Diabetes sugar disease symptomEverything you need to know about causes, symptoms, diagnosis and treatment.
Diabetes is one of the most common chronic diseases worldwide. The disease often begins insidiously, is significantly influenced by one's lifestyle and can have a variety of late effects if left untreated. As a so-called "disease of affluence", the number of sufferers is now increasing everywhere where food is plentiful. Health authorities and researchers have recognized the seriousness of the situation and are trying to counteract it with education and new treatment approaches. This article gives comprehensive information about causes, symptoms, diagnostics and treatment.
1. What exactly is diabetes?
Diabetes mellitus – colloquially just diabetes or diabetes – is a chronic metabolic disease in which the control of blood glucose levels in the body is disturbed. The disease is known by many as diabetes due to its often high blood glucose levels. However, not all diabetes is the same: there are different types, which have completely different causes and thus treatment approaches [1].
However, good education and understanding of the disease is important for all types of diabetes, as poor glycemic control can result in both severe short- and long-term consequences for those affected. However, with a good understanding of the disease, an active lifestyle and modern treatment options, the course of the disease and prognosis can be greatly improved [2].
2. Types and causes of diabetes
2.1. Diabetes type 1
Type 1 diabetes mellitus is a form of diabetes in which the hormone insulin is not produced or is not produced sufficiently by the body. Since insulin is crucial in lowering blood glucose levels, elevated blood glucose levels and derailments occur as a result [1].
The cause is a so-called autoimmune reaction, in which a person's immune system attacks certain structures of their own body. In the case of type 1 diabetes, the immune system is directed against the so-called beta cells of the pancreas, where insulin production takes place. Only when about 80% of beta cells have been destroyed do sufferers experience symptoms [3].
The disease often starts in childhood for those affected. However, it can also occur in previously healthy adults [4]. In the same way, there are an increasing number of children who have diabetes mellitus type 2 [5].
Incidence of diabetes. Original source.
4. Diagnosis of diabetes
The diagnosis of diabetes mellitus is made by a doctor and requires a laboratory test. Although the symptoms may be characteristic (see 3.). Thus already arousing strong suspicion.) and thus already arouse strong suspicion. Nevertheless, an abnormal test result is needed to confirm the diagnosis of diabetes mellitus [23, 24, 25].
For the diagnosis of diabetes, one of the following evidences must be present [11, 23]:
– an increased “fasting blood glucose" – this refers to elevated blood glucose levels after the person has not eaten for eight hours – an elevated "HbA1c-who"t" – this laboratory marker gives conclusions about the blood glucose level of the last one to three months – an elevated "2-h value of the oral glucose tolerance test" – a test for unclear cases, in which the person must drink a glucose solution and two hours later the increase is determined from the blood glucose
However, depending on the country, diagnostic possibilities and other health conditions of the affected person, the tests may vary in extent. Also, different types of diabetes may require further investigation [23].
Further investigations in diabetes may include [23, 24, 25, 26]:
Urine tests – Albumin is a protein that can be determined in urine and whose quantity can be used to draw conclusions about the consequences of diabetes, such as kidney damage (see7.) allows. Determination of kidney values – Blood markers such as creatinine and glomerular filtration rate (GFR) can be determined, which indicate impaired renal function in advanced disease. Determination of blood lipids – Changes in blood lipids can be elevated both at the onset of the disease in type 1 diabetics and in type 2 diabetics with a chronic lipid metabolic disorder. Gene diagnostics – If no type 1 or type 2 diabetes is present and instead a specific genetic defect is suspected (see 2.3.), the targeted analysis of individual genes can be useful. Antibody tests – If it is unclear whether type 1 or type 2 diabetes mellitus is present, determination of antibodies (usually GAD-AK and IA-2-AK) may be useful. The C-peptide is part of an insulin precursor. Is split off later. Since there is an absolute lack of insulin in type 1 diabetes, the C-peptide is also lowered here.
In children, a correct distinction between type 1 and type 2 diabetes mellitus is important because nowadays there are also an increasing number of children with type 2 diabetes and the treatment of the two types differs (see 5.) [24].
5. Treatment of diabetes
5.1. Differences in the treatment of type 1 and type 2 diabetes
There are significant differences in the treatment of diabetes mellitus type 1 and type 2. Because type 1 diabetics do not produce sufficient insulin of their own (see 2.1), affected individuals always require therapy with insulin. In type 2 diabetes, however, this is only necessary in advanced stages of the disease when other measures have been unsuccessful [27].
Due to the strong influence of one's own lifestyle on the development and progression of the disease, behavioral changes in diet and exercise play a major role for type 2 diabetics. In addition, there are a number of drugs – the so-called oral antidiabetics – that can be used in type 2 diabetes mellitus as opposed to type 1 diabetes [27].
5.2. Treatment of type 1 diabetes
People with type 1 diabetes mellitus are dependent on insulin treatment for the rest of their lives. After the initial onset of signs of the disease, some sufferers enter a temporary phase with little or no need for insulin. Over time, however, daily insulin doses are necessary [28, 29, 30].
