Diabetes: definition, signs & risk factors

Diabetes mellitus (or simply diabetes) is a chronic metabolic disease that is associated with increased blood glucose levels. The hormone insulin regulates blood sugar levels. Insulin is produced by the pancreas. In healthy individuals, the pancreas always produces just enough insulin to regulate blood glucose levels adequately. In cases of the illness diabetes, the pancreas produces little or no insulin. The sugar (glucose) remains in the blood, which leads to a permanently elevated blood glucose level. Over time, this damages the vessels and the organs.

Doctors distinguish between various different types of diabetes.

Type 1 diabetes mellitus

In cases of low insulin, specialists talk about type 1 diabetes. This is an autoimmune disease. The individual’s own immune system destroys the cells in the pancreas that are responsible for producing insulin (referred to as the beta cells), quickly decimating and finally eliminating the body’s own insulin production. Those affected rely on injecting insulin life-long. Around 10% of diabetics have type 1 diabetes. Type 1 diabetes mellitus is the most common form of diabetes in people under 25. This form of diabetes generally develops in children and adolescents, but adults can become ill with type 1 diabetes too. Where type 1 diabetes doesn’t develop until adulthood, this is referred to as LADA, which stands for “latent autoimmune diabetes in adults”.
According to researchers, type 1 diabetes mellitus is becoming more and more common in children and adolescents – and in adults too.

Type 2 diabetes mellitus

Roughly 90% of diabetics have type 2 diabetes. This type of diabetes was formerly referred to as adult-onset diabetes. This version of diabetes is less common in children and adolescents than type 1 diabetes.

What causes type 2 diabetes? The body has developed insulin resistance: more and more insulin is required to keep the blood glucose level normal. If the pancreas is no longer able to guarantee this additional insulin production, the blood glucose level rises, and this results in diabetes. This version of diabetes has become an epidemic. Why? Because people are eating increasingly unhealthy diets and moving less than ever before. This leads to weight gain, which increases the risk of insulin resistance. Around a third of those affected are unaware that they have diabetes and consequently do nothing to treat it. In fact, on average, it takes seven years from the start of the illness to getting a diagnosis.

Other forms of diabetes

There are other forms of diabetes in addition to type 1 and 2 diabetes. A rarer form of diabetes is MODY (“maturity onset diabetes of the young”), a genetically inherited insulin secretion disorder, occurring primarily in young, non-overweight patients.
Gestational diabetes occurs during pregnancy and represents a risk factor for the subsequent development of type 2 diabetes mellitus.
In addition to this, other hormonal imbalances as well as certain medications – such as cortisone preparations – can increase the risk of diabetes.

There are various diabetes symptoms that occur in both type 1 and type 2 variants. The symptoms of diabetes are similar in women and men. These include:

• Thirst: sufferers feel a strong thirst and drink significantly more than usual, which in turn leads to an increased urge to urinate.
• Tiredness and weakness: another sign of diabetes is physical exhaustion and tiredness.
• Impaired vision: an acute rise in blood glucose levels can temporarily cause impaired vision. Those affected suffer from blurred and fuzzy vision. As the illness progresses, retinal damage can occur. That’s why it is important to check any change in your vision with your doctor.   
• Skin diseases: diabetes can lead to dry skin and itching. Diabetes also weakens the skin’s barrier function, causing bacteria and fungi to spread faster. This, in turn, increases susceptibility to issues like osteoarthritis. Diabetes can lead to a wide range of potential skin changes.  
• Sweating: another possible sign of diabetes is increased sweating. This occurs especially when those affected have low blood sugar.
• Bad breath: unpleasant, acetone-like bad breath is another typical indicator of poor blood sugar levels.

How is diabetes measured? To test for diabetes, doctors carry out a blood test. They use it to measure the amount of fasting glucose (amount of sugar in the blood after a long period of not eating) or long-term glucose (HbA1c value).

There is no singular cause of diabetes mellitus. In fact, there are a variety of risk factors that predispose individuals to developing diabetes. These vary depending on the type of diabetes.

Tip: the Swiss Diabetes Association provides a simple test for assessing your susceptibility to diabetes. The questions take just a few minutes. You should repeat the test every three to five years.

Risk factors for type 1 diabetes

Some factors increase the risk of type 1 diabetes. These include:

• Genetic predisposition: researchers suspect a connection between genetic predisposition and diabetes risk. If the mother has type 1 diabetes, the child also has a 3% chance of developing the disease. If the father is affected, the probability is 5%. If both parents have type 1 diabetes, the probability is about 20%.
• Infections: infections with certain viruses also pose diabetes risks. Among other illnesses, mumps and rubella are suspected of increasing the risk of diabetes.

Risk factors for type 2 diabetes

Various factors increase the risk of type 2 diabetes:

• Weight: diabetes and being overweight are related. This is especially true in those with a high proportion of belly fat. This is deemed an abdominal circumference of over 80 centimetres in women and over 94 centimetres in men (measured at the height of the belly button). The risk of diabetes increases five to tenfold with significant weight gain.
• Nutrition: the risk of diabetes also increases if you consume a lot of sugar. The regular consumption of low-fibre and high-fat foods also increases the risk of diabetes.
• Lack of exercise: not getting enough exercise may also increase the risk of type 2 diabetes. Any less than 30 minutes of exercise per day is deemed insufficient.
• Medication: certain medications increase the risk of diabetes. These include, for example, antidepressants and cortisone.
• Genetic predisposition: if a parent is affected by type 2 diabetes, the risk of their child developing the disease is 30 to 50%.
• Age: the risk of type 2 diabetes increases with age.

Type 1 diabetes is not preventable or treatable because it is an autoimmune disease. But what can help prevent type 2 diabetes? There are some measures that reduce the risk of diabetes. A healthy lifestyle is the most effective preventive measure.

• Prevent diabetes with exercise and sport. Increase the amount of exercise you do each day
• Pay attention to your diet. A varied diet is essential in preventing diabetes. A balanced diet includes fresh fruit and vegetables. Eat carbohydrates in moderation, drink plenty of water or unsweetened tea and go easy on sugary foods.
• Avoid being overweight. Lower your risk of diabetes by losing weight if you are overweight. If possible, ensure your weight remains within the normal range.
• Avoid tobacco: smoking or nicotine poses a significant diabetes risk. Quitting smoking can help minimise the risk of diabetes by 30 to 50%.

Contact your doctor if you have an increased risk of diabetes. With regular blood glucose measurements, specialists can also detect prediabetes, enabling early treatment.

Avoiding diabetes: studies

The Harding Center for Risk Literacy at the University of Potsdam analysed eleven studies on diabetes prevention in people with slightly elevated blood sugar levels. The study compared two groups. One received the standard care with tips on a healthy lifestyle, while the other followed a systematic change in diet and targeted physical activity. Within six years, around a quarter (26%) of people in the standard group developed type 2 diabetes. In the second test group, which combined a change in diet with targeted physical activity, the figure was 15% – 11% less.

Diabetes is a serious disease, so preventive measures and the earliest possible diagnosis are crucial. If you are unsure or are exhibiting signs of diabetes, talk to your doctor.