What is diabetes?
It is a disease that is characterized by an increase in blood glucose concentration because the pancreas does not produce, or the body does not use, insulin properly.
Insulin is an essential hormone for life. All people need insulin 24 hours a day in a continuous and variable, that is, you do not need the same amount of insulin at all hours. When a person eats, they need more insulin and when they do a physical activity they need less.
The factory of insulin is the pancreas, which is a gland located on the left side of the abdomen, very close to the stomach. From there, insulin passes into the circulation of blood to be distributed throughout the body.
Our body needs energy to function, just like a car needs fuel. We can obtain this energy from the food we eat. Generally, half of what we eat contains carbohydrates (also called sugars or carbohydrates), which, once passed to the stomach and intestine, are transformed by digestion into glucose, which is the simplest sugar. When carbohydrates are in the form of glucose, they pass into the blood and it is at this moment when insulin acts.
Insulin is necessary for glucose to enter cells as if it were a key, and thus glucose can be used as an energy source. Without insulin, glucose accumulates in the blood in excess and causes hyperglycaemia., and it is eliminated in the urine, which causes you to urinate in a large amount (what is called polyuria), and you must drink a lot of fluid (polydipsia). The lack of food in our cells causes thinning and fatigue
HOW IS IT DIAGNOSED?
The diagnosis of diabetes is made through an analysis performed in the laboratory, measuring the blood glucose. Diagnostic criteria are the detection of values of:
- Glycemia Fasting, greater than 126 mg/dl in two different determinations.
- Random blood glucose greater than 200 mg/dl accompanied by typical symptoms such as excessive thirst and frequent urination
- Values higher than 200 mg/dl, after an oral overload of glucose (or drink with 75 g of glucose).
Normal blood glucose values range between 70-100 mg / dL.
When the figure is between 100-125 mg/dl, it is considered an abnormal fasting glycemia, which is a pre-diabetic state.
Another diagnostic criterion is a glycosylated haemoglobin value greater than 6.5%. This protein estimates the average glycemia of the last 2-3 months.
IS DIABETES CURE?
It is a chronic disease that has no cure, for now, although an effective treatment that allows you to lead a practically normal life.
HOW IS DIABETES TREATED?
Although we will talk more about treatment at another time, it is based on the balance of three factors: diet, drugs (either oral antidiabetics or insulin) and regular physical exercise (especially in people with DM2). The person with diabetes must always coordinate these three elements so that the glucose is kept most of the time in normal values. To do this, you should measure capillary blood glucose with a drop of finger blood with some frequency. Dialectological education will allow this learning process so that people with diabetes can take an active part in making daily decisions about treatment.
Diabetes can cause long-term complications from vascular injury that can affect the eyes, kidneys, heart, brain, and feet; although they can be avoided with adequate glycaemic control.
TYPES OF DIABETES
- The most frequent forms are DM 1 and DM2.
- Gestational diabetes. It is a form of diabetes induced by pregnancy, which appears 3-10% of pregnancies. When the baby is born, diabetes can continue or be “cured.”
- Secondary diabetes: to medications (corticosteroids, immunosuppressants, …). Diabetes secondary to pancreatic surgery (total or partial removal of this organ)
DIABETES MELLITUS TYPE 1:
It usually begins in childhood or adolescence (hence the name of juvenile diabetes) but is not exceptional at other ages.
It represents between 5 to 10% of all cases of diabetes.
It is due to the destruction of insulin-producing pancreas cells, usually by an autoimmune mechanism. Our immune system (which are what we know as defenses) is designed to protect us from external aggression, but in this case, it becomes the aggressor and attacks our body producing the inactivation of beta cells of the pancreas. This results in an absolute deficit of insulin, so it is essential ALWAYS treatment with insulin from the beginning.
Type 1 diabetes tends to occur suddenly, with a marked increase in thirst (polydipsia) and the amount of urine (polyuria), fatigue and weight loss (despite having eaten much more than usual).
Usually, type 1 diabetes appears in isolation, but sometimes there is a history in the family.
So far, no treatments have been developed to prevent type 1 diabetes, although there is much research in this field that we hope will give results soon.
DIABETES MELLITUS TYPE 2:
It is the most common form of diabetes, between 90-95% of all cases.
It is much more frequent to start in adulthood, hence the popular name of diabetes in older people, although it can be started at any age. It is more frequent in more advanced ages, and especially in obese people. In our environment, of every 100 people, 8 have diabetes, although it is estimated that another 6% do not know that they have the disease.
Diabetes mellitus type 2 (DM2) is due to the inability of the body to produce or be able to use insulin properly.
Type 2 diabetes generally results in symptoms that are generally less evident than type 1 diabetes and often do not cause any discomfort, going unnoticed for a long time. For this reason, many people find out by chance through routine analysis performed for another reason (company reviews, controls for another disease, …) If the glucose values are very high, you may notice the typical symptoms.
The treatment may vary depending on the stage in which the disease was diagnosed and the evolution of it. Always follow a healthy eating plan, which helps control body weight, along with regular physical activity; It may be necessary to add medication (oral antidiabetics or pills) and sometimes, over the years, may also need insulin.
It is common for other people in the same family to also have diabetes.
It is usually associated with other cardiovascular risk factors, such as hypertension, or alterations of lipids (elevation of cholesterol).
Unlike DM1, people at high risk of developing DM2 can prevent and/or delay the onset of DM2 if they maintain correct body weight and perform regular physical activity.
Diabetes is a chronic disease because the pancreas does not produce, or the body does not use, insulin properly. Insulin is essential in type 1 diabetes, while in type 2 diabetes, diet and exercise are the basis of treatment, although oral antidiabetics and/or insulin may be needed later. The diabetic must learn everything necessary about diabetes so that he can enjoy a long and healthy life thanks to the integral treatment of his disease.