Diabetes mellitus is a condition characterized by repeated elevated blood glucose levels (hyperglycaemia). The term diabetes (and popularly sugar) is also used, but is not recommended by some because these wrong associations would evoke such that diabetes was caused by too much sugar to eat, or that one should eat when one diabetes no sugar has. How high blood glucose levels should be exactly and under what conditions that measurements must be done is set out in international agreements that each country may differ slightly. Causes the continuous hyperglycemia, as it is high enough, glucosuria (sugar loss in the urine) in severe cases a noticeable polyuria (urinating a lot) as well as polydipsia (excessive drinking) has caused. Prolonged hyperglycemia or excessive hyperglycemia can eventually lead to coma if not detected early and treated.
Diagnosis
The convention states that the ideal blood glucose (blood sugar) depending on circumstances, between 4 and 8 mmol / l should lie. A normal fasting value is between 4 and 5.6 mmol / l. If the "sober" values in an untreated person above 6 mmol / l and 'non-fasting' above 11.0 mmol / L, it is called diabetes mellitus (sugar diabetes). In the gray area between these limits, some do, some do not speak of diabetes. Nationally and internationally on these values periodically made appointments or they are reviewed by physicians on the basis of research results. Usually when complaints come with the symptoms of diabetes mellitus they sit well above the targets. In order to determine whether a person has diabetes, and what type it is, should be determined, not only the blood glucose value at the blood test with certainty but also the C-peptide and the insulin content of the blood. A type-1 patient has an elevated blood glucose level, but does not produce a C-peptide greater; a Type 2 patient (but not always) exhibiting mostly an elevated blood glucose value that is always associated with an increased insulin level.
Cause of disease
Diabetes is an incurable metabolic disorder in which the body is insufficient energy from glucose (sugars) can extract. Sugars can be incorporated into most of the cells (insulin-dependent cells) only in the presence of insulin sufficient if there is also acting insulin receptors on those cells are present. The exact cause of diabetes is not yet known. The best-known problems in diabetes are:
inadequate or no production of insulin (known as Type 1 diabetes) or
a problem with respect to the insulin receptors (known as Type 2 diabetes).
Symptoms
Many people with type 2 diabetes are entirely or almost symptom free.
The much pee aforementioned and much drinking occurs at high to very high blood glucose levels (above 13 mmol / l).
Patients have poor glucose (too high) higher than average suffer from cystitis, thrush, and / or boils.
Sometimes one can smell acetone in the breath of patients with diabetes, especially if glucose can be processed that the body is switched to fat burning, with ketones as by-products formed, of which acetone is one. So bad by insulin deficiency Glucose in the blood is usually too high. At high blood sugars and severe dehydration ketoacidosis (metabolic acidosis) can occur with a life-threatening coma.
Increased risk of non or poorly healing wounds, because the nerves do not work properly and it's (mostly on foot) does not feel good when a wound occurs. These usually heal poorly or not.
Red or burning eyes. Blurred vision. Inflammation of the eyes.
Fatigue or sleepiness
impotence
Dry mouth and dry tongue
Creates polyfagi (increased hunger) by the reduced glucose uptake in muscle, liver and adipose tissue, which require insulin to absorb glucose.
Complications
In the long term, joined other complications:
In the larger arteries strongly accelerated atherosclerosis occurs. Diabetes mellitus is the major risk factor for cardiovascular disease. Even the smallest stroke veins are less well (microangiopathy) which leads to damage anywhere in the body, such as diabetic retinopathy, damage to the retina, resulting in visual impairment or even blindness, or diabetic nephropathy, the kidneys do not work anymore .
The sensory nerves to work less well, so after years insensitivity often occurs in the feet and hands. The feet and hands will excite and tingle and at the same time, the sense of touch less well, making fine work such as closing up buttons impossible or the patient does not feel that he has kicked. in a thumbtack Such wounds will furthermore earlier ignited by the higher sugar content and the cure is worse due to the disturbed blood supply. The patient notices the late because he did not feel. This may mean that eventually will toes, feet or lower legs lost, because they have to be amputated.
