Diabetes: Causes, Symptoms, Treatments, Types And Prevention

 

Diabetes mellitus is a chronic metabolic disease characterized by elevated blood sugar levels

This occurs when the effect of the hormone insulin is reduced (as is usually the case with type 2 diabetes) or when insulin cannot be produced (as is the case with type 1 diabetes). Treatment of diabetes is absolutely necessary, as permanently elevated blood sugar can lead to severe damage to vessels and organs. Depending on the type of diabetes and the severity of the disease, various treatment options are used.

 

Diabetes overview

kind	metabolic disease
cause	Insulin deficiency (type 1 diabetes) or lack of insulin action
transmission	non-infectious
symptoms	in severe blood sugar imbalances: feeling thirsty, urinary urgency, weight loss, reduced performance, vision problems
treatment	insulin therapy in type 1 diabetes; Lifestyle measures, various ant diabetics including insulin in type 2 diabetes

 What is diabetes?

Diabetes mellitus is a chronic metabolic disease characterized by high blood sugar levels. Diabetes is one of the most widespread diseases. In Austria, up to 800,000 people suffer from diabetes, and younger people are becoming increasingly common. The most common form is type 2 diabetes.

 How does diabetes develop?

Insulin plays a key role in the development of diabetes mellitus. The hormone is made in the pancreas. It has the task of transporting the sugar produced by the breakdown of food from the bloodstream into the cells. If the blood sugar level is no longer adequately regulated due to a lack of insulin or a lack of effectiveness, the function of vessels and organs can be severely impaired. As the disease progresses, this can lead to heart attack, stroke, kidney failure, or blindness, among other things.

There are different types of diabetes, the most common being type 1 and type 2 diabetes. Diabetes is classified into four types:

• type 1 diabetes
• type 2 diabetes
• other specific forms of diabetes
• Gestational (pregnancy) diabetes

Type 1 diabetes (approx. 5% of sufferers)

The insulin-producing beta cells in the pancreas are destroyed by an autoimmune reaction, and the body can no longer produce insulin – insulin deficiency occurs. People with type 1 diabetes are dependent on insulin therapy, which can be administered by injections several times a day or in the form of an insulin pump. This form of diabetes occurs very frequently in childhood or adolescence, but it can also rarely occur in adulthood.

Type 2 diabetes (approx. 90% of sufferers)

Type 2 diabetes is the most popular type of diabetes. In contrast to type 1 diabetes, type 2 diabetes initially has an oversupply of insulin, but its effect is limited (insulin resistance). The pancreas has to produce more and more insulin to get the sugar out of the blood and into the cells - until the cells in the pancreas eventually become exhausted. The blood sugar level in the blood remains high, and the organs can be damaged.

In addition, there are often other diseases such as high blood pressure or dyslipidemia, which can also damage blood vessels. There is a strong hereditary predisposition to type 2 diabetes. Obesity, an unhealthy diet, nicotine, and a lack of exercise increase the risk of disease. The good news: A change in diet to a Mediterranean diet, physical activity, weight loss if you are overweight and abstinence from smoking (smoking cessation) can significantly reduce the risk of diabetes.

The risk of type 2 diabetes increases with age. In addition, the risk increases with:

• a positive family history (parents and siblings are affected)
• overweight or obese
• high blood pressure
• previous presence of gestational diabetes (diabetes during pregnancy)
• fatty liver disease
• polycystic ovary syndrome
• lack of exercise
• nicotine consumption

Differences between type 1 diabetes and type 2 diabetes

 

	type 1 diabetes	type 2 diabetes
First Appearance (Manifestation)	mostly in childhood and adolescence	mostly in adulthood
Frequency	Rare	frequently
Cause	Autoimmune reaction: the body's own cells attack and destroy the insulin-producing beta cells	hereditary predisposition to insulin resistance and impaired insulin secretion; Risk factors for the onset of the disease: obesity, unhealthy diet, lack of exercise
Symptoms	frequently	less common
Familial accumulation	small amount	High
body weight	mostly normal weight	often overweight
insulin therapy	required immediately	usually only necessary if diabetes has lasted a long time
prevention (prevention)	not possible	physical exercise, Mediterranean diet, not smoking, normal weight

Diabetes during pregnancy (gestational diabetes)

During pregnancy, sensitivity to insulin worsens, and in the case of hereditary predisposition or other risk factors, this can lead to increased blood sugar levels. These can be harmful to the fetus and lead to birth complications. For this reason, a glucose load test between the 24th and 28th week of pregnancy is planned for all pregnant women as part of the mother-child examinations, in some cases even at an earlier point in time. For most patients with gestational diabetes, a change in diet and exercise normalizes blood sugar levels, and about a third require temporary insulin therapy.

The causes of special forms of diabetes are diverse. They range from genetic diseases to hormonal disorders and infections. Taking certain medications (e.g. glucocorticoids) can also increase blood sugar levels.

