Detecting, preventing and treating diabetes

Diabetes (also known as diabetes mellitus) is a metabolic disorder that leads to elevated blood sugar levels because the hormone insulin cannot transfer sugar in the blood into the cells for various reasons.

In Switzerland, around 500,000 people suffer from diabetes, around 90% of whom have type 2 diabetes.

There are other forms of diabetes, such as gestational diabetes (diabetes during pregnancy) or MODY 3 (type 3 diabetes), which is similar to type 2, but is caused by genetic mutations.

Characteristic diabetes symptoms include:

• Frequent urination (polyuria)
• Extreme thirst (polydipsia)
• Weight loss
• Fatigue

In type 1 diabetes, these symptoms are often more severe. Type 2 diabetes, on the other hand, develops gradually and is therefore often only discovered when complications occur. These include, for example:

• Poorly healing wounds
• Dry, itchy skin
• Frequent infections
• Impaired vision

Gestational diabetes usually manifests itself as non-specific symptoms, such as frequent urinary tract infections, elevated amniotic fluid volume or increased sugar excretion in the urine. Pregnant women are therefore tested for gestational diabetes by a gynaecologist between the 24th and 28th week of pregnancy. High-risk patients (e.g. those who are overweight or have diabetes in the family) are tested earlier.

Regardless of the type of diabetes, permanently elevated blood sugar levels can lead to serious complications:

• Damage to nerves (diabetic neuropathy) which, for example, promotes diabetic foot syndrome, but can also trigger gastrointestinal complaints.
• Blood vessel disorders, which may lead to cardiovascular diseases (such as a heart attack or stroke) or damage to the eyes (diabetic retinopathy) and kidneys (diabetic nephropathy).

Acute metabolic disorders such as hypoglycaemia and hyperglycaemia (which can lead to diabetic coma) are also possible. These are medical emergencies (dial the emergency number 144!).

Type 1 diabetes is an autoimmune disease in which the immune system fights insulin-producing beta cells in the pancreas. The disease is believed to be caused by a combination of hereditary predisposition and environmental factors.

Risk factors for type 2 diabetes include:

• Being overweight
• Lack of exercise
• High-fat diet
• Excessive alcohol consumption
• Smoking
• Older age
• A history of gestational diabetes
• Medicines
• Hormonal diseases

By leading a healthy lifestyle, you can avoid many of these risk factors and do a lot to prevent type 2 diabetes.

First, the doctor will take the patient’s medical history and perform a physical examination. This includes measuring the patient’s height, weight and blood pressure, for example, and assessing him or her for typical consequential damage (such as to the feet).
Laboratory values also play a role in the assessment, especially fasting blood sugar and long-term blood sugar (HbA1c).
Fasting blood sugar of at least 7.0 mmol/l and an HbA1c value of at least 6.5% indicate diabetes.
Pre-diabetes is defined by fasting blood glucose levels of 5.6 to 6.9 mmol/l and a long-term blood glucose level of at least 5.7%. This means that there is a high risk of developing type 2 diabetes unless lifestyle changes are made. Fasting blood sugar of less than 5.6 mmol/l (100 mg/dl) is normal. In Switzerland, mmol/l are the commonly used units, but mg/dl is also used abroad.
It is also possible to test yourself for diabetes at home using a blood glucose meter or urine test strips. However, this is only a guide. A clear diagnosis can only be made by the doctor.

The aim of diabetes treatment is to maintain long-term blood sugar levels in a healthy range and to minimise the risk of complications.