Diabetes Mellitus: Causes and Symptoms

There are about seven million people in Germany who have been diagnosed with diabetes mellitus – but estimates suggest that there are many more affected people in whom the disease is still undiagnosed. The more people know about the dangers posed by diabetes, its causes and symptoms, the sooner they can be recognized and countermeasures taken. In the following, we will introduce you to the causes and signs of the metabolic disease and explain which examinations are necessary for diagnosis and how 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. This is where the colloquial term “diabetes” comes from. There are different forms of diabetes mellitus, which have different causes and symptoms and require different treatments. The most common forms are type 1 and type 2 diabetes, with type 2 diabetes accounting for about 90 to 95 percent of cases. In both conditions, the hormone insulin plays an important role.

Here’s how insulin affects blood glucose levels

Sugar is one of the carbohydrates and is an important source of energy. We consume sugar not only through sweets, but mainly in the form of starch, for example in cereals or potatoes. In the course of digestion, our body breaks down the carbohydrates to produce glucose. This increases the blood sugar level, i.e. the amount of sugar in the blood. In order for this sugar to pass from the blood into the body’s cells, where the energy is needed, the body’s own hormone insulin is needed. When the concentration of sugar in the blood rises, insulin is released into the blood from certain cells in the pancreas (called Langerhans cells), which then helps to transport the sugar into the cells, thus lowering the blood sugar level. However, when the pancreas no longer produces enough insulin, or when the cells no longer respond properly to the insulin, the glucose no longer reaches the cells from the blood. While the organs are “starving” because no sugar is getting in, the sugar concentration in the blood is very high. Some of the excess sugar is excreted in the urine. This causes the urine to take on a sweet taste – which was actually used to diagnose diabetes in the past. This is where the name of the disease comes from: diabetes mellitus means something like “honey-sweet flow.”

Forms and causes of diabetes

Diabetes mellitus can have a wide variety of causes. The following forms of diabetes are distinguished – depending on the respective cause:

  • In type 1 diabetes, the insulin-producing cells of the pancreas (beta cells) are usually destroyed in childhood or adolescence by an immune process (i.e., an autoimmune disease) – because of this early occurrence, it is also called juvenile diabetes. In this form of diabetes, there is a so-called absolute insulin deficiency.
  • Type 2 diabetes is usually a result of obesity, lack of exercise and unhealthy diet. This form develops gradually from a developing insulin resistance and is trivializing also called adult-onset diabetes. However, this should not hide the fact that younger adults can also develop this form of diabetes.
  • Under the unofficial name type 3 diabetes is a very diverse group of different and very rare forms of diabetes. Causes here are:
    • Genetic defects of the beta cells, which hinder the release of insulin (MODY forms).
    • Genetic defects of insulin action (for example, Rabson-Mendenhall syndrome).
    • Diseases of the pancreas (for example, chronic pancreatitis or cystic fibrosis).
    • Hormonal disorders (for example, Cushing’s syndrome or acromegaly).
    • Medications or chemicals (for example, corticosteroids or ingested thyroid hormones).
    • Infections (such as cytomegaly).
    • Unusual forms of immune-mediated diabetes (for example, insulin autoimmune syndrome).
    • Other genetic causes (for example, Wolfram syndrome or Down syndrome).
  • Gestational diabetes (gestational diabetes) is diabetes that, as its name suggests, is diagnosed for the first time during pregnancy, regardless of whether the disease was previously undiagnosed.This is usually diabetes type 1 or type 2.
  • LADA (latent autoimmune diabetes in adults) is a special form of diabetes type 1, which is delayed onset and occurs only in adults. It is often mistaken for diabetes type 2 in the early stages and only gradually develops the typical features of diabetes type 1.

What triggers diabetes type 2?

Type 2 diabetes is the most common form of diabetes mellitus. Its development is influenced in many cases by one’s lifestyle: often the trigger is a combination of an unhealthy diet, too little exercise and being overweight. Obesity causes the organs to require more and more insulin until they allow the blood sugar to enter the cells. This is known as insulin resistance, an important precursor to diabetes mellitus. At the same time, the years of overproduction of insulin that the increased demand entails leads to a kind of “exhaustion” of the insulin-producing cells. This means that insulin is still produced, but not sufficiently. Experts therefore speak of a relative insulin deficiency. In addition to the factors mentioned above, risk factors also include smoking, elevated blood pressure and elevated blood lipid levels. However, a genetic predisposition, older age or certain medications (for example, cortisone) can also play a role in the development of the disease.

Symptoms and signs of diabetes

Early detection of diabetes is important in order to start appropriate treatment and avoid secondary diseases. But how do you recognize diabetes? Possible signs or symptoms of diabetes include:

  • Excessive thirst
  • Increased urination and excretion of large amounts of urine – especially at night
  • A tendency to infections, for example urinary tract infections.
  • Ravenous appetite
  • Fatigue, exhaustion and drop in 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 is more likely to develop within weeks. This form of the disease can also cause unexplained weight loss and gastrointestinal problems.

What happens if diabetes is not detected?

If diabetes is not noticed or adequately treated, the permanently elevated blood sugar can result in serious complications. For example, the lack of insulin can cause diabetic coma with nausea, vomiting and unconsciousness. The high blood glucose level also causes damage to the blood vessels over time, which can cause irreparable damage to the eyes, feet, heart, kidneys and other organs. Diabetics therefore have an increased risk of developing diseases such as nerve damage, strokes, heart attacks, kidney failure, high blood pressure or erectile dysfunction. Gestational diabetes primarily endangers the child, and it can also develop into so-called pregnancy poisoning (gestosis). What is problematic about diabetes is its usually slow development via insulin resistance. Many internal organs are already affected, while the disease is not yet known or the symptoms and signs are not yet obvious. You can read detailed information about the possible consequences of diabetes in this article. Here we also inform you about the course of diabetes mellitus.

Therapy does not always require insulin

The large number of possible secondary diseases shows how important it is to treat diabetes. In each case, treatment depends on the cause and form of the disease. In type 1 diabetes, insulin injections are required for life. In type 2 diabetes, the most important measures include a change in diet and lifestyle, for example in the form of more exercise. In addition, tablets (known as antidiabetics) and insulin can help to lower blood glucose levels. More information on the treatment of diabetes can be found here.

Preventing type 2 diabetes: what you can do

Not all forms of diabetes can be prevented. But with regard to the most common form, type 2 diabetes, a health-conscious lifestyle is considered the most important measure to reduce the risk of diabetes. The following tips are useful for preventing type 2 diabetes:

  1. Avoid excess weight and say especially existing belly fat the fight.
  2. Move: Already 30 to 60 minutes of exercise daily help to improve your health.
  3. Eat healthy. Reduce especially your consumption of fat (especially animal fats), sugar, salt, soft drinks as well as alcohol and reach instead for fiber (such as in fruits, vegetables and whole grains), fish and omega-3 fatty acids (for example, in linseed oil or herring).
  4. Sleep enough and ensure enough relaxation, because lack of sleep and stress can negatively affect blood sugar levels.
  5. Avoid high blood pressure, because this increases the risk of secondary diseases in combination with diabetes.
  6. Refrain from smoking, as it has a negative effect on metabolism.