Diabetes mellitus: Symptoms, Consequences, Causes

Brief overview

Diabetes types: Diabetes type 1, diabetes type 2, diabetes type 3, gestational diabetes
Symptoms: Severe thirst, frequent urination, itching, dry skin, general weakness, fatigue, increased infections due to weakened immune system, pain due to secondary diseases of the kidneys and cardiovascular system, neurological deficits such as sensory disturbances or impaired visual function
Causes and risk factors: Genetic factors, unfavorable lifestyle (obesity, little exercise, smoking, etc.), other metabolic diseases, substances such as alcohol or drugs and medication
Examinations and diagnosis: measurement of blood glucose and HbA1c, oral glucose tolerance test (oGTT), test for autoantibodies (for type 1 diabetes)
Treatment: dietary changes, regular physical activity, blood sugar-lowering tablets (oral antidiabetics), insulin therapy
Prevention: Healthy lifestyle with a varied and calorie-conscious diet, sufficient exercise, reducing excess weight, treating existing illnesses, consuming alcohol in moderation, stopping smoking

What is diabetes mellitus?

Diabetes mellitus, also known as diabetes, is a chronic disease in which the sugar metabolism in particular is disturbed. As a result, those affected have a permanently high blood sugar level (chronic hyperglycemia), which has a lasting detrimental effect on various organs.

Doctors speak of an elevated or high blood sugar level when the fasting blood sugar level is between 100 and 125 milligrams of glucose per deciliter of blood serum (mg/dl). Values of 126 mg/dl or higher indicate diabetes mellitus. For comparison: in healthy people, this value is around 80 mg/dl.

What types of diabetes are there?

Depending on the cause and time of onset of the disease, different types of diabetes can be classified:

Type 1 diabetes mellitus

Type 1 diabetes is an autoimmune disease in which the immune system attacks certain cells of the pancreas. These so-called beta cells normally produce insulin, which is important for sugar metabolism. The resulting lack of insulin ultimately leads to diabetes mellitus.

This form of diabetes mainly affects young people and children between the ages of ten and 16, but older people also sometimes develop it.

You can find more information about this form of diabetes in the article Diabetes type 1.

Type 2 diabetes mellitus

Type 2 diabetes affects most diabetics and primarily older people, which is why doctors used to refer to the disease as “adult-onset diabetes”. However, more and more younger people now also have type 2 diabetes.

You can read more about the most common form of diabetes in the article Type 2 diabetes.

Type 3 diabetes mellitus

Type 3 diabetes includes all forms of diabetes that occur less frequently and are caused by other illnesses, infections or the consumption of harmful substances such as alcohol or drugs.

You can read more about this group of rare forms of diabetes in the article Type 3 diabetes.

Gestational diabetes

If diabetes mellitus develops during pregnancy, doctors refer to this form of diabetes as gestational diabetes (or type 4 diabetes). In most cases, it disappears after the birth of the child, but in some women it persists and is treated accordingly.

You can read everything you need to know about gestational diabetes in the article Gestational diabetes.

Diabetes in children

Most diabetic children have type 1 diabetes. However, more and more children are now also developing type 2 diabetes. The “modern” lifestyle has led to more and more children and adolescents having the main risk factors for the disease: These are obesity, lack of exercise and an unhealthy diet.

You can read more about the causes, symptoms and treatment of childhood diabetes in the article Diabetes in children.

Symptoms and consequences of diabetes mellitus

The abnormally high blood sugar levels in diabetes mellitus trigger a wide range of symptoms. This applies both to the two main forms of diabetes (type 1 and type 2 diabetes) and to the rarer forms.

Increased urge to urinate

If blood sugar levels are permanently high, the kidneys excrete more sugar (glucose) in the urine (glucosuria). As sugar physically binds water, those affected also excrete large amounts of urine (polyuria) – they have to go to the toilet very often. Many diabetics are plagued by an annoying urge to urinate, especially at night. The urine is usually clear and only slightly yellow in color.

Polyuria is a typical sign of diabetes mellitus, but can also have other causes. For example, increased urination occurs with various kidney diseases and during pregnancy.

The sugar in the urine of diabetics gives it a slightly sweet taste. This is where the technical term diabetes mellitus comes from: it means “honey-sweet flow”. However, the days when doctors tasted their patients’ urine to make a diagnosis are long gone. Today, they use rapid diabetes tests with indicator sticks to determine the sugar content.

