Diabetes mellitus (DM) is the name for a group of metabolic diseases and describes their initial main symptom: excretion of sugar in the urine. In ancient times, the diagnosis was made by a taste test of the urine because the urine of people with diabetes has elevated blood sugar levels.
Meanwhile, it is in the technical language of the collective term for various (heterogeneous) disorders of metabolism, whose hallmark is hyperglycaemia the blood (hyperglycemia).
Cause is either a lack of insulin, insulin sensitivity (insulin resistance) or both. Depending on the cause, there are different types of diabetes, which are based on unifying commonalities. To increase the awareness of this condition since 1991 on the 14th November there is World Diabetes Day.
Physiological Basis
The digestive system builds the dietary carbohydrates that are contained for example in sugar, bread and other cereal products with glucose (dextrose). This is then absorbed through the intestinal wall into the blood and distributed throughout the body.
Main article: insulin, glycogen, gluconeogenesis
Produced in the pancreas β-cells of islets of Langerhans of the hormone insulin. Insulin increases in muscle and fat cells, the permeability of cell membranes to glucose in the cells of the glucose is consumed to produce energy. Insulin also causes the glucose uptake into the liver cells to store it in the form of glycogen. The blood sugar rises in the digestion phase, and thereafter (kept constant until two hours after the last feeding) within narrow limits, 80-120 mg/dL or 4.5-6.7 mmol/l.
Even in long fasting, blood glucose levels remain at normal levels. This is primarily the liver: on one hand, the stored glycogen is broken down and released back into the blood, the other is constantly re-formed glucose from smaller building blocks (gluconeogenesis).
If the insulin-producing β-cells are not working properly, or due to pathological processes they are no longer present, both the uptake of glucose is derailed into the tissue and the inhibition of sugar does not form in the liver. The liver can produce under these conditions every day up to 500 grams of glucose.
This also explains the rise in blood sugar levels in diabetics, regardless of food intake. In addition, insulin has a third effect. It is the only hormone in the human body which ensures that fat remains in the depots. A major feature of the insulin deficiency is therefore extreme weight loss. In diabetes mellitus (insulin deficiency or reduced insulin action) glucose remains in the blood and the formation of glucose in the liver goes unchecked, leading to an increase in blood sugar.
