman of the foundation "Der herzkranke Diabetiker" in the German Diabetes Foundation.