Diabetes Mellitus

+What is diabetes mellitus?

It is a condition in which our body cannot effectively utilize glucose (“sugar”). Normally, glucose either enters our body from food or is produced by the body mainly in the liver, which plays a significant role in regulating, storing, and releasing glucose. Glucose travels through the bloodstream and enters various organs with the help of a substance called insulin. Therefore, insulin acts like a key to unlock the doors of cells to allow glucose to enter.

+Is there only one type of diabetes?

No: In Type 1 diabetes mellitus, insulin levels are nearly zero. This type usually appears in childhood, adolescence, or young adulthood.

In contrast, in Type 2 diabetes mellitus, insulin is present and even initially elevated. However, tissues require more insulin than normally needed for glucose to enter cells (a condition called “insulin resistance”). As a result, the pancreas, after some time, cannot meet this increased demand for insulin. Since glucose cannot enter the cells, it remains in the blood. Type 2 diabetes mellitus is often associated with increased weight/obesity and appears at an older age.

+How common is each type?

The likelihood of each child being born with Type 1 diabetes is less than 1%. Type 2 diabetes is much more common: It is estimated that about one in ten adults in Europe lives with Type 2 diabetes.

+How is diabetes diagnosed?

With blood tests. Any one of the following is sufficient:

• Fasting blood glucose of 126 mg/dL or higher, on two separate days. Fasting means no food or drink other than water for at least 8 hours.

• Glycated haemoglobin (HbA1c) of 6.5% or higher, confirmed by a second test.

• A random blood glucose of 200 mg/dL or higher, together with symptoms such as excessive thirst, frequent urination or unexplained weight loss.

• Blood glucose of 200 mg/dL or higher 2 hours after drinking 75 g of glucose (oral glucose tolerance test).

In pregnancy, different and stricter limits apply. These are assessed by the doctor monitoring the pregnancy.

+What is hemoglobin A1c?

Since measuring blood glucose reflects sugar levels only at the moment of measurement, the best way to monitor good long-term regulation is through “hemoglobin A1c,” which shows—like an average—how well regulation has been maintained over the last three months.