Key points
- Diabetes can be type 1 or type 2, as well as gestational in pregnant women.
- Type 2 can go for years without complaints and is detected incidentally on a routine test.
- The diagnosis is made based on fasting venous plasma glucose, not a glucometer.
- The condition is managed by an endocrinologist; if one is unavailable, you can start with a general practitioner.
- The danger lies in the gradual damage to blood vessels, kidneys, eyes and nerve endings.
What is diabetes mellitus
Diabetes mellitus is a condition in which blood sugar levels remain elevated for a long time. Let us look at what underlies the disorder and what circumstances cause it.
What happens in the body
Diabetes mellitus develops when glucose from the blood does not enter the cells in the required amount. Insulin is responsible for transporting glucose — a substance produced by the pancreas. When there is a lack of insulin or a loss of sensitivity to it, sugar accumulates in the blood. The cells are left without energy, even though nutrients are supplied with food. A person may not notice the changes for a long time, because type 2 diabetes can proceed for years without complaints. Quite often the disorder is detected incidentally during a routine test, when there was no reason for concern. Therefore, even when feeling well, it is worth checking blood sugar levels if there are grounds for caution.
What causes it to develop
- Lack of insulin: the pancreas produces less of it than the body needs to transport glucose into the cells.
- Loss of sensitivity to insulin: the cells stop responding to the signal, and glucose remains in the blood.
- Autoimmune destruction: the body's defence system mistakenly damages the cells that produce insulin, and this is not related to diet.
- Age of onset: type 1 is more often detected in childhood and youth, when the destruction of cells has already gone far.
- Absence of complaints: type 2 does not make itself known for a long time, so it is found during a routine test rather than through how one feels.
Who encounters it more often
Diabetes mellitus occurs in people of different ages, but the frequency differs noticeably by type of disorder. Type 1 more often begins in childhood and youth, when autoimmune destruction of cells has already led to a lack of insulin. Type 2 is usually detected in adults, and quite often this happens incidentally during a routine test. The frequency is also influenced by how long the disorder remains unnoticed: without complaints, a person does not seek help for years. Therefore, in adults type 2 is detected more often than type 1, although both variants require attention. If close relatives have had elevated blood sugar, it is worth discussing with a doctor how often to check this indicator. Early detection helps to bring the condition under control in time and avoid complications.
What symptoms can occur?
Type 2 diabetes starts unnoticed: blood sugar rises over years, and there are no complaints. The first noticeable signs appear when the numbers are already high, so it is important to know what to pay attention to.
How it is noticed at the very beginning
Type 2 diabetes starts unnoticed: blood sugar rises over years, and there are no complaints. The first noticeable signs appear when the numbers are already high. Constant thirst and dry mouth bother you even after a glass of water. Frequent urination, especially at night, makes you get up several times a night. Fatigue without cause builds up by the evening and does not go away after rest. Slow-healing sores and recurring fungal infections are alarming with ordinary care. Deterioration of vision and a "veil" before the eyes make it difficult to read and work at a computer. Numbness and tingling in the feet appear gradually and are often put down to uncomfortable shoes. If such signs persist for weeks, it is worth checking your blood sugar level without postponing a visit to the doctor.
Signs that occur most often
- Constant thirst and dry mouth: a person drinks more than usual, but the dryness returns, and water does not bring relief for long.
- Frequent urination, especially at night: the urge wakes you several times a night and prevents proper sleep, which increases daytime exhaustion.
- Fatigue without cause: strength runs out even with the usual workload, and rest does not restore alertness, although the routine has not changed.
- Slow-healing sores, recurring fungal infections: minor skin damage takes weeks to heal, and infections return after ordinary treatment.
- Deterioration of vision, a "veil": the image blurs, letters and faces lose clarity, and sharpness either returns or disappears again.
- Numbness and tingling in the feet: the feet go numb, tingle or burn, especially at night, and this noticeably interferes with walking.
When to seek help urgently
Examinations and tests
Examination when diabetes mellitus is suspected is based on laboratory blood tests, not on home glucose meter readings. Below is an analysis of which investigations are used, what each of them shows, and what information is worth bringing to an appointment.
How the examination begins
The examination begins with a fasting venous plasma glucose blood test, and this is the first step in making a diagnosis. Blood is taken from a vein in the morning, before eating, because food changes the sugar level and distorts the result. The diagnosis is made specifically on the basis of laboratory blood tests, not on a glucose meter and not on symptoms. If the result turns out to be borderline, it is rechecked, because a single figure does not yet confirm the diagnosis. For borderline values, an oral glucose tolerance test is prescribed to assess how the body absorbs sugar. Additionally, glycated haemoglobin is determined, which shows the average sugar over three months. Therefore, it is worth bringing all previous test results to the appointment so that the doctor can see the picture over time.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: all previous doctors' conclusions and test results, to see the dynamics of indicators over the period of observation.
- Measurement diary: records of home measurements with dates and circumstances, they help to compare the data with laboratory results.
- List of complaints: a brief description of what is troubling you and for how long, this speeds up the analysis of the causes.
- Questions for the doctor: points written down in advance about what is unclear, so as not to forget them during the conversation.
- Copies of results: a second copy of the tests for personal keeping, so that the data is always at hand at the next visit.