Strong thirst

Weakness, tiredness and concentration problems

Poor performance is also a common sign of diabetes. This is because diabetics have a lot of energy-rich glucose in their blood. However, this does not enter the cells and is therefore not available to them for energy production. This results in an energy deficiency within the cells. As a result, patients often feel weak and are physically less efficient.

Most of the glucose that the body needs during the day is destined for the brain. A glucose deficiency therefore impairs brain function. It triggers, for example, poor concentration, headaches and fatigue, and can even lead to severe loss of consciousness and coma.

Visual disturbances

Itching (pruritus) and dry skin

Sometimes diabetes triggers itching and causes very dry skin in many patients. One reason for this is the high fluid loss due to increased urination. Experts suspect that there are other mechanisms that may be responsible for increased itching in diabetics. One example is stress hormones such as adrenaline and cortisol, which the adrenal glands release more of into the blood when blood sugar levels are too high or too low.

Changes in the blood vessel walls, which may contribute to the development of itching, are also under discussion.

Weakened immune system

Signs of the consequences of diabetes

Undetected diabetes mellitus, blood sugar levels that are not well controlled or are often too high have consequences. For example, they damage the blood vessels and nerves, leading to sometimes serious disorders of various organ systems and bodily functions. Diabetes often only becomes noticeable through these accompanying symptoms. Signs of incipient or advanced diabetes mellitus include, for example

Nerve damage (polyneuropathy)

High blood sugar levels damage the peripheral nervous system over time. Both motor (controlling the muscles) and sensitive (feeling) and vegetative (controlling the organs) nerve pathways are affected. Diabetics therefore often have an impaired perception of pain. For example, they do not perceive injuries to the skin or a heart attack as pain. Muscle coordination during movements also often suffers.

Damage to the blood vessels (angiopathies)

High blood sugar levels usually trigger changes in the inner wall layer of the small and smallest blood vessels (capillaries) first (microangiopathy). Over time, the medium and large blood vessels are also affected (macroangiopathy). The vascular damage results in circulatory disorders or even complete occlusion. This has consequences for various organs. Here are the most important examples:

Heart: An undersupply of the heart muscle can lead to heart failure, coronary heart disease (CHD) or a heart attack.
Brain: Circulatory disorders in the brain cause chronic neurological deficits – in the worst case a stroke.
Eyes: Vascular damage to the retina of the eye (diabetic retinopathy) causes symptoms such as “flashes of light”, blurred vision, impaired color vision and ultimately loss of vision or even blindness.
Skin: Vascular damage in the skin makes it more susceptible to colonization with germs (skin infections) and ensures poor blood circulation and wound healing, which can be recognized by brownish spots on the legs, among other things. Poorly healing chronic wounds and ulcers in the area of the lower legs/feet are referred to by doctors as diabetic foot.

Diabetes and depression

Around a quarter of all diabetes patients suffer from a depressive mood or depression. The trigger is usually the diabetes itself as well as any late effects that put a psychological strain on those affected.

Conversely, people with depression have an increased risk of developing type 2 diabetes. Depression apparently alters the patient’s hormonal system and metabolism via various signaling pathways in such a way that diabetes is favored.

Diabetes and impotence

What causes diabetes mellitus?

All forms of diabetes mellitus are caused by impaired blood sugar regulation. To understand this, it is advisable to know the basics of blood sugar regulation:

After a meal, the body absorbs food components such as sugar (glucose) into the blood via the small intestine, which causes blood sugar levels to rise. This stimulates certain cells in the pancreas – the so-called “Langerhans beta islet cells” (beta cells for short) – to release insulin. This hormone ensures that glucose is transported from the blood into the body’s cells, where it serves as an energy supplier for the metabolism. Insulin therefore lowers the sugar level in the blood.

In diabetes, this blood sugar regulation is disrupted at (at least) one important point. Depending on where the disorder is present, doctors distinguish between different types of diabetes:

Type 1 diabetes mellitus

Type 1 diabetes is therefore an autoimmune disease. It is not yet known exactly why it occurs. Experts assume a genetic predisposition and various risk factors (such as infections) that favor the development of this diabetes.

The destruction of the beta cells results in an absolute insulin deficiency. People with type 1 diabetes inject themselves with insulin throughout their lives to compensate.

You can read more about the development, treatment and prognosis of this form of diabetes in the article Type 1 diabetes.