Treatment
Type 2 diabetes can be treated with diet and with some oral drugs (sulfonylureas such as Amaryl (R) and Uni Diamicron (R), biguanides such as metformin and thiazolidinediones such as pioglitazone) To prevent diabetes complications could chamomile tea and turmeric (turmeric) deployed to be. Also, it is recommended to go sports because sports reduces hyperglycemia; This is because the skeletal muscles used do not need insulin to absorb glucose. Type 1 can currently only be treated with insulin. Insulin is also used as a type 2 diabetes do not respond satisfactorily to treatment with tablets. The treatment of diabetes is not just medication. It is by holding a combination of medication, diet and exercise. Surrounding blood sugar as stable as possible That is also the reason that people with diabetes may use, in contrast to what was previously thought. Moderation sugar It is the total carbohydrate intake. People with diabetes should note both hats for hypoglycaemia (low blood sugar), which can be achieved by eating as hyperglycaemia (high blood sugar) should be in which case carbohydrates avoided carbohydrates remedied if possible insulin must be bijgespoten . Finding the correct balance between these extremes, such as strenuous exercise or sports, is sometimes difficult.
Insulin is made in a very short, short and long-acting forms and different mixtures thereof; all have to be injected under the skin or can be introduced. by means of an insulin pump Also, combinations of oral medications and various types of insulins are possible.
However, medication that lowers blood glucose is not enough. People with diabetes also have a greater sensitivity to risk factors other than transmitted, especially smoking, high blood pressure and high cholesterol, together known as the metabolic syndrome. It is for people with diabetes so even more important than in other groups that they are not smoking, maintaining a normal weight, physical exercise and a possible high blood pressure and high cholesterol treatment.
In the Netherlands, the aim is to treat as one in which patients are seen. Several times a year and any additional diabetes risk entirely It will look at:
The blood glucose value, and the treatment is optimized. In addition to the concentration of glucose in the blood itself, which can vary from hour to hour, there is a strong substance that reflects the average glucose concentration over the past few weeks, namely the HbA1C or glycated hemoglobin. By this, the average blood glucose level may vary over a period of several months to be assessed;
The feet are inspected: the podiatrist or medical pedicure activated as necessary;
The occurrence of neuropathy is detected;
Smoking behavior is monitored and the patient is encouraged to stop;
High blood pressure is actively detected and treated;
The cholesterol is measured and treated as such evidence exists, in some primary prevention guidelines are recommended and therefore standard prescribed a statin;
The patient is encouraged to move, and to keep his body weight down;
The patient is regularly checked by an ophthalmologist to treat by laser therapy. Occurring a diabetic retinopathy at an early stage
A vast majority of diabetics (especially type 1) measuring their own blood sugar with a glucose meter. The patient can usually the fingertip itself with a barely perceptible prick, check out what his blood glucose and possibly inject insulin modify it. The amount through a small drop of blood This so-called self-control is of great importance for an as stable as possible and the resulting blood glucose as much as possible of late complications.
Diabetes and alcohol
Although it varies from person to person, a person who has diabetes to be careful with alcohol. Should When drinking a beer for example, blood glucose by the sugars (carbohydrates) that beer contains first rise, after which they will fall by the alcohol again. When drinking spirits, such as whiskey for example, blood glucose will only decrease.
Depending on the degree to which the diabetic patient is predictable responds, alcohol is also sometimes used as an active agent in order to reduce, for example, when insulin is not available. The blood sugar value temporarily However, this is a risky practice.
Recent research by the National Institute for Public Health and Environment (RIVM), conducted in collaboration with the Julius Center of the University Medical Center Utrecht, TNO and Wageningen University, has shown that drinking one to two glasses of alcohol per day by adults risk of developing type 2 diabetes reduces.
Diabetes and energy drinks
Energy drinks (Energy Drink) can be a huge rise in blood sugar levels which cause these drinks can be for people with diabetes or people with a genetic predisposition for diabetes risk with a high content of caffeine and sugars.
Consequences
Diabetes is a disease in which - even if it is not treated Especially with type 1 the best - after a period of time, in many places causes damage in the body of the patient, thereby increasing the life expectancy and the quality of life clearly decline. The consequences are a powerful treatment much less severe.
The damage is mainly caused by changes to the vessel wall of the blood vessels, particularly the large and small arteries. Atherosclerosis occurs in people with diabetes greatly accelerated and gives rise to a much greater risk of heart attack, stroke, kidney failure and amputation of a foot for example, than in healthy people. The retina can suffer damage which eventually blindness can occur. Impotence and incontinence is another common consequence of diabetic neuropathy.
There is also the changing 'high' and 'low' blood sugar levels brain damage as possible, as with alcoholics. There is still a lot of research has been done and it is not yet sure whether the very high or low blood sugar is the most damaging.
With the necessary self-discipline people with diabetes can function normally in society. The consequences of this debilitating disease for everyday life should not be underestimated: few can afford the level of discipline that their doctors would like. Despite it being very serious consequences, but the time that this action appears to the young man with diabetes still very far away.
