Mastering Diabetes: Causes, Symptoms, and Effective Management Strategies

Mastering Diabetes: Causes, Symptoms, and Effective Management Strategies

Diabetes mellitus is like honey-sweet (Latin: mellitus = honey-sweet) flow (Greek: diabetes = flow, increased urine flow). It is understood as a chronic disorder of sugar metabolism triggered by a lack of the hormone insulin. The result is an excessively high level of sugar in the blood. The two most important forms of diabetes mellitus are called type 1 and type 2, with type 2 affecting about 90 to 95 per cent of people with diabetes. The two forms differ fundamentally in their causes and, thus, also in their effects and course.

Causes of type 1 diabetes

Type 1 diabetes is caused by a complete failure of insulin production (absolute insulin deficiency). Type 1 diabetes is classified as an autoimmune disease because this form of the disease shows its antibodies (autoantibodies) against the insulin-producing islet cells in the pancreas in the affected person’s blood.

The frequency in families (about 20 per cent of those affected also have a type 1 diabetic in their family) seems to confirm this. In addition, it is assumed that certain viruses (e.g. rubella) or certain toxins could initiate an autoimmune reaction.

The irreversible destruction of the insulin-producing cells means that symptoms of high blood sugar levels appear at a young age (usually in late childhood), also called juvenile diabetes.


Causes of type 2 diabetes

In contrast to the adolescent type, the cause of type 2 diabetes is usually lifestyle. Although genetic factors also play a vital role here, there is a very close connection with a diet that is too fat, too sugary and generally too high in calories, as well as a lack of exercise and obesity. 

Two disorders play the leading role in the development:

  • impaired insulin delivery by the pancreas
  • reduced insulin action on cells and organs

This means that even if the insulin level in the blood is high (as can occur in type 2 diabetics), the hormone has no effect if the receptors no longer work or only work to a reduced extent. Just as little as a formerly suitable key (insulin) cannot open a new defective lock (insulin receptor). This is known as relative insulin deficiency or insulin resistance.

Occasionally, pregnancy (gestational diabetes), hormonal imbalances, stress factors (infections, injuries, operations) and certain medications ( e.g. cortisone ) can also cause a diabetic metabolic state.

Type 2 diabetes: course

In contrast to type 1 diabetes, type 2 diabetes often progresses gradually. Since the body only develops insulin resistance over time, in this case, it can often take years for symptoms to appear and be noticed.

The first signs of type 2 diabetes are, for example, tiredness and poor performance. Food cravings and increased sweating can also occur. An increased urge to urinate and a feeling of thirst or itchy and dry skin often develop as the disease progresses. 

When these symptoms are correctly diagnosed, organs may already be damaged. If the diabetes is not treated with the help of behavioural changes (e.g. change in diet and fitness ), insulin or oral antidiabetics, the course can be severe. Damage to the vessels in the eyes, feet, heart or kidneys can result. This, in turn, increases the risk of other diseases, such as stroke or kidney failure. Nerve damage can also occur.

You can find more information about the complications of diabetes here.


Type 2 diabetes prognosis

By consistently following the therapeutic recommendations and regular check-ups, the progression of type 2 diabetes can be alleviated or slowed down. The risk of secondary diseases decreases, which, in turn, has a positive effect on life expectancy.

The course of type 2 diabetes is, therefore, often heavily dependent on consistent implementation of therapy and changes in personal circumstances, especially about nutrition and exercise. For this reason, early diagnosis can improve the prognosis.

Type 1 diabetes: course and prognosis 

Due to the absolute lack of insulin in type 1 diabetes, the first symptoms appear very quickly in this form of diabetes mellitus. These include frequent urination and excessive thirst, gastrointestinal problems, fatigue and weight loss.

This weight loss occurs because the cells burn fat due to the lack of glucose. The resulting metabolic product acetone leads to acidification of the blood ( ketoacidosis ). The body tries to expel acetone through the air we breathe. Gasping and a lousy breath reminiscent of slightly rotten fruit occur. Since the metabolism no longer works properly, those affected suffer stomach pains

If left untreated, type 1 diabetes takes a dramatic course: Frequent urination leads to dehydration, which can lead to kidney failure. In the further course, the person concerned falls into a diabetic coma, which, in the worst case, can be fatal.

Correct therapy has a positive influence on the course.

If type 1 diabetes is treated with insulin in good time and blood sugar is adequately controlled, everyday life is possible. However, the life expectancy of type 1 diabetics is still lower than that of healthy people. According to a Scottish study from 2015, at that time, a 20-year-old man with type 1 diabetes had a life expectancy reduced by 11 years, and for a 20-year-old woman, it was almost 13 years. The main reason for this is high blood sugar or the higher risk of developing kidney disease.

However, some recent studies from other European countries indicate that the life expectancy of those affected with type 1 diabetes has increased in recent decades. Improved treatment methods, a well-adjusted long-term value, and the right therapy can, therefore, positively affect the course of type 1 diabetes. 


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