Type 2 diabetes mellitus

In type 2 diabetes, the starting point of the disturbed blood sugar regulation lies in the body’s cells: Initially, the pancreas usually still produces enough insulin. However, the body’s cells become increasingly insensitive to it. This insulin resistance triggers a relative insulin deficiency: There would actually be enough insulin, but it is not effective enough.

In some type 2 diabetics, however, the pancreas also produces too little insulin directly.

You can read more about the most common form of diabetes in the article Type 2 diabetes.

Type 3 diabetes mellitus

There are some rare forms of diabetes that are summarized under the term type 3 diabetes. They have different causes than type 1 and type 2 diabetes.

One example is MODY (maturity onset diabetes of the young), also known as type 3a diabetes. It includes various forms of diabetes that occur in children and adolescents (before the age of 25). They are caused by certain genetic defects in the beta cells of the pancreas.

Type 3b diabetes, on the other hand, is caused by genetic defects that impair insulin action. If certain chemicals or medication are the cause of diabetes, doctors refer to it as type 3e.

You can read more about this group of rare forms of diabetes in the article Type 3 diabetes.

Some women become temporarily diabetic during pregnancy. Various factors appear to be involved in the development of gestational diabetes:

During pregnancy, the female body secretes more hormones, namely the antagonists of insulin such as cortisol, oestrogen, progesterone or prolactin. In addition, affected women apparently have a chronically reduced insulin sensitivity: the body’s cells respond less to insulin. This increases in the course of pregnancy.

You can read more about diabetes during pregnancy in the article Gestational diabetes.

How can diabetes mellitus be detected?

Many people therefore ask themselves: “How do I recognize diabetes? What signs should I look out for if I have diabetes?” If you answer “yes” to one or more of the following questions, talk to your doctor about it:

Without any unusual physical exertion, do you often feel thirsty and drink considerably more than usual?
Do you need to urinate frequently and in large quantities, even at night?
Do you often feel physically weak and tired?
Do you have a family history of diabetes?

Doctor’s consultation and physical examination

The doctor will first talk to you in detail to establish your medical history (anamnesis). For example, he will ask you about your symptoms in detail. You should also tell him about any complaints that you suspect have a different cause (such as stress as a reason for concentration problems).

The consultation is followed by a physical examination. Here, the doctor will look at how well you can feel subtle touches on your hands and feet. If there is little or no sensation, this may indicate diabetes-related nerve damage (diabetic polyneuropathy).

Measuring blood sugar (diabetes tests)

Measuring blood glucose levels is understandably the most informative test for diabetes. The following tests play a special role here:

Fasting blood glucose: measurement of blood glucose after at least eight hours without food
HbA1c: So-called “long-term blood sugar”, also important for the course of the disease
Oral glucose tolerance test (oGTT): A “sugar load test” in which the patient drinks a defined sugar solution; the doctor then measures the blood sugar levels at certain intervals

Blood and urine tests to diagnose diabetes are usually carried out by a doctor. Some self-tests are commercially available that any layperson can carry out independently at home. However, they do not provide a reliable medical diagnosis – if the test results are abnormal, go to the doctor for a more detailed examination.

You can find detailed information on the subject of diabetes tests in the text Diabetes test.

Diabetes values

Diabetes is present if the fasting blood glucose, HbA1c or oral glucose tolerance test results are too high. But what does “too high” mean? Which threshold values mark the transition from “healthy” to “impaired glucose tolerance” and on to “diabetes”?

The various diabetes values not only play a decisive role in the diagnosis of diabetes. They are also monitored regularly afterwards: This is the only way to assess the progression of the disease and the effectiveness of diabetes treatment. Some of the control measurements can be carried out by the patients themselves (e.g. blood glucose measurement).

You can read more about limit values and assessment of blood glucose, HbA1c and oGTT in the article Diabetes values.

Antibody test for type 1 diabetes

The detection of antibodies against the beta cells (islet cell antibodies) or against insulin (insulin antibodies) is helpful in the diagnosis of the autoimmune disease type 1 diabetes. These autoantibodies can be detected in the blood of many sufferers long before the first symptoms appear.

Further examinations

Further examinations serve to detect any possible consequences of diabetes at an early stage. For example, the doctor will check whether your sense of touch in your hands and feet is normal. This is because increased blood sugar levels damage the nerve tracts, among other things. Over time, this causes sensory disturbances.

The vascular damage sometimes also affects the retina of the eyes. The doctor will therefore check whether your eyesight has deteriorated. If this is suspected, the ophthalmologist will carry out a special eye examination.