The quality of life of people with diabetes type I is similar to that of healthy people, according to research by Dr.. Bertien Hart at the Erasmus University Rotterdam. However, the quality of life greatly impacted by the experience of high blood glucose and symptoms of chronic complications. There may also backlog at puberty. An example thereof being found in women's breasts develop later and that they can be. Periods later.
Diagnosis
The convention states that the ideal blood glucose (blood sugar) depending on circumstances, between 4 and 8 mmol / l should lie. A normal fasting value is between 4 and 5.6 mmol / l. If the "sober" values in an untreated person above 6 mmol / l and 'non-fasting' above 11.0 mmol / L, it is called diabetes mellitus (sugar diabetes). In the gray area between these limits, some do, some do not speak of diabetes. Nationally and internationally on these values periodically made appointments or they are reviewed by physicians on the basis of research results. Usually when complaints come with the symptoms of diabetes mellitus they sit well above the targets. In order to determine whether a person has diabetes, and what type it is, should be determined, not only the blood glucose value at the blood test with certainty but also the C-peptide and the insulin content of the blood. A type-1 patient has an elevated blood glucose level, but does not produce a C-peptide greater; a Type 2 patient (but not always) exhibiting mostly an elevated blood glucose value that is always associated with an increased insulin level.
Cause of disease
Diabetes is an incurable metabolic disorder in which the body is insufficient energy from glucose (sugars) can extract. Sugars can be incorporated into most of the cells (insulin-dependent cells) only in the presence of insulin sufficient if there is also acting insulin receptors on those cells are present. The exact cause of diabetes is not yet known. The best-known problems in diabetes are:
inadequate or no production of insulin (known as Type 1 diabetes) or
a problem with respect to the insulin receptors (known as Type 2 diabetes).
Symptoms
Many people with type 2 diabetes are entirely or almost symptom free.
The much pee aforementioned and much drinking occurs at high to very high blood glucose levels (above 13 mmol / l).
Patients have poor glucose (too high) higher than average suffer from cystitis, thrush, and / or boils.
Sometimes one can smell acetone in the breath of patients with diabetes, especially if glucose can be processed that the body is switched to fat burning, with ketones as by-products formed, of which acetone is one. So bad by insulin deficiency Glucose in the blood is usually too high. At high blood sugars and severe dehydration ketoacidosis (metabolic acidosis) can occur with a life-threatening coma.
Increased risk of non or poorly healing wounds, because the nerves do not work properly and it's (mostly on foot) does not feel good when a wound occurs. These usually heal poorly or not.
Red or burning eyes. Blurred vision. Inflammation of the eyes.
Fatigue or sleepiness
impotence
Dry mouth and dry tongue
Creates polyfagi (increased hunger) by the reduced glucose uptake in muscle, liver and adipose tissue, which require insulin to absorb glucose.
Complications
In the long term, joined other complications:
In the larger arteries strongly accelerated atherosclerosis occurs. Diabetes mellitus is the major risk factor for cardiovascular disease. Even the smallest stroke veins are less well (microangiopathy) which leads to damage anywhere in the body, such as diabetic retinopathy, damage to the retina, resulting in visual impairment or even blindness, or diabetic nephropathy, the kidneys do not work anymore .
The sensory nerves to work less well, so after years insensitivity often occurs in the feet and hands. The feet and hands will excite and tingle and at the same time, the sense of touch less well, making fine work such as closing up buttons impossible or the patient does not feel that he has kicked. in a thumbtack Such wounds will furthermore earlier ignited by the higher sugar content and the cure is worse due to the disturbed blood supply. The patient notices the late because he did not feel. This may mean that eventually will toes, feet or lower legs lost, because they have to be amputated.
Treatment
Type 2 diabetes can be treated with diet and with some oral drugs (sulfonylureas such as Amaryl (R) and Uni Diamicron (R), biguanides such as metformin and thiazolidinediones such as pioglitazone) To prevent diabetes complications could chamomile tea and turmeric (turmeric) deployed to be. Also, it is recommended to go sports because sports reduces hyperglycemia; This is because the skeletal muscles used do not need insulin to absorb glucose. Type 1 can currently only be treated with insulin. Insulin is also used as a type 2 diabetes do not respond satisfactorily to treatment with tablets. The treatment of diabetes is not just medication. It is by holding a combination of medication, diet and exercise. Surrounding blood sugar as stable as possible That is also the reason that people with diabetes may use, in contrast to what was previously thought. Moderation sugar It is the total carbohydrate intake. People with diabetes should note both hats for hypoglycaemia (low blood sugar), which can be achieved by eating as hyperglycaemia (high blood sugar) should be in which case carbohydrates avoided carbohydrates remedied if possible insulin must be bijgespoten . Finding the correct balance between these extremes, such as strenuous exercise or sports, is sometimes difficult.
