What Is Diabetes mellitus: causes, symptoms, treatment

Diabetes mellitus (diabetes) is a pathological disorder of sugar metabolism. In Pakistan, an estimated eight million people suffer from diabetes, which is why it is called a "widespread disease". Diabetes is serious effects on the whole body, therefore, early detection and treatment are important. There are different types of diabetes, which differ in their causes, symptoms, and treatment.

 

Product Overview Diabetes mellitus

Causes and risk factors	Treatment
Diabetes mellitus type 1	Disease course and prognosis
Diabetes mellitus type 2	Living with diabetes
Gestational diabetes
Diabetes mellitus type 3
Diabetes in children
Examinations and diagnosis

Diabetes: description

What is diabetes mellitus and what is behind the name? The term comes from the Greek and means translated "honey-sweet flow". By this definition urine is meant, which is first formed in people with diabetes mellitus in excess and secondly because of the sugar contained in it gets a somewhat sweetish taste. The days when doctors needed to diagnose the urine of their patients are long gone. But the disease is more relevant than ever.

In western industrialized countries, but also in emerging countries such as China and India, the incidence of diabetes mellitus has been steadily rising for years. Physicians assume that by the year 2030, one in ten people worldwide will suffer from diabetes. The most important reason for this is probably the spread of a lifestyle with a combination of high-sugar and high-calorie diet and lack of exercise.

Definition of "diabetes mellitus"

According to the common definition of diabetes mellitus, diabetes mellitus can be assumed if the person affected has a disturbance of sugar metabolism with permanently elevated blood sugar (hyperglycemia). While in the healthy, the fasting blood sugar (after eight hours of abstinence) is between 65 to 100 milligrams per deciliter (mg/dl), a fasting blood glucose of more than 126 mg/dl makes the diagnosis of diabetes mellitus very likely.

Diabetes mellitus is divided into two main types of diabetes type 1 and diabetes type 2. In addition, one has now defined a type 3 diabetes, besides there is gestational diabetes. Increasingly, pediatric diabetes is being diagnosed. All of these forms of diabetes have in common that their blood sugar levels are abnormally elevated. The causes are different, however.

Diabetes mellitus type 1

Diabetes mellitus type 1 account for about five percent of all diabetes diseases. In principle, it can occur at any age, but above all, it is a common cause of diabetes in children.

Diabetes mellitus type 2

Diabetes mellitus type 2 is a common type of diabetes. About 90 percent of patients with diabetes mellitus suffer from type 2 disease. You can find out all about this form of diabetes in the Diabetes Type 2 article.

Diabetes mellitus type 3

The term diabetes mellitus type 3 refers to forms of diabetes mellitus that cannot be classified as type 1 or type 2. Find out more in the article Diabetes Type 3.

Diabetes during pregnancy

Gestational diabetes (gestational diabetes) is sometimes referred to as type 4 diabetes mellitus. Read more in article Gestational diabetes. Diabetes in children

In Pakistani, about 45,000 children suffer from type 1 “diabetes mellitus” Read all about childhood diabetes in the article Diabetes in Children.

Diabetes in children.

In Pakistan, about 70,000 children suffer from type 1 diabetes mellitus. Read all about childhood diabetes in the article Diabetes in Children.

Diabetes: symptoms

Read all about the typical signs of diabetes in the article Diabetes - Symptoms.

Diabetes: causes and risk factors

How does diabetes develop? There are several causes of diabetes - illnesses and also the risk factors that differ from the different types of diabetes. Whether the diabetes is curable, also depends on the form. To better understand diabetes, it is helpful to know the basic role of blood sugar regulation. Because this is out of balance for all forms of diabetes:

Blood sugar regulation

After a meal, the food components are absorbed into the organism via the small intestine, which raises the blood sugar level. Certain cells of the pancreas, the so-called "Langerhans beta islet cells" are then stimulated in the healthy for insulin production. Insulin ensures that the sugar (glucose) from the blood can be absorbed into the cells (liver, kidney, brain and muscle cells) and is there as an energy source for the metabolism available. Insulin lowers the sugar level in the blood. In diabetes, the hormone-metabolism relationship is (at least) disturbed at one important point.

Cause diabetes mellitus type 1

Diabetes mellitus type 1 (insulin-dependent diabetes) is caused by damage to the insulin-producing pancreatic beta cells. Responsible for this is the body's own antibodies (autoantibodies).

Causes diabetes mellitus type 2

Type 2 diabetes is not a disease of the immune system but largely influenced by lifestyle factors. But how do you get type 2 diabetes mellitus? Although the body still produces insulin in type 2 diabetes, the body cells are no longer adequately responsive (so-called insulin resistance). After a phase of overproduction, insulin production will also decrease as the pancreas "exhausted".