Which doctor should I see?
Diabetes mellitus is managed by an endocrinologist, but care is not limited to a single specialist. This section explains who to see, what happens at the first appointment and what treatment consists of.
Which specialist manages this condition
Diabetes mellitus is managed by an endocrinologist, and it is to them that a patient is referred when a confirmed disorder of carbohydrate metabolism is found. If there is no endocrinologist nearby, you can start with a general practitioner: they will assess your general condition and refer you along the right pathway. Management often takes place together with a dietitian, who helps build a diet around a person's specific lifestyle and habits. At the first appointment the doctor clarifies complaints, health history, family history and how the person eats and moves on ordinary days. Then they look at how the condition changes over the course of a day and a week, and how stable the readings are. Particular attention is paid to the eyes, kidneys and feet, because these are the areas affected by persistently high blood sugar. If there is no specialist nearby, do not put off a visit to a general practitioner — they will advise you where to go next.
What treatment consists of
- Nutrition: the diet is restructured so that blood sugar stays steadier throughout the day, and this affects how you feel more than it may seem.
- Physical activity: regular feasible exercise helps the body use glucose better, and the type of activity is selected to suit the person's condition and habits.
- Weight loss: in type 2, reducing body weight sometimes produces a noticeable shift, and in the early stages this is sometimes enough.
- Monitoring: the doctor keeps track of average blood sugar and the condition of the eyes, kidneys and feet in order to notice changes in time and respond.
- Support from specialists: the endocrinologist, general practitioner and dietitian work in a coordinated way, and each is responsible for their part of the overall picture.
What depends on the patient themselves
Regular monitoring is the part of the result that rests on the person themselves, and not only on the doctor. If visits and monitoring of readings happen as agreed rather than occasionally, changes are noticed earlier and responded to more calmly. Missed appointments and postponed check-ups are most often linked to the person feeling fine and deciding to wait. But how you feel with this condition is deceptive: readings can change unnoticed, and the consequences accumulate gradually. Home monitoring helps you see the whole picture rather than a single random measurement. Records of how your condition, diet and activity have changed make the conversation with the doctor specific and short. The goal of treatment is not a single number on the glucose meter, but maintaining average blood sugar and preventing complications involving the eyes, kidneys and feet. So it is worth deciding in advance how you will fit monitoring into an ordinary week, so that it does not depend on your mood and free time.
What helps prevent an exacerbation?
Preventing the worsening of diabetes is helped by everyday lifestyle, not only by the doctor's prescriptions. Below is an analysis of which habits and observations reduce the risk of the condition deteriorating.
What is changed in habits
Diet and movement are among the things a person can change on their own, without outside help. Sweet drinks deliver sugar faster than any food, so reducing them noticeably smooths out glucose fluctuations. Replacing fizzy drinks with water removes sharp rises in sugar after meals and reduces the load on the body. Moderate exercise takes one hundred and fifty minutes a week, and it can be distributed across the days in any convenient way. Regular walking improves muscle function and helps the body absorb glucose from the blood better. Losing five to seven per cent of body weight reduces the risk in people with prediabetes and eases the course of the condition. Sleep and giving up smoking also affect how steadily glucose stays throughout the day. Start with one change, for example water instead of a sweet drink, and make it a habit before taking on the next one.
What should be kept under control
- Fasting glucose: it is checked once a year after the age of forty-five, in order to notice deviations in time.
- Body weight: it is measured regularly, since losing five to seven per cent reduces the risk with prediabetes.
- Family history: diabetes in parents means that glucose should be checked earlier and more often than usual.
- Sweet drinks: their amount in the diet is reduced, because they raise sugar faster than solid food.
- Physical activity: moderate exercise takes one hundred and fifty minutes a week and is distributed across the days.
- How you feel: any changes in your condition should be remembered and discussed with the doctor at an appointment.
How often to see a doctor
Regular visits to the doctor are needed even when you feel well and nothing is bothering you. Glucose can change gradually, and a person does not always notice this by how they feel. Checking fasting glucose once a year after the age of forty-five helps to see shifts earlier than complaints appear. If you are overweight and have diabetes in your parents, you should be checked earlier, without waiting for this age. At an appointment the doctor compares the person's observations with the test results and assesses the overall picture. Such meetings allow habits to be adjusted in time and the condition not to be brought to a worsening. Write down changes in how you feel between visits, so that the conversation with the doctor is specific rather than general.
What is worth remembering
Diabetes remains a condition that a person lives with permanently, rather than completing a short course. Understanding its nature helps to notice changes in time and build everyday habits without unnecessary strain.
Key takeaways
Diabetes is a metabolic disorder in which blood glucose levels remain above normal. Constant thirst, frequent urination, rapid weight loss and wounds that take a long time to heal help to spot the problem. In some people the disease runs hidden for a long time and is detected incidentally during a blood test. Diabetes is dangerous not in itself, but through the gradual damage to blood vessels, kidneys, eyes and nerve endings. That is why monitoring glucose levels and regular check-ups with a doctor remain the foundation of a calm life. Diet, movement and daily routine affect the condition no less than follow-up with a specialist. If new complaints appear, it is not worth waiting for a scheduled visit — it is better to discuss them with a doctor earlier.
