Diabetes mellitus type 2In Germany alone, there are approx. 8 million diabetics. Of these, approx. 95% suffer from type 2 diabetes. Diabetes is characterized by Elevated blood glucose levels. Blood glucose levels are regulated by insulin. If there is not enough insulin or if it does not work appropriately, diabetes can result.
The consequences of the disease for the human body are very different. In any case, type 2 diabetes entails changes in diet and lifestyle. In many cases, the effects of the disease are severe. Require more extensive treatment. But it does not have to get that far in the first place. If you take a few tips to heart, you can significantly reduce the risk of developing type 2 diabetes.
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Diabetes mellitus type 2 cases in Germany
216.729 cases in 2019
223.231 cases in 2022 ( forecast )
Consequences of insulin deficiency
In diabetes, insufficient insulin is produced by the pancreas or the body's immune system. it no longer has sufficient effect. As a result, the sugar absorbed from food can no longer be stored properly in muscle and fat, and therefore the blood sugar level rises. But even in the morning, in the fasting state, the blood sugar level is elevated in diabetics, because the sugar production of the liver is no longer sufficiently controlled by insulin.
When the sugar level in the blood reaches a certain upper limit (the so-called renal threshold), sugar is excreted via the kidneys together with a lot of water. Therefore belong increased urination and great thirst to the typical signs of elevated blood glucose levels.
diagnosis of diabetes mellitus type 2
In type 2 diabetes, the focus is not on insulin deficiency, but on a reduced insulin action (so-called "insulin resistance") in the foreground. Initially, the body tries to compensate for the reduced effect by producing more and more insulin in the pancreas. In the long run, however, this stress leads to the exhaustion of the islet cells and thus to the drying up of the body's own insulin production. Type 2 diabetes often starts very slowly with unspecific symptoms. Especially at the beginning, the disease can also run completely symptom-free. The disease is therefore often diagnosed by chance, and it is often only the secondary diseases that indicate type 2 diabetes.
Most of the time, this form of diabetes occurs in overweight and elderly people, although in recent years, due to the increasing obesity in the population, the number of young patients with this disease has also risen sharply. In addition to overweight and obesity (adiposity), type 2 diabetes is very often associated with heart disease, high blood prere and lipometabolic disorders.
Signs of type 2 diabetes can include severe thirst, increased urine production, irritability, fatigue, blurred vision and wounds that are difficult to heal.
The disease can be detected by several methods. The diagnosis of diabetes mellitus can be unequivocally established on the basis of clear Elevated blood glucose levels (when measured repeatedly) in the fasting state are placed. Also a clearly increased HbA1c value, which expresses the long-term glucose level in the blood, can be an expression of diabetes mellitus. Most often, however, diabetes mellitus is diagnosed on the basis of a Sugar load tests (oral glucose tolerance test) is determined. The course of the blood glucose level in the blood is measured after drinking a standardized sugar solution.
Treatment of diabetes mellitus type 2
There are standardized guidelines for the treatment of diabetes mellitus type 2. Specialists in the treatment of diabetes are specialists in the field of diabetology.
The aim of therapy is to avoid short-term complications such as hypoglycemia and blood sugar slips and to counteract the symptoms of poorly controlled diabetes, such as reduced performance and a tendency to infection. From a long-term point of view, the goal is to prevent the occurrence of secondary diseases (damage to the eyes, feet, kidneys, vessels and nerves) or. to delay.
alone by a Change of diet the majority of type 2 diabetics can be treated. For example, exercise requires less insulin to regulate sugar metabolism because the working muscle can absorb and burn sugar independently of insulin. Only when dietary changes and exercise are not sufficient do medications (tablets or insulin) come into.
Proper and conscious nutrition is a lifelong companion for diabetics. For it to be consistent, it should be varied and palatable. Patients can learn more about proper and conscious nutrition in special training courses.
Complications and secondary diseases
Detailed knowledge of possible complications is crucial for diabetics and their relatives, because many diabetics are confronted with a variety of complications and secondary diseases in their lifetime. Complications can occur in the short term. Long-term are subdivided.
