Diabetes

 

Diabetes

Compared to the over-all population, people with diabetes mellitus have a higher risk of developing cardiovascular diseases. Heart attacks are more common and less favorable in diabetics than in people without diabetes. In many cases, the additional diabetic damage to the autonomic nervous system can lead to disturbances in the conduction of pain and to cardiac arrhythmias. In type 2 diabetes in particular, in addition to increased blood sugar levels, there are often disorders that have a negative effect on blood vessels. Increased blood pressure ( hypertension ) and dyslipidemia also damage the vessel walls and cause constrictions ( stenoses) and blockages ( thromboses ) of the arteries. Dyslipidemia can also occur in type 1 diabetes mellitus.

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The diabetes mellitus (honey-sweet flow ', Honigharnruhr'; from ancient Greek διαβήτης diabetes [to διαβαίνειν diabainein , pass' , flow through '] and Latin mellitus , honeyed' ), commonly known as just diabetes , German diabetes (formerly Zuckerharnruhr ) computersmarketing or, more rarely, blood sugar disease , describes a group of metabolic disorders of the carbohydrate metabolism, which are based on an (absolute or relative) lack of insulin hollyhealthfitness and become chronic Cause hypoglycaemia . The hallmarks webtechgalaxy of this complex disorder include hyperglycemia , glucosuria , acidosis, and ketosis .

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The word  describes their main symptom , the excessive healthbeautystudio  excretion of sugar with the urine . Thomas Willis diagnosed the disease in 1675, as did doctors of antiquity in India, Alexandria and Rome, on the basis of a taste test of the urine, because the urine of people with diabetes has a sweet taste when the blood sugar level is elevated .

 

Mechanisms that lead to excess sugar in the blood (hyperglycemia), set mainly on insulin, the main control hormone of glucose metabolism in the human body, to: absolute insulin deficiency, relative insulin deficiency due to a weakened effectiveness of insulin ( insulin resistance ) or both. The main consequences of diabetes mellitus are changes in the nervous system and the blood vessel system, including diabetic foot syndrome .

Physiological foundations

The digestive system breaks down the carbohydrates ingested with food (from fruits, grain products, potatoes, corn, rice) into glucose (grape sugar), which is then captivated into the blood through the intestinal wall and spread throughout the physique.

 

The pancreas products the hormone insulin in the β cells of the islets of Langerhans . As a messenger substance , insulin brings about the transport of glucose into the cell interior, where the glucose is then used to generate energy ( glycolysis ). In addition, insulin also causes the storage of glucose in the form of glycogen in the liver and in the muscle cells, which means that the blood sugar level after eating is within narrow limits (approx. 80–120 mg / dl or 4.5–6.7 mmol / l ) is kept constant.

 

Even with long periods of sobriety, the blood sugar level remains at a normal level, which in turn is mainly provided by the liver , on the one hand by the fact that the previously formed glycogen is split back into glucose and released back into the blood, on the other hand by the fact that the liver is biochemical constantly produces new glucose ( gluconeogenesis ).

 

If the insulin-producing β-cells no longer produce enough or no insulin at all or e.g. B. due to inflammation or surgery are no longer available, so both the glucose uptake in the body cells and the inhibition of glucose formation in the liver (which can produce up to 500 grams of glucose daily in humans) are missing. This new formation explains the rise in blood sugar levels in diabetics. B. in the early morning in the sober state (see also dawn phenomenon ).

In diabetes mellitus, the glucose ingested remains in the blood, or the body's own formation of new glucose in the liver continues unchecked and constantly supplies glucose, which offsets or even exceeds the continuous consumption and, as a result, causes the blood sugar to rise. It is a very complex and dynamic organic process in which inflows, outflows, new formation and degradation of glucose have to be constantly balanced, i.e. offset. In order to understand these relationships - and thus the disease and how to deal with the disease - affected patients must be carefully informed and advised and, if necessary, trained, for example in drawing up suitable nutrition plans.

 

Insulin also has another, third effect. It is the only hormone in the human body that builds up body fat and also ensures that this fat remains in the depots (so-called adipogenic effect).

 

An essential characteristic of the severe, persistent insulin deficiency is therefore also an extreme weight loss due to the loss of the adipogenic effect, in particular through the breakdown of body fat and (muscle) protein for energy production.

 

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