There are diverse treatment regimens and insulin types that have different benefits for different individuals and are therefore used in different combinations. The duration of action of different insulin types can vary significantly and be suitable for different targets [27, 28, 30].
Conventional insulin therapy has a relatively rigid injection schedule with fixed morning and evening insulin doses. Although the implementation here is quite simple, this approach requires a fixed diet plan. For young patients and especially for type 1 diabetics, this approach is not very advisable. In intensified insulin therapy, however, shorter-acting insulins are injected in addition to long-acting insulin, depending on the meal, time of day and blood glucose levels. The greater effort involved here is offset by significantly finer blood glucose control [27, 28, 29, 30].
An insulin pump that continuously delivers insulin into the subcutaneous fat tie of the affected person is also a treatment option that should be discussed with a physician [27, 28].
5.3. Treatment of type 2 diabetes
Type 2 diabetes mellitus is usually treated according to a stepwise regimen in which – in contrast to type 1 diabetes – insulin is only prescribed in advanced stages of the disease. The key to all stages of treatment is an active lifestyle consisting of a balanced diet and plenty of exercise [27, 31, 32, 33].
The step regimen for the treatment of type 2 diabetes consists of [27, 31, 32, 33]:
Basic therapy – These measures are aimed at the everyday life of those affected and include weight reduction in the case of overweight, sufficient physical activity as well as a balanced diet. Monotherapy – Here, in addition to the basic therapy, a so-called oral antidiabetic drug is used, which is taken daily as a tablet. In most cases, this is the drug metformin. Combination therapy – This step usually involves metformin, which is then combined with another oral antidiabetic or insulin. Intensified insulin therapy – A long-acting insulin is injected along with shorter-acting insulins depending on the meal, time of day, and blood glucose levels. Each stage should be tried for at least three to six months. Subsequently assessed on the basis of the HbA1c value (see 4). Only if there is no satisfactory improvement in blood glucose should the patient proceed to the next stage [27, 31, 32].
It is important for all diabetics to maintain the components of basic therapy even at higher levels. Abundant physical activity not only effectively lowers blood glucose levels, but has also been shown to increase the effect of insulin [27, 31, 32, 34].
With regard to diet, there are a few basic pillars to consider, but they are medically recommended for all people, regardless of diabetes as a disease [27].
The basic pillars of a balanced diet in diabetes mellitus type 2 include [27, 31]:
– The daily calorie intake with food should not exceed the daily requirement. – A good half of the diet should consist of carbohydrates, a quarter of fats, and a fifth of proteins. – Short-chain sugars found in sweets, soft drinks and many convenience foods should be avoided as much as possible. – Industrial ready-made products should be avoided – even if they are labeled as "diabetes food" or "diabetes diet". – The diet should also be as rich as possible in dietary fiber, which can be found in vegetables, oatmeal, and whole-grain bread, among other foods. – If alcohol is consumed, care should be taken to consume additional carbohydrates. Here's how to avoid dangerously low blood glucose levels.
Ultimately, the exact measures should be taken in consultation with the treating physician [27].
Weight categories for adults. Original source.
6. The typical course of diabetes
6.1. The course of the disease in type 1 diabetes mellitus depends to a large extent on the motivation of the patient. The resulting quality of blood glucose control from. With good education about the disease and about the optimal treatment of type 1 diabetes, most affected individuals can expect a long life expectancy and good quality of life [35, 36, 37].
However, severe disease sequelae can be expected in type 1 diabetics who neglect their treatment (see 7.) [35].
6.2. Progression of type 2 diabetes
The course of the disease in diabetes mellitus type 2 depends to a large extent on the behavior of the affected person himself. In addition to targeted adaptation of drug therapy to the current state of the disease, the patient's own lifestyle plays a decisive role: Weight normalization, a healthy diet and sufficient physical activity have a strongly positive effect on the course of the disease and can delay or even completely prevent severe consequences (see 7.) [35, 38].
7. Consequences of diabetes
With inadequate treatment, diabetes mellitus can result in numerous disease sequelae and complications. This applies to all types of diabetes.
Among the possible consequences and complications of diabetes mellitus are [39, 40, 41, 42]:
Severe hyperglycemia to coma – Unrecognized or insufficiently treated, it can lead to extremely high blood glucose levels and even coma with loss of consciousness. life-threatening hypoglycemias – If insulin therapy is too high in relation to food intake, extremely low blood glucose levels may result. Diabetic macroangiopathies – Long-term elevated blood glucose levels can lead to damage of large blood vessels with myocardial infarction, stroke, or leg artery occlusion. Diabetic microangiopathies – Long-term elevated blood glucose levels can cause damage to small blood vessels with harmful consequences for kidneys, eyes and nerves. Long-term elevated blood sugar levels can weaken immune system. Making sufferers more susceptible to infectious diseases.
Wound healing disorders – Long-term elevated blood glucose levels can weaken the body's ability to heal wounds. Stay up to date. Subscribe to our Data4Life newsletter.You can unsubscribe at any time by clicking on the appropriate link in our newsletter or by sending an email to [email protected] HELP. For more information, please see our privacy policy.
Sources [42]
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