Diabetes type 1 type 2 or type 3 symptoms and treatment

This is how physicians correctly assign symptoms
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Picture: "Type 1 Diabetes" by BruceBlaus. License: CC BY 3.0

symptoms of diabetes mellitus type 1

As a rule, patients affected by type 1 diabetes are at a younger age, which is why this form of diabetes used to be called dry skin juvenile diabetes was called. In rare cases the Type 1 diabetes in adults which is why it is also called LADA diabetes (latent autoimmune diabetes in the adult) exists.

Image: "Diabetes and High Blood Sugar." from BruceBlaus. License: CC BY 3.0

Autoimmune reaction leads to destruction of pancreatic beta cells of islets of Langerhans responsible for insulin production. Only when 80-90% of the beta cells have been destroyed are the first symptoms of type 1 diabetes visible. Stressful situations can accelerate the onset of the disease that has not yet become acute.

Since diabetes does not become symptomatic until a late stage, the Onset often sudden and dramatic. Noticeable symptoms are Weight loss, polydipsia and polyuria. Due to the lack of insulin, the glucose level in the blood is greatly increased because the glucose cannot be absorbed into the cells. Glucose is also excreted in the urine to lower the glucose level in the blood. At a concentration of 160 to 180 mg/dl (or 8.9 to 10 mmol/l), the renal threshold is exceeded and glucose enters the urine through the kidneys.

However, glucose can only be absorbed by the kidney with sufficient fluid, which is why patients experience an excessive feeling of thirst. At the same time, urine production increases due to this. Leads to frequent elimination. Stage not uncommon, especially in children. Must be understood as a warning sign of diabetes. Since glucose can no longer be processed as a source of energy, the body draws on the energy reserves of fatty tie, resulting in significant weight loss.

Can be added Unspecific symptoms of the disease like fatigue, Fatigue, Inappetence, amenorrhea, potency problems and Exsiccosis come. Also Consequential damage due to diabetes are already recognizable in the late course of the disease. Dry skin, Pruritus, Muscle cramps, Wound healing and visual disturbances are the first indications that the disease is progressing.

In Emergencies type 1 diabetics may develop diabetic coma or even diabetic ketoacidosis named. Insulin deficiency converts fatty acids into ketone bodies, which can be absorbed into cells independently of insulin and provide them with energy. However, ketone bodies are highly acidic, which causes the pH of the blood to drop, resulting in metabolic acidosis. Typical for diabetic coma is the Acetone odor in the breath and of the patient's urine.

If unconsciousness has not yet occurred, patients often complain of Nausea, vomiting and abdominal pain. In the case of peritonitis with guarding, one should also always think of a Pseudoperitonitis to think in the context of an undetected diabetes mellitus type 1. Respiration may also be disturbed and manifests itself in a typical Kussmaul breathing, in which hyperventilation occurs at a normal respiratory rate.

Symptoms of diabetes mellitus type 2

While symptoms in type 1 diabetes occur suddenly Disease progression in type 2 diabetes is gradual. It is not uncommon for the disease to be discovered only by chance. Patients may suffer from elevated blood glucose levels for years, which is associated with damage to the body. Late complications can be another reason for the diagnosis of diabetes mellitus type 2. As with type 1 diabetes, stressful situations can lead to the onset of the disease.

Prior to this, patients complain only of unspecific symptoms, which are similar to those of diabetes type 1:

Picture: "Diabetic Retinopathy." by BruceBlaus. License: CC BY 3.0

– tiredness, fatigue – concentration problems – headaches, dizziness – frequent susceptibility to infections (colds, flu) – wound healing disorders – visual disturbances – muscle cramps – pruritus – amenorrhea, potency problems – frequent infections due to the increased sugar content, especially of the urine (fungi, cystitis, etc.)

In type 2 diabetes, too, the kidney threshold can be exceeded by excessive glucose levels, which is why in some cases it also leads to Polyuria, glucosuria and polydipsia comes. However, these symptoms are more common in type 1 diabetes.

Type 2 diabetes often occurs in connection with the so-called metabolic syndrome, also affluence syndrome, to. These include obesity, elevated triglyceride levels, insulin resistance, and hypertension.

Due to the increasing incidence of obesity, even in childhood and adolescence, type 2 diabetes affects not only older people, but also younger people. However, the majority of patients are over 40 years old.

In an emergency, diabetes mellitus type 2 can lead to the hyperosmolar coma which is also called coma diabeticum but should be distinguished from ketoacidotic coma. In hyperosmolar coma, the body's increased need for fluids due to high urine output can no longer be met by drinking, leading to loss of consciousness. Hyperosmolar coma is less common in type 2 diabetes than ketoacidotic coma is in type 1 diabetes.

If diabetes mellitus type 2 is not recognized over a long period of time or is inadequately treated, the first symptoms of micro- and macroangiopathy appear. These include visual disturbances, polyneuropathy, and wound healing disorders.

Notice: Acanthosis nigricans of the inguinal and axillary region is typical for insulin resistance and can be found especially in young patients.

Image: "Acanthosis nigricans" by Madhero88. License: CC BY-SA 3.0

Symptoms of gestational diabetes

Gestational diabetes remains in most cases symptom-free, which is why an oral glucose tolerance test in the 24. to 28. SSW is recommended. Untreated gestational diabetes may lead to Developmental disorders in the fetus, resulting in an increased birth weight of more than 4 kg, respiratory distress syndrome, hypoglycemia, hyperbilirubinemia and caesarean section. In an emergency, the fetus develops a damage syndrome embryopathy diabetica.

During pregnancy, diabetes can be caused by hydramnion, a larger than average fetus, Urinary tract infections and preeclampsia are noticeable.

As a rule, gestational diabetes is a diabetes mellitus type 2, as the hormonal change leads to insulin resistance in 3 to 5 % of women. In rare cases pregnancy is the trigger for diabetes mellitus type 1.

Symptoms of diabetes mellitus type 3

All forms of diabetes, which are grouped under type 3, are not easy to recognize in practice. Often diagnosed with diabetes type 1 or 2 because the symptoms are similar. Only special diagnostics can reveal the exact type of diabetes involved.

According to the WHO, type 3 diabetes includes all forms that do not apply to type 1, 2 and gestational diabetes. A total of eight groups are distinguished. differentiation is made according to the various causes, which occur very rarely in diabetics in terms of frequency. Therapeutic measures are similar to those for type 1, 2 and gestational diabetes. gene defects in glucose metabolism is due to. Occurs predominantly in adolescence. These specific gene defects are monogenic autosomal dominant inherited. To date, eleven different forms of MODY diabetes have been specified:

– MODY 1: Mutation in chromosome 20, defect of the hepatic transcription factor HNF4A – MODY 2: Mutation in chromosome 7, defect of the enzyme glucokinase – MODY 3: Mutation in chromosome 12, defect of hepatic transcription factor HNF1A – MODY 4: Mutation in chromosome 13, defect of PDX1 – MODY 5: Mutation in chromosome 17, defect of hepatic transcription factor TCF2 – MODY 6: Mutation in chromosome 2, defect of NEUROD1 – MODY 7: Mutation in chromosome 2, defect of KLF11 – MODY 8: Mutation in chromosome 9, defect of CEL – MODY 9: Mutation in chromosome 7, defect of PAX4 – MODY 10: Mutation in chromosome 11, defect of INS – MODY 11: Mutation in chromosome 8, defect of BLK

If MODY diabetes is diagnosed at an early stage, treatment with oral antidiabetic agents such as sylfonylurea is initially sufficient, but insulin administration is very likely to become necessary in the later course of the disease.

B Diabetes due to genetic defects in insulin action

So far, two types are distinguished in this group, both of which have a Insulin resistance due to genetic defects Together. For the insulin resistance syndrome type A hyperinsulinemia, the skin disease acanthosis nigricans (hyperpigmentation and hyperkeratosis (keratinization) mostly in groins and armpits) and hyperandrogenism are typical in women. The Lawrence syndrome or lipatropic diabetes on the other hand, is characterized by the massive breakdown of subcutaneous fat tie, with which insulin resistance is associated for as yet unknown reasons.

C Diabetes as a consequence of pancreatic disease

All disorders of exocrine pancreatic secretion as a defect of the pancreas per se or as a consequence of another disease can lead to diabetes. Also the intake of certain chemicals. Medication can lead to diabetes as a side effect. Rubella virus triggered. Often occurs in children. As a result of the disease, pancreatic islet cells may be destroyed, leading to insufficient insulin production, which in turn results in type 1 diabetes mellitus. Can also lead to the development of diabetes the human cytomegalovirus (HCMV) contribute to the development of pancreatitis in the course of the disease.

G Diabetes due to immunological defects

In autoimmune disease Stiff-Man syndrome Among other things, endocrine glands can be damaged; accordingly, the disease is also directed against cells of the pancreas, which can lead to type 1 diabetes. Another immunological defect that leads to diabetes is the anti-insulin receptor antibodies. These block the insulin receptors of the cells. Thus block the uptake of insulin.

H Diabetes due to hereditary diseases

Diabetes has been observed as an accompanying symptom in numerous genetic syndromes:

– Huntington's disease – Down syndrome – Dytsrophia myotonica – Friedreich's ataxia – Klinefelter's syndrome – Porphyria – Prader-Willi-Labhart syndrome – Turner syndrome – Wolfram syndrome