Diabetes mellitus The term "diabetes mellitus" describes a chronic disorder of carbohydrate metabolism caused by insulin deficiency or reduced insulin sensitivity. The consequence of this metabolic disease is an elevated blood glucose level which, if left untreated, can lead to secondary diseases such as vascular changes and even blindness. Acute complications include hypoglycemic shock.
Colloquially, this disease is also called diabetes. Most commonly known are type 1 diabetes and type 2 diabetes.
"urinary dysentery". Term for diseases with increased or. abnormally increased excretion of fluid u./or certain metabolites by the kidney; z.B. Amin-D. (ABDERHALDEN*-FANCONI* syndrome), phosphate D. as well as – endocrine i.e.S. – Diabetes mellitus u. the D. insipidus.
D. insipidus D. spurius; engl.: d. insipidus "water urination"; disturbance of the hydrogen exchange with increased water excretion (polyuria) u. corresponding increased feeling of thirst (polydipsia) with a lack of concentration of the kidneys (specific gravity of urine< 1012); in the absence of fluid replacement, hypernatremia (hypertonic dehydration) develops rapidly.
As D. i. neurohormonalis s. centralis caused by a disturbance in the synthesis or secretion of ADH (acquired, z.B. idiopathic, due to trauma, neurosurgery, malignant or benign tumors, inflammatory, vascular; congenital). – As D. i. renalis = "adiuretin- or vasopressin-resistant D. i."a recessive hereditary (X-linked) congenital disorder due to lack of responsiveness of the tubules to ADH; a so-called. pseudoendocrinopathy, in which ADH administration is ineffective. – CARTER*-ROBBINS* test.
D. mellitus; engl.: d. mellitus; Diagnosis in diabetes mellitus  *in the absence of symptoms only if the value has been confirmed in at least one follow-up chron. Hyperglycemia with consequent disruption of other metabolic processes u. organ damage. Different forms of diabetes are distinguished according to the cause of their development (Tab.), which is based on either an absolute insulin deficiency (absent or reduced insulin secretion) or a relative insulin deficiency.
Most common forms: Type 1 diabetes and type 2 diabetes
The Type 1 diabetes Mostly occurs in young people under 20 years of age; today it is classified as an autoimmune disease, whereby insulitis with subsequent destruction of the B cells occurs under the influence of various factors in the case of a corresponding genetic disposition.
About 10 % of diabetics suffer from this disease.
The type 2 diabetes usually begins at an advanced age; there is insulin resistance v.a. of the liver and skeletal muscles, but also a disturbance of insulin function. The most important factor in the development of type II diabetes is considered to be obesity or. the underlying lifestyle.
About 90% of diabetics unfortunately suffer from this condition.
Symptoms Diabetes mellitus
Symptoms of diabetes mellitus include polydipsia, polyuria, fatigue, lassitude, decreased performance, pruritus genitalis, weight loss, visual disturbances, hypoglycemia with hunger pangs, cold sweats u. Tachycardia, muscle cramps, nausea u. Vomiting. Acute complications include hypoglycemic shock, diabetic ketoacidosis, hyperglycemic hyperosmolar coma u. the rare lactic acidosis.
At Type 1 diabetes the classic symptoms are usually present, it almost always begins acutely with a diabetic ketoacidosis.
The Type 2 diabetes on the other hand, begins gradually, the classic symptoms are often absent. Consequential diseases of diabetes are v.a. due to vascular changes (micro- u. Macroangiopathy), the severity of which depends on age at first manifestation, duration of disease, quality of metabolic control, etc. Concomitant diseases from.
In the first place is diabetic retinopathy up to blindness, further consequences are nephropathy up to renal insufficiency, neuropathy, diabetic foot syndrome u. cardiovascular complications.
Diagnosis and therapy diabetes mellitus
diagnosis via anamnesis u. clinical picture, glucose in blood u. Urine, determination of glycated proteins (glycated hemoglobin = HbAl, fructosamine), insulin, lipids, ketone bodies, oral glucose load test, intravenous glucose load, glucagon test, oral metabolic tolerance test; s.a. Scheme.
Type 1 diabetes is diagnosed at manifestation by special diagn. Procedures such as z.B. Detection of islet cell u. Glutamate decarboxylase antibodies, of insulin autoantibodies or determined by HLA typing.
Therapy includes general measures such as patient education, diet, reduction of risk factors, is carried out medicinally by means of oral antidiabetic drugs (sulfonylureas, biguanides, glucosidase inhibitors, guar) u. parenterally with insulin v.a. in type 1 diabetes u. complicated type 2 courses.
To prevent possible secondary diseases, the aim should be to achieve as stable a metabolic situation as possible. Pancreas or islet transplantation is possible surgically.
D. renalis; primary renal glucosuria; engl.: renal d. autosomal recessive inherited disorder of proximal tubular glucose reabsorption with constant glucosuria with normal glucose load test. There is no clinical. symptoms, therapy is not necessary.