Diabetes mellitus

Within the diabetes is a metabolic disease in which blood sugar is chronically elevated. Doctors refer to this condition as hyperglycemia, and diabetes itself as Diabetes mellitusThere are two forms: Diabetes mellitus type 1 is an autoimmune disease that is triggered by a viral infection and usually occurs before the age of 35. 

Until recently, type 2 diabetes mellitus mostly affected older people and is therefore also referred to as adult-onset diabetes.

In recent years, however, more and more young people have been suffering from the disease. In addition to genetic factors, this incurable metabolic disorder is mainly caused by poor lifestyle habits, which are associated with a lack of exercise, obesity and poor nutrition.

After all, around 90% of all diabetics have type 2 diabetes.

When we eat, our body converts parts of the food we eat into sugar. This glucose is transported to the body tissues via the blood. Insulin - a hormone produced in the pancreas - enables it to enter the body's cells, where the glucose is needed as an energy source.

Insulin resistance is a precursor to diabetes

At least 30 percent of all Germans suffer from so-called prediabetes, insulin resistance, in the course of their lives: muscle, liver and fat cells become insensitive to insulin. As a result, glucose remains increasingly in the blood and blood sugar levels rise, but without yet reaching the levels of a Type 2 diabetes .

This insulin resistance cannot be recognized by symptoms. But the accompanying symptoms pose serious health risks: increased cholesterol levels in the blood and Hypertension can occur, heart disease or a Stroke become more likely.

It is also true that anyone who has suffered from prediabetes will probably develop type 2 diabetes within the next ten years. This is because insulin resistance causes the glucose level in the blood to continue to rise. The pancreas tries to compensate for the apparent lack of insulin by producing more and more insulin. The cells in turn become increasingly resistant to insulin. Eventually the body can no longer cope with the constant production of insulin: the blood sugar level continues to rise until type 2 diabetes develops.

Lack of exercise and poor diet promote diabetes

This process is particularly promoted by excess weight due to poor nutrition and physical inactivity. The fatty tissue in the abdominal cavity increases and the proportion of free fatty acids in the blood rises. Genetic predisposition also plays an important role: with each sick family member, the risk of diabetes increases. If one parent is diabetic, this risk is 50%.

Certain medications also play a role in the development of diabetes mellitus, such as statins (cholesterol synthesis enzyme inhibitors), which are intended to lower the cholesterol level in the blood, cortisone, diuretics (thiazides), blood pressure lowering drugs (beta-blockers), ovulation inhibitors and antidepressants.

Gestational diabetes can occur during pregnancy: a disorder of glucose tolerance during pregnancy, which usually disappears after birth. Finally, liver diseases, stress factors for the body such as infections, injuries or operations, and hormonal disorders can be responsible for a disturbed glucose balance.

Identify personal diabetes factors

The personal risk of developing diabetes mellitus can be determined using various measurements. The following applies: If you reduce your body fat, you reduce your risk of diabetes. The body's cells respond more strongly to insulin. This is especially the case if you do not have a fatty liver. Determining the liver fat content therefore allows statements to be made about the individual risk.

Hemoglobin A1c (HbA1c), also known as long-term blood sugar, is important for assessing an individual’s risk of diabetes.

The value provides information about the blood sugar level over the last eight to twelve weeks. It is measured regularly in diabetics and should be below seven to eight percent; in frail older people, slightly higher values ​​are acceptable on an individual basis in order to prevent hypoglycemia with the risk of falls and thus fractures (femoral neck fracture). A value above 8,5 percent means that the blood sugar level was on average over 200 milligram percent over the last two to three months. Values ​​between 70 and 140 are considered normal.

The body mass index (BMI, kg/m2) must also be taken into account. From a value of 27, the risk of diabetes increases.

A fasting blood sugar level (mg/dl) of less than 110 is considered normal. This is considered abnormal fasting glucose, and values ​​above 126 indicate diabetes. Regardless of age and body weight, it is recommended that a glucose tolerance test be carried out if fasting blood sugar levels are elevated before making lifestyle changes such as diet or exercise training begins.

Diabetes causes serious health problems

Diabetes mellitus is particularly dangerous because it develops slowly over the years and is therefore often diagnosed too late. The first non-specific symptoms can be tiredness, weakness, visual disturbances and a tendency to infections, such as repeated bladder infections. Poorly controlled diabetes often leads to irreversible damage. Cardiovascular diseases such as Heart attack or stroke can occur due to the increased risk of arteriosclerosis. Kidney disease and renal insufficiency are also a risk, as are eye diseases that can lead to blindness.

