Diabetes mellitus (diabetes) is a chronic disease of the entire metabolism. It is characterized by insufficient insulin action or insulin deficiency. This initially affects the carbohydrate metabolism, but the fat and protein metabolism are also disturbed.
Insulin is a hormone that regulates the sugar balance. It is produced in the so-called “islets of Langerhans” in the pancreas and released into the bloodstream as required. The gland reacts to the blood sugar level.
Normally, as soon as the blood sugar level rises after food intake, sufficient insulin is released to lower it and thus keep it within the norm. The blood sugar level should be between 80 and 110 mg/dl when fasting. After food intake, a value not exceeding 145 mg/dl is considered normal.
Diabetes is present if repeated blood sugar concentrations of > 126 mg/dl on an empty stomach and > 200 mg/dl after administration of 75 g glucose are detectable. There are two types of diabetes, also known as diabetes type I and diabetes type II. The second form is by far the more frequent one with more than 90% of all diabetes patients.
Diabetes type I is when the pancreas is not sufficiently capable of producing insulin. Mostly this form is genetically determined and occurs in early childhood or adolescence. In type II diabetes, the body is usually resistant to insulin, which develops over the course of life and usually leads to the onset of the disease in adulthood.
Both types of diabetes also differ in their therapy. While type I diabetics are dependent on insulin injections for their entire life, the milder courses of type II diabetes can often be treated with tablets and a change in lifestyle. In the case of a strong increase in blood sugar, the so-called kidney threshold (approximately 180mg/dl) is exceeded and sugar appears in the urine.
Diabetes mellitus means translated ” honey-sweet flow” or also “sugar urine dysentery”. Increased thirst (sugar needs solvents) and increased urination are often the first signs and lead patients to the doctor. As soon as there is a lack of insulin, the sugar is no longer distributed properly in the organism, which severely impairs the organ functions and performance of the body cells.
Naturally, the cells want to compensate for their glucose deficit and to do so they draw on carbohydrates (glycogen) stored in the liver. When this energy reserve is exhausted, protein is also converted into sugar in the liver. However, this disturbs the protein metabolism and attacks the cells.
In addition, the sugar is only partially utilized and is partially excreted via the kidneys. The loss of protein and energy ultimately leads to muscle atrophy and weight loss. The fat reserves provided for energy supply can also be insufficiently metabolized in the liver when there is a lack of sugar.
The misdirected breakdown of fat leads to the formation of so-called ketone bodies, which acidify the blood, are excreted in the urine and can be measured as acetone. Their detection indicates an advanced stage of the disease. The sweetish smell of acetone in the air we breathe is also characteristic.