Diabetes mellitus symptoms of blood sugar disease
Causes, symptoms, complications and treatment of diabetes mellitus
As diabetes mellitus, (colloquially abbreviated to diabetes or Diabetes mellitus) refers to a number of endocrinological disorders of carbohydrate metabolism. All are due to the fact that insulin is not produced in sufficient quantity or is not effective. This leads to Chronic elevation of blood glucose levels. Diabetes mellitus is one of the most common chronic diseases with an incidence rate of about 5%. Along with cardiovascular diseases and cancer, it is often referred to as a widespread disease.
diabetes mellitus – What does diabetes mean
What is blood sugar?
Blood sugar is the amount of glucose (dextrose) in the blood. This monosaccharide is the "most important energy supplier of the body". The brain in particular needs them for its work. Hypoglycemia (Hypoglycemia) leads to its undersupply, which manifests itself in tremors, convulsions and sweating, and in the worst case leads to coma. In contrast, chronic hyperglycemia (Hyperglycemia) can be a sign of diabetes.
Regulation of the blood glucose level
The superior organ for blood sugar regulation is the anterior lobe of the pituitary gland (hypophysis). Sensors in the blood vessels ensure that a blood glucose level of "80 – 120 mg/dl" is set. If it rises after a meal, the pituitary gland triggers the release of insulin. This leads to the synthesis of the storage substance glycogen from glucose in the liver and muscles, which is then removed from the blood. When blood glucose levels drop as a result of physical activity, adrenaline and corticosteroids from the adrenal gland and glucagon from the pancreas are released. Breakdown of glycogen leads to release of glucose, blood glucose rises.
Production and functions of insulin
Insulin takes its name from island-like structures in the pancreas. These consist of A and B cells. A-cells produce glucagon, which raises blood glucose levels, B-cells produce insulin, which lowers them. Hormones enter the bloodstream. Together regulate blood glucose levels.
Diabetes mellitus – blood sugar measurement Copyright: Toeytoey, Bigstockphoto
Classification of diabetes mellitus
In diabetes mellitus, two main groups can be distinguished:
Type I diabetes (primary D., insulin-dependent D., juvenile D., absolute insulin deficiency)
Autoimmune diseases or viral infections lead to degeneration of many B cells, which then no longer produce insulin. The disease occurs preferentially at a young age within a few days to weeks and leads to coma if left untreated. ( diabetes mellitus type 1 )
Type II diabetes (secondary D., insulin-independent D., Altersd., relative insulin deficiency)
In type II diabetes, the course of the disease is gradual. Insulin is actually produced in sufficient quantities, but for reasons that are not yet fully understood, it can no longer exert its effect ("insulin resistance"). The slow progression of the disease leads to a number of irreversible organ damage, so that there is also an urgent need for therapy here.
Symptoms of diabetes mellitus
General symptoms. Diabetes mellitus manifests itself in similar symptoms in both forms. If the blood glucose level rises above 200 mg/dl, glucose is excreted in the urine. This requires large amounts of water. That is why diabetics Constant thirst and must be accompanied by urge to urinate to the toilet. Hence the name: diabetes mellitus means Honey-sweet flow.
The excreted glucose is missing as a source of energy. This leads to a general deterioration of the general condition, Weight loss and Reduction in performance. Fats burn in the fire of carbohydrates is a medical mnemonic. If carbohydrates are missing, fat breakdown is no longer complete. The breakdown products, known as keto bodies, accumulate in the blood and enter the urine and respiratory air. This lowers the natural pH of the blood (acidosis), which is Breath smells fruity and acidic and acetone can be detected in the urine.
Acute complications of diabetes mellitus
Go to hypoglycemic shock it occurs when blood glucose drops below 40 mg/dl. This leads to Headache, cramps, Coordination disorders and ultimately to the Coma. Acetone in urine on. Blood glucose rises above 300 mg/dl. This is followed by nausea, abdominal pain and vomiting, visual disturbances and finally coma.
Late complications
are vascular changes of the retina (Retinopathies), kidney damage (nephropathies), Polyneuropathies and Macroangiopathies (coronary heart disease, peripheral arterial occlusive disease, vascular calcifications, stroke).
Examination methods for diabetes mellitus
Numerous diagnostic procedures are used for diabetes. Here are only the most important.
– A Blood glucose determination Can also be performed at home. To do this, a test strip is inserted into a meter. The strip has a small capillary into which a drop of capillary blood is drawn from the fingertip. A biosensor in the test strip converts glucose enzymatically. Generates an electrical signal from this information. The meter uses this to calculate the blood glucose value.
– Urine test. Special test strips enable rapid. Simple measurement of sugar or acetone in urine. The degree of discoloration provides information about the approximate concentration.
– Long-term blood glucose. HbA1c is a molecule of the red blood pigment hemoglobin to which glucose has been attached. Since red blood cells have a lifespan of eight to twelve weeks, this percentage value indicates how often blood glucose was elevated during this time. Normal values are around 5 %, diabetics are above this level. An HbA1c of 10 % indicates that the average blood glucose level has been around 150 mg/dl during the time indicated.
Diagnosis of diabetes mellitus
Doctors used to use the increased excretion of glucose via the kidneys for diagnosis by testing the urine for a sweet taste. Today, they prefer blood glucose measurements, which are quick and easy to perform thanks to modern measuring devices. Characterized by repeated fasting blood glucose above 120 mg/dl or blood glucose levels above 180 mg/dl. After oral glucose tolerance test (oGTT), blood glucose remains above 200 mg/dl for at least two hours in diabetic patients.
Risk factors for the occurrence of diabetes mellitus
In many diabetics, other metabolic disorders occur. These include high blood prere (hypertension) and elevated blood lipid levels (hyperlipidemia, hypercholesterolemia). Obesity is the main cause of pathological changes in fat and sugar metabolism. This combination of diseases is referred to as. Risk factors for cardiovascular diseases of the "metabolic syndrome.
Therapy of diabetes mellitus
Type I diabetics must be treated with insulin. Type II diabetics are given insulin only when oral antidiabetic drugs such as metformin, which was used at the beginning of the disease, no longer have any effect.
In the past, the precisely calculated amount of insulin had to be taken from an ampoule and injected using a syringe and needle. Today, there are special "insulin pens" that contain the hormone in a cartridge. The required amount is injected into the subcutaneous fat tie of the abdomen or thigh at the touch of a button using a disposable needle. This is easy to handle. As good as painless.
H. Honey, A. F. H. Pfeiffer (Ed.): Diabetology compact. Basics and practice. Springer-Verlag Berlin Heidelberg 2019.