Insulin associated diseases

The metabolic disease known as insulin resistance (synonym: pre-diabetes) is a preliminary stage of type 2 diabetes. It has now been proven that the causes of this disease have a strong genetic component. Studies have shown that 40% of children whose parents have type 2 diabetes suffer from insulin resistance.

If two parents are affected, the probability increases to 80%. Not every patient affected by insulin resistance needs to develop the full picture of type 2 diabetes. In many cases, the only thing that remains is a reduced responsiveness of the insulin-specific receptors to their binding partners.

Insulin resistance can be clinically diagnosed by determining the so-called fasting blood glucose level. A blood glucose level of more than 100 to 125 mg/dl should be interpreted as an early warning sign. In such cases, the determination of the so-called HbA1c value should be aimed for.

While the blood glucose level in pre-diabetes can be only slightly elevated in many cases, large amounts of insulin can be detected in the blood of almost all affected persons. The fatal thing about pure insulin resistance is the fact that it is usually completely asymptomatic and for this reason is usually only diagnosed after damage to the pancreas. Type 1 diabetes is based on an absolute insulin deficiency (synonym: primary insulin-dependent diabetes).

Due to a genetic defect and the formation of special antibodies directed against the beta cells of the pancreas, the insulin-producing cells are destroyed. As a result, the organ is no longer able to produce sufficient amounts of the tissue hormone and release it into the bloodstream. Glucose ingested through food can no longer be absorbed, or only insufficiently, in cells of fatty tissue, muscles or the liver.

The blood sugar level in the affected patients is usually at a very high level (hyperglycemia). This condition has several dangers. On the one hand, the various cells cannot be supplied with sufficient amounts of sugar.

This means that they cannot be supplied with enough energy and can only perform their tasks inadequately.If type 1 diabetes is not treated, in the long term it leads to hyperacidity of the blood and a serious impairment of many metabolic processes within the organism. In the worst case, type 1 diabetes can even lead to death. This form of insulin deficiency is commonly known as juvenile diabetes.

For a long time it was assumed that young people in particular suffer from type 1 diabetes. Even today, this fact cannot be completely denied, as the age peak for the first occurrence of this form of diabetes is between 11 and 14 years. However, there are also cases in which affected patients do not show the first symptoms until middle age.

The treatment of type 1 diabetes is usually carried out via an external insulin supply. This can be done by oral administration or injection of the hormone. Especially in children, the use of so-called insulin pumps is now used.

In contrast to type 1 diabetes, which is characterized by an insulin deficiency from the outset, this form of diabetes in its early stages is based on a malfunction of the specific insulin receptors. In particular, the insulin receptors of the liver, muscle and fat cells gradually lose the ability to respond to the tissue hormone. This stage is known in medicine as insulin resistance.

Type 2 diabetes is also called relative insulin deficiency in many textbooks. In the initial stage, the pancreas tries to compensate for the existing insulin resistance by increasing the production and secretion of the hormone. In the long run, this compensatory mechanism overtaxes the pancreas.

As receptor resistance progresses, the amount of insulin that can be mobilized is no longer sufficient to adequately lower blood sugar levels. The initial insulin resistance is therefore followed by insulin deficiency. Especially at this point in time, most patients show unspecific symptoms such as tiredness, weakness, hunger and weight gain. In addition, depressive moods can be a first indication of the presence of type 2 diabetes. Due to the very unspecific signs, this form of diabetes is usually detected too late.