Diabetes Mellitus

Diabetes mellitus (abbreviated to DM below) refers to a condition involving elevated blood sugar levels, or an impaired processing of the carbohydrates you consume as a result of an absolute or relative insulin deficiency, and belongs to the group of metabolic disorders.

DM type 1 is defined by an absolute insulin deficiency, has a genetic or immunological origin and often appears at a young age. In 80% of cases, the underlying pathological mechanism is the destruction of the beta cells in the islets of Langerhans by autoantibodies.

With DM type 2 (90% of diabetics in Western Europe), insulin is provided by the beta cells of the pancreas but cannot take effect at the target organ. In this case, we speak of insulin resistance. This resistance is usually acquired and is frequently linked to metabolic syndrome.

DM can also occur as a result of secondary conditions, for example acute or chronic pancreatitis, a tumour, or as a medication-induced form, among others.

Symptoms

In the early stages of DM, clear symptoms are often absent. In type 1 diabetics, symptoms tend to appear earlier in the course of the disease than in type 2 diabetics. Classic signs are polyuria, polydipsia and weight loss due to dehydration. Non-specific symptoms can also occur, such as reduced general performance, loss of appetite, increased susceptibility to infection, poor wound healing, pruritus, among others.

The full clinical picture, always a medical emergency, is the diabetic coma, the hypoglycaemic shock.

Treatment

Regardless of the DM type, patient education is essential. Physical training and diet can delay the need for medication and the onset of late complications. If the desired results are not achieved, oral antidiabetic therapy should be discussed with the doctor for type 2 diabetics.

For type 1 diabetics, insulin replacement is by definition required. Here too, patient education is important with regard to the timing between eating and injecting, the general importance of nutrition and physical activity, and recognising and treating hypoglycaemic episodes.

If the treatment is not carried out consistently, irreversible late complications can often occur. The kidneys, eyes, blood vessels and nerves can sustain major damage, significantly worsening the course of the disease.

Exercise

Diabetics should also follow a normal training programme! At least 2.5 hours of moderate to vigorous endurance and strength training are recommended. Meta Training is an efficient form of training for improving general performance. At the start of the training phase, joint-friendly cardio equipment such as exercise bikes or cross-trainers should be chosen in particular.

Intensive muscle training combined with adapted nutrition can change the ratio of fat to muscle mass, increasing insulin sensitivity by up to 50 percent and reducing the risk of diabetes. This means muscle training works just as well as diabetes medication.