Symptoms of diabetes can include impaired wound healing and diabetic foot syndrome caused by nerve and vascular damage as well as arterial circulatory disorders.

With the right one prevention You can effectively combat diabetes. Lifestyle changes are not only preventive, but are also beneficial in every phase of the disease. Disease just as important as medical measures. In addition to a high-calorie diet, lack of physical activity is the main cause of obesity and type 2 diabetes.

Obesity occurs when more energy is consumed than used. There are basically two ways to remedy this: by consuming fewer calories or by burning more through increased physical activity.

Diabetes prevention: losing weight through activity

If there is an increased risk of diabetes, a weight loss of five to seven percent should be aimed for.

Reducing body weight promotes the transport of glucose from the blood into the cells. The more you move, the less glucose remains in the blood. The cells' responsiveness to insulin also improves.

The following measures can significantly reduce the risk:

• Aerobic exercise with endurance sports (walking, swimming, cycling, etc.) 30 minutes on at least 5 days per week;
• Strength training (therapy bands, weights, etc.) two to three times a week;
• Flexibility training, 5 to 10 minutes daily;
• An active everyday life with 10.000 steps per day.

When exercising, you should try to work up a sweat, but only exert yourself to the point where you can say a sentence out loud at any given time without having to stop for air. If you have not been physically active for a long time, or have been very active, you should only start training after consulting a doctor. This also applies if you have a damaged vascular system or changes to the back of your eyes. It is ideal to approach the 30-minute goal gradually.

Review foods and eating habits

In order to protect yourself against diabetes, you should also check your eating habits, because the components of our diet have a direct influence on the development of type 2 diabetes. High levels of sugar and (animal) fats as well as high-protein foods, such as low-carbohydrate diets, promote the disease. Conversely, a predominantly plant-based, high-fiber diet protects against it.

You should largely avoid industrially processed foods and instead eat vegetables, pulses, beans, berries and whole grain products. These contain numerous nutrients and are high in fiber. They are filling and increase insulin sensitivity.

Saturated fats, which are found in red meat or fatty dairy products, should also be avoided because of their high calorie density. They also promote insulin resistance. Fish fats and vegetable oils (e.g. rapeseed or olive oil) do not do this. Low-fat dairy products, fish and other protein sources are allowed in moderation. Sweets, baked goods and sugary drinks should also be largely avoided. They contain too much sugar, fat and calories and have little nutritional value.

When eating, it is important to eat smaller portions. You should also eat slowly so that your brain can signal a feeling of fullness. Other activities while eating, such as watching TV or working, should be taboo. Moderate consumption is allowed: one or two cups Coffee, a bar of dark chocolate, an alcoholic drink per day can even increase insulin sensitivity.

People who suffer from diabetes must measure their blood sugar regularly and rely on reliable blood glucose meters.

Modern measuring devices now have average deviations of only five to ten percent compared to laboratory analysis. Good devices also have numerous additional functions. In addition to storing the values ​​with the measurement time and date, many devices offer complete evaluation programs, either integrated or for the computer. Some can send the data via the mobile phone to another computer, for example in the doctor's office. This allows changes to the treatment plan to be made at short notice.

Thorough prevention with the diabetesCheck-up the practice clinic Bornheim

The thorough diabetes check-up at the Bornheim practice clinic covers all factors of diabetes. The important tests that should be carried out approximately every three months include: the determination of HbA1c, total cholesterol, HDL and LDLcholesterol, triglycerides and creatinine, blood pressure measurement, a microalbumin urine test (urine test for protein).

Once a year, the vessels should be examined by ultrasound for premature calcification. An ultrasound examination of the heart (Echocardiography) is one of the tests that should be performed annually. In order to detect neurological damage at an early stage, tests for the sense of pain, touch and vibration are also necessary. Regular visits to the ophthalmologist are also recommended.

The specialist doctors at the practice clinic will also advise you on questions of nutrition and show you how to control your blood sugar independently, avoid low blood sugar levels (hypoglycaemia) and high blood sugar levels (hyperglycaemia, diabetic coma), and give you tips on proper personal care, for example in the prevention or treatment of diabetic foot syndrome.