Diabetes mellitus

Diabetes mellitus, Diabetes or just diabetes is a common chronic metabolic disease. A typical feature here is the increased blood sugar level. Diabetes mellitus should definitely be treated by a doctor, as the consequential damage can lead to death.

What is Diabetes Mellitus?

Diabetes mellitus (“honey-sweet flow”) or diabetes is a chronic metabolic disease. It is characterized by a chronically high blood sugar level (hyperglycaemia).

Diabetes mellitus is caused by a lack of insulin (absolute or relative) or a decreased response of the body to insulin.

Insulin is made in the pancreas. Its main job is to absorb grape sugar (glucose) from the bloodstream into the cells. If this hormone is missing, the glucose can no longer be introduced into the cells. As a result, diabetes mellitus increases the blood sugar level.

causes

The two main forms of diabetes mellitus, type 1 and type 2, have completely different causes. Only about five percent of diabetics are affected by type 1 diabetes mellitus. The disease usually begins at a young age and is therefore also known as juvenile (adolescent) diabetes. It is an autoimmune disease that is favored by genetic predisposition and viral infections (especially measles, mumps and flu viruses).

In type 2 diabetes mellitus, the cells no longer respond adequately to the body's own hormone insulin. A relative insulin deficiency develops and as a result insulin resistance - insulin is present, but the cells do not respond to it.

In most of the sick, physical changes are found, which are summarized as "prosperity syndrome". These include being very overweight (more than 80% of those affected), lipid metabolism disorders (high cholesterol), high blood pressure and impaired sugar metabolism. Hereditary predisposition also plays a major role in type 2 diabetes mellitus.

Diagnosis & course

In order to diagnose diabetes mellitus, the so-called fasting blood sugar (the glucose concentration in the blood) is measured and a glucose load test is carried out. If an increased blood sugar value is measured on at least two days, this is considered an indication of diabetes mellitus.

In the course of the disease, organs may malfunction without treatment or with an incorrect control of blood sugar. In extreme cases, various organs can even fail completely. In addition, without treatment, patients with Type 1 diabetes usually lose weight, feel unwell, and have to urinate frequently. In type 2, however, the symptoms are much less pronounced.

Symptoms, ailments & signs

The body tries to excrete the increased accumulation of sugar in the blood through the urine. A strong urge to urinate can therefore be a sign of diabetes mellitus. The urine then tastes sweet and may have a sour and fruity smell. Frequent urination makes those affected constantly thirsty. In addition, dry, itchy skin can be a sign of the disturbed fluid balance due to diabetes.

Other possible complaints are tiredness, exhaustion and difficulty concentrating because the sugar does not get into the cells as a source of energy. This can also lead to weight loss because the body subsequently makes use of fat reserves. Conversely, diabetes can also cause hunger pangs and weight gain.

Since diabetes mellitus also affects the immune system, those affected are often more susceptible to infections such as bladder infections, fungal infections and colds, or they observe delays in wound healing. Furthermore, visual and erectile dysfunction, tingling in hands and feet and cardiovascular problems can occur.

While the symptoms of type 2 diabetes often appear insidious and are not so easy to assign, type 1 diabetes usually becomes noticeable within a few weeks. The doctor can definitely measure high or low blood sugar levels.

If the signs of diabetes are ignored, life-threatening symptoms such as dehydration, kidney failure or loss of consciousness in the form of a diabetic coma (hypoglycemia) or diabetic shock (hypoglycaemia) can occur.

course

The course and prognosis of diabetes mellitus mainly depend on how well it is possible to keep the blood sugar level at a constant level. In type 1 diabetes mellitus, without treatment, changes in the acid-base balance of the body occur within a few weeks. This can lead to a diabetic coma that can lead to death. Type 2 diabetes mellitus develops more slowly and is often only discovered after years of progress.

Symptoms of both types include increased thirst, frequent urination, weight loss, susceptibility to infections, leg cramps, itching, and blurred vision. The course is mainly determined by secondary diseases (eye damage, kidney damage, nerve damage, circulatory disorders). Common causes of death as a result of diabetes mellitus are strokes, heart attacks and kidney failure.

Complications

In the case of untreated or poorly controlled diabetes mellitus, both acute complications and long-term organ damage can occur. Highly elevated blood sugar levels (hyperglycaemia) often lead to a derailment of the sugar metabolism with unconsciousness and circulatory failure, without immediate treatment the patient can slide into a diabetic coma. The administration of too much insulin or too little carbohydrate intake, on the other hand, can trigger an equally life-threatening low blood sugar level (hypoglycemia) with the risk of hypoglycemic shock.

If a high blood sugar level does not cause acute complaints and therefore remains untreated for a long time, it damages the small blood vessels of vital organs. One of the most common complications is diabetic retinopathy, which affects the vessels in the retina of the eyes. Detected too late can lead to blindness. The blood vessels of the kidneys are also affected by an increased blood sugar level over a long period of time (diabetic nephropathy).

The organ's filtering performance decreases, and other complications of diabetes mellitus such as high blood pressure and lipid metabolism disorders also affect the kidneys. The doctor describes damage to the nerves caused by diabetes mellitus as diabetic polyneuropathy, which is noticeable through sensory disturbances. Poorly healing wounds and ulcers, which occur mainly on the feet and can lead to tissue death, are another consequence of poorly controlled blood sugar levels.

