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What is Diabetes?


Diabetes mellitus

Diabetes mellitus is a condition, where the body is not able to handle sugar.

There are two kinds of diabetes, Type 1 diabetes (T1D) and Type 2 diabetes (T2D). This latter type is more common in older and/or overweight people. Type 1 affects five to ten % of about eight millions German diabetic people.

Type 1 Diabetes
is caused by a lack of insulin output because of damage to the pancreas gland, which is normally producing this hormone. Insulin as a key hormone controls the glucose flow in organism cells.

Damage to the pancreas can occur for a many reasons, e.g. a viral infection, or most common by self-destruction of insulin-producing cells in the pancreas as result of an auto-immune reaction. In an auto-immune process the body appears to turn against itself and the pancreas is destroyed by cells that normally defend from invading organisms. Auto-immune diseases may reflect an inherited tendency that is triggered by some environment factors.


Symptoms of Diabetes mellitus

Glucose is one of the key fuels used by the cells of the body for its energy needs. While most other cells can also utilise fat for producing energy, the brain and nervous system use only glucose.

As a result of the lack of insulin output in Type 1 diabetes, the blood sugar level climbs to abnormal values and glucose starts to appear in urine.

Because glucose use becomes very inefficient, a person with untreated Type 1 diabetes develops symptoms such as:

  • increased thirst
  • tiredness
  • frequent urination
  • weight loss (although appetite often increases)
  • infections on the skin (like yeast infections)

Diabetes must be treated by regular injections of insulin given several times a day, by staying physically active, by maintaining a steady weight as well as controlling the amount of carbohydrates of the diet.

The goal of insulin treatment is to control the amount of insulin in the bloodstream so that glucose levels become normal, or near normal.

At present, this type of diabetes cannot be prevented or cured.

Possible complications associated with Diabetes mellitus.

Atherosclerosis (hardening of the arteries) can lead to poor circulation in the legs, stroke and heart conditions such as angina and heart attack.

Diabetic kidney disease.

Diabetes-related eye disease (retinopathy)


Degeneration of the nerves (neuropathy) leading to foot ulceration and infection.

Susceptibility to infections, e.g. urinary tract infections.

Low blood sugar levels leading to loss of consciousness.

Inadequate insulin replacement will lead to high blood sugar levels and may also cause a serious illness called ketoacidosis.

Type 2 diabetes is caused by:

  • insufficient production of insulin in the pancreas
  • a resistance to the action of insulin in the body's cells - especially in muscle, fat and liver cells.

Type 2 diabetes is strongly associated with being overweight. Genetic factors play a very important role in type 2 diabetes, but the pattern is complicated, since both impairment of beta cell function and an abnormal response to insulin are involved. In Type 2 diabetes, insulin circulate in the blood because the pancreas can still produce the hormone.

However, the effect of the insulin is impaired. This means it doesn't have its normal effect on the cells of the body, (so called insulin resistance).

Insulin resistance has a number of effects:

  • it causes high blood glucose
  • it disturbs the fat levels in the blood, making the arteries of the heart more likely to clog (coronary heart disease).
  • it raises blood pressure.
  • it increases the likelihood of gout developing (a painful condition of the joints).

The insulin-producing cells of the pancreas in people with Type 2 diabetes don't seem to come under attack from the immune system as they do in Type 1, but they are still unable to cope with the need to produce insulin release after a meal.

Normally, this insulin release causes the body to store excess glucose coming in and so keeps the blood sugar level fairly constant.

One of the major problems with Type 2 diabetes is in its very mild early stages symptoms, which cannot be noticed.

This means that as many as half of those diagnosed with Type 2 diabetes have had the condition for months or even years before they know it.

It also means that a very high proportion of people with Type 2 diabetes already show signs of tissue damage to the eyes or hardening of the arteries from their diabetes by the time of diagnosis.

The main symptoms are similar to those of Type 1 diabetes.

As the disease progresses, many people need insulin injections.


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