Diabetes mellitus

Older people, in particular, suffer from type 2 diabetes mellitus. How can the disease be prevented?  How does it manifest itself and how can it be treated? Learn how type 2 diabetes mellitus develops, what therapy options are available and what you can do to prevent and treat it yourself.

woman checking bloodsugar

A quick look at the topic: 

What is type 2 diabetes mellitus and what other types of diabetes are there?

Diabetes is a metabolic disorder that leads, among other things, to chronically elevated blood sugar levels in the body. The disease “diabetes mellitus” is also known simply as “diabetes”. Medicine distinguishes between the following types of diabetes, among others:

Diabetes mellitus type 1 (autoimmune disease)

Type 1 diabetes is an autoimmune disease. The insulin-producing cells in the pancreas are destroyed by the body’s own defence system, resulting in an insulin deficiency. Patients with type 1 diabetes mellitus must inject themselves with insulin several times a day from a young age and for the rest of their lives.

Diabetes mellitus type 2 (adult-onset diabetes)

In Germany, roughly 6.7 million people have diabetes mellitus. Of this number, approximately 5.8 million suffer from type 2 diabetes mellitus.1 Type 2 diabetes is the most common form of diabetes and is also commonly referred to as adult-onset diabetes. Obesity can be one of the main risk factors for developing type 2 diabetes mellitus. This form of diabetes is very complex and results from insulin deficiency and / or insulin resistance.

Gestational diabetes

If the disorder afflicting glucose utilisation occurs for the first time during pregnancy, doctors speak of “gestational diabetes”. This type of diabetes usually disappears after birth. However, the risk of developing type 2 diabetes later on is increased.

Diabetes can lead to severe secondary damage, for example, so-called diabetic foot syndrome.

How do I recognise diabetes mellitus? Common symptoms and signs of type 2 diabetes

The typical signs and symptoms in people with type 2 diabetes may include:  

  • increased thirst
  • physical weakness, listlessness, fatigue
  • temporarily reduced concentration and ability to retain information
  • depressive moods
  • itching
  • a tendency for the skin, mucous membranes and urinary tract to become infected
  • weight loss

Infographic: Living with diabetes

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Causes and risk factors: How does type 2 diabetes develop?

Due to an insulin deficiency and/or insulin resistance in key organs such as the brain, liver, muscles and fatty tissue, acute and chronic hypoglycaemia or hyperglycaemia can occur – even leading to coma. The carbohydrate, fat and protein metabolism is disturbed. 

People have an increased risk of developing type 2 diabetes mellitus if they are

  • older,
  • overweight,
  • affected by high blood pressure,
  • pre-disposed genetically,
  • afflicted by metabolic disorders
  • a smoker.

Consequential diseases of diabetes mellitus type 2, among others: Diabetic foot syndrome

Diabetic neuropathy – damage to the nerves

Chronic diseases such as diabetic neuropathy usually develop over years: If the nerves in different parts of the body become damaged by high blood sugar levels, this is at the expense of certain bodily functions that are controlled by the nerves. Among other things, there can also be sensory disturbances in the feet, which can manifest themselves in reduced pressure- and pain sensation.

Other secondary diseases in diabetes can include:

  • Infections of the skin, mucous membranes or urinary tract
  • Heart disease
  • Strokes
  • Kidney failure
  • A disturbance in sight, leading up to blindness

Diabetic foot syndrome – a common complication

Diabetic foot syndrome is a common complication of diabetes. It is caused by excessive blood sugar levels over a long period of time, which then damages the nerve pathways and/or blood vessels. That is why even small injuries do not heal well. This can quickly lead to an open ulcer with additional inflammation. In a worst case, the surrounding tissue dies, which manifests itself in a black discolouration of the tissue (necrosis).

woman swollen feet

How can healthy people prevent type 2 diabetes from occurring? How can diabetics support their therapy?

In particular, people with an increased risk of developing type 2 diabetes should receive regular diabetes screening. A healthy lifestyle contributes significantly to the prevention of type 2 diabetes:

  • Reduce your excess weight.
  • Eat a healthy, balanced diet.
  • Make time for daily exercise / sport.
  • Watch your blood pressure.
  • If necessary, quit smoking.
  • Drink alcohol only in moderation.
  • Make sure to get enough sleep.
  • Develop anti-stress strategies (for example, with autogenic training).
  • Stick to your check-up appointments and take your medication as prescribed by your doctor.

Preventive measures against diabetic foot syndrome

The feet of people with diabetes are very sensitive: In a worst case, minor injuries can worsen within a few days to the point where (partial) amputation of the feet or toes is the last resort.