Treatment of diabetes mellitus

Secondly, diabetes treatment often requires additional diabetes medication (antidiabetics). Oral preparations (blood sugar-lowering tablets) and insulin, which must be injected, are available. Which antidiabetic drugs are used in individual cases depends on the type of diabetes and the severity of the disease.

Below you will find more information on the various diabetes treatment measures:

Diabetes education

If diabetes is diagnosed, doctors recommend that patients take part in diabetes education. There they learn everything important about their disease, the possible symptoms and consequences as well as the treatment options. During the training, diabetics also learn how sudden complications (such as hypoglycaemia) can occur and what to do in such cases.

Diabetes diary

Such a diabetes diary is particularly advisable for type 1 diabetics with so-called “brittle diabetes”. This is an outdated term for type 1 diabetes in which the blood sugar levels fluctuate greatly (brittle = unstable). Such metabolic imbalances sometimes lead to numerous hospitalizations.

Diabetes diet

A varied and balanced diet is important for everyone, but especially for diabetes patients. It is important to avoid massive blood sugar spikes after eating and sudden hypoglycaemia. This is why those affected usually receive individual nutritional advice immediately after being diagnosed with diabetes. There they learn how to eat properly and healthily.

If patients consistently implement the individual dietary recommendations, they make a significant contribution to lowering their blood sugar levels and keeping them under control. This is why an adapted diet is part of every diabetes therapy.

Bread units

Carbohydrates play a special role in the proper nutrition of diabetes patients. They are mainly responsible for the rise in blood sugar levels after eating. It is therefore particularly important for patients who inject themselves with insulin to correctly estimate the amount of carbohydrates in a planned meal. This is the only way to select the correct dose of insulin.

The so-called “bread units” (BE) are used to make it easier to assess the carbohydrate content of a food. One BE corresponds to twelve grams of carbohydrates. For example, a slice of wholemeal bread (60 grams) has two bread units. A glass of carrot juice provides one BE.

You can find out more about the calculation of bread units and a BE table with various foods in the article Bread units.

Diabetes and sport

Diabetics benefit from physical activity in several ways:

Muscle work directly increases the insulin sensitivity of the body’s cells. This improves the absorption of sugar from the blood into the cells. If you exercise regularly, you ideally have the opportunity to reduce the dose of blood sugar-lowering medication (tablets or insulin) (only in consultation with your doctor!).

Physical activity improves well-being and quality of life. This is particularly important for people with chronic illnesses such as diabetes. Chronic illness is very stressful psychologically and often contributes to depression.

Doctors therefore advise diabetics to ensure they get enough exercise in their everyday lives and to exercise regularly – adapted to their age, physical fitness and general state of health, of course. Ask your doctor or a sports therapist for advice on which and how much sport is best for you and what you should pay attention to when exercising.

Oral diabetes medication

The basis of any treatment for type 2 diabetes is a change in lifestyle. Above all, this includes a change in diet as well as regular exercise and sport. Sometimes these measures are enough to reduce the blood sugar levels of type 2 diabetics to a healthier level. If not, the doctor will prescribe additional oral antidiabetic drugs. In some cases, drugs that are injected under the skin are also used.

There are different classes of diabetes medication in tablet form. They differ in the mechanism of action they use to lower the elevated blood sugar levels. Doctors most frequently prescribe metformin and so-called sulfonylureas (such as glibenclamide).

Doctors do not normally use oral antidiabetics for type 1 diabetes – they do not achieve sufficient success here. They are only useful for overweight patients with an increased risk of heart disease.

They are also not approved for the treatment of gestational diabetes because most active substances cannot be ruled out as having harmful effects on the child. Only in very rare exceptional cases and when absolutely necessary do doctors use metformin in pregnant women to lower severely elevated blood sugar levels (as “off-label use”).

You can find more information about which oral antidiabetics are used in the article Diabetes type 2.

Insulin therapy

Conventional insulin therapy

In conventional insulin therapy, insulin is administered according to a fixed schedule, usually in the morning and evening. Conventional insulin therapy is therefore easy to use.

However, it restricts the patient: major deviations from the usual meal plan are not possible and extensive physical activity sometimes leads to problems. Conventional insulin therapy is therefore primarily suitable for patients who can adhere to a fairly rigid daily and dietary plan and for whom the implementation of intensified insulin therapy would be too difficult.