When should you go to the doctor?

In type 1 diabetes mellitus, the body's own antibodies destroy the insulin-producing cells in the pancreas. As a result, no or too little insulin is produced. Patients must substitute insulin for life. Type 1 diabetes mellitus is the most common type of diabetes in children.

If this disorder is suspected, the doctor must always be consulted immediately. Type 1 diabetes mellitus is associated with a number of typical symptoms. These include, in particular, strong thirst, increased urination, regular food cravings and unspecific itching. The patients also feel constantly exhausted and are very susceptible to infectious diseases.

Anyone who observes such symptoms in themselves or their child should have their blood sugar level tested immediately. Many pharmacies also offer this test at a low price. If the sugar level is abnormal, it is important to see a doctor. If there are no abnormalities, the test should be repeated as a precaution.

Type 2 diabetes mellitus is the most common form of diabetes in adults and is mainly caused by overweight, obesity and a lack of exercise. This form of diabetes is usually less dangerous, but if left untreated it can lead to serious complications. In the case of poorly adjusted diabetics, not only does the quality of life decrease, but also life expectancy. Regular visits to the doctor are therefore essential here too.

Doctors & therapists in your area

Treatment & Therapy

To avoid acute symptoms and long-term effects of diabetes mellitus, good blood sugar control is particularly important. A healthy lifestyle is in the foreground. In addition to more exercise and weight loss in overweight people, it is important to achieve normal blood lipid levels and blood pressure.

A healthier lifestyle is often not enough to bring the blood sugar in diabetes mellitus into an appropriate range. In this case, a range of drugs, so-called anti-diabetic drugs in tablet form (biguanides, sulfonylureas, glucose regulators, insulin sensitizers) are available.

Type 1 diabetics have to inject insulin from the onset of the disease because their pancreas is not able to produce insulin by itself. Secondary diseases can be prevented or delayed if diabetes mellitus and its comorbidities are treated properly. If the blood sugar level is well controlled, diabetics can lead a life without restrictions or discomfort.

Outlook & forecast

The prognosis of diabetes mellitus is linked to the type of diabetes diagnosed and differs immensely between the different types. In addition, the behavior of the patient has a strong influence on the course of the present disease. This can have a positive as well as a negative influence on all forms of diabetes.

Despite all efforts, the diabetes does not cure because it is a chronic underlying disease. According to current scientific possibilities, a full recovery from the metabolic disorder is not possible. However, if the patient is well adjusted, the complications of diabetes are reduced to a considerable extent. The life expectancy of the person affected is also based on the setting and regular monitoring of the blood sugar level.

In the worst case, under negative conditions, the patient dies prematurely. This is especially true if there is no treatment and continuous blood sugar monitoring. Under optimal conditions, the patient has the chance to lead a good life with diabetes mellitus.

This requires a change in food intake and suboptimal lifestyle habits and the use of drug treatment. The metabolic disease can become a manageable disease with a healthy lifestyle and the avoidance of the intake of harmful substances in long-term therapy.

Aftercare

Diabetes mellitus is a chronic disease and requires regular follow-up care. Since the disease affects different organs and organ systems, various specialists must be consulted for follow-up care in order to identify and treat secondary diseases at an early stage. After the disease is recognized, the patient should be trained to prepare them to take the medication and provide information about follow-up care.

In general, regular blood sugar checks should be carried out so that it can be checked whether the patient is well on the antidiabetic drugs or insulin in order to change the medication if necessary. In the case of long-term diabetes mellitus, an annual check-up by an ophthalmologist is necessary because the disease can damage small vessels in the fundus and thus lead to vision problems and even blindness.

This requires a fundoscopy to detect early changes in the retina. Since diabetes mellitus also affects the kidneys frequently, regular monitoring by the nephrologist is necessary. If left untreated, diabetes mellitus can lead to kidney failure.

Regular foot controls should also be carried out by the family doctor, as a diabetic foot is a common complication of unchecked diabetes mellitus. The patient should also go to the neurologist, as damage to the nerves from the increased blood sugar is not uncommon.

You can do that yourself

Daily behavior and self-help measures in the event of diabetes mellitus can be important for the course of the disease. With correct control and regulation of blood sugar and following a few rules of conduct, there are practically no restrictions for diabetes sufferers and also no loss of life expectancy. This applies both to acquired type 2 diabetes and to genetically determined type 1 diabetes, which only accounts for around five percent of all diabetes diseases.

The difference in treatment between type 1 and type 2 diabetes is that in type 1 diabetes, which is an autoimmune disease, the specialized cells of the pancreas can no longer produce insulin, so the necessary insulin has to be injected because it would be ineffective if administered orally through the digestive tract. In the acquired variant type 2 diabetes, the pancreas is still able to produce insulin.

Regardless of the need to possibly have to inject insulin, strict adherence to the individually composed diet and exercise therapy, which is reflected in individual sports programs, apply to both disease variants.

For those affected, we recommend attending a training course on diabetes mellitus and the consequences of behavior. Sports activities as part of recommended exercise therapy are, in addition to conscious nutrition and effective blood pressure control, important building blocks for the prevention of secondary diseases such as damage to the vessels in important organs, such as the kidneys and the retina of the eyes.