Insulin is made in a very short, short and long-acting forms and different mixtures thereof; all have to be injected under the skin or can be introduced. by means of an insulin pump Also, combinations of oral medications and various types of insulins are possible.
However, medication that lowers blood glucose is not enough. People with diabetes also have a greater sensitivity to risk factors other than transmitted, especially smoking, high blood pressure and high cholesterol, together known as the metabolic syndrome. It is for people with diabetes so even more important than in other groups that they are not smoking, maintaining a normal weight, physical exercise and a possible high blood pressure and high cholesterol treatment.
In the Netherlands, the aim is to treat as one in which patients are seen. Several times a year and any additional diabetes risk entirely It will look at:
The blood glucose value, and the treatment is optimized. In addition to the concentration of glucose in the blood itself, which can vary from hour to hour, there is a strong substance that reflects the average glucose concentration over the past few weeks, namely the HbA1C or glycated hemoglobin. By this, the average blood glucose level may vary over a period of several months to be assessed;
The feet are inspected: the podiatrist or medical pedicure activated as necessary;
The occurrence of neuropathy is detected;
Smoking behavior is monitored and the patient is encouraged to stop;
High blood pressure is actively detected and treated;
The cholesterol is measured and treated as such evidence exists, in some primary prevention guidelines are recommended and therefore standard prescribed a statin;
The patient is encouraged to move, and to keep his body weight down;
The patient is regularly checked by an ophthalmologist to treat by laser therapy. Occurring a diabetic retinopathy at an early stage
A vast majority of diabetics (especially type 1) measuring their own blood sugar with a glucose meter. The patient can usually the fingertip itself with a barely perceptible prick, check out what his blood glucose and possibly inject insulin modify it. The amount through a small drop of blood This so-called self-control is of great importance for an as stable as possible and the resulting blood glucose as much as possible of late complications.
Diabetes and alcohol
Although it varies from person to person, a person who has diabetes to be careful with alcohol. Should When drinking a beer for example, blood glucose by the sugars (carbohydrates) that beer contains first rise, after which they will fall by the alcohol again. When drinking spirits, such as whiskey for example, blood glucose will only decrease.
Depending on the degree to which the diabetic patient is predictable responds, alcohol is also sometimes used as an active agent in order to reduce, for example, when insulin is not available. The blood sugar value temporarily However, this is a risky practice.
Recent research by the National Institute for Public Health and Environment (RIVM), conducted in collaboration with the Julius Center of the University Medical Center Utrecht, TNO and Wageningen University, has shown that drinking one to two glasses of alcohol per day by adults risk of developing type 2 diabetes reduces.
Diabetes and energy drinks
Energy drinks (Energy Drink) can be a huge rise in blood sugar levels which cause these drinks can be for people with diabetes or people with a genetic predisposition for diabetes risk with a high content of caffeine and sugars.
Consequences
Diabetes is a disease in which - even if it is not treated Especially with type 1 the best - after a period of time, in many places causes damage in the body of the patient, thereby increasing the life expectancy and the quality of life clearly decline. The consequences are a powerful treatment much less severe.
The damage is mainly caused by changes to the vessel wall of the blood vessels, particularly the large and small arteries. Atherosclerosis occurs in people with diabetes greatly accelerated and gives rise to a much greater risk of heart attack, stroke, kidney failure and amputation of a foot for example, than in healthy people. The retina can suffer damage which eventually blindness can occur. Impotence and incontinence is another common consequence of diabetic neuropathy.
There is also the changing 'high' and 'low' blood sugar levels brain damage as possible, as with alcoholics. There is still a lot of research has been done and it is not yet sure whether the very high or low blood sugar is the most damaging.
With the necessary self-discipline people with diabetes can function normally in society. The consequences of this debilitating disease for everyday life should not be underestimated: few can afford the level of discipline that their doctors would like. Despite it being very serious consequences, but the time that this action appears to the young man with diabetes still very far away.
The quality of life of people with diabetes type I is similar to that of healthy people, according to research by Dr.. Bertien Hart at the Erasmus University Rotterdam. However, the quality of life greatly impacted by the experience of high blood glucose and symptoms of chronic complications. There may also backlog at puberty. An example thereof being found in women's breasts develop later and that they can be. Periods later.