What is diabetes?
Diabetes is a disease characterized by an increase in the concentration of glucose in the blood because the pancreas does not produce, or the body does not use, insulin properly.
Insulin is a hormone essential for life. We all need insulin 24 hours a day in a continuous and variable way, i.e. we do not need the same amount of insulin at all times of the day. When a person eats, he needs more insulin and when he is physically active, he needs less.
The insulin factory is the pancreas, which is a gland located on the left side of the abdomen, very close to the stomach. From there, the insulin passes into the bloodstream to be distributed throughout the body.
Our bodies need energy to function, just as a car needs fuel. This energy can be obtained from the food we eat. Generally, half of what we eat contains carbohydrates (also called sugars or glucides), which, once they pass through the stomach and intestine, are transformed by digestion into glucose, which is the simplest sugar. When the 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 the cells, as if it were a key, so that the glucose can be used as a source of energy. Without insulin, glucose accumulates in the blood in excess and causes hyperglycemia. The glucose is eliminated in the urine, which leads to urinating in large amounts (called polyuria), and having to drink a lot of fluids (polydipsia). The lack of food in our cells causes weight loss and tiredness.
How is it diagnosed?