Short-term complications
Short-term complications include hypoglycemia or blood sugar slippage, which can go as far as coma.
Hypoglycemia
These pose a major risk and occur particularly in insulin-treated patients who are treated with certain diabetes medications (e.g. B. sulfonylurea preparations) can be treated. Causes of hypoglycemia include unusual physical exertion or dietary errors such as skipping meals, and sometimes drinking alcohol.
Clinical signs of hypoglycemia, in which there is a risk of hypoglycemic shock, include palpitations, pallor of the skin, sweating, trembling, hunger, anxiety, restlessness, headache, lack of concentration and irritability. The measured blood glucose level is then low.
Acute hypoglycemia should be treated quickly with 2-3 sugar cubes or glucose, 1 glass of fruit juice or sweetened tea or 1-2 units of fruit, bread or cookies. In the case of severe hyperglycemia, performance is usually impaired. There may be from a disturbance of consciousness to unconsciousness (diabetic coma). The blood glucose level is elevated. In addition, symptoms such as nausea and vomiting, thirst, abdominal pain, dry skin, deep breathing and the smell of acetone in the exhaled air occur.
Causes include sudden illness, infections, overeating, other medications, or interruption of diabetes treatment.
Depending on the severity of the hyperglycemia, treatment with insulin is administered and the body must be supplied with fluids. Knowing the cause of the derailment is important to be able to adjust the therapy if necessary and to avoid further derailments.
Long-term complications
Possible long-term complications include damage to the eyes, kidneys, nerves, heart and blood vessels. Complications and sequelae of diabetes mellitus can be life-threatening and are responsible for limiting the life expectancy of diabetics.
Poor adjustment of blood glucose levels over a long period of time leads to changes in the small (microangiopathy) and large blood vessels (macroangiopathy). Microangiopathy damages the kidneys (diabetic nephropathy) and the eyes (retinopathy) in particular, and plays a crucial role in the development of diabetic nerve disease (diabetic polyneuropathy) and diabetic foot.
Diabetic retinopathy
The cause of this is poor blood sugar control over many years. The vessels in the retina are damaged. Outpouchings (microaneurysms) are formed. Fatty deposits on the blood vessels may occur. New blood vessels are formed, which can bleed easily and lead to blindness.
In Germany, approx. 1,000 people currently go blind each year. 8.000 people as a result of diabetic complications. For the treatment of diabetic retinal damage, a good blood glucose control is initially necessary. In addition, regular check-ups with an ophthalmologist are necessary, because only in this way can even small changes in the retina be detected at an early stage and diabetic retinopathy be avoided.
Diabetic nephropathy
In the kidneys, too, poor adjustment of blood sugar (and high blood prere) over a period of years leads to damage in the small and smallest vessels. This in turn leads to progressive loss of kidney function, which necessitates dialysis (blood washing). In Germany, about half of all patients requiring dialysis are diabetics.
Nephropathy often becomes noticeable through an accumulation of water in the tie (edema) or through high blood prere that is difficult to control with medication. When these symptoms occur, normalization of kidney function is usually no longer possible. Only the progression of the disease can be prevented with therapy. Therefore, a close monitoring of blood glucose levels coupled with preventive examinations is absolutely necessary.
Diabetic feet
Various causes can play a role in the development of diabetic foot syndrome, such as circulatory disorders and peripheral neuropathy (nerve damage) as a result of long-standing diabetes mellitus. Due to nerve damage in particular, the foot is often subjected to abnormal or incorrect loads. Because of the reduced sensitivity, unnoticed injuries often occur, which then represent a possible entry point for germs and are the starting point for chronic, poorly healing wounds. Lack of foot care or incorrect foot care can also play an important role in the development of this serious disease.
If the disease is not treated or is treated too late, it can lead to amputation. In Germany, almost 30.000 amputations per year are performed on diabetics. This high number could be significantly reduced by good blood sugar control, regular check-ups, timely and proper treatment.
