Frequency (Epidemiology)

Diabetes mellitus Occurrence in the population7-8% of the adult German population have diabetes mellitus, 95% of these people have type 2 diabetes.

History

For the course of the diabetes disease it is crucial that careful blood glucose control is ensured throughout the life of the patient, as this is the only way to prevent late damage. The disease is particularly stressful for the blood vessels, which is why a heart attack (myocardial infarction), coronary artery disease (coronary heart disease (CHD), angina pectoris) or stroke (apoplexy) can occur due to vascular constriction, or vascular occlusion in the arm and leg arteries (pAOD) can lead to a restriction of the patient’s mobility. Disturbances in the kidney supply (diabetic nephropathy) or in the blood flow to the retina from the eye (diabetic retinopathy) are further possible consequences of diabetes.

Diabetes-induced damage to the body’s nerves that are far from the body leads to the clinical picture of diabetic polyneuropathy. In order to prevent or delay potential organ damage, various diagnostic measures are used to monitor the progression of diabetes. These include regular blood sugar checks by the family doctor as well as independent self-monitoring by the patient.

A very reliable and far-reaching diagnostic tool is the HbA1c determination. The HbA1c value indicates the percentage share of glycosylated hemoglobin in total hemoglobin (red blood pigment). The standard value for healthy people is 4 – 6.2%, for diabetes therapy a value below 7% is aimed for, optimally it is below 6.5%.

Glycosylated red blood pigment is formed when glucose, which cannot be introduced into the cells due to the lack of insulin, attaches itself to the red blood cells. The extent of this accumulation reflects the blood sugar level of the last 6-8 weeks. In this respect, the HbA1c value can also be called sugar memory.

The test for microalbuminuria (for explanation see “Complications”) is performed once a year for every diabetic. This involves examining the urine for the smallest amounts of protein, as these indicate damage to the kidneys by the diabetes at an early and treatable stage. Regular visits to the family doctor (general practitioner or internal medicine doctor = internist) and ophthalmological check-ups (ophthalmology) to assess the course of the disease are recommended to the diabetic patient in view of the possible long-term consequences (e.g. blindness, heart attack).