Diabetes mellitus: causes and symptoms

There are around seven million people in Germany who have been diagnosed with diabetes mellitus – but estimates assume that there are many more people who still go unrecognized. The more people know about the danger of diabetes, its causes, and symptoms, the sooner it can be recognized and countermeasures can be taken. In the following, we will introduce you to the causes and signs of metabolic disease, and explain which tests are necessary for diagnosis and how the treatment is performed.

Definition: what is diabetes?

When people talk about diabetes, they are usually referring to diabetes mellitus. Diabetes mellitus is a chronic disorder of sugar metabolism. This is where the colloquial term “diabetes” comes from.

There are different forms of diabetes mellitus that have different causes and symptoms and require different treatments. The most common forms are type 1 and type 2 diabetes, with type 2 diabetes accounting for about 90-95% of cases. The hormone insulin plays an important role in both diseases.

This is how insulin affects blood sugar levels

Sugar belongs to the group of carbohydrates and is an important supplier of energy. We do not only consume sugar in the form of sweets but mainly in the form of starch, for example in cereals or potatoes. During digestion, our body breaks down carbohydrates and grape sugar (glucose) is produced. This increases the level of sugar in the blood, that is, the amount of sugar in the blood.

In order for this sugar to pass from the blood to the cells of the body, where energy is needed, the body’s own hormone insulin is needed. When the concentration of sugar in the blood rises, insulin is released into the blood from certain cells in the pancreas (called Langerhans cells), which then helps transport the sugar to the cells and thus lower blood levels. blood sugar.

However, if the pancreas no longer produces enough insulin or if the cells no longer respond properly to insulin, glucose cannot travel from the blood to the cells. While the organs “starve” because no sugar is entering them, the concentration of sugar in the blood is very high.

Some of the excess sugar is excreted in the urine. This makes the urine taste sweet – which was actually used in the past to diagnose diabetes. Hence the name of the disease comes from: Diabetes mellitus means something like “sweet flow of honey”.

Types and causes of diabetes

Diabetes mellitus can have many different causes. The following forms of diabetes are distinguished, depending on the cause:

In type 1 diabetes, the insulin-producing cells of the pancreas (beta cells) are usually destroyed by an immune process (i.e. an autoimmune disease) in childhood or adolescence – this early-onset is also called juvenile diabetes. In this form of diabetes, there is a so-called absolute insulin deficiency.
Type 2 diabetes is usually the result of being overweight, sedentary, and unhealthy eating. This form gradually develops from resulting insulin resistance and is also called adult diabetes in a trivial way. However, that shouldn’t hide the fact that younger adults can develop this form of diabetes too.
The unofficial name of type 3 diabetes covers a very different group of different and very rare forms of diabetes. The causes are:
genetic defects in the beta cells that hinder the release of insulin (MODY forms)
genetic defects in the action of insulin
Pancreatic disorders (for example, chronic pancreatitis or cystic fibrosis)
hormonal disorders (such as Cushing’s syndrome or acromegaly)
Medicines or chemicals (for example, corticosteroids or ingested thyroid hormones)
Infections (such as cytomegaly)
unusual forms of immune-mediated diabetes (such as insulin autoimmune syndrome)
other genetic causes (for example Wolfram syndrome or Down syndrome)
Gestational diabetes is a type of diabetes that – as its name suggests – is diagnosed for the first time during pregnancy, regardless of whether the disease was previously undetected. This mostly types 1 or type 2 diabetes.
LADA (latent autoimmune diabetes in adults) is a special form of type 1 diabetes that occurs after a delay and only occurs in adults. It is often mistaken for type 2 diabetes in the early stages and only gradually develops the typical characteristics of type 1 diabetes

What causes type 2 diabetes?

Type 2 diabetes is the most common type of diabetes mellitus. In many cases, its development is influenced by one’s own lifestyle: the trigger is often a combination of an unhealthy diet, too little exercise, and being overweight.

Being overweight means that the organs need more and more insulin before they let blood sugar into the cells. One speaks of insulin resistance, an important harbinger of diabetes mellitus. At the same time, the years of overproduction of insulin, which the increased demand brings with it, leads to a kind of “exhaustion” of the insulin-producing cells. This means that insulin is still being produced, but not enough. Experts, therefore, speak of a relative insulin deficiency.

In addition to the factors mentioned, the risk factors also include smoking, increased blood pressure and increased blood lipid levels. However, genetic predisposition, older age or certain medications (e.g. cortisone) can also play a role in the development of the disease.

Symptoms and signs of diabetes

The early detection of diabetes is important in order to start appropriate treatment and avoid secondary diseases. But how do you recognize diabetes?

Possible signs or symptoms of diabetes include:

  • excessive thirst
  • Increased need to urinate and passing large amounts of urine – especially at night
  • a tendency to infections, for example urinary tract infections
  • Cravings
  • Fatigue, exhaustion and a drop in performance
  • poorly healing wounds
  • dry and itchy skin
  • heavy legs
  • excessive or decreased sweating
  • Type 2 diabetes usually develops slowly

Years, with type 1 diabetes the onset of the disease is more likely within weeks. This form of the disease can also lead to unexplained weight loss and gastrointestinal problems.

What happens if diabetes is not recognized?

If diabetes is not noticed or is not properly treated, permanent high blood sugar can lead to serious complications. For example, a lack of insulin can lead to a diabetic coma with nausea, vomiting and loss of consciousness.

Due to the high sugar content in the blood, damage to the vessels develops over time, which can sometimes irreversibly damage the eyes, feet, heart, kidneys or other organs. Diabetics are therefore at an increased risk of developing diseases such as nerve damage, stroke, heart attack, kidney failure, high blood pressure, or erectile dysfunction.

Gestational diabetes mainly puts the child at risk, and it can also lead to so-called poisoning during pregnancy (gestosis).

The problem with diabetes is the generally slow development of insulin resistance. Many internal organs are affected while the disease is not yet known or the symptoms and signs are not yet evident.


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