Intensified insulin therapy (ICT diabetes)

Intensified insulin therapy attempts to mimic physiological insulin secretion as precisely as possible. The administration of insulin is therefore more difficult than with conventional insulin therapy. It is carried out according to the basic bolus principle:

Intensified insulin therapy requires good training and very good patient cooperation (compliance). Otherwise there is a risk of dangerous diabetes hypoglycemia due to incorrect calculation of the insulin dose.

The advantage of the basic bolus concept is that it allows very good blood glucose control when used correctly. Patients can also eat what they want and exercise as they wish.

Insulin pump (“diabetes pump”)

Doctors refer to diabetes treatment with an insulin pump as “continuous subcutaneous insulin infusion therapy” (CSII). The small device consists of a pump with an insulin reservoir, which the diabetes patient always carries with them (e.g. on their waistband). The pump is connected to a small needle via a thin tube, which remains permanently in the subcutaneous fatty tissue (usually on the abdomen).

The insulin pump saves type 1 diabetics from having to handle insulin syringes and allows flexible meal planning and spontaneous sporting activities. This is particularly advantageous for young patients. In addition, blood glucose levels can be adjusted more stably in this way than with insulin injections. Many patients report that their quality of life has improved significantly thanks to the “diabetes pump”.

The insulin pump is set up and adjusted in a specialized diabetes clinic or practice. Patients receive comprehensive training on how to use the pump, as dosing errors can quickly become life-threatening. If, for example, the insulin pump breaks down or the patient has to take it off for a longer period of time for medical reasons, an immediate switch to insulin syringes is necessary.

Continuous glucose monitoring (CGM)

However, it is important that patients still measure their own blood glucose, at least in certain situations, such as after exercise or before a planned insulin administration. This is because there is a natural difference between tissue glucose (recorded by the CGM) and blood glucose: above all, tissue glucose lags behind blood glucose – by around five to 15 minutes, possibly a little longer. If the blood sugar drops after physical exertion, for example, the tissue measurement often still shows normal values.

Insulins

Doctors use various insulins in the treatment of diabetes mellitus. Most of these are artificially produced human insulin. In addition to human insulin, porcine insulin and insulin analogs are also available. Insulin analogs are also artificially produced active ingredients. However, their structure differs slightly from that of human insulin and therefore from human insulin.

You can read more about the various insulin preparations and their use in the article Insulin.

To make therapy easier, experts are currently researching patches that are applied to the skin, measure the glucose level in sweat and deliver either diabetes medication or insulin. However, they are still in the experimental phase.

“DMP – Diabetes” (Disease Management Program)

Diabetes mellitus is one of the most common chronic diseases in western industrialized countries. This is why so-called disease management programs are becoming increasingly important. They originated in the USA.

This is a concept organized by health insurance companies to make it easier for treating physicians to offer a standardized, close-meshed therapy and care program for chronically ill patients. In the case of diabetes, this includes information brochures, counseling sessions and training on the subject of diabetes.

Diabetes mellitus is a chronic disease that cannot be cured. However, with the help of therapy, the progression of the disease can be slowed down and the symptoms can be controlled and alleviated.

The course of the disease and the prognosis vary greatly from one type of diabetes to another. Patients have a positive influence on the course of the disease in all forms of diabetes by conscientiously implementing the treatment recommendations (adherence to treatment = compliance). This prevents complications and significantly reduces the risk of diabetes-related complications.

Regular check-ups with the doctor are important for diabetics. In this way, for example, signs of secondary diseases of diabetes can be recognized and treated at an early stage.

A complete diabetes cure is only possible with gestational diabetes: the woman’s body usually returns to normal status after the exceptional hormonal state of pregnancy and the diabetes disappears.

With diabetes mellitus, life expectancy depends on whether the blood glucose can be controlled well in the long term and how consistently the patient adheres to the therapy. Possible concomitant and secondary diseases such as high blood pressure, increased blood lipid levels or kidney weakness also have a major influence. If they are treated professionally, this has a positive effect on life expectancy.

Complications of diabetes mellitus

The transitions between normal blood sugar levels, hypoglycemia and hyperglycemia are fluid.

In the long term, poorly controlled blood sugar levels trigger secondary diseases in most diabetics. For example, high blood sugar levels damage the blood vessels (diabetic angiopathy), resulting in circulatory disorders. This causes, for example, “intermittent claudication” (PAOD), kidney disease (diabetic nephropathy), eye disease (diabetic retinopathy), a heart attack or stroke. The nerves are also often damaged in diabetes patients (diabetic polyneuropathy). This results in diabetic foot syndrome, for example.

