The essential problem of type 2 diabetes is not insulin deficiency – on the contrary, the body initially produces more insulin – but insulin resistance. It is – along with impaired insulin secretion – the engine that drives the disease ever onward. This finding has emerged from research conducted in recent years. Since type 2 diabetes rarely causes symptoms at the beginning, the disease is usually discovered by chance, e.g. during a routine check-up. The precursor of this metabolic disease is insulin resistance. It is the actual key problem of type 2 diabetes and may be congenital or acquired.
What happens in the body?
In order for glucose (dextrose) to get into the cells it always takes insulin, it sort of unlocks the cell for the glucose. Insulin is produced in the B cells of the pancreas. If there is insulin resistance, insulin can no longer work properly on muscle, fat and liver cells – glucose can no longer enter the cells in sufficient quantities. The pancreas now tries to compensate for the insulin resistance by secreting more insulin. Initially, this is also possible, so the blood glucose level remains normal for the time being.
The second stage of the disease is still characterized by fasting blood glucose in the normal range. However, the B cells produce at the edge of their capacity. Day-dependent blood glucose peaks, such as after meals, can no longer be absorbed by the amount of insulin produced. This is referred to as “impaired glucose tolerance”.
In the third stage, after several years of insulin resistance and impaired glucose tolerance, type 2 diabetes is easy to diagnose. Now, fasting blood glucose levels are also persistently above normal. This is caused by either a further increase in insulin resistance or a decrease in insulin production due to exhaustion of the pancreatic B cells.
Thus, insulin resistance means
- Limited sensitivity of the body’s cells to insulin.
- Insulin can no longer act properly on the cells
- Insulin resistance usually precedes diagnosed diabetes by years.
Danger for the vessels
Already in the presence of insulin resistance begins the development of arteriosclerotic vascular changes, which in the further course can lead to serious diseases such as heart attack, stroke, kidney failure or blindness. In about half of all newly diagnosed diabetics, organ damage is already detectable. Conversely, this means that insulin resistance usually exists many years before the onset of type 2 diabetes!
The “Deadly Quartet”
Insulin resistance develops when, on the one hand, there is a genetic disposition and/or, on the other hand, external factors are added. Here, overweight (obesity) clearly plays the main role – no other disease is so closely associated with type 2 diabetes!
If other risk factors are added to insulin resistance, obesity and lack of exercise, the probability of developing diabetes in the course of one’s life increases even further. High blood pressure or a lipometabolic disorder lead to an additional increase in risk. To detect diabetes mellitus as early as possible, everyone over the age of 40 should have their blood glucose measured every two years. Incidentally, if a family member already has diabetes, there is a significantly higher risk of also developing it.
Detected early – better under control
Diabetes mellitus is a real widespread disease. After all, it is assumed that 5 million people are affected – but the number of unreported cases is much higher. Unfortunately, the diagnosis of type 2 diabetics often occurs late (on average after 5 years) and rather accidentally. Consequential damage is therefore pre-programmed and is not treated consistently enough. However, early diagnosis is of decisive importance for the prevention of possible secondary diseases, since the quality of life of those affected can be significantly reduced by the dangerous secondary damage. This makes it all the more important to detect diabetes mellitus and its precursor insulin resistance at an early stage and to counteract it in a more targeted manner.
