Diabetes, often simply referred to as “diabetes”, is a chronic disease that affects millions of people in Germany. It occurs when the body is unable to regulate blood sugar properly – either because too little insulin is produced or because the cells no longer respond to it. Laboratory medicine plays a key role in reliably diagnosing diabetes and finding the right treatment. But what exactly is diabetes, how do you recognize it and why are laboratory values so important? This article explains it clearly and comprehensibly.

What is diabetes?

Diabetes mellitus – the medical name – means that the blood sugar level is permanently too high. There are two main forms: Type 1 diabetes, in which the immune system destroys the insulin-producing cells in the pancreas, and type 2 diabetes, in which the body no longer uses insulin properly or makes too little of it. Type 1 often occurs in childhood or adolescence, type 2 usually later and is often linked to lifestyle factors such as obesity. Around 8 million people in Germany live with diabetes, most of them with type 2.

Signs that indicate diabetes

The symptoms can come on gradually or suddenly. Frequent thirst, constant urination, tiredness, poorly healing wounds or blurred vision are typical warning signs. With type 1, weight loss and weakness often occur quickly, while type 2 can go unnoticed for a long time. Because these signs could also have other causes, a precise diagnosis by laboratory medicine is crucial.

How is diabetes determined in laboratory medicine?

In Germany, laboratory medicine uses various tests to diagnose and monitor diabetes. It usually starts with a blood sample that is analyzed in a laboratory. Here are the most important methods:

1. Fasting blood sugar:
   Blood sugar is measured in the morning before eating, after at least 8 hours without food intake. If the value is 126 mg/dl (milligrams per deciliter) or higher – measured on two different days – this indicates diabetes. Values between 100 and 125 mg/dl are considered to be a preliminary stage (prediabetes).
   
2. HbA1c value:
   This value indicates the average blood sugar level over the last 2 to 3 months by measuring how much sugar is bound to the red blood pigment (haemoglobin). An HbA1c of 6.5% or more confirms diabetes. Values between 5.7 and 6.4 % indicate an increased risk. The test is practical because it does not have to be carried out on an empty stomach.
   
3. Oral glucose tolerance test (oGTT):
   Here you drink a sugar solution (75 grams of glucose) and your blood sugar is measured after 2 hours. If it is 200 mg/dl or more, this is a sign of diabetes. This test is often used if the other values are unclear or in pregnant women to check for gestational diabetes.
   
4. Random blood sugar:
   If someone has severe symptoms and their blood sugar is spontaneously above 200 mg/dl, this – together with symptoms – can already confirm the diagnosis.
   
5. Autoantibodies (for type 1):
   If type 1 diabetes is suspected, the blood is tested for antibodies (e.g. against insulin or pancreatic cells). These show whether the immune system is attacking insulin production.
   
6. C-peptide and insulin levels:
   These tests measure how much insulin the body produces itself. In type 1, the value is often very low, in type 2 it can be normal or elevated, despite insulin resistance.

From test to diagnosis

Blood sampling is uncomplicated – a small prick in the finger or a sample from the vein is usually sufficient. The values are analyzed in the laboratory using modern equipment, often within a few hours. Doctors compare the results with reference values and check whether they meet the diagnostic criteria of the German Diabetes Association (DDG). It is important to note that a single high value does not automatically mean diabetes – several tests are often combined to be sure.

Why is laboratory medicine so important?

Without laboratory tests, diabetes would be difficult to detect, especially in the early stages when symptoms are absent. In Germany, laboratory medicine helps to differentiate between type 1 and type 2, which is crucial for therapy: type 1 needs insulin immediately, type 2 often starts with lifestyle changes or tablets. The tests also show how well the disease is controlled and help to prevent secondary damage such as problems with the eyes, kidneys or nerves. Regular HbA1c checks are standard in order to adjust the therapy.

Diabetes in Germany

Diabetes is a major issue in this country – around one in ten people are affected and the numbers are rising. Type 2 accounts for around 90% of cases and is often linked to diet, lack of exercise and age. Thanks to laboratory medicine, the disease can be detected early, which significantly increases the chances of living well with diabetes.

Conclusion

Diabetes is a challenge, but laboratory medicine in Germany makes it manageable. With simple blood tests such as fasting blood sugar or HbA1c, the diagnosis is made, the cause clarified and the treatment monitored. This enables those affected to lead an active life despite diabetes. Laboratory medicine is the invisible helper that provides clarity and shows the way – a small prick with a big effect!

Editorial office: X-Press Journalistenbüro GbR

Gender note. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple references and gendered designations are avoided for the sake of better readability ected.