Different forms of diabetes are distinguished. The two most common forms are diabetes mellitus type 1 and type 2.
In type 1 diabetes, autoantibodies are the cause of the destruction of insulin-producing cells, the beta cells, in the pancreas. In the course of the disease, insulin deficiency occurs and diabetes is the outcome. This form of diabetes is classified as an autoimmune disease. The exact causes have not yet been determined.
In type 2 diabetes mellitus, insulin resistance increasingly develops, that means that insulin is actually present in sufficient quantities or initially even in excess, but its effect on the body or the target cells is no longer sufficient to keep blood glucose within the normal range. Type 2 diabetes mellitus is a systemic disease (the whole body is affected). This is associated with increased inflammation in the body (called “silent inflammation”). Furthermore, increased oxidative stress can be detected by laboratory chemistry. This can be triggered by many causes and chronic inflammatory processes in the body are observed (measurable by laboratory chemistry, e.g. by increased levels of hsCRP, TNF alpha or interleukin 1 or 6). As a result, damage occurs to all organs, especially the kidneys, the eyes and the vascular wall. The occurrence of vascular diseases is frequent (heart, brain, carotid artery, legs, etc.). The affected persons usually underestimate the significance of a newly diagnosed diabetes mellitus type 2, because at the beginning there are “only” elevated blood sugar values and there is no suffering (yet).
Within the framework of my consultation hours, I try to carry out modern diabetes therapies for diabetes mellitus type 2.
- A reduction of insulin resistance
- A therapy that positively influences weight loss and does not lead to weight gain (note: insulin administration leads to weight gain and reinforcement of insulin resistance)
- A treatment of all other risk factors including environmental factors
- Optimal compensation of vitamin and trace element deficiencies
- Elimination of chronic inflammatory foci in the body
According to the guideline, I prefer to use metformin as the primary therapy and, if this is not sufficient, I prefer combinations with SGLT-2 inhibitors and GLP-1 analogues as opposed to insulin as the next step. These have been shown (LEADER study and EMPA-REG study) to reduce severe cardiovascular events (e.g. myocardial infarction, stroke) and also microvascular events (e.g. eye complications, renal failure). Furthermore, they have a positive effect on the heart. How this works exactly has not yet been conclusively clarified. GLP analogues (e.g. liraglutide) seem to have anti-inflammatory and anti-atherosclerotic properties and have a positive effect on the innermost layer of the vessels (endothelium). SGLT-2 inhibitors seem to achieve their positive effects through an interplay between the heart and the kidneys. In principle, more and more professional societies recommend the use of these substances in patients with cardiovascular diseases and atherosclerosis in addition to standard therapy (in the absence of contraindications).
In addition to the conventional medical therapy (blood sugar control, lipid metabolism and vessels check, etc.) I also examine trace elements (in diabetes especially vanadium is quite interesting) and vitamins. Furthermore, depending on the clinic, I test for various viruses, bacteria and parasites, check the function of the mitochondria (power plants of the cell) and the load of the body with environmental toxins. I then create an individual therapy plan for you, which takes various factors into account, and combine methods of conventional medicine with sensible methods of complementary medicine.