Diabetes mellitus treatmentIn type 2 diabetes, the body's cells respond less effectively to insulin and absorb less glucose. This is called insulin resistance. Because less glucose is absorbed, the blood glucose level rises. The pancreas reacts with an increased production of insulin. The increased insulin production can initially compensate for the insulin resistance of the body's cells, so that sufficient sugar is absorbed into the cells and the blood sugar level remains within the normal range. As a result, the disease often goes unnoticed for a long time.
List of physicians Diabetes Mellitus Type 2
Information about diabetes mellitus type 2
What happens in type 2 diabetes?
Diabetes mellitus is a metabolic disease whose main characteristic is elevated blood glucose levels. A distinction is made between type 1 diabetes and type 2 diabetes. The latter is the most common form. About 90 percent of people with diabetes have type 2 diabetes. In this case, the body's cells react less sensitively to insulin.
The hormone insulin is produced in the b-cells of the pancreas and ensures that sugar (glucose) can be absorbed from the blood into the body's cells. After a meal, the pancreas releases insulin and glucose from the blood is absorbed by liver, muscle or fat cells. The body's cells need glucose as an energy supplier.
If the fasting blood glucose level is slightly elevated, but not yet as high as in diabetes, this is called impaired glucose tolerance or prediabetes.
It often takes years until the body can no longer compensate for insulin resistance. As a result of years of increased insulin release, the b-cells become "exhausted" and produce less and less insulin, and insulin deficiency develops in addition to insulin resistance. This means that the body's cells can absorb less glucose. The blood sugar rises. The diabetes becomes manifest.
How does type 2 diabetes manifest itself??
The symptoms are often unspecific at first and develop gradually, so that the disease often goes unnoticed in the first few years or is discovered by chance when other complaints are clarified.
Typical symptoms of an advanced disease with derailed blood sugar are increased thirst, frequent urination, fatigue, tiredness, poor concentration and a feeling of prere in the head. Visual deterioration and skin changes are also common, for example itching or reddened skin on the face, hands and cheeks.
Both loss of appetite and ravenous hunger can be symptoms of diabetes. Other possible complaints include potency disorders, muscle cramps, sensory disturbances, nausea and abdominal pain. People with diabetes are also more susceptible to infections; for example, recurrent urinary tract infections can be an indication of diabetes.
Type 2 diabetes often occurs together with high blood prere, a lipometabolic disorder, and so-called truncal obesity – the term used to describe morbid obesity with fat deposits in the abdominal cavity. These complaints are summarized under the term "metabolic syndrome".
How diabetes type 2 is diagnosed?
Blood glucose levels are elevated in people with diabetes. Since this is also elevated in healthy people after food intake, a simple blood glucose measurement is usually not suitable for diagnosis. If the value is very high – more than 200mg/dl – this is an indication of diabetes.
The HbA1c value, the long-term blood glucose value, is more suitable for diagnosis. This value is a measure of the average blood glucose concentration over the last 8 to 12 weeks.
Fasting blood glucose level can also be determined for diagnosis. For this, the last food intake must be at least eight hours ago. Normally, the level is 100 mg/dl or less; people with diabetes have a level of 126 mg/dl or more.
For further clarification, the doctor usually carries out an oral glucose tolerance test. The doctor determines the blood glucose on an empty stomach and two hours after the patient has taken a glucose solution. Both values are elevated in diabetes. This test can also be used to detect impaired glucose tolerance or so-called prediabetes, the preliminary stage of diabetes.
What treatment options are available?
An important part of the treatment of type 2 diabetes is a change in lifestyle. This includes a healthy diet, weight reduction and plenty of exercise.
Regular exercise can lower the long-term blood glucose value HbA 1 c similarly well as oral antidiabetic drugs. Physical activity improves insulin uptake into muscle cells and can thus lower blood glucose levels. Sports should be a force-. Include endurance training. People with diabetes should exercise at least three times a week. Regular exercise is important to avoid fluctuations in blood sugar.
In addition, various drugs are available for diabetes therapy. The use of these drugs depends on the severity of the disease, secondary symptoms, the ability of the b-cells to produce insulin, and the age of the patient. In some patients, a change in lifestyle is sufficient to get diabetes under control. However, most people need additional medication to lower blood glucose levels.
Oral antidiabetics are tablets that lower the blood glucose level. There are different active ingredients, which can also be combined.
The best known is metformin. It is suitable for diabetes therapy and prevention. Metformin is well tolerated and safe and is part of the standard therapy for diabetes. Drug therapy is usually started with this drug. Metformin causes increased sugar absorption in muscle and fat cells and inhibits new sugar formation in the liver. It is most effective in younger patients who are overweight. Sufficient insulin production well.
