Scientific support: Dr. Theresia Sarabhai
With type 2 diabetes, various processes involved in glucose metabolism are impaired, which means that the blood glucose level is persistently higher than it should be. This is why this complex disease is often referred to as “sugar disease” in German.
After a meal, the blood glucose level rises and is used as a source of energy for the cells in the body. For the cells in the body to be able to take up glucose, they need the hormone insulin. Insulin is formed in the beta cells of the islets of Langerhans in the pancreas and is released depending on the blood glucose level in the blood. It ensures that glucose is transported into the cells in the body, which then reduces the level of glucose in the blood.
With type 2 diabetes the cells in the body are, however, no longer as sensitive to the released insulin (insulin resistance) and the beta cells in the pancreas that produce insulin release too little of the hormone. This causes blood glucose levels to rise.
Type 2 diabetes often develops over the course of several years. Because it does not have any symptoms or because the symptoms are non-specific and can be wrongly interpreted, it is often only diagnosed by chance. However, very high blood glucose levels can result in patients with type 2 diabetes having the typical symptoms of diabetes. These include:
- Increased thirst
- Increased urination
- Feeling of weakness
- Lack of drive
- Poor performance or concentration
- Low mood through to depression
- Visual impairment
- Frequent infections
- Poor wound healing
- Dry skin
In many patients, type 2 diabetes goes undetected for a long time. It is not uncommon for it to be detected only because of complications or diseases that go hand-in-hand with diabetes or by chance, for example at a health checkup with the family practitioner.
An early diabetes diagnosis and treatment is, however, important to prevent potential complications at an early stage or to at least delay its progression. This is because a persistently elevated blood glucose level can in the long term increase the risk of
- nerve damage, such as the development of diabetic foot syndrome.
- Changes to the large blood vessels which can result in serious complications (heart attack, stroke or impaired blood circulation to the legs).
- Damage to the small blood vessels. This can lead to damage in the heart, eyes and/or kidneys.
Blood glucose levels that are very high over a long period of time can lead to hyperosmolar hyperglycemic syndrome, which can lead to coma.
This is why it is so important for the family practitioner or the diabetologist to manage glucose levels with medication and, first and foremost, a change in lifestyle to avoid complications.
American Diabetes Association: Standards of Medical Care in Diabetes - 2019. In: Diabetes Care, 2019, 42: S1-S193
Bundesärztekammer et al.: Nationale Versorgungsleitlinie Therapie des Typ-2-Diabetes. Langfassung. 1. Auflage. Version 4. 2014 (Gültigkeit abgelaufen, in Überarbeitung)
Bundesärztekammer et al.: Patientenleitlinie zur Nationalen Versorgungsleitlinie Therapie des Typ-2-Diabetes. 1. Auflage. Version 1. 2015
As of: 10.12.2019