Different characteristics of the consequences for type 1 and type 2

There are two different types of diabetes. Type 1 diabetes mellitus usually occurs in adolescence. In type 1 diabetes, presumably mediated by an autoimmune disease, the cells of the pancreas that produce insulin are destroyed, resulting in an absolute lack of insulin in the long term.

People with diabetes mellitus type 1 are dependent on external insulin supply for their entire lives. Type 2 diabetes mellitus only develops at an advanced age. It is often the result of a rather unhealthy lifestyle.

The tendency, however, is that so-called diabetes mellitus type 2 also increasingly occurs in younger – usually overweight – adults. The earlier diabetes occurs, the higher the potential for consequential damage. Although type 1 diabetes occurs in adolescence, type 2 diabetes mellitus is more likely to result in consequential damage.

One reason for this is that type 1 diabetics already grow up with the disease and have therefore learned to change their lifestyle at an early age, whereas type 2 diabetics usually do not have to change their lifestyle until around the age of 50, which is very difficult for many. On the other hand, insulin is used directly as the first therapy for type 1 diabetics to lower their sugar levels, as these patients have an absolute lack of the hormone. Type 2 diabetics still have the body’s own insulin, which, however, has a weakened effect on the body.

The effect of insulin can be improved through sport, and through adequate nutrition the blood sugar level can often be sufficiently lowered. If patients do not adhere to the recommended rules of conduct, the blood sugar level can reach high peak values, which can cause damage. Before one resorts to insulin therapy with them, so-called oral antidiabetics are used, i.e. tablets that are taken to improve the effect of insulin.

This is also sometimes unable to achieve a sufficient reduction in blood sugar levels. As a last measure insulin is then prescribed. If the patient adheres to the prescribed injection plan, the blood sugar can be sufficiently lowered.

However, the patient must be sufficiently trained for this. Accordingly there are more weak points with the type 2-Diabetiker at those it over a longer period to unsatisfactory high sugar values comes, which damage the vessels and nerves. This is usually less the case with type 1 diabetics because they are trained at an early age and diabetes is part of their lives almost from the beginning, while type 2 diabetics have lived without this disease for more than half of their lives.

There are two forms of diabetes during pregnancy. On the one hand, there is diabetes that existed before the pregnancy. This can be type 1 or type 2 diabetes.

However, if elevated sugar levels only occur after the 20th week of pregnancy, this is known as gestational diabetes. This is a type of diabetes that only developed during pregnancy and usually disappears again after pregnancy. However, the risk of developing diabetes later in life is higher for both mother and child.

In both forms, diabetes must be strictly controlled during pregnancy to avoid elevated blood sugar levels, as elevated levels can have a detrimental effect on the pregnancy and the child. Mothers with diabetes have an increased risk of miscarriage or premature birth. In addition, the child may develop malformations of the lungs, heart and nervous system, for example.

Because of the possible risks, these mothers should deliver in a specialized hospital, a so-called perinatal center with level 1 or 2. However, these risks only exist if the blood sugar level is poorly adjusted. Because of the risks, patients should be closely monitored by a diabetologist in addition to the gynecologist.

Blood sugar levels should be adjusted accordingly in advance in the case of a planned pregnancy. The goal should be to keep the long-term glucose level below 6.5%, at least below 7%. If the mother has permanently increased blood sugar levels during pregnancy, this usually affects the growth of the child.

Typical for these children is an increased birth weight of over 4500g (macrosomia).The increased growth is due to an increased supply of glucose (glucose = sugar) in the child’s blood, which makes more nutrients available for growth. The increased growth can promote the development of malformations. It can also lead to complications during birth.

A high birth weight is often an indication for a caesarean section. Mothers with diabetes during pregnancy more often suffer from urinary tract infections and vaginal infections. These infections can also put the child at risk and increase the risk of premature birth.

As the baby is used to high sugar levels in the womb, the pancreas of the unborn child produces more insulin. After birth, there is still an increased insulin production, but the baby is no longer supplied by the mother’s blood, so the blood sugar level is normal. Therefore, after birth, a child born to a mother with diabetes is at risk of hypoglycaemia.

There are not only risks regarding the unborn child and the upcoming birth, but also for the mother herself. The consequences of diabetes, as described above, can become worse during pregnancy. Existing damage to the retina or kidney can worsen.