Diabetes mellitus

Diabetes mellitus - the diabetes mellitus - represents the most common metabolic disorder. In the Federal Republic of Germany, more than 6 million people are suffering from it.

What is diabetes?

Sugar is one of the carbohydrates and is an important energy supplier. Humans consume carbohydrates mainly in the form of starch (eg in cereals, potatoes, rice), cane sugar and by the glycogen contained in the meat. During the subsequent digestion these carbohydrates are degraded to glucose (glucose). The intake of carbohydrates increases the blood glucose level. The glucose can be introduced into muscle and fat cells only if insulin is present. Insulin is a vital, endogenous hormone that is produced in the pancreas. If the pancreas is no longer able to produce insulin or the tissue in which the insulin is supposed to act no longer responds to the hormone, the glucose will no longer enter the cells. Thus, the cells suffer from glucose deficiency, while the sugar level in the blood increases and excess sugar is excreted in the urine.

The following symptoms can occur in diabetes

  • Excessive thirst and large quantities of urine.
  • Weight loss and weakness. The lack of sugar in the cells is offset by the increased breakdown of protein and fats, which can lead to weight loss and weakness.
  • Tendency to skin, mucous and gum diseases and itching.
  • In the worst case, it can lead to a diabetic coma. Symptoms include nausea, vomiting, severe thirst, and eventually unconsciousness.

The following late complications are to be feared:

  • Circulatory disorders in the small and large vessels lead to vascular damage. This increases the risk of a heart attack or stroke.
  • Diabetic retinal disease (retinopathy). Due to the diabetic vascular disease creates a circulatory disorder of the retina. This can lead to the impairment of vision to blindness.
  • Disorders of the nervous system (neuropathy). The nerves are less sensitive to stimuli, which can first be felt in a tingling or burning in the hands or feet.
  • Kidney damage through changes in the small vessels in the kidney to kidney failure.
  • Potency disorders in men.

Type I diabetes

Mostly in childhood or adolescence, the insulin-producing cells of the pancreas are destroyed until ultimately no more insulin can be released. The patient must administer insulin. In this case, the need for insulin must be adapted exactly to the requirements. Important is the amount and type of food consumed and the physical activity, which reduces the insulin requirement. By regular blood glucose measurements, the exact insulin requirements can be determined. If more insulin is added than needed, it can lead to hypoglycaemia (hypoglycemia). These express themselves in feeling hungry, sweating, paleness, slight headache, trembling, palpitations or restlessness. Insulin deficiency (hyperglycemia) can lead to unconsciousness in the worst case. The most common causes are:

  • heredity
  • After a virus infection (eg rubella, mumps) it can lead to a defense reaction (immune reaction), which leads to the destruction of the insulin-forming cells.

Diabetes type II

This type of diabetes is much more common than type I diabetes. Insulin deficiency usually increases slowly. Most insulin is still killing, but this is not enough or can no longer work properly due to changes in the target cells. The patients are usually over 40 years old and often suffer from overweight and lack of exercise. The most common causes are:

  • Hereditary predisposition
  • lack of exercise
  • overweight

These lead to the fact that initially increased amounts of insulin are released, with the result that in the long run the cells react less sensitive to insulin and the pancreas can no longer withstand the increased requirements.

What you can do yourself:

As a diabetic you should strictly follow the instructions of your doctor

  • Regularly check your sugar in the urine or blood.
  • Overweight diabetics should reduce their weight with a diet. Frequently, the blood glucose levels and the associated symptoms after a successful diet significantly or even completely go back.
  • The food should be distributed to at least six small meals a day, as this way the insulin can be better utilized.
  • For sweetening, sugar substitutes (fructose, sorbitol, xylitol) or sweeteners (eg saccharin) can be used.
  • Physical activity contributes to the sugar being consumed directly and with low insulin requirements from the blood in the muscle cells. A lot of exercise can reduce the need for medication or insulin.
  • In special diabetes training, you can learn the right way to deal with the disease.
  • In order to avoid hypoglycaemia, a piece of bread or dextrose should always be kept ready.
  • Diabetics should go to the ophthalmologist regularly, at least once a year.
  • Diabetic patients must visit a doctor for poorly healing wounds, especially in the foot area.

How the doctor can help you:

  • In overweight diabetics, the doctor advises first to reduce weight.
  • In the case of an unsuccessful diet, blood sugar lowering medications may be prescribed.
  • If adequate blood glucose control is not possible with medication, the patient must be treated with insulin.
  • Type I diabetics are usually dependent on an insulin dose immediately.
  • The doctor determines in the adjustment phase with the patient the appropriate insulin and the required dosage. This is adapted to the daily conditions (eating, exercise, illness etc.) and usually checked by measuring the blood sugar at least four times a day.
  • The doctor performs regular examinations to detect possible complications or a bad sugar setting in time.


Have your blood sugar checked once or twice a year by your doctor or pharmacist! Especially type II diabetes is recognized and treated far too late.

Diabetics should

... always pay attention to an optimal adjustment of the blood sugar level. Avoid under- or over-sugaring as much as possible. In a healthy lifestyle with regular exercise and healthy, balanced diet can be led to a largely symptom-free and active life with diabetes.

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