Diabetes prevention and treatment information

A highly experienced diabetes specialist, Dr. Michael Mühlhause from the Centre for Nephrology, Hypertension and Diabetology in Nürtingen, Germany, discusses the disease in our interview. He explains what diabetes is, what we can do to prevent it and how it can be treated.
In this interview, German diabetes specialist Dr. Michael Mühlhause shares his expertise. A highly experienced expert, he has taken care of patients with diabetic disorders for many years. In this interview, he shares his extensive knowledge of diabetes and discusses how it can be prevented and treated.

What is diabetes?

Basically, diabetes is an inability to use blood glucose.

This is caused by a lack of insulin, which opens the door for glucose to reach cells.

Insulin is either missing (as in type 1 diabetes, mostly found in young people) or cannot be produced in the required amounts (type 2 diabetes mellitus, mostly affecting adults who are overweight).

If the blood glucose cannot enter the body‘s cells, there will not enough energy for the metabolism.

Why do some people get diabetes? What causes it?

Most people develop type 2 diabetes, as a large number of fat cells absorb the insulin that is produced.

This, in turn, leads to a lack of normal metabolism.

Type 1 diabetes develops mainly in young people who have a normal body weight.

The disease is a result of the deterioration of beta cells - part of the Langerhans cells in the pancreas. 

After a period of very good control of blood glucose (known as the honeymoon phase, since a lot of insulin in released into the blood due to the deterioration of the beta-cells), the patient is likely to experience a period of critical illness, since this eventually results in a lack of insulin.

So the causes of diabetes are different: with type 2, it is caused by being overweight and in type 1 it‘s the result of a lack of insulin.

What is the best treatment for diabetes? Can diabetes be cured?

Its important to distinguish between the two types. Type 1 will be best treated by imitating normal blood glucose regulation.

This is best achieved by an insulin-pump or intensive insulin therapy that mimicks the two parts of insulin secretion: the basal and the acute insulin secretion.

This means measuring the blood glucose level before eating and anticipating how much energy needs to be ingested in the following meal.

It leads to the units of insulin needed to maintain a normal blood glucose level 2 hours after the meal.

Type 1 diabetes can be cured only when an intact pancreatic organ is transplanted. A transplant would require immuno-suppressive therapy.

Diabetes can lead to blindness, apoplexy, heart attack or renal insufficiency, and in extreme cases to the need for dialysis.

Dr. Mühlhause

What complications and secondary damage can be caused by diabetes?

Elevated blood glucose and the by-products of the cell degradation process are mostly vascular toxic.

This means that highly vascularised organs like the brain, the heart and the kidneys will be predominantly injured.

As a result, this can lead to blindness, apoplexy, myocardial infarction or renal insufficiency, and in extreme cases, to the need of dialysis.

Can you prevent diabetes from developing?

In the case of type 2 diabetes, lifestyles should be changed, to be based on less energy input and more energy consumption.

This means consuming less calories and doing more physical exercise.

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