Diabetes mellitus: causes and symptoms

Diabetes mellitus: causes and symptoms

There are around seven million people in Germany who have been diagnosed with diabetes mellitus – but estimates assume that many more people are affected who are still unaware of the disease. The more people know about the danger of diabetes, the causes and the symptoms, the sooner they can be recognized and countermeasures taken. In the following section, we present the causes and signs of metabolic disease, explain which examinations are required for diagnosis, and explain how the treatment is carried out.

Definition: what is diabetes?

When people talk about diabetes, they usually mean diabetes mellitus. Diabetes mellitus is a chronic disorder of sugar metabolism. Hence the colloquial term “diabetes”.

Different forms of diabetes mellitus have different causes and symptoms that require other treatments. The most common forms are type 1 and type 2 diabetes, with type 2 diabetes accounting for about 90 to 95 per cent of cases. The hormone insulin plays a vital role in both diseases.


How insulin affects blood sugar levels

Sugar is one of the carbohydrates and is an essential supplier of energy. We consume sugar not only through sweets but mainly in the form of starch, for example, in cereals or potatoes. During digestion, our body breaks down the carbohydrates and glucose is produced. This increases the blood sugar level, i.e. the amount of sugar in the blood.

For this sugar to get from the blood into the body cells, where the energy is needed, the body’s hormone, insulin, is required. When blood sugar levels rise, specific cells in the pancreas (called Langerhans cells) release insulin into the blood, which then helps transport sugar into the cells, lowering blood sugar levels.

However, when the pancreas no longer produces enough insulin or the cells no longer respond appropriately to insulin, glucose stops moving from the blood to the cells. While the organs are “starving” because no sugar is getting into them, the sugar concentration in the blood is very high.

Some of the excess sugar is excreted in the urine. This leads to the urine taking on a sweet taste – used in the past to diagnose diabetes. Hence, the name of the disease, Diabetes mellitus, means “honey-sweet flow”.

Forms and causes of diabetes

Diabetes mellitus can have a wide variety of causes. A distinction is made between the following forms of diabetes, depending on the cause:

  • In type 1 diabetes, the insulin-producing cells of the pancreas (beta cells) are usually already destroyed in childhood or adolescence by an immune process (i.e. an autoimmune disease) – because of this early occurrence; it is also referred to as juvenile diabetes. In this form of diabetes, there is a so-called absolute insulin deficiency.
  • Type 2 diabetes is usually a result of being overweight, lack of exercise and an unhealthy diet. This form gradually develops from an emerging insulin resistance and is also trivialized as adult-onset diabetes. However, this should not hide the fact that younger adults can also create this form of diabetes.
  • The unofficial term type 3 diabetes covers a very diverse group of different and sporadic forms of diabetes. The causes here are:
    • Genetic defects in the beta cells that impede the release of insulin (MODY forms)
    • genetic defects in insulin action (e.g. Rabson-Mendenhall syndrome)
    • Diseases of the pancreas (e.g. chronic pancreatitis or cystic fibrosis)
    • hormonal disorders (e.g. Cushing’s syndrome or acromegaly )
    • Medications or chemicals (such as corticosteroids or thyroid hormones taken)
    • Infections (such as cytomegaly)
    • unusual forms of immune-mediated diabetes (e.g. insulin autoimmune syndrome)
    • other genetic causes (e.g. Wolfram syndrome or Down syndrome)
  • Gestational diabetes is diabetes that – as its name suggests – is diagnosed for the first time during pregnancy, regardless of whether the disease previously existed undiagnosed. This is usually type 1 or type 2 diabetes.
  • LADA  (latent autoimmune diabetes in adults) is a unique form of type 1 diabetes that occurs with a delay and only occurs in adults. It is often mistaken for type 2 diabetes in the early stages and only gradually develops the typical characteristics of type 1 diabetes.


What triggers type 2 diabetes?

Type 2 diabetes is the most common form of diabetes mellitus. In many cases, its development is influenced by one’s lifestyle: The trigger is often a combination of unhealthy nutrition, too little exercise and being overweight.

Being overweight means that the organs need more and more insulin before letting the blood sugar into the cells. One speaks of insulin resistance,  an essential precursor of diabetes mellitus. At the same time, the years of overproduction of insulin, which the increased need brings with it, leads to a kind of “exhaustion” of the insulin-producing cells. This means that insulin is still being produced, but more is needed. Experts, therefore, speak of a relative lack of insulin.

In addition to the factors mentioned, the risk factors include smoking, increased blood pressure and blood lipid levels. However, a genetic predisposition, advanced age or certain medications ( e.g. cortisone ) can also play a role in the development of the disease. 

Symptoms and signs of diabetes

Early detection of diabetes is essential to start appropriate treatment and avoid complications. But how do you recognize diabetes?

Possible signs or symptoms of diabetes include:

  • excessive thirst
  • Increased urge to urinate and pass large amounts of urine – especially at night
  • a tendency to infections, such as urinary tract infections
  • cravings
  • Tiredness, exhaustion and loss of performance
  • poorly healing wounds
  • dry and itchy skin
  • heavy legs
  • excessive or decreased sweating

Type 2 diabetes usually develops slowly over years, while type 1 diabetes tends to break out within weeks. This form of the disease can also cause unexplained weight loss and gastrointestinal problems.

What happens if diabetes is not recognized?

If diabetes goes unnoticed or is not treated adequately, permanently elevated blood sugar can lead to severe complications. For example, the lack of insulin can lead to a diabetic coma with nausea, vomiting and loss of consciousness.

Due to the high blood sugar content, vessel damage develops over time, which can cause irreparable damage to the eyes, feet, heart, kidneys or other organs. People with diabetes, therefore, have an increased risk of diseases such as nerve damage, strokes, heart attacks, kidney failure, high blood pressure or erectile dysfunction.

Gestational diabetes primarily puts the child at risk, and it can also develop into what is known as pregnancy poisoning (gestosis).

The problem with diabetes is the mostly slow development via insulin resistance. Many internal organs are already affected while the disease is unknown, or the symptoms and signs are not yet apparent.

Therapy does not always require insulin.

The large number of possible complications shows how important diabetes therapy is. Treatment depends on the cause and form of the disease.

Type 1 diabetes requires lifelong injections of insulin. In the case of type 2 diabetes, a change in diet and lifestyle, for example, in the form of more exercise, is one of the most important measures. In addition, tablets (so-called antidiabetics) and insulin can help to lower blood sugar levels.

Prevent type 2 diabetes: You can do that.

Not all forms of diabetes can be prevented. But about the most common form, type 2 diabetes, a health-conscious lifestyle is the most critical measure to reduce the risk of diabetes.

The following tips are suitable for the prevention of type 2 diabetes:

  1. Avoid being overweight and, above all, declare war on existing abdominal fat.
  2. Get moving: Just 30 to 60 minutes of exercise daily can help improve your health.
  3. Eat healthy. Above all, reduce your consumption of fat (especially animal fat), sugar, saltsoft drinks and alcohol and instead use fibre (e.g. in fruit, vegetables and whole grain products), fish and omega-3 fatty acids (e.g. in linseed oil or herring ).
  4. Get enough sleep and relax because lack of sleep and stress can negatively impact blood sugar levels.
  5. Avoid high blood pressure because this increases the risk of secondary diseases in combination with diabetes.
  6.  Please refrain from smoking, as it hurts the metabolism.


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