Type 2 diabetics usually suffer from overweight or obesity (obesity). The fat cells, especially the fat in the abdomen, form according to current scientific findings inflammatory substances that can cause insulin resistance. An increased waist circumference, therefore, increases the risk of insulin resistance and thus of type 2 “diabetes Mellitus".

Higher age is also an important risk factor for type 2 diabetes mellitus. In the past, type 2 diabetes mellitus was therefore also referred to as "adult-onset diabetes". Due to the increasing overweight and the lack of movement of many people in the industrialized countries, meanwhile, more and more young people suffer from it.

Diabetes mellitus type 2 is also attributed to a genetic component. The child of a parent suffering from diabetes mellitus 2 carries a 50 percent risk of also developing type 2 diabetes mellitus.

Difference diabetes type 1 and 2

The key difference in the onset of type 1 or 2 diabetes is the location of the disorder. In diabetes mellitus type 1, the insulin-producing cells are damaged. Even though the body's cells are still sensitive to insulin, there is an absolute insulin deficiency. On the other hand, type 2 diabetes mellitus is associated with insulin resistance of the body cells, which can no longer adequately respond to insulin secreted by the body. Thus, there is a relative insulin deficiency in type 2 diabetes.

Causes of diabetes during pregnancy

A number of different causes seem to play a role in the development of gestational diabetes. During pregnancy, the hormones cortisol, estrogen, progesterone, prolactin and human placental lactogen, which are antagonists of insulin, are increasingly being released. The pancreas must, therefore, produce more insulin during pregnancy. If she can not do that, she will develop gestational diabetes. Women who are overweight before or during pregnancy are at increased risk for gestational diabetes.

Diabetes: examinations and diagnosis

The right person to contact if you suspect diabetes is your family doctor or a specialist in internal medicine and endocrinology. But diabetes often comes slowly and many symptoms do not seem to be directly related to metabolism. The question is therefore often: "How do I recognize diabetes at all? What are the signs that I should report to my doctor? If you answer yes to one or more of the following questions, you should discuss this with your doctor:

• Do you often lately without unfamiliar physical stress often a tormenting feeling of thirst and drink significantly more than usual?
• Do you feel physically weak and often very tired?
• Do they need to be watered frequently and in large quantities, even at night?
• Is diabetes known to family members?

In diabetes mellitus, measuring blood glucose levels understandably has the greatest significance. After a food-free of at least eight hours, therefore, the "fasting blood sugar" is determined. In addition, the so-called HbA1c value ("long-term sugar"), as well as an oral glucose tolerance test can give indications of diabetes mellitus. The patient must drink a larger amount of a sugar-containing solution in a short time. Subsequently, the blood sugar is measured several times to see if the body can handle the sudden sugar load normally. If the values increase excessively, this confirms the suspected diagnosis of diabetes mellitus. In addition, the blood can be searched for autoantibodies, which are directed against the pancreas. The urine is also examined in cases of suspected diabetes mellitus.

Other signs of diabetes mellitus

A doctor will also notice any signs of suspected sugar. These serve to better estimate the duration of the disease and its course and to reduce the risk of consequential damage. For example, the doctor will examine if your sense of touch is normal in the area of the hands and feet. Increased blood sugar levels can damage the nerves, causing sensory disturbances over the course of a few years. Or whether your vision has diminished, which can happen in diabetes mellitus through changes in the retina of the eye. A special eye examination is then usually taken over by the ophthalmologist.

Diabetes: treatment

The therapy of diabetes mellitus aims to lower the elevated blood sugar level and to prevent harmful diabetes consequences on organs, nerves and blood vessels. Whether the diabetes is curable depends on the particular form of the disease. Thus, type 1 is currently usually an irreversible diagnosis because the lost insulin-producing cells cannot be easily replaced.

In Type 2, a consistent adaptation of the lifestyles can significantly alleviate the disease, at least at an early stage, and sometimes no further therapy is required. Complete diabetes cure is usually only possible in Type 4 diabetes mellitus (gestational diabetes) when the woman's body returns to normal after the pregnancy hormonal state of emergency. In any case, living with diabetes requires a lot of self-discipline from those affected.

Diabetes Diary

If the diagnosis "diabetes mellitus" has been made, the blood sugar levels must be checked regularly. To get a better overview of the course of blood glucose levels and their setting, diabetics should keep a journal. In type 1 diabetic patients with brittle diabetes, it is highly recommended to keep a diabetic diary. Brittle diabetes is an obsolete term for type 1 diabetics who suffer from fluctuating blood glucose levels (brittle = unstable). Metabolic disorders can make numerous hospital stays necessary.

Diabetes Diet

A central component in the treatment of all forms of diabetes is the diet. Read all important information about the diabetic diet here.

Diabetes and sports

Sporting activity is a particularly valuable treatment method for diabetics. First, because regular physical activity helps reduce possible overweight. In type 2 diabetics, this is often the main cause of reduced sensitivity of insulin to the body's cells. However, muscle work also directly increases the sensitivity of the cells to insulin, which increases the absorption of sugar from the blood. Often this can significantly reduce the dose of blood glucose-lowering drugs or the insulin dose.

Even competitive sports are possible with diabetes. In particular, type 1 diabetics must but because of the strong blood sugar-lowering affect their blood sugar levels closely monitor and practice the correct adjustment of insulin and sugar intake.

The treatment of various forms of diabetes

How diabetes therapy looks exactly depends on the type of diabetes.

Diabetes Mellitus Therapy (Type 1)

In diabetes mellitus type 1 there is an absolute insulin deficiency, which means that there is too little or no insulin circulating in the body. The hormone must, therefore, be injected by the patient. Once the diagnosis is made, the first and most important step is that patients learn about the background of the disease and the importance of proper treatment through diabetes education. Above all, type 1 diabetics need to get to know the need and effects of insulin and practice self-measurement of blood sugar. Patients also learn how much insulin to consume each time for a given amount of food. Unfortunately, it is usually not possible to do without daily injections. Tablets (oral antidiabetics) would be ineffective in people with advanced “type 1 diabetes”. Doctors distinguish the conventional (conventional) from the intensified insulin therapy.

The required diabetic accessories include a blood glucose meter, finely scaled, sterile syringes, the hormone insulin and a small amount of glucose for emergency use. The diabetes syringe has a very fine needle, which allows patients to inject the insulin very easily into the abdominal fat or thigh. The kit should have diabetics in both forms of therapy always available to respond to sudden problems with blood sugar.

Conventional insulin therapy: In conventional insulin therapy, insulin is injected according to a fixed schedule. As a rule, two insulin syringes are required daily. About two-thirds are given in the morning before breakfast and one-third of the daily insulin dose in the evening before dinner. Conventional insulin therapy is easier to use but restricts the patient, as a large deviation from the nutritional plan is not possible and extensive physical activity can also cause problems. Conventional insulin therapy is therefore used primarily in people for whom implementation of intensified insulin therapy would be too difficult.

Intensified Insulin Therapy (ICT-Diabetes): In order to give diabetic patients a maximum quality of life, intensified insulin therapy is suitable. However, this method is associated with a higher risk of low blood sugar (hypoglycemia) and is therefore only useful for patients who understand this somewhat complicated scheme and can use it safely. For mentally handicapped people or people with dementia, this diabetes therapy is usually not suitable.

Intensified insulin therapy tries to imitate the physiological insulin secretion as precisely as possible. Patients do not use insulin according to a defined schedule as with conventional insulin therapy. Instead, long-acting insulin is injected one or two times a day in a smaller amount, so that about 50 percent of the basic needs are covered (basis). Depending on the current blood sugar, normal insulin or short-acting insulin (bolus) is injected before a meal, the amount of which is calculated according to the time of day and the planned meal size.

The form of therapy is therefore also called the basic bolus principle. It requires good training and patient compliance, otherwise, it can easily lead to dangerous diabetes hypoglycemia due to incorrect calculations. The basic bolus concept allows for well-trained patients with a very good sugar setting, in which the blood glucose value is always in the range of about 100mg / dl. The patient can also eat what he wants and do sports at will.

Insulin pump ("diabetes pump"): Especially in type 1 diabetics, an automatic insulin pump is often used. The pump is worn permanently on the body and consists of a small needle, which lingers permanently in the Unterhautfettgewebe, as well as a pump, which is connected via a thin hose with the needle. Newer generations of such pumps even measure blood sugar and deliver insulin levels appropriate to individual needs. Such an insulin pump thus mimics the function of the pancreas. Studies show that this form of diabetes treatment can further lower HbA1c levels in many type 1 diabetics, as blood glucose control works even more tightly. Patients often report a significant improvement in the quality of life due to the "diabetes pump". Gestational diabetes (gestational diabetes) a pump. A pump is especially recommended for young patients. If there is a suspicion that the patient can not manage it safely, for example as a result of a brain disease or depression, an insulin pump should not be prescribed as diabetes insulin dosing errors can quickly be life-threatening. We should know about how to control diabetes?

Diabetes Mellitus Therapy (Type 2)

For patients with type 2 diabetes, the highest priority is a change in diet and lifestyle. Weight loss and regular physical exercise lower blood sugar levels. In some cases, these simple measures improve “diabetes mellitus” and no further treatment is required. Oral antidiabetic drugs: If no improvement occurs after three months of a consistent diet and life change, drugs are used that positively influence the sugar metabolism. Oral and diabetics (diabetes medications in tablet form) are the first choice. There are different classes of substances that are used depending on the patient and any comorbidities.