Read more about diabetes complications and secondary diseases below.

Low blood sugar (hypoglycemia)

Skipping a meal or extensive exercise can also trigger hypoglycemia if the medication is not adjusted accordingly.

Patients with low blood sugar sweat, tremble and experience palpitations, among other things. Severe hypoglycemia is life-threatening, as it can lead to multiple organ failure. If you suspect this, call an ambulance immediately.

Hyperosmolar hyperglycemic syndrome (HHS)

This severe metabolic derailment occurs mainly in older type 2 diabetics. If insulin or oral antidiabetics are used incorrectly, a lack of insulin can occur in some cases. HHS then develops slowly over a period of days to weeks:

Skipping a meal or extensive exercise can also trigger hypoglycemia if the medication is not adjusted accordingly.

Hyperosmolar hyperglycemic syndrome (HHS)

However, this so-called gluconeogenesis further exacerbates hyperglycemia. The breakdown of fat also produces acidic metabolic products (ketone bodies). However, the body only utilizes some of these. The rest remains in the blood as acids and “over-acidifies” it – resulting in acidosis.

This is usually triggered by physical stress situations such as an infection: the body then needs more insulin than normal. If the insulin therapy is not adjusted accordingly, there is a risk of metabolic derailment. The same happens, for example, if patients forget insulin injections, dose the insulin too low or if the insulin pump malfunctions.

Diabetic ketoacidosis is a medical emergency! Those affected are immediately taken to hospital and treated in the intensive care unit.

You can read more about the symptoms, causes and treatment of this metabolic imbalance in our article Diabetic ketoacidosis.

Diabetic retinopathy

Poorly controlled blood sugar levels often damage the small blood vessels of the retina in the eyes. This leads to the development of a retinal disease, which doctors refer to as diabetic retinopathy.

Affected patients experience visual disturbances and their eyesight deteriorates. In extreme cases, there is a risk of blindness. In industrialized countries, diabetic retinopathy is the main cause of blindness in middle age and the third most common across all age groups.

If the retinal disease is not yet too advanced, laser therapy can sometimes help to stop the progression or slow it down.

Diabetic nephropathy

Like diabetic retinopathy, diabetes-related kidney disease is caused by damage to small blood vessels (microangiopathy) due to poorly controlled blood sugar levels. The kidneys are then restricted in their function, which means that they no longer filter the blood sufficiently (detoxification) and do not properly regulate the water balance.

Possible consequences of diabetic nephropathy are kidney-related high blood pressure, water retention in the tissue (oedema), lipometabolic disorders and anaemia as well as chronic kidney failure.

Diabetic polyneuropathy

Diabetes with permanently poorly controlled blood sugar often leads to nerve damage and dysfunction. This so-called diabetic polyneuropathy first manifests itself in the feet and lower legs – a diabetic foot develops.

Diabetic foot

Diabetic foot syndrome develops on the basis of diabetes-related nerve and vascular damage:

The nerve disorders trigger abnormal sensations (such as “formication”) and sensory disturbances in the foot and lower leg. The latter mean that patients only perceive heat, pressure and pain (e.g. from shoes that are too tight) to a lesser extent. In addition, there are circulatory disorders (as a result of vascular damage).

All of this together leads to poor wound healing. As a result, chronic wounds develop, which often also become infected. Gangrene also occurs, whereby the tissue dies. In the worst case, amputation is necessary.

You can read more about these diabetes complications on the foot in the article Diabetic foot.

Disability certificate

Living with diabetes mellitus

Diabetes mellitus affects the entire life of those affected. It starts with small things such as alcohol consumption at family celebrations and extends to life issues such as family planning and the desire to have children.

Travel is also an important issue for many diabetics: As a diabetic, what do I need to consider when traveling by air? What medication and medical utensils do I need to take with me? How should they be stored? What about vaccinations?

You can read the answers to these and other questions about everyday life with diabetes mellitus in the article Living with diabetes.

Can diabetes be prevented?

Diabetes mellitus can be prevented in certain cases, especially type 2 diabetes or gestational diabetes. For example, a healthy diet and sufficient exercise have a major influence on achieving a healthy metabolic state. This reduces the risk of permanent hyperglycemia, which leads to diabetes in the long term.

If you are overweight, doctors recommend losing it in order to achieve better fitness and minimize the risk of diabetes.

As type 1 diabetes primarily has genetic causes, this disease cannot be prevented.