If metformin alone is not sufficient, it can be combined with other oral antidiabetic agents, for example sulfonylureas, glinides or gliptins. These agents increase insulin production. Sulfonylureas have long been used in diabetes therapy. Glinides are only recommended in exceptional cases in the latest version of the care guideline. Other oral antidiabetic drugs include alpha-glucosidase inhibitors. SGLT2 inhibitors (Gliflozine). Alpha-glucosidase inhibitors prevent the breakdown of di- or polysaccharides into monosaccharides in the intestine. However, the effect on blood glucose levels is only weak.
SGLT2 inhibitors inhibit the reabsorption of sugar in the kidney, causing more sugar to be excreted in the urine. According to recent studies, they seem to have a positive effect on the course of cardiovascular and renal secondary diseases. Therefore, in patients with increased risk or existing cardiovascular-. Kidney disease can be given together with metformin already at the beginning of the therapy.
GLP-1 receptor agonists are diabetes drugs for injection. They have a stronger effect than oral antidiabetics and can be used if these do not work or in patients with cardiovascular and kidney diseases in combination with metformin. Like SGLT2 inhibitors, they have a positive effect in these patients.
All drugs can have side effects – for example, gastrointestinal symptoms. Some can also cause hypoglycemia. The therapy should therefore be individually adapted to the patient – depending on tolerability and efficacy.
If therapy with oral antidiabetics and GLP-1 receptor agonists and a change in lifestyle is not sufficient, there is still the possibility of injecting insulin. Insulin therapy is usually started with a basal insulin. These are long-acting insulins that meet the basic need for insulin. If necessary, insulin therapy can be intensified.
How bad is type 2 diabetes??
The fact that type 2 diabetes often causes hardly any symptoms at all at first is a temptation not to take the disease seriously and to stick to one's old lifestyle habits.
This can have serious consequences for health. If the diabetes persists for a long time, secondary diseases may develop. One consequence of diabetes is vascular changes. These can even develop in the first symptom-free years – long before the diabetes becomes noticeable. Despite normal blood glucose levels, the metabolic state is already altered at this early stage, which can cause damage to organs.
Arteriosclerotic changes occur on larger vessels. In the case of Arteriosclerosis deposits form on the inside of the arteries. These can impede blood flow. Diabetes can also damage small blood vessels. damage capillaries. This mainly affects the retina of the eye and the kidneys. In diabetic retinopathy, high blood sugar damages the walls of the small blood vessels in the retina, which can cause severe vision problems. In the kidney, damage to the blood vessels leads to poorer blood flow and reduced function. This kidney dysfunction is called diabetic nephropathy.
Diabetes can also damage the nerves. Diabetic neuropathy is one of the most common consequences of prolonged diabetes. Nerve damage is usually manifested by pain, insensitivity and numbness in the hands and feet.
Other possible consequences are diabetic foot syndrome, heart disease and hypertension.
The secondary diseases are often difficult to treat. Nerve damage, for example, can no longer be reversed. However, timely and consistent measures such as a change in diet, weight reduction and exercise can still stop the disease in its early stages, when the b-cells are still producing sufficient insulin.
Can type 2 diabetes be prevented??
Diabetes type 2 is a widespread disease. A genetic predisposition plays a significant role in the disease. If other family members have diabetes, they are more likely to develop it themselves.
In addition Excess weight and an unhealthy lifestyle – such as lack of exercise, a high-fat diet, smoking and alcohol – are important factors contributing to the development of the disease. Advanced age, certain medications, hormonal disorders, pregnancy and depression are also risk factors for diabetes.
If you have an increased risk of diabetes, there are a number of things you can do to prevent the disease.
Above all, attention should be paid to a healthy diet with foods rich in fiber and low in fat. This includes whole grains, fruits, vegetables, legumes, and small amounts of low-fat meat and dairy products.
In addition, exercise is important. Experts recommend at least 150 minutes of light exercise per week, such as walking, or at least 75 minutes of exercise, such as jogging or cycling.
Since smoking can also promote the development of diabetes, people at risk of developing diabetes should avoid smoking as far as possible.
Which doctors are specialists in diabetes?
People with diabetes type 2 are usually treated by their family doctor. In difficult cases, patients can also visit specialized practices or diabetologists.
We can help you find an expert for your condition. All listed physicians and clinics have been reviewed by us for their outstanding specialization in diabetes mellitus type 2 and are awaiting your inquiry or request for treatment.