Therefore, diabetics should pay plenty of attention to their feet and take preventive action:
 

  • Check your legs and feet at regular intervals for skin irritations and sores.
  • Do not hesitate to go to the doctor immediately in case of injuries, the incorrect positioning of extremities or sensory disturbances in your feet.
  • Wear suitable shoes and ensure that you have the correct supply of special insoles in consultation with your doctor or your specialist retailer.
  • Attend regular medical foot care. When caring for your nails, be careful not to damage the nail bed or skin.
  • Treat any dry skin with a moisturiser. Avoid constriction caused by stockings, especially if you wear medical compression stockings due to venous disease.
  • Protect your feet from infection and do not walk barefoot.
  • Avoid overheating, for example, with hot water bottles and heating pads.

Diagnosis: How does a doctor diagnose type 2 diabetes?

If preventive examinations are not utilised, type 2 diabetes often remains undetected for too long. The disease develops gradually: Those affected by it get used to the symptoms without perceiving them as serious signs of the disease. Meaning that years can pass before diabetes is diagnosed. Often, secondary diseases have already manifested themselves. One decisive diagnostic criterion is the body’s blood glucose level. Among other things, the doctor determines the so-called fasted blood glucose level, occasional blood glucose and the HbA1c value.

doctor with glucometer and insulin pen

How does type 2 diabetes develop? What helps with diabetes?

The goals of diabetes therapy are

  • maintaining a good quality of life and
  • preventing secondary diseases and
  • increasing the ability (empowerment) of those affected in dealing with the disease.

Let your doctor show you the different treatment options – also ensure to ask what you can do yourself to prevent the diabetes from getting worse.

Once the diagnosis of diabetes is established, improving the patient’s understanding of diabetes is a first measure. This is offered by the statutory health insurer in cooperation with doctors. There, patients learn how they can best achieve their treatment goals.

As a rule, the treatment proceeds according to a step-by-step plan:

  • At the beginning, the patient is recommended to complete some informative training on diabetes and learn ways to optimise their lifestyle. If a person’s recommended blood values can already be achieved, the patient can manage without diabetes medication.
  • If the blood glucose level is still too high, the doctor may prescribe oral antidiabetics (blood glucose-lowering tablets) and other forms of medication.
  • Those affected whose blood glucose levels are too high despite all previous measures receive insulin therapy and other diabetes medication.

Which doctor treats type 2 diabetes?

The first points of contact are the family doctor and the diabetologist. If diabetic foot syndrome (DFS) has already occurred, treatment is carried out in a diabetological foot centre by an interdisciplinary team of diabetologists, angiologists, radiologists, vascular surgeons, orthopaedists and medical chiropodists.

Medi products for diabetics

Diabetic foot syndrome: Preventive care with insole blanks from the medi CAD range

For the soft cushioning of particularly pressure-sensitive feet – such as that seen in diabetic foot syndrome or in the preliminary stages of it (diabetic neuropathy) – medi offers insole blanks from the medi CAD Diabetes range for prevention.** The experts at your specialist retailer process the milled blanks into an insole and adjust it to fit the patient precisely.

 

Study results: Vein therapy for diabetes mellitus type 2

Due to age, type 2 diabetes mellitus is a frequent concomitant disease in patients with venous disease. For diabetics with venous diseases, medical compression stockings must have certain product characteristics. The medical compression stocking mediven angio* was specifically developed for patients with chronic venous disease and mild to moderate PAD and/or diabetes mellitus: The product development focused on the arterial situation and possible sensory disturbances – especially in the foot and toe area. A study with the mediven angio proves that no skin lesions occurred in compression classes 1 and 2 and that blood flow in the smallest blood vessels (microcirculation) – including oxygen saturation – remained stable when under compression.2

In addition: mediven angio is the only medical compression stocking whose safety for use for patients with chronic venous disease and concomitant mild- to moderate PAD and/or diabetes mellitus has been scientifically investigated and confirmed in a clinical study.

Sources and remarks:

Sources 

1 Deutscher Gesundheitsbericht Diabetes 2019; Herausgeber: Deutsche Diabetes Gesellschaft (DDG) und diabetesDE – Deutsche Diabetes-Hilfe.
2 Rother U et al. Safety of medical compression stockings in patients with diabetes mellitus or peripheral arterial disease. BMJ Open Diab Res Care 2020;8:e001316. 

*Intended purpose

Round-knitted medical compression stocking used for compression of the lower extremities, mainly for the treatment of disorders of the venous system.

**Purpose determination

Insole blank: Insole blanks for submission to the care professionals for the creation of custom-made products for the indication-appropriate care of the patient’s foot.