Diabetes mellitusE14.90

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 02.12.2023

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Synonym(s)

Diabetes

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DefinitionThis section has been translated automatically.

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.

ClassificationThis section has been translated automatically.

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/EpidemiologyThis section has been translated automatically.

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 featuresThis section has been translated automatically.

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

LaboratoryThis section has been translated automatically.

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

DiagnosisThis section has been translated automatically.

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

Complication(s)This section has been translated automatically.

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)

TherapyThis section has been translated automatically.

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.

Phytotherapy internalThis section has been translated automatically.

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Last updated on: 02.12.2023