Overview
Type 2 diabetes mellitus is a chronic metabolic disease in which blood glucose levels are persistently elevated. It is caused by a reduced effect of the body's own insulin (insulin resistance), often combined with declining insulin production by the pancreas. The disease usually develops over years and initially causes no symptoms or only unspecific complaints. Left untreated, persistently high blood glucose can damage blood vessels, nerves, eyes and kidneys. Treatment is based on an adapted diet, regular physical activity and – where necessary – blood-glucose-lowering medication. Many patients with well-controlled type 2 diabetes primarily need reliable follow-up care: the regular review of blood glucose and laboratory values as well as repeat prescriptions for their existing medication. This is exactly where the video consultation comes in. After a medical assessment, a private prescription for your ongoing therapy can be issued, for example for oral antidiabetic drugs such as metformin. The video consultation complements care by your general practitioner or diabetologist – it does not replace it.
Common causes
Type 2 diabetes develops through an interplay of several factors. Hereditary predisposition plays an important role: if the disease occurs in your family, your own risk is increased. In addition, there are modifiable factors such as excess weight – especially increased abdominal fat –, lack of exercise and an energy-dense, low-fibre diet. Increasing age, high blood pressure, lipid metabolism disorders, smoking and persistent lack of sleep can also promote its development. In women, previous gestational diabetes is considered a risk factor. Certain medications, for example longer-term cortisone treatment, can additionally raise blood glucose. Diabetes is usually preceded by a years-long phase of borderline elevated blood glucose values (prediabetes), which often goes unnoticed. In many cases, an early change in lifestyle can slow progression during this phase.
When to see a doctor
Seek medical advice if you notice persistently increased thirst, frequent urination, marked tiredness, visual disturbances or poorly healing wounds – especially if diabetes runs in your family. If you have known type 2 diabetes, you should consult a doctor if your blood glucose values are repeatedly well above or below your target range, if side effects of your medication occur, or if an acute illness, for example a febrile infection, disrupts your blood glucose control. Warning signs of a severe metabolic derailment are impaired consciousness or confusion, very deep and rapid breathing, an acetone smell on the breath, repeated vomiting, severe dehydration and severe hypoglycaemia with seizures or loss of consciousness. In these cases, call the emergency number 112 immediately. New wounds on the foot, numbness or a sudden deterioration in vision should be examined promptly in a local practice.