Unlike type 1 diabetes, type 2 diabetes usually shows fewer typical symptoms and is therefore usually discovered late in life. Often, nonspecific symptoms occur, such as fatigue, weakness and reduced performance. Frequent urination and an increased feeling of thirst can also be signs of diabetes: Above a certain blood sugar concentration, excess glucose is excreted through the urine (known as the renal threshold). The sugar-containing urine draws in more water than usual, so sufferers now have to urinate much more often than before. The body compensates for the loss of fluids by producing a strong feeling of thirst.
Other diabetes symptoms can be:
- Itch
- constant feeling of hunger
- Weight changes
- depressive mood
- recurrent urinary tract infections
- poorly healing wounds.
Hyperosmolar coma
Rare, but typical of type 2 diabetes is hyperosmolar coma: when blood glucose levels are extremely high, the kidneys excrete so much fluid that the body can no longer compensate for the loss by drinking. The fluid deficiency is on average eight to twelve liters. The body becomes increasingly dehydrated; there may be impaired consciousness or even coma. The causes of hyperosmolar coma are often infectious diseases, treatment with diuretics or the ingestion of highly sugary food.
Diagnosis: Recognizing diabetes
In order to detect type 2 diabetes as early as possible, it is important to attend regular screenings and check blood glucose levels. This is especially true if you have an increased risk of diabetes. During the test, the doctor will examine your blood, measure your blood pressure, and check your height and body weight. If diabetes goes unnoticed for years, cardiovascular disease, damage to the kidneys and eyes, and dangerous circulatory problems in the feet and legs can develop. However, if diabetes or its preliminary stages are detected in time and treated appropriately, the disease and its sequelae can be avoided.
For the diagnosis of diabetes, the doctor measures the following values:
- Fasting blood glucose
- Occasional blood glucose (blood glucose measured at any time)
- oral glucose tolerance test
- Long-term blood glucose (HbA1c value)
Fasting blood glucose
The value is determined in the morning before breakfast, i.e. on an empty stomach. You should not eat anything for at least four hours before the blood collection and also avoid caloric drinks, coffee, black tea and smoking. Fasting blood glucose or fasting glucose proves the presence of diabetes when the value is at least 126 mg/dl or. 7.0 mmol/l in the blood plasma amounts to. Values between 110 and 125 mg/dl are considered borderline. It is possible that a pre-stage of diabetes is present (impaired glucose tolerance). For further testing, an oral glucose tolerance test (sugar load test) is often performed.
Oral glucose tolerance test
This test is used to detect pre-diabetes stages in which blood glucose is elevated only intermittently – especially after eating. Three days before the test you should eat a normal diet with sufficient carbohydrates and refrain from smoking. The test is carried out in the morning in an empty state, i.e. you should not eat anything 10 hours beforehand. For the test, drink a liquid containing 75 g of sugar. Blood glucose is measured before and two hours after drinking. If after two hours it is at least 200 mg/dl resp. 11.1 mmol/l, diabetes is present.
Occasional blood glucose
If diabetes is present, the occasional blood glucose is at least 200 mg/dl or. 11.1 mmol/l.
Long-term blood glucose (HbA1c value)
HbA1c (glycohemoglobin) is the pigment in red blood cells (hemoglobin) that is linked to sugar residues. This value shows how high the concentration of blood glucose has been in the last six to eight weeks, and is therefore also called long-term blood glucose or blood glucose memory. Diabetes exists when the HbA1c- value is at least 6.5 % or. is 48 mmol/mol. The value is also important during the course of diabetes treatment: an elevated HbA1c indicates poor blood glucose control.
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