Therapeutic goal and treatment recommendations Individualized HbA1c target corridor of 6.5-7.5% (48-58 mmol/mol). HbA1c target value close to 6.5%, only if this can be achieved by lifestyle changes and/or metformin! (DEGAM) Individual target should be in the lower range of the HbA1c target corridor or even below if necessary: Short duration of diabetes; moderately elevated … Diabetes Mellitus Type 2: Drug Therapy
The diagnosis of type 2 diabetes mellitus is made on the basis of the clinical picture and laboratory parameters.Optional medical device diagnostics – depending on the results of the history, physical examination and laboratory diagnostics – to identify secondary diseases of diabetes mellitus. Cardiovascular diagnostics Repeated blood pressure measurement on both arms with cuff adjusted … Diabetes Mellitus Type 2: Diagnostic Tests
Medical history (history of illness) is an important component in the diagnosis of type 2 diabetes mellitus. Family History Are there any conditions in your family that are common, such as obesity, hypertension, diabetes mellitus, dyslipidemia, myocardial infarction, stroke, early mortality, amputation? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic … Diabetes Mellitus Type 2: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Genetic lipodystrophy including lipatrophic diabetes. Hereditary neuromuscular diseases. Mendenhall syndrome – group of extreme insulin-resistant syndromes (together with leprechaunism, the lipodystrophies and insulin resistance syndromes type A and B); Mendenhall syndrome has an autosomal recessive mode of inheritance: growth retardation starting already intrauterin (“in utero”) Myotonic dystrophy Myotonic … Diabetes Mellitus Type 2: Or something else? Differential Diagnosis
An etiologically (causally) based classification according to the recommendations of the American Diabetes Association (ADA) and WHO is shown in the table below. Classification of diabetes mellitus I. Type 1 diabetes mellitus – absolute insulin deficiency due to destruction (destruction) of ß-cells (site of insulin production): Type 1a: immunologically mediated form Special form: LADA (latent … Diabetes Mellitus Type 2: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) [Delayed wound healing, pruritus (itching), recurrent therapy-resistant infections for example dermatomycosis; Poorly healing wounds, bacterial or mycotic skin infections … Diabetes Mellitus Type 2: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. HbA1c level (long-term blood glucose value): Diagnostic marker: ≥ 6.5% [Both the German Diabetes Society and the American Diabetes Association consider glycated hemoglobin to be a relevant diagnostic marker, provided it has been determined according to an internationally standardized procedure]. Prognostic marker: ≥ 5.6% [patients … Diabetes Mellitus Type 2: Test and Diagnosis
Diabetes mellitus is always accompanied by oxidative stress, which must be treated in any case. Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for prevention (prevention): Vitamin E Mineral magnesium Flavonoids Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for supportive … Diabetes Mellitus Type 2: Micronutrient Therapy
To prevent type 2 diabetes mellitus, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Chronic overeating High calorie intake High-fat diet (saturated fat) High proportion of saturated fatty acids High intake of carbohydrates, especially mono- and disaccharides (monosaccharides and disaccharides) due to excessive consumption of sweets and sweet drinks: per … Diabetes Mellitus Type 2: Prevention
In type 2 diabetes, the classic symptomatology of insulin deficiency seen in type 1 diabetics rarely exists. A type 2 diabetic with mildly or only passively elevated blood glucose levels may remain completely asymptomatic, that is, without symptoms. Such a situation may prevail in type 2 diabetes for a prolonged period, sometimes for several years, … Diabetes Mellitus Type 2: Symptoms, Complaints, Signs
Pathogenesis (disease development) The cells of the pancreas lie arranged in islands called islets of Langerhans. One type of cell in the islets of Langerhans is the β-cells (B cells). These cells produce insulin. Insulin is responsible for promoting the uptake of glucose from the blood. It also ensures the conversion of glucose into glycogen, … Diabetes Mellitus Type 2: Causes
General measures Aim for normal weight!Notice. A weight gain of 8-10 kg increases the relative risk of diabetes mellitus by a factor of 3, and a gain of 11-20 kg by a factor of 5.Determine BMI (body mass index) or body composition using electrical impedance analysis and participate in a medically supervised weight loss program. … Diabetes Mellitus Type 2: Therapy