What are the symptoms of diabetes?

 For a long time, the constantly elevated blood sugar does not cause any symptoms, but it attacks vessels, nerves, and the fundus of the eye, kidneys, liver, and heart. In type 1 diabetes, the rapid and significant increase in blood sugar at the onset of the disease can lead to significant symptoms such as a strong urge to urinate, thirst, weight loss, or failure to thrive in children.

The following symptoms can occur with severely elevated blood sugar:

• constant feeling of thirst
• frequent urge to urinate (even at night)
• weight loss
• Fatigue and difficulty concentrating
• dry mouth
• nocturnal leg cramps
• Failure to thrive in children

With type 1 diabetes, symptoms develop more quickly—usually within a few days to weeks. Type 2 diabetes develops over a much longer period of time - it often takes several years before signs of the disease appear. Gestational diabetes usually has no symptoms and is diagnosed using a sugar load test (glucose tolerance test).

 

Complications of diabetes

 Persistently elevated blood sugar levels damage tissue and organs. Diabetes can lead to vascular, heart, kidney, eye, liver, and nerve diseases. The risk of disease can also rise more than before. Possible symptoms and diseases that can occur in connection with diabetes are:

• poorly healing wounds, especially on the legs or feet (diabetic foot)
• Vision deterioration ( retinopathy )
• Nerve damage with tingling or numbness in the legs (polyneuropathy)
• kidney damage
• Coronary heart disease
• Peripheral Arterial Disease
• fatty liver disease
• stroke
• increased risk of infection

 How is diabetes diagnosed?

If you suspect diabetes, it is advisable to visit your family doctor or a specialist in internal medicine. After a detailed anamnesis and a physical examination, measuring the blood sugar is important for the diagnosis. Several examinations are often necessary for a reliable diagnosis and to determine the stage of the disease. The following test procedures are available:

• Determination of the occasional glucose (non-fasting glucose): If an elevated blood sugar level is determined during another examination, the following applies: If the blood sugar level is above 200 mg/dl, regardless of the time of day and the last food intake, there is a suspicion of diabetes. Further investigations are necessary.
• Measurement of the fasting blood sugar: For this purpose, blood is taken from the vein in the fasting state; the blood sugar is measured in the blood plasma. The value determined should be below 100 mg/dl. Diabetes is present when the fasting blood sugar (measured several times) is above 126 mg/dl. Values ​​between 100 and 126 mg/dl are referred to as prediabetes, a preliminary stage of type 2 diabetes.
• Determination of the HbA1c value: This value indicates the average sugar concentration in the blood over the last few weeks. The HbA1c value is also suitable for monitoring therapy.
• Oral glucose tolerance test (OGTT): A solution containing sugar is drunk and the blood sugar is measured two hours later. Diabetes is present when the level is more than 200 mg/dl.

What do the blood test results mean?

	normal	Pre-diabetes	diabetes
Blood sugar fasting (mg/dl)	≤ 99	100-125	≥ 126
HbA1c (%)	≤ 5.6	5.7 – 6.4	≥ 6.5
Blood glucose (mg/dl), two hours after glucose tolerance test	≤ 139	140-199	≥ 200

Diabetes precursor (prediabetes)   

Prediabetes is a preliminary stage of diabetes, which turns into type 2 diabetes in 5-10% of those affected each year. The blood sugar values ​​in the pre-diabetes stage are still below the critical diagnostic value but above the normal value. Organic changes such as erectile dysfunction, nerve or kidney damage, and the onset of poor eyesight can already occur and the risk of heart disease also increases. A change in lifestyle – especially weight loss, a healthy diet, and sufficient exercise – can prevent prediabetes from developing into type 2 diabetes in the long term. People with prediabetes often also have other diseases such as high blood pressure or elevated blood lipids that need to be treated consistently.

 

How is diabetes treated?

 The aim of the treatment is to lower elevated blood sugar. The exact target values ​​are determined together with the attending physician, taking into account various factors (such as age, concomitant diseases, and type of diabetes). Regular self-measurements and medical check-ups are necessary so that the blood sugar can be adjusted precisely and excessive hypoglycemia (hyper- and hypoglycemia) can be avoided.

Type 1 diabetes treatment

Type 1 diabetics must start insulin therapy immediately after diagnosis.

Type 2 diabetes treatment

The therapy is based on several pillars:

• diet change
• Lifestyle measures (e.g. more exercise, stopping smoking)
• Medications (e.g. ant diabetics as tablets or injections)
• Treatment of comorbidities

 Diabetes: What else can sufferers do?

• regular check-ups with the doctor
• regular medication
• Self-monitoring of blood sugar levels, blood pressure, and weight
• if you are overweight, try to lose weight
• ensure sufficient exercise and a balanced diet
• do not smoke
• Carrying out the recommended screening examinations and vaccinations
• Participation in structured training and treatment programs (e.g. the disease management program "Therapy Active")