WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES. Living your life as normal as possible

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1 WHAT IS DIABETES MELLITUS? CAUSES AND CONSEQUENCES DEDBT01954 Lilly Deutschland GmbH Werner-Reimers-Straße Bad Homburg Living your life as normal as possible

2 What is Diabetes mellitus? DIABETES MELLITUS is a lifelong condition. In Germany at least 6 million people have diabetes. There are also 2-5 million people, who are undiagnosed and are not aware that they have the disease. IN SIMPLE WORDS: IF YOU HAVE TOO MUCH SUGAR IN YOUR BLOOD YOU HAVE DIABETES (GLUCOSE, HIGH BLOOD SUGAR). Glucose is an important energy source for the body. It is so important that your body will produce glucose if needed, although the majority comes from the food we eat. In diabetes, the blood vessels can be compared to an overflowing river, which cannot transport water and nutrients (sugar) to their destination (plants, etc.). This is because access to the fields is blocked, just like in diabetes, where glucose cannot reach the cells because of poor insulin action.

3 What is Diabetes mellitus? BLOOD SUGAR LEVELS IN THE BODY ARE CONTROLLED BY INSULIN, A HORMONE PRODUCED BY THE PANCREAS. Insulin facilitates entry of glucose into the cells of muscle, liver and fatty tissue. Diabetes develops, when the body has insufficient amount of insulin and glucose keeps accumulating in the blood. Medicinal products and, in particular, the appropriate lifestyle clean up the blood, ensure the proper functioning of the metabolism and prevent any potential long-term damage of organs. Fields cannot flourish without nutrients from the river; they only recover when they are fed water and nutrients. The same is happening in our body. It suffers, when the blood sugar is increased, but blood sugar levels can be improved with the appropriate treatment.

4 Types of diabetes IN TYPE 1 DIABETES T1 the insulin producing beta cells in the pancreas are destroyed. This causes the loss of insulin production and blood sugar cannot be regulated properly. This form of diabetes is always treated with insulin injections, to achieve the best possible blood sugar control. TYPE 2 DIABETES T2 is a mixed disorder: Insulin is not used effectively (insulin resistance), and the pancreas fails to produce enough insulin. This form of diabetes is initially treated with a balanced diet, exercise and weight loss. Further treatment also includes medication and, if necessary, insulin. There are also other forms of diabetes: GESTATIONAL DIABETES (occurs during pregnancy) Also some less frequent forms such as: GENETIC TYPES OF DIABETES DRUG INDUCED DIABETES (for example, during cortisone treatment) DIABETES CAUSED BY SOME DISEASES OF THE PANCREAS

5 What are the signs of diabetes? The signs of diabetes occur as a result of surplus glucose (elevated blood sugar). The main symptoms of diabetes are: FREQUENT URINATION FATIGUE EXCESSIVE THIRST WEIGHT LOSS LOSS OF VISION These symptoms may occur suddenly, particularly in type 1 diabetes. Type 2 diabetes, with no or only very mild symptoms, is of insidious onset and may not be recognised for several years. Type 2 diabetes is often discovered by chance through a blood test.

6 Risk factors for type 2 diabetes Some factors that may encourage the development of type 2 diabetes: OBESITY LACK OF EXERCISE AGE FAMILY HISTORY Type 2 diabetes in the family HIGH BLOOD PRESSURE PREGNANCY If diabetes has occurred during pregnancy Type 2 diabetes is caused by external influences (wrong diet, lack of exercise), as well as by the body itself (genetic predisposition). Many people can prevent or delay the onset of Type 2 diabetes by changing their lifestyle and habits.

7 The importance of good diabetes management Consistently high blood sugar levels can lead to complications, which may affect the heart, kidneys, nerves (particularly of the feet), blood supply to the brain and the legs as well as the eyes. The aim of diabetes treatment is to keep blood sugar levels as near to normal. Furthermore, all other risk factors that cause damage to the heart, kidneys, blood vessels and the eyes must be treated. In addition to the treatment of blood sugar, it is important to keep blood pressure and cholesterol levels low. It is also very important to quit smoking. Your doctor will help you with this. Taking good care of yourself can limit the symptoms of diabetes. It is also important to have regularly check-ups, for example of the heart, the eyes and the feet.

8 How do I know if my diabetes is under control? To check if your diabetes is under control, you can measure your blood sugar. Another option is the determination of the long-term blood sugar, the HbA 1c (glycated haemoglobin) test. The HbA 1c is a blood test done by your doctor and shows the average amount of sugar in your blood over the past 2-3 months. The current blood sugar can also be measured. For this, a drop of blood is taken from the tip of the finger and checked for the blood glucose level with a BLOOD SUGAR MEASURING DEVICE. This measurement can also be done at home, and can help modify the treatment. Your doctor will discuss with you whether blood glucose monitoring at home is suitable for you and how to do it.

9 A few figures for the diagnosis of diabetes. In healthy non-diabetics, fasting blood sugar should be below 126 mg/dl (7 mmol/l) and the HbA 1C below 5.7%. A fasting blood sugar above 126 mg/dl on at least two separate occasions and a glycated haemoglobin above 6.5% indicates you have diabetes. FASTING BLOOD SUGAR 126 mg/dl (7 mmol/l) Confirmed readings indicate diabetes mg/dl mg/dl mg/dl ( mmol/l) Impaired glucose tolerance, more test required mg/dl ( mmol/l) Normal blood sugar mg/dl mg/dl < 70 mg/dl (3.9 mmol/l) Hypoglycaemia: low blood sugar can be harmful, particularly in in older adults with diabetes BLOOD SUGAR AFTER MEALS Random blood sugar readings above 200 mg/dl are also an indication of diabetes. High blood sugar (fasting or spontaneous) on several occasions or in combination with an HbA 1c 6.5% indicates diabetes. German Medical Association (BÄK), The German Associations of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies in Germany (AWMF). German National Disease Management Guideline on the Treatment of Type 2 Diabetes - long version, 1st (Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes Langfassung, 1.) Edition Version

10 A few figures for the control of diabetes. GLYCATED HEMOGLOBIN (HbA 1C ) The HbA 1c test is the most reliable way to check whether your diabetes is under control. Target range for well controlled diabetes: 6.5% 7.5% (48-59 mmol/mol) Individual target levels are dependent on: - length of diabetes history - age of patient - concomitant diseases - type of treatment Please discuss your personal target levels with your diabetes team. The glycated haemoglobin (HbA 1C ) value can be expressed in two ways: in % or in mmol/mol (see the comparison table below). % mmol/mol Recommended blood glucose levels in diabetics: Fasting blood sugar: between 100 and 125 mg / dl ( mmol/l); Blood sugar 2 hours after a meal: 140 to 199 mg/dl ( mmol/l) German Medical Association (BÄK), The German Associations of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies in Germany (AWMF). German National Disease Management Guideline on the Treatment of Type 2 Diabetes - long version, 1st (Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes Langfassung, 1.) Edition Version

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