Consequences of diabetes

introduction

Diabetes mellitus is a disease that becomes more common with age. When the disease is the body's own hormone insulin no longer sufficiently able to lower the blood sugar level, since insulin can either no longer be produced or it becomes a Development of resistance the body came against the insulin. A too high blood sugar level in the blood ensures in the long run serious damage, which is why the blood sugar should be checked closely and conscientiously by a Lifestyle change (in the case of type 2 diabetes) and, if that is no longer sufficient, additionally Medication should be lowered.

Physical consequences

Elevated sugar levels promote that Calcification of blood vessels. In technical terms, one speaks of a calcification of arterial blood vessels arteriosclerosis. As the calcification increases, the diameter of the vessel decreases and a poor blood circulation. In principle, all blood vessels in the body are affected, but it can be particularly critical in the case of the coronary arteries and the carotid artery, because it can lead to one Heart attack or stroke come. A diabetic is at risk of having a heart attack or stroke two to four times higher than a non-diabetic.

A heart attack usually manifests itself as relatively typical ones Heart attack symptoms like sharp chest pain radiating into the left arm and accompanying shortness of breath. However, since an increased blood sugar level in diabetics also attacks the nerves in the long term, the pain of a heart attack is sometimes not fully perceived, but often only as Burn felt. A burning sensation cannot be properly classified by those affected.

The calcification of vessels can also lead to peripheral arterial occlusive disease (PAOD), in which there is increasing pain in the legs when running because they are not supplied with enough blood.
The vessels of the retina are also particularly affected by damage over the long term. Vascular sagging, fat deposits, bleeding and occlusions of vessels can occur on the retina. As a result, new vessels often form, which, however, can easily tear open again and lead to retinal detachment. In addition to retinal detachment, the risk of developing glaucoma or cataracts is also increased. In the long term, diabetic damage to the vessels of the retina can lead to blindness. This process is known as diabetic retinopathy. In order to prevent blindness, diabetics should go to the ophthalmologist once a year for an eye fundus examination to check whether the retinal vessels have already been damaged. These consequences can be largely prevented with a well-adjusted blood sugar level.

Similar to diabetic retinopathy, diabetic nephropathy can occur. In diabetic nephropathy, the blood vessels of the kidneys are damaged, so that in the long run they no longer properly drain the body and "clean“Can. Damage to the kidney due to diabetes is the most common cause of kidney weakness or even kidney failure.
An early sign of the onset of kidney weakness is the detection of small proteins in the urine (Microalbuminuria). Normally, proteins should not be able to cross the kidney barrier and get into the urine. Proteins in the urine are therefore a sign that the kidney's filter function is no longer working properly.
In addition, the kidneys are continuously overloaded due to the increased concentration of glucose in the blood and can no longer absorb the glucose from the urine. The sugar ends up in the urine, which is not the case in healthy people. As a result, people with diabetes are more likely to develop urinary tract infections, as the sugar is food for the bacteria.

Read more about this under Symptoms and course of diabetic nephropathy

As already mentioned, high blood sugar levels damage the nerves in the long term. The result is what is known as diabetic neuropathy. The neuropathy mostly affects the feet. At the beginning of the nerve damage that occurs, those affected feel a burning sensation, tingling sensation and even numbness of the feet. Sensitive nerves, which are responsible for the sense of touch, temperature transmission and pain, are particularly susceptible to the damage.
With regard to pain, the nerve damage manifests itself through an increased pain sensation, so that those affected often suffer from severe pain in the area of ​​the feet. At a later stage, nerves that supply internal organs can also be affected, which can lead to problems with urination and bowel movements, for example. Increased sweating or erectile dysfunction can also be the result of nerve damage from high blood sugar levels.

Please also read our page Diabetic neuropathy

A so-called diabetic foot can result from a combination of reduced blood flow due to vascular calcification and nerve damage to the feet. In this case, small injuries occur at the beginning, which on the one hand are not properly perceived by the person concerned due to the nerve damage and on the other hand cannot heal properly due to the lack of blood supply. The wounds can also become infected. So that the infection can be fought, the foot must be supplied with sufficient blood, which contains components of the immune system and can fight the pathogen.

Read more on the topic: Diabetic foot

Ulcers develop over time. If these ulcers develop on a massive scale and do not heal further, it may sometimes be necessary to amputate the foot so that the infection does not spread to life. To avoid this, the feet, especially the spaces between the toes, should be checked regularly for small wounds. The doctor treating you will also want to look at your feet from time to time.

Read more about this under Diabetic microangiopathy and superinfection

Different severity of the consequences in type 1 and type 2

There are two different types of diabetes. Type 1 diabetes mellitus usually occurs in Adolescence on. In type 1 diabetes, presumably mediated by an autoimmune disease, the cells in the pancreas that produce insulin are destroyed, so that it becomes one in the long run absolute insulin deficiency comes. Sufferers with a type 1 diabetes mellitus diagnosis are lifelong on the external supply of insulin reliant.

Type 2 diabetes mellitus only develops with older age. It is often the result of a rather unhealthy lifestyle. The tendency, however, is that the so-called age sugar (Type 2 diabetes mellitus) increasingly among younger - usually overweight - adult occurs.

