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Diabetes mellitus

Diabetes mellitus - often colloquially referred to as "diabetes" - is a chronic metabolic disease in which the blood sugar level is permanently elevated. It is caused either by an absolute insulin deficiency (when the pancreas produces too little or no insulin) or by insulin resistance (when body cells react inadequately to insulin). Insulin is a hormone that is responsible for transporting glucose from the blood into the body's cells and thus regulates blood sugar levels.

Types of diabetes mellitus

  1. Type 1 diabetes

    • Autoimmune destruction of the insulin-producing beta cells of the pancreas.
    • Often occurs in childhood or adolescence, but can also manifest itself at any other age.
    • Absolute insulin deficiency, which is why lifelong insulin therapy is necessary.

  2. Type 2 diabetes

    • Usually characterized by insulin resistance and relative insulin deficiency.
    • Closely linked to obesity, lack of exercise and genetic predisposition.
    • This type often occurs in adulthood, but can also increasingly occur in younger people.

  3. Gestational diabetes (pregnancy diabetes)

    • Occurs during pregnancy and often disappears again after delivery.
    • Increases the risk of developing type 2 diabetes later on.

  4. Other specific forms of diabetes

    • Triggered by diseases, genetic defects or medication (e.g. glucocorticoids).

Symptoms

  • Frequent urination (polyuria) and severe thirst (polydipsia)
  • Tiredness, reduced performance
  • Weight changes (weight loss in type 1, often overweight in type 2)
  • Wound healing disorders, increased susceptibility to infections
  • Visual disturbances

The symptoms of type 2 diabetes in particular are often unspecific at first. The disease is therefore often diagnosed by chance or late.

Possible secondary diseases

  • Damage to blood vessels: Increased risk of cardiovascular diseases such as heart attack and stroke.
  • Nerve damage (neuropathy): Can cause numbness and discomfort, for example in the feet.
  • Eye diseases (retinopathy): If the disease persists for a long time, there is a risk of blindness.
  • Kidney damage (nephropathy): Can lead to kidney failure.
  • Diabetic foot syndrome: Poor circulation and reduced wound healing increase the risk of foot ulcers and amputations.

Therapy and management

  1. Lifestyle changes
    • A balanced diet (e.g. according to the recommendations of the German Diabetes Society), weight control and regular exercise (e.g. 150 minutes of moderate exercise per week).
  2. Medication
    • Oral antidiabetics for type 2 diabetes (e.g. metformin, SGLT2 inhibitors, DPP4 inhibitors).
    • Insulin therapy for type 1 diabetes and advanced type 2 diabetes if the blood glucose level can no longer be adequately controlled otherwise.
  3. Regular checks
    • Self-measurement of blood glucose levels.
    • Medical monitoring (HbA1c level, blood pressure, blood lipids, kidney function, eye examinations).
  4. Prevention of complications
    • Thorough foot care (podiatry) to prevent diabetic foot syndrome.
    • Good blood pressure and lipid control to reduce vascular risks.

Outlook

Diabetes mellitus is on the rise in many countries. Preventive measures such as a healthy diet and sufficient exercise can help to reduce the risk of type 2 diabetes in particular. Early diagnosis and consistent treatment have been shown to improve quality of life and reduce the risk of serious late complications. Regular check-ups are important in order to counteract secondary diseases in good time and keep blood sugar levels within the target range in the long term.