Diabetes is increasing rapidly in the western world: more than 400 million people worldwide suffer from diabetes, as it is also called, and the number is rising. There are over six million diabetics in Germany, with around 300,000 new cases every year. The most common cause is obesity. Today, diabetes is one of the most common diseases of affluence, along with gout.
What is diabetes?
Diabetes – more correctly diabetes mellitus – is a chronic metabolic disease in which too much sugar accumulates in the blood.
A distinction is made between two classic forms:
Type 1 diabetes mellitus is a rare autoimmune disease, which is genetically predisposed and occurs in families. Diabetes mellitus type 2 is the much more common form, accounting for 95 percent of all cases.
In addition, there are various forms of diabetes mellitus that cannot be clearly assigned to either of the two classic types and are therefore classified under Diabetes mellitus type 3 summarized. In addition, there are rare forms such as gestational diabetes (Diabetes mellitus type 4), which affects four out of every hundred pregnant women.
The scientific name Diabetes mellitus comes from the ancient Greek diabainein for "to flow through" as well as the Latin mellitus for "honey-sweet"; it was already coined in the first century after Christ. This is because diabetes is accompanied by an increased urge to urinate (flow) in order to eliminate the excess sugar. Doctors at that time recognized the disease by testing the urine – it tasted sweetish.
How diabetes develops?
The concentration of sugar in the blood is regulated by the hormone insulin, which is produced in the pancreas. It transports the sugar that we take in with food from the blood into the cells, where it is needed for energy production. Strictly speaking, insulin causes sugar to be absorbed into the cells.
At Type 1 diabetes the body gradually destroys the cells in the pancreas that produce insulin. At Type 2 diabetes the available insulin does not act sufficiently, so that the cells cannot absorb the sugar.
If there is too little insulin in the blood or if the insulin does not work as it should, the cells have to obtain their energy from other substances. Sugar accumulates in the blood – the blood sugar level rises.
Too much blood sugar
Our body can compensate a disturbance in the blood sugar balance for a long time. In type 1 diabetes, blood sugar levels do not rise until around 80 percent of the insulin-producing cells in the pancreas have been destroyed. By then, the remaining cells simply produce more insulin! In type 2 diabetes, more insulin is produced to compensate for its low effect. In both cases, the pancreas takes over in the long term.
Type 2 diabetes often occurs as a so-called "diabetes of the body" Affluence syndrome because it is believed that obesity is the main cause of diabetes. In fact, 80 percent of diabetics in Europe are overweight! Many also suffer from lipid metabolism disorders, such as elevated cholesterol or high blood prere.
But what does body weight have to do with sugar?? Due to the increased food intake, the sugar level in the blood is constantly elevated, the pancreas has to produce insulin almost non-stop. This causes a kind of resistance to form on the body's cells – they no longer react to the insulin present and do not absorb the sugar. As a result, the pancreas produces even more insulin to lower blood glucose levels. The insulin in the blood also triggers a feeling of hunger, the affected persons eat again – a vicious circle develops.
Diabetes in children
Type 1 diabetes often occurs in adolescence, which is why it used to be referred to as juvenile diabetes. Since the ie of lack of exercise and obesity is now also increasingly affecting children and young people, many younger people are already suffering from type 2 diabetes, which used to be called adult-onset diabetes.
How do I notice this?
The fatal thing is that you do not notice an elevated blood glucose level at first – your body compensates for it unnoticed for a long time! Often, an elevated blood glucose level is discovered by chance, as part of a routine checkup or an examination in another context.
Do you have excessive thirst? Are you often fatigued and exhausted? Do you constantly have to. Urinate more often? Do your feet tingle as if ants are walking over them? Then have your glucose level tested by your doctor as soon as possible. Itching, cravings, visual disturbances or an overall higher susceptibility to infections are also complaints that indicate advanced diabetes.
It is important to detect diabetes as early as possible. Because if left untreated, this leads to long-term damage in various areas of the body, especially the blood vessels themselves (e.g. B. atherosclerosis). This can lead to late complications such as heart attacks and strokes, as well as kidney failure, often resulting in death. Around three-quarters of diabetics still die prematurely from complications of the heart or blood vessels. About 50,000 diabetics per year in Germany have body parts amputated, mostly the feet, which are no longer supplied with blood properly. Around 25 percent of those affected suffer from vision damage or gradually lose their eyesight as the sugar is deposited in the tie. The doctor measures your blood glucose level. The so-called long-term blood glucose (HbA1c value). He may also test your urine for sugar and ketones, which are produced when the body breaks down fat instead of sugar for energy, or he may do an oral glucose tolerance test (oGTT).