The earlier diabetes occurs, the higher the potential for consequential damage. Although type 1 diabetes occurs in adolescence, it does happen more likely to cause consequential damage in type 2 diabetes mellitus. On the one hand, this is due to the fact that type 1 diabetics grow up with the disease and have therefore learned to change their way of life at an early age, whereas type 2 diabetics usually only have to change their way of life around the age of 50, which is very difficult for many.
On the other hand, it is used directly as the first therapy for type 1 diabetics Insulin to lower sugar used because these patients have an absolute deficiency of the hormone. Type 2 diabetics still have their own insulin, which, however, is a weakened effect owns in the body. By Sports the effect of insulin can be improved and through a adequate nutrition the blood sugar level can often be lowered sufficiently.

Hold the patient Not to the recommended rules of conduct blood sugar levels can spike what Can result in damage. Before resorting to insulin therapy with them, so-called oral antidiabetic drugs used, i.e. tablets that are taken to improve the effectiveness of insulin. In some cases this also does not lead to a sufficient lowering of blood sugar. As a final measure, insulin is then prescribed. If the patient adheres to the prescribed injection schedule, the blood sugar can ultimately be lowered sufficiently. But the patient has to adequately trained become. Accordingly, there are more weak points in type 2 diabetics where unsatisfactory high sugar levels occur over a long period of time, which damage the vessels and nerves. This is usually less the case with type 1 diabetics because they are trained early on and diabetes has been part of their life almost from the start, while type 2 diabetics have lived without this disease for more than half of their lives.

During pregnancy

There are two types of diabetes during pregnancy. For one thing, there is diabetes that does before pregnancy duration. This can be type 1 or type 2 diabetes. However, increased sugar levels only occur after the 20th week of pregnancy on, this is called the so-called Gestational diabetes. This is a type of diabetes that only developed during pregnancy and usually disappears again after pregnancy. However, the risk for both mother and child to develop diabetes later in life is increased.
In both forms, the diabetes must be during pregnancy strictly adjusted so that the blood sugar level does not rise, as high levels can have a harmful effect on the pregnancy and the child.

Mothers with diabetes are at increased risk for one Miscarriage or one Premature birth. Furthermore, it can be too Malformations for example at lung, heart and Nervous system come.Because of the possible risks, these mothers should give birth in a specialized hospital called a Perinatal Center with level 1 or 2.
However, these risks only exist when the blood sugar level badly adjusted is. Due to the risks, those affected should be looked after by a diabetologist in addition to the gynecologist. If you are planning a pregnancy, the blood sugar level should be adjusted accordingly in advance. The goal should be that Long-term sugar value below 6.5%to keep at least below 7%.

If the mother has permanently elevated blood sugar levels during pregnancy, this usually has an effect Growth of the child out. Typical for these children is a increased birth weight from over 4500g (Macrosomia). The increased growth is due to an increased glucose supply (Glucose = sugar) in the child's blood, which gives them more nutrients to grow. The increased growth can cause the emergence of Malformations favor. Furthermore it can cause too Complications during childbirth come. A high birth weight is often the indication for one Caesarean section.

Mothers with diabetes during pregnancy are more likely to suffer from it Urinary tract infections and Vaginal infections. The infections can also put the child at risk and the risk of premature birth is greater.

Since the child is used to high sugar levels in the womb, the pancreas of the unborn child produces increased insulin. After the birth there is still an increased production of insulin, but the child is no longer supplied by the mother's blood, so the blood sugar level is normal, so there is a risk of a child with diabetes after the birth of a child who has diabetes Hypoglycaemia.

There are not only risks with regard to the unborn child and the upcoming birth, but also for the mother herself. The consequential damage of diabetes described above can develop during pregnancy amplify. Existing damage to the retina or kidney can worsen.

Diabetes insipidus

A Diabetes insipidus has little in common with diabetes mellitus. Alone the increased urination and the Feeling thirsty is common to them. That is why the consequences of diabetes insipidus are completely different. In diabetes insipidus there is a ADH deficiency in front. ADH is a pituitary hormone that normally ensures that water retained in the kidney and accordingly less water is excreted in the urine.
With diabetes insipidus, there is a deficiency in the hormone, so there is one excessive urination with a strong urge to urinate. The urine that is excreted is very weakly concentrated. Because the body loses so much fluids, it also creates a great thirst.

The root cause for the disease can in the brain or on the kidneys lie. Either the hormone is not produced sufficiently in the brain (Diabetes insipidus centralis) or it is produced but cannot work properly on the kidneys (Diabetes insipidus renalis).
Is diabetes insipidus diagnosed and adequately treated there are generally no long-term effects of the disease. Those affected are not restricted in their quality of life under therapy and can lead a completely normal life. Depending on what the trigger of the disease is, one can even diagnose diabetes insipidus with successful therapy of the underlying disease healwhich is not possible with diabetes mellitus. This is possible, for example, if increased calcium or decreased potassium or a Brain tumor the triggers are.

However, if the disease is not adequately treated, you can Complications occur as a result of the high Fluid loss arise.
If too much ADH is supplied from the outside, it can be contrary to one Overwatering come, causing it to Clouding of consciousness and Convulsions can come.