Diabetology

The Diabetology is a medical specialty that deals with the diagnosis and therapy of diabetes mellitus. Diabetes mellitus is a metabolic disease that is associated with excess sugar.

What is diabetology?

Until 2003, diabetology was not a recognized specialist medical specialty, but could only be learned in training courses under private law. Since 2003, however, some federal states have offered the opportunity to train to become a diabetologically qualified general practitioner.

All doctors who have worked in this field for at least one and a half years and who have also passed an examination at the Medical Association may use the addition of diabetology. In summary, there are currently three different groups of diabetologists: internists with a focus on endocrinology and diabetology, doctors with the additional designation of diabetology and diabetologists according to DDG (German Diabetes Society). However, it is common to all of them that they are primarily concerned with the treatment of diabetes mellitus.

Treatments & therapies

Diabetes mellitus, also known as diabetes, is a metabolic disease in which blood sugar levels rise. Essentially, the disease can be divided into two types. In patients with type 1 diabetes mellitus, there is an absolute insulin deficiency due to the destruction of the insulin-producing cells in the pancreas.

In type 2 diabetes mellitus, insulin is usually still present. However, this can no longer fulfill its functions due to insulin resistance. Without insulin, glucose from the blood can no longer be absorbed into the body cells. There is an excess of sugar. Gestational diabetes is also known as type 4 diabetes. It is a glucose tolerance disorder. In most women with gestational diabetes, however, the sugar metabolism regulates itself again after giving birth.

Sharp weight loss is typical for the first onset of type 1 diabetes. Those affected lose several kilograms of weight within days or a few weeks. In addition, they suffer from constant thirst, frequent urination, vomiting, abdominal pain and headaches.

Many type 2 diabetics often have no symptoms at all for years. Since the patients are often overweight, small weight losses are hardly noticeable. Increased thirst or increased urination only occurs when the blood sugar level is massively elevated. The symptoms are often very uncharacteristic, especially at the beginning of the disease. Fatigue, weakness, increased susceptibility to infections and visual disturbances develop.

The increased blood sugar level damages various structures of the body, so that various accompanying and secondary diseases can occur in diabetes mellitus. In the treatment of diabetes mellitus, a network of different doctors is therefore usually necessary. More than 80% of all diabetics suffer from high blood pressure. The reasons for this are, on the one hand, sugar deposits in the vessels and, on the other hand, the suppression of the formation and repair of blood vessels in the event of damage. This vascular damage has a negative effect on many organs.

In the retina, for example, they lead to diabetic retinopathy, a disease of the retina. Diabetic retinopathy is the leading cause of blindness in the western world. Around a quarter of all diabetics suffer from neuropathies, i.e. diseases of the peripheral nervous system. These express themselves, for example, in sensory disturbances, paresthesia or pain. In diabetology, special attention is paid to neuropathies. They are the reason why heart attacks are often not noticed in diabetics. Heart attacks in diabetics are often silent due to the neuropathies.

Diagnosis & examination methods

A blood sugar test is carried out in diabetology to make a diagnosis. Blood is taken from the vein of the fasting patient. The fasting blood sugar should not exceed a value of 126 mg / dl. In a random blood sample, even in a non-fasting state, the blood sugar value must not exceed 200 mg / dl.

In order for the diagnosis of diabetes mellitus to be made, an increased blood sugar level (fasting or coincidental) or a pathological oral glucose tolerance test must be available either at least two times. In the glucose tolerance test, the patient drinks a certain amount of glucose, which is dissolved in water. Then blood is drawn from the patient after 60 minutes and after 120 minutes. If the measured blood sugar values ​​exceed the normal values, diabetes mellitus can be assumed. The HbA1C level in the blood is determined for long-term monitoring. This provides information about the blood sugar levels of the last eight weeks.

Due to the dangerous complications of diabetes mellitus, the goal of diabetology is to control the patient's blood sugar optimally. All diabetics receive diabetes training. Here you learn how you can influence your sugar levels with diet and exercise. Foot care is also on the program.

Feet are particularly at risk in diabetes mellitus. Due to the poor blood supply in diabetes, small injuries can easily occur on the feet, which then heal poorly. Due to the polyneuropathy, the patients often hardly notice these injuries, so that the inflammation quickly spreads. The result is the dreaded diabetic foot. The course participants also learn how to properly monitor their blood sugar levels and what to do if the blood sugar is too high or too low.

Of course, the drug attitude of diabetics is also the task of diabetology. The main active ingredient in the therapy of type 2 diabetes is metformin. Metformin lowers blood sugar levels, inhibits sugar production in the liver and reduces the absorption of sugar from the intestines into the blood. Metformin also improves sugar utilization.

Type 1 diabetics depend on insulin injections for life. Once or twice a day, the patients inject themselves with an insulin pen or a syringe so-called delay insulin or a long-acting insulin analogue.