Diabetology is a medical specialty that deals with the diagnosis and treatment of diabetes mellitus. Diabetes mellitus is a metabolic disease associated with hyperglycemia.
What is diabetology?
Diabetology is a medical specialty that deals with the diagnosis and treatment of diabetes mellitus. Until 2003, diabetology was not a recognized medical specialty; it could only be learned in private-law training programs. Since 2003, however, it has been possible in some German states to train as a diabetology-qualified family doctor. All physicians who have worked in this specialty for at least one and a half years and who have also passed an examination before the Medical Association are allowed to use the addition diabetology. In summary, there are currently three different groups of diabetologists: Internists specializing in endocrinology and diabetology, physicians with the additional designation of diabetology, and diabetologists according to DDG (German Diabetes Society). What they all have in common, however, is that they are primarily concerned with the treatment of diabetes mellitus.
Treatments and therapies
Diabetes mellitus, also known as diabetes, is a metabolic disease that causes elevated blood glucose levels. Essentially, the disease can be divided into two types. Patients with diabetes mellitus type 1 have an absolute insulin deficiency due to destruction of the insulin-producing cells in the pancreas. In diabetes mellitus type 2, insulin is usually still present. However, it can no longer fulfill its functions due to insulin resistance. Without insulin, glucose can no longer be absorbed from the blood into the body cells. Hyperglycemia occurs. Gestational diabetes is also known as type 4 diabetes. It is a glucose tolerance disorder. In most women with gestational diabetes, however, the sugar metabolism regulates itself again after birth. Typical of the initial manifestation of type 1 diabetes is severe weight loss. Within days or a few weeks, those affected lose several kilograms of weight. In addition, they suffer from constant thirst, frequent urination, vomiting, abdominal pain and headaches. Many type 2 diabetics often have no symptoms at all for years. Since patients are often overweight, small weight losses are hardly noticeable. Only when blood glucose levels are massively elevated do patients experience increased thirst or urination. Especially at the beginning of the disease, the symptoms are often very uncharacteristic. There is fatigue, weakness, increased susceptibility to infections and visual disturbances. The elevated blood glucose levels damage various structures of the body, so that various concomitant and secondary diseases can occur with diabetes mellitus. The treatment of diabetes mellitus therefore usually requires a network of different physicians. More than 80% of all diabetics suffer from high blood pressure. The reason for this is, on the one hand, sugar deposits in the blood vessels and, on the other hand, a suppression of the formation of new blood vessels and the repair of damaged ones. This vascular damage has a negative effect on many organs. In the retina, for example, they lead to diabetic retinopathy, a disease of the retina. Diabetic retinopathy is the most common cause of blindness in the Western world. Around a quarter of all diabetics suffer from neuropathies, diseases of the peripheral nervous system. These manifest themselves, for example, in sensory disturbances, insensations or pain. In diabetology, particular attention is paid to neuropathies. They are the reason why heart attacks in diabetics are often not noticed. Heart attacks in diabetics are often silent because of the neuropathies.
Diagnosis and examination methods
To make a diagnosis, diabetology involves a blood glucose test. This involves drawing blood from the vein of the fasting patient. Fasting blood glucose should not exceed a value of 126 mg/dl. In a random blood draw, i.e. even when the patient is not fasting, the blood glucose value should not exceed 200 mg/dl. For a diagnosis of diabetes mellitus to be made, either an elevated blood glucose value (fasting or random) or a pathological oral glucose tolerance test must be present in at least two blood draws. In the glucose tolerance test, the patient drinks a certain amount of glucose dissolved in water.Blood is then taken from the patient after 60 minutes and after 120 minutes. If the measured blood glucose values exceed the normal values, diabetes mellitus must be assumed. For long-term monitoring, the HbA1C value in the blood is determined. This provides information about the blood glucose values over the last eight weeks. Due to the dangerous secondary diseases of diabetes mellitus, the goal of diabetology is the optimal blood glucose control of patients. All diabetics receive diabetes training. Here they learn how to influence their sugar levels with diet and exercise. Foot care is also on the program. Feet are particularly at risk with diabetes mellitus. Due to the poor blood supply in diabetes, small injuries easily occur on the feet, which then heal poorly. Due to the polyneuropathy, patients often hardly notice these injuries, so that the inflammation quickly spreads. The result is the dreaded diabetic foot. The course participants also learn how to control their blood glucose levels correctly and what to do in the event of hyperglycemia or hypoglycemia. Of course, diabetology is also responsible for the medication of diabetics. The main active ingredient in the treatment of type 2 diabetes is metformin. Metformin lowers blood sugar levels, inhibits sugar production in the liver and reduces sugar absorption from the intestine into the blood. Metformin also improves sugar utilization. Type 1 diabetics rely on insulin injections for the rest of their lives. Once or twice a day, patients inject themselves with an insulin pen or syringe a so-called long-acting insulin or insulin analog.
