Diabetes mellitus, diabetes
The term diabetes mellitus comes from Latin or Greek and means something like " honey-sweet flow ". This name comes from the fact that sufferers excrete a lot of sugar in their urine, which helped the doctors earlier by a simple tasting for diagnosis.
Diabetes mellitus is just an umbrella term for various metabolic diseases. There are many different types of diabetes that all have in common that for some reason there is a lack of insulin in the body. Since this is the most important hormone in the regulation of blood sugar, the result is an elevated blood sugar level, which in the long term can lead to a variety of secondary diseases.
The most common types are type 1 diabetes, also called juvenile diabetes, which is based on absolute insulin deficiency, type 2 diabetes, also called adult onset diabetes, which relies on relative insulin deficiency or insulin resistance, and gestational diabetes.
According to estimates from 2007, around 246 million people worldwide suffered from the disease diabetes mellitus worldwide, of which about 7 million lived in Germany. This means that about 8.9% of the German population is affected. In addition, there is probably a very high number of unreported cases, since it is believed that among adults almost half of diabetics go undetected.
An estimated 20% of people over the age of 65 are diagnosed with diabetes mellitus.
According to projections, it is not unlikely that the number of diabetic patients will double again within the next 10 years. This is mainly due to the fact that only about one in 20 affected persons has type 1 diabetes and the remaining cases are subject to very few exceptions from type 2 diabetes. Since this type is mainly favored by risk factors of the modern way of life, such as obesity and lack of exercise, the number of diseases will increase rapidly.
Causes of diabetes are many. Depending on the origin of diabetes, the disease is divided into different types. Most common are types 1 and 2 and gestational diabetes.
Type 1 diabetes is an autoimmune disease and is based on an absolute insulin deficiency. This means that the hormone insulin, which regulates blood sugar levels, is not or not sufficiently produced by the body.
Type 2 diabetes is due to a relative insulin deficiency. This means that the body still produces insulin, but this can no longer meet the demand. This can either come about because the need for some reason is increased or the target structures, in this case the membranes of the cells to which the insulin is supposed to "dock", no longer show sufficient sensitivity to the hormone. This is called insulin resistance. Most often, this type is found in severely overweight people and those with a genetic predisposition.
Pregnancy can also be the cause of diabetes mellitus and affects up to 3% of all pregnant women. However, unlike the other types, it usually recovers completely after the pregnancy has ended.
In addition, there are many more reasons for diabetes: pancreatic diseases, other hormonal disorders, medications, infections, genetic defects of B cells or insulin secretion, or other syndromes that cause this condition.
The characteristic symptoms of diabetes mellitus are frequent urination with compensatory increased thirst, headache, poor performance, fatigue, blurred vision, increased susceptibility to infection and itching. However, all these symptoms are usually only at a relatively late stage of the disease, especially in type 2 diabetes, which is why between time and diagnosis of diabetes or treatment of the disease often takes too long a time.
There are also type-specific symptoms such as severe weight loss in type 1 diabetes or large growth of the fetus in gestational diabetes.
Consequences and concomitant diseases:
The bad thing about diabetes mellitus is usually the diseases that develop secondarily on its basis. These include high blood pressure, myocardial infarction, vascular disease (especially in the retina, which can lead to diabetic retinopathy and, in the worst case, loss of vision), neuropathy and renal insufficiency. However, these occur only when diabetes has long remained undetected or poorly adjusted.
There are several ways to diagnose diabetes mellitus that can be used on all types.
First of all, the blood sugar level should be measured, which should normally be below 110 mg / dl in the fasted state. If it is higher than 126 mg / dl, diabetes is present.
In addition, various laboratory tests are available. First of all, the measurement of HbA1c. This is a value that affects the hemoglobin, ie the red dye of the blood cells. Normally, only a very small portion of hemoglobin is associated with glucose. With a surplus of sugar in the blood, as is the case with diabetes, this proportion is significantly higher than the normal 4-6% of hemoglobin. As this value reflects the blood glucose levels of recent weeks, it is not only a good way to diagnose, but also to check if diabetes therapy is successful. If it is in the normal range, the occurrence of consequential damage is unlikely. In addition, there is still the measurement of sugar or ketone bodies in the urine, which should be below a certain value in healthy people. To determine the insulin production of the body, the so-called C-peptide can be measured in the blood. This is always delivered by the pancreas in the same amount as the insulin, so you can conclude its release.
The therapy of diabetes depends on the type of diabetes a patient suffers from.
In type 1 diabetes, the insulin deficiency must be compensated for life with the help of artificially applied insulin. There are various preparations that differ mainly in terms of their effectiveness. The treatment of a type 2 diabetes is based on a graduated plan and always begins without medication. At first you should try to get the disease by losing weight and activity alone. If this does not help (HbA1c is used as a basis for assessment), then step 2 follows. This means taking an oral antidiabetic.
These are unlike the injected drugs in diabetes, which are used in type 1, no insulin preparations, since there is indeed no absolute lack of insulin. Oral hypoglycaemic agents ensure that the already existing insulin can work better again by stimulating the body's own production or by sensitizing the cells for the intake of insulin. Which antidiabetic drug is most indicated must be weighed individually and depends, among other things, on the weight. The drug most commonly used is metformin. If this therapy does not prove successful, it will be followed in stage 3 by the addition of another antidiabetic. Should this also fail, the administration of insulin is recommended in step 4.
Gestational diabetes is usually treated with insulin, and the therapy is particularly tightly controlled to prevent the embryo from sustaining permanent damage.
Unfortunately, there are no preventive measures to prevent the development of type 1 diabetes mellitus. In contrast, the development of type 2 diabetes mellitus is quite easy to prevent (provided that there is no genetic component underlying it) through a healthy lifestyle. Care should be taken to maintain normal weight and to move regularly.