Normal and elevated values
Even in healthy people, blood glucose levels fluctuate daily, depending on whether we are fasting or have eaten. Fasting blood glucose levels are usually below 100 mg/dl. Should not be higher than 160 mg/dl two hours after eating.
If the blood glucose level is 126 mg/dl or higher when you are fasting and over 200 mg/dl two hours after eating, you have diabetes mellitus.
What to do if you have diabetes?
The treatment of diabetes depends primarily on the type of disease you have. Type 1 diabetics need to make lifelong Insulin injections as soon as they receive the diagnosis.
At Type 2 diabetics the options are initially broader. Primarily, they must permanently change an unhealthy lifestyle: Reduce excess weight, eat a balanced diet and exercise regularly. Often this is enough to normalize the blood sugar level again.
The doctor may prescribe additional medication. So-called Oral antidiabetics (z. B. Metformin) lower blood glucose levels. If they no longer work adequately, type 2 diabetics also have to inject insulin.
In addition, treat vascular damage that has already occurred due to hardening of the arteries, high blood prere and high cholesterol.
As a rule, diabetics inject themselves with insulin one to several times a day, depending on the stage they are in. Insulin is injected under the skin with special insulin pens.
Nutrition for diabetes – it's up to you!
Above all, it is important to eliminate all risk factors that can promote diabetes: The most important of these is obesity.
You can make a big difference in diabetes with a healthy diet. Reduce your excess weight to a BMI of around 25. This prevents secondary diseases. Your doctor can provide you with advice. Stop smoking. Reduce your alcohol consumption. It is important to consistently check your blood glucose and keep it constant. Many patients are largely symptom-free as a result.
Household sugar and sugar substitutes
For a long time, household sugar was absolutely taboo for diabetics. In the meantime, saccharin – as the double sugar made from one molecule of glucose and one molecule of fructose is also called in technical jargon – is even recommended in moderation as an alternative to sweeteners by the diabetes specialist societies in Europe and the USA. Because these substances, long recommended as a substitute for sugar, are more likely to increase the risk of developing diabetes. Artificially sweetened soft drinks in particular are harmful in the long term, as they raise blood sugar levels.
Diabetes is not about completely avoiding certain foods or a special diet – just the right amount. It is important to avoid major fluctuations in blood glucose levels, so eat several small meals rather than three large ones. The motto is: balanced, low-fat and wholesome, with sufficient fruit and vegetables. Alcohol lowers sugar levels, so always eat something with a glass of wine.
Sport and exercise make your muscle cells react more sensitively to insulin and thus absorb the sugar better – your blood sugar level drops! 30 minutes of exercise three times a week is sufficient. And remember: Every kilo that you lose prevents late damage! Your health will thank you.
Exercise lowers blood sugar, so always take a snack or snack with you when you exercise. And do not forget to take this into account when dosing insulin.
Diagnosis of diabetes?
You are not left alone with the diagnosis of diabetes. There are patient education and treatment programs that you can take part in to help you come to terms with the disease and learn how best to manage it. Your doctor will accompany you. Giving them the information they need.
Remember: if your diabetes is well controlled, you have a good prognosis and will be able to live largely symptom-free. Poorly controlled or untreated diabetes, on the other hand, reduces both your quality of life and your life expectancy!
Go for regular check-ups! Take care of your feet! It is best to apply for a health passport right away. Go to the doctor if you are ill, fever or taking certain medications may also affect blood sugar levels.
Life-threatening conditions in diabetics
When blood sugar levels are derailed – too low or too high – it can trigger life-threatening conditions. It is important to know how to react in such a case, both as a patient and as a family member.
Hyperglycemia (diabetic coma): The diabetic coma – also known in Latin as "diabetes Coma diabeticum – Occurs mainly in type 1 diabetics. If the pancreas stops producing insulin, blood glucose levels can rise sharply as a result. Affected persons react with vomiting and increasing disturbances of consciousness, later with palpitations and a drop in blood prere up to shock. Make an emergency call immediately!
Hypoglycemia: If you have inadvertently injected too much insulin or forgotten to eat something after insulin administration, your blood glucose level may drop below 70 mg/dl quite quickly. Affected people usually get ravenous appetite, become tired and restless at the same time, start shaking and sweating. Later, drowsiness and impaired consciousness, even coma, can follow (Coma hypoglycaemicum), breathing and circulation collapse. This is also a life-threatening condition! As soon as you as a patient notice an acute hypoglycemia, it is best to consume quickly usable carbohydrates such as glucose, juice or lemonade. Relatives or even work colleagues should be aware of how to deal with the administration of a "sugar shot".