Diabetes mellitus E14.90

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 01.01.2022

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Synonym(s)

Diabetes

Definition
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Diabetes mellitus is a metabolic disease. It is caused by a chronically elevated blood sugar level and insulin resistance or insulin deficiency in the body. The disease is usually associated with severe concomitant and secondary diseases.

Classification
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Type 1 diabetes (about 5 %): beta-cell destruction leads to insulin deficiency. This form can occur due to immunological factors. A special form is LADA (latent autoimmune diabetes), in which the disease spreads slowly in adulthood.
In addition, type 1 diabetes can occur idiopathically (rare in Europe).

Type 2 diabetes(about 90%): Type 2 diabetes is influenced by three factors: insulin resistance, secretory defect of B and A cells and progressive apoptosis of B cells.

Other forms of diabetes:

  • Genetic defects in beta-cell function: MODY (Maturity-onset diabetes of the young): manifestation before the age of 25 (circa 1%); includes 11 forms.
  • Genetic defects of insulin action
  • Diseases of the exocrine pancreas
  • Endocrinopathies: glucagonomic, Cushing's syndrome, hyperthyroid aldosteronomic, acromegaly, pheochromocytoma
  • Drug-induced: thyroid hormones, hormonal contraceptives, glucocorticoids, betaadrenergics, thiazides
  • Infections: CMV infection, congenital rubella infection
  • Genetic syndromes associated with diabetes: Down syndrome, Klinefelter syndrome, Turner syndrome
  • Rare immunological forms such as anti-insulin receptor antibodies

Occurrence/Epidemiology
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The prevalence of manifest diabetics depends on age, but has increased significantly in the last 3 years: < 50 years = 1 to 2 %, > 60 years = about 10 %, > 70 years up to 20 %.

Clinical features
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Manifest diabetes mellitus:

While the development to type 1 diabetes is relatively fast, type 2 diabetes manifests itself rather slowly and unnoticed. The following symptoms may occur:

Non-specific general symptoms: Fatigue, reduced performance

Symptoms due to electrolyte and fluid balance disorders: Calf cramps and visual disturbances

Skin symptoms: Pruritus, bacterial skin infections, rubeosis diabetica, necrobiosis lipoidicaPotency disorders
, amenorrhoea

symptoms due to hyperglycaemia and glucosuria with osmotic diuresis: thirst, weight loss, polyuria, polydipsia

Laboratory
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Blood sugar determination, determination of glucose in urine, determination of ketone bodies, oral glucose tolerance test (OGTT), continuous measurement of blood sugar level over 72 hours, diagnosis of gestational diabetes, screening for diabetes mellitus, HbA1c

Diagnosis
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A diagnosis is made on the basis of a medical history, the clinical picture and laboratory tests

Complication(s)
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Macro-/microangiopathy, diabetic cariomyopathy, reduction of resistance with a tendency to bacterial skin and urinary tract infections, fatty liver, lipid metabolism disorder, hyporeninamic hypoaldosteronism, Coma diabeticum (hypoglycemic shock)

Therapy
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It is recommended that you diet or reduce your weight within the BMI to a normal level. In addition, physical activity should be increased and medication should be prescribed. Patients should take prophylaxis and therapy of possible complications and other risk factors, this is also possible by means of training.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 01.01.2022