Diabetes mellitus, also known as diabetes mellitus, is a chronic metabolic disease. With diabetes, there is too much sugar in the blood, and the body can no longer maintain the blood sugar level itself. There are several types of diabetes: gestational diabetes, diabetes caused by medication use, surgery or transplant, but the most common are type 1 diabetes and type 2. In both cases, the blood sugar is too high, but the types develop in different ways.
About 90% of people with diabetes have type 2 diabetes. In people with type 2 diabetes, the body produces too little insulin and/or there is insulin insensitivity, because the tissues have a certain insensitivity to the action of insulin (insulin resistance). ). Type 2 is common in overweight people, increasingly including young children and young people. The causes of type 2 diabetes are:
- Genetic predisposition
- Severe obesity
- Unfavorable fat distribution
- Lack of physical activity
- To smoke
- Nutritional Factors
The increase in the number of people with type 2 diabetes is mainly caused by a less active lifestyle and unfavorable eating habits, which lead to overweight.
Type 2 diabetes symptoms
The symptoms of type 2 diabetes are:
- Dry mouth
- Blurred vision
- very thirsty
- Pee a lot
- Bladder infections or fungal infections
Type 2 diabetes is more common than diabetes type 1 but also affects daily life.
Usually the diagnosis is established by the general practitioner. The doctor can determine whether your blood glucose is elevated with a blood drop and/or laboratory test. However, elevated blood sugar can also be discovered accidentally. If it turns out that you have type 2 diabetes, the doctor will start the treatment himself.
The treatment of type 2 diabetes
If you have type 2 diabetes, you usually first receive lifestyle advice: healthy eating, exercising more and losing weight, for example. Knowledge of healthy food is essential here, a dietician can support you. If this is insufficient, you can start taking tablets to lower the blood glucose level. It is possible that the blood glucose levels remain too high. In that case, the doctor advises you to start with insulin or another medication. You may then be redirected to the internist and diabetes nurse.
On the first visit you will be seen by the internist or diabetes nurse and a physical examination may take place. You will also be asked extensively about your history and your complaints, and blood tests will take place. The results will be assessed, which can be done within a few weeks. If there is no indication to the Department of Internal Medicine to continue treatment, we can refer you back to the general practitioner.
If it is decided to treat with insulin, the follow-up consultations will take place once every 3 months in consultation. One time you see the internist, the other time the diabetes nurse. Your blood will be drawn prior to these appointments. The result is discussed. Furthermore, blood pressure is measured and, if necessary, the results of the glucose meter/sensor are viewed. If everything goes well, you will be given another appointment in 3 months. If things are not going well, for example because you have hypos or blood sugars are too high, we may want to see you again sooner. We then look together at how we can improve glucose regulation. Sometimes this can be done with small dietary changes, sometimes the medication/insulin has to be adjusted.
Once a year, in the month in which it is your birthday, the check is more extensive. Your feet will be checked for abnormalities, your blood and urine will be checked further and, if indicated, we will make an appointment with the ophthalmologist. You can contact the ophthalmologist of the Jan van Goyen Medical Center for this. We also ask you to complete a questionnaire.
The diabetes team
The treatment revolves around you. With diabetes, good contact between our diabetes team and you is of great importance. We strive for guidance by the same doctor/nursing specialist, but situations may arise in which you are guided by one of the other colleagues.
Who will you be dealing with?
The internist treats the medical side of the diabetes and does an extensive physical examination, among other things. Based on the results of the examination, the internist proposes a treatment. The internist will refer you to the diabetes nurse and possibly other experts.
The nurse specialist
The nurse specialist is an independent practitioner with an independent authority. It offers an integrated treatment to patients and ensures continuity and quality of the treatment. Treatment includes both medical and nursing interventions. The nurse specialist works from a holistic perspective. This means that she focuses on the disease and on being ill, with you as a patient being the focal point.
The diabetes nurses
The diabetes nurse guides you in all matters related to your diabetes. For example, you suddenly have to think about all kinds of things that used to go automatically. What and when should I eat? What is the effect of this walk on my blood sugar? The diabetes nurse will teach you how to check your blood glucose and inject your insulin yourself. She specializes in insulin pump therapy and has experience with sensors. Ultimately, she and you will look at how you can manage your diabetes yourself as much as possible. It is also possible to remotely evaluate the blood glucose during a certain period of time in order to quickly arrive at a better setting.
The diabetes nurse also has a lot of knowledge in the field of adolescents and young adults with type 1 diabetes. So if you have just turned 18 and are ready to switch from the pediatrician to the internist, just come and meet us to see if it clicks.
The main reason for keeping blood glucose as good as possible is to prevent complications. If you have had diabetes for a long time and the sugars are not properly adjusted, various organs may not work as well:
Heart and vessels
In the long run, you run a greater risk of a heart attack or stroke. The vessels in the legs can also cause problems, such as shop windows or poorly healing wounds on the feet.
The small blood vessels in the retina can be damaged. If not treated by the ophthalmologist, it can lead to blindness in extreme cases.
The kidneys may not work as well. You will not notice this in the beginning. The risk of kidney damage is greater if you have had diabetes for years and are not well adjusted. That's why controls are so important.
Erectile dysfunction/libido loss
You are more likely to experience erectile dysfunction or loss of libido (earlier). This can have a physical and/or psychological cause.
You can develop joint problems, such as limited movement limitations LJM (limited joint mobility syndrome) or trigger finger.