Diabetes mellitus is a metabolic disease that affects many parts of the body. Depending on the type of diabetes, the body either cannot produce insulin (type 1) or does not use it sufficiently (type 2) . Insulin is a hormone: a chemical messenger that is transported in the blood and regulates important bodily functions. Without insulin, the body cannot use the food it consumes.
Normally, the pancreas produces the vital hormone and releases it into the blood. It ensures that the sugar absorbed through food and drink is transported into the body's cells, where it is converted into energy for the body. Without insulin, the sugar in the blood cannot be used and accumulates. A very high concentration of sugar in the blood causes a number of symptoms.
People with type 1 diabetes need to inject insulin daily because their pancreas produces no or very little insulin . Insulin treatment protects against excessive fluctuations in blood glucose levels and discomfort caused by hypoglycemia and hyperglycemia. It is also intended to help prevent secondary diseases that can result from high blood sugar as much as possible.
Location of the pancreas and insulin cells
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If type 1 diabetes is not treated well, blood glucose levels are permanently elevated. This is not always immediately noticeable. However, a very elevated blood sugar level can cause the following complaints:
– frequent urination – strong feeling of thirst – tiredness and lack of drive – nausea – dizziness
If the blood glucose level is very high, this can also lead to impaired consciousness or even unconsciousness (diabetic coma).
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Insulin is produced in certain cells of the pancreas called beta cells. In people with type 1 diabetes, these cells are attacked by the body's own immune system and, over the years, become so damaged that they release very little or no insulin at all.
Type 1 diabetes occurs more frequently in certain families. Some people have a hereditary increased risk of the disease as a result. Other influences are suspected, such as certain infections or environmental factors. However, it is not yet possible to say exactly what role they play.
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About 200.000 people in Germany have type 1 diabetes, including about 30.000 children and adolescents up to 19 years. About 2 out of 10 people get diabetes every year.000 children new to it.
The disease usually begins in childhood, adolescence or young adulthood, and rarely in older people. This is why type 1 diabetes is also called juvenile (adolescent) diabetes.
If left untreated, type 1 diabetes rapidly causes problems. Severe hyperglycemia triggers the typical symptoms of thirst, frequent urination, and debilitating fatigue. These symptoms can be quickly alleviated by administering insulin. Diabetic coma due to extreme hyperglycemia is very rare today. Before the development of insulin therapy in 1922, it was an inevitable consequence of the disease and led to death. People who developed type 1 diabetes therefore did not survive long.
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If blood glucose levels are significantly elevated over a period of years, this can have serious and irreversible health consequences. Consequential diseases and damage caused by inadequately treated ("poorly controlled") diabetes can affect many organs. Damage occurs to the small blood vessels that supply the tie.
Over time, the finest vessels, for example in the retina of the eye (diabetic retinopathy) or in the kidneys (diabetic nephropathy), can be damaged to such an extent that blindness or kidney failure is imminent. A common consequence is also diabetic neuropathy , which attacks the nerves. The sense of touch, the perception of temperature and the sensation of pain are then impaired. As a result, wounds can develop because prere points and small injuries are not noticed. These wounds often heal very poorly because of the restricted blood flow.
High blood glucose levels can also damage the large blood vessels. Then the risk of heart attack and stroke increases .
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To detect diabetes mellitus , the sugar content of the blood is measured before the first food intake and during the day. For this purpose, blood is drawn several times in the doctor's office and examined in a laboratory. To check whether the blood glucose level is too high on average over a longer period of time, the HbA1c value in the blood is measured. This value shows how high the blood sugar has been on average in the last 2 to 3 months.
Treatment information for $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_ELSE$$CMS_VALUE(tt_textCategory.dataset.formData.tt_name. In type 1 diabetes, daily control of blood glucose is the most important factor. Regular supply of insulin at the forefront of treatment. Insulin therapy replaces the missing insulin in the body and lowers blood sugar. It is important to use neither too much nor too little insulin so that blood glucose levels do not drop too low or rise too high.
The typical complaints can be largely avoided by treatment. It can also protect against long-term complications from diabetes. There are different insulins. Treatment concepts.
However, the level of blood glucose depends not only on how much insulin you inject, but also on what you eat and drink and how much energy you expend through physical activity. The time of day, inflammatory diseases, other medications or hormonal changes can also influence blood glucose levels. Most people with diabetes learn to tailor their insulin therapy to their body and habits. Devices such as insulin pumps or continuous glucose monitoring can make treatment easier.
Successful therapy requires sufficient knowledge about one's condition, good self-management, and reliable medical care. But long-term health depends on more than just blood glucose levels. Other aspects such as blood prere may also be important in diabetes. Therefore, other medications besides insulin may be useful, for example, to prevent cardiovascular disease.
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Diabetes is not yet curable – but it is possible to live life with the disease almost normally. There were times when the daily routine of people with diabetes was strictly regulated: for example, they had to keep certain intervals between insulin injections, food intake, and physical activities. Meanwhile, therapy with insulin has become much more flexible.
Today, people with diabetes can largely decide for themselves about their treatment and how to incorporate it into their daily lives. The disease no longer determines all aspects of life.
However, managing diabetes still requires some effort, care and discipline. This is not always easy and can sometimes be very stressful, especially for young people. Like almost all chronically ill people who need to take daily medication over the long term, people with diabetes can forget their injections or medications from time to time. People who do not use their therapy consistently can feel quite well and then not feel that their diabetes is poorly controlled. However, this can lead to serious health problems in the long run.
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The family doctor's or pediatrician's office is usually the first place to go when you are sick or need medical advice for a health problem. In our topic "Healthcare in Germany", we provide information on how to find the right doctor's office – and with the help of our question list, we would like to help you prepare for a visit to the doctor's office .
For people with type 1 diabetes, there are numerous offers of support in Germany. This includes self-help groups. Advice centers. However, many of these facilities are organized differently locally. A list of contact points helps to find and use suitable offers.
German Diabetes Society (DDG). S3 guideline: Therapy of type 1 diabetes . AWMF registry no.: 057-013. 2018.
DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes . Lancet 2018; 391(10138): 2449-2462.
Updated on 11. August 2021 Next planned update: 2024