Symptoms of diabetes
The characteristic symptoms of diabetes mellitus are frequent urination with compensatory increased thirst, headaches, poor performance, fatigue, impaired vision, increased susceptibility to infections and itching. However, all these symptoms usually occur at a relatively late stage of the disease, especially in type 2 diabetes, which is why there is often far too much time between the time of diagnosis and the diagnosis or treatment of the disease. In addition, there are type-specific symptoms, such as severe weight loss in type 1 diabetes or large foetal growth in gestational diabetes.
Consequential and concomitant diseases: The worst thing about diabetes mellitus are usually the diseases that develop secondary to it. These include high blood pressure, heart attack, vascular diseases (especially in the area of the retina, which can lead to diabetic retinopathy and in the worst case to loss of vision), neuropathy and renal insufficiency. However, these only occur if diabetes has remained undetected for a long time or is poorly controlled.
Diagnosis
There are several ways to diagnose diabetes mellitus that can be used for all types. First of all, the blood sugar level should be measured, which in a fasting state should normally be below 110 mg/dl. If it is higher than 126 mg/dl, diabetes is present.
There are also various laboratory tests available. First and foremost the measurement of HbA1c. This is a value that affects haemoglobin, the red pigment of the blood cells.
Normally only a very small part of the haemoglobin is associated with glucose. If there is an excess of sugar in the blood, as is the case with diabetes, this proportion is significantly higher than the normal 4-6% of haemoglobin. As this value reflects the blood sugar level of the last weeks, it is not only a good way to diagnose but also to check whether a therapy of diabetes is successful.
If it is within the normal range, the occurrence of consequential damage is rather unlikely. In addition, there is also the measurement of sugar or ketone bodies in the urine, which should be below a certain level in healthy individuals. To determine the body’s own insulin production, the so-called C-peptide can be measured in the blood.
This is always released by the pancreas in the same quantity as insulin, which allows us to deduce its release. The therapy of diabetes depends on the type of diabetes a patient suffers from. With type 1 diabetes, the lack of insulin must be compensated for throughout the patient’s life by means of an artificially supplied insulin.
There are various preparations available here, which differ mainly in their duration of effectiveness. The therapy of type 2 diabetes is carried out according to a step-by-step plan and always begins without medication. Initially, one should try to control the disease by weight loss and activity alone.
If this does not help (the HbA1c value is used for evaluation), stage 2 follows, which means taking an oral antidiabetic. These are not insulin preparations, in contrast to the injected drugs used in type 1 diabetes, as there is no absolute lack of insulin. Oral antidiabetics ensure that the insulin that is already present can work better again by stimulating the body’s own production or sensitising the cells to absorb insulin.
Which antidiabetic drug is most likely to be indicated must be weighed individually and depends, among other things, on weight. The drug metformin is used most frequently. If this therapy is also unsuccessful, another antidiabetic is added in stage 3. If this also fails, the administration of insulin is recommended in stage 4. Gestational diabetes is usually treated with insulin and the therapy is monitored very strictly to prevent permanent damage to the embryo.