How does diabetes mellitus occur

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Transmission date: 11/27/2017 10:00 p.m. | archive
In diabetes it is not always necessary to inject insulin.

More than seven million people in this country suffer from diabetes mellitus - the so-called diabetes. In addition, there is an estimated number of unreported cases of two million people who have not yet been diagnosed with the disease. This makes Germany one of the ten countries in the world with the highest number of diabetes sufferers. According to the Diabetes Health Report 2017, 300,000 more people fall ill - every year. The patients are also getting younger and younger.

Insulin: vital messenger substance

History of Artificial Insulin

At the beginning of the 19th century, the diagnosis of type 1 diabetes was tantamount to a death sentence. The patients died within a short time without any help. The life expectancy of type 2 diabetics was also greatly reduced, mainly due to the serious secondary diseases caused by the excessively high blood sugar level. The first successful isolation of insulin in 1921 by the Canadian scientist Frederick Grant Banting and his assistant Charles Best promised salvation. In 1923, Banting and his colleague John Macleod, who was instrumental in researching insulin, received the Nobel Prize for Medicine for their work. In the past, patients were given insulin obtained from the pancreas of pigs. Today a genetically engineered human insulin is usually administered.

The hormone insulin plays an extremely important role in a healthy metabolic balance. It serves as a messenger substance: the hormone enables the cells to absorb glucose (sugar), which they need to supply energy. Insulin is produced in the pancreas, more precisely by the beta cells of the so-called islets of Langerhans (named after the physician Paul Langerhans). These react to high blood sugar levels, for example after eating, and produce insulin. The body can absorb the energy obtained from food and the blood sugar level drops again.

A normal level in adults is between 70 and 110 milligrams per deciliter of blood. If the pancreas produces too little or no insulin or the cells cannot absorb it, there is a massive disturbance of the metabolic balance: diabetes. "Sugar" is now one of the most common chronic diseases worldwide. An abnormally high blood sugar level does not in itself cause pain, but the consequences can be life-threatening.

Forms and characteristics of diabetes

The disease, which sounds so harmless when translated - honey-sweet flow - is actually a collective term for two different ways in which the metabolic disorder develops.

Type 1 diabetes

At Type 1 diabetes it is usually an autoimmune disease, in which the immune system is directed against its own body. In this case, the pancreas produces hardly any or no insulin at all, since the beta cells of the islets of Langerhans are perceived as foreign bodies and are destroyed. Why this is so has not yet been fully explored. Mostly children and adolescents are affected. Type 1 diabetes occurs less often in adulthood.

Type 2 diabetes

Type 2 diabetes Often referred to as so-called adult diabetes, because until recently it was mainly older people who suffered from this type of metabolic disorder. Today it is spreading epidemically. Their causes include a lack of exercise coupled with overeating.

The pancreas initially still produces sufficient amounts of insulin, but the cells that actually need it no longer recognize it and do not absorb it. Resistance to the hormone develops, but it continues to be produced because the blood sugar level does not drop. At some point, however, the body shuts down the production of insulin and, in the worst case, stops it entirely. The pancreas no longer produces enough insulin for the excess weight that has arisen, because the need for insulin increases with an increased body fat percentage. However, with a change in diet and weight reduction, the amount produced would be sufficient. In summary, type 2 has predominantly insulin resistance with a relative insulin deficiency.

First symptoms of diabetes

Since diabetes is not painful in itself and the symptoms are usually not perceived as serious when taken individually, the diagnosis is often made quite late. It is therefore likely that the disease has already broken out before the following symptoms appear: feeling very thirsty, frequent urination, itchy skin, tiredness, fatigue and decreased performance, poorly healing wounds, impaired vision, chronic infections and weight loss. Heart problems and sensory disorders in the legs can also occur.

Detect diabetes with a blood test

Due to the increased blood sugar level, however, if the disease is suspected, it can be clearly demonstrated with a blood test. If the blood sugar value is over 200 milligrams per deciliter and over 126 on an empty stomach, diabetes is present.

Consequences of disease for type 2 diabetics

The large and small arteries are affected by increased blood sugar.

If diabetes is not treated, the complications can be life-threatening. In type 2 diabetics, the cause is permanently high blood sugar levels. Since the disease usually begins insidiously and without symptoms, organs can be damaged in the early stages. The increased blood sugar affects the large and small arteries that carry oxygen-rich blood around the body. This can lead to circulatory disorders, both in large vessels and in very fine ones.

The serious consequences: blindness, arteriosclerosis with the risk of a heart or stroke, kidney failure or diabetic foot syndrome. The latter is caused by the reduced blood flow to the legs and feet. Wounds heal poorly, increasing the risk of tissue damage. In the worst case, an affected foot has to be amputated. The tricky thing is that we don't notice when nerves die off. Another consequence for men can also be impotence.

The most common cause of death in a diabetic is silent heart attack. Often they do not even notice that their heart is poorly supplied with blood. Shortness of breath can be the only symptom that heralds a heart attack. It is therefore important that diabetics regularly undergo an exercise ECG.

Hypoglycaemia: danger mainly for type 1 diabetics

Hypoglycemia can be acutely life-threatening for a diabetic. Insulin also ensures that the brain is supplied with energy. Type 1 diabetics in particular, whose pancreas no longer produce insulin, run the risk of having too little glucose in their blood. A diabetic coma threatens because the brain is undersupplied. This can damage brain cells. Some patients may not be aware of the symptoms of impending hypoglycaemia. For example, a diabetic warning dog could make everyday life safer for them.

People with type 1 diabetes mellitus are dependent on insulin for life. The hormone has to be injected as it would be broken down too quickly in the intestine.

Several treatments are possible for the second form of diabetes, depending on the severity of the metabolic disorder. Some manage to control their blood sugar levels simply by changing their lifestyle. That means: more exercise, a healthy diet and weight loss. Endurance sports not only improve blood sugar levels, but also reduce the risk of a heart attack or stroke. But some type 2 diabetics also have to inject insulin regularly and for life.

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45 min | 11/27/2017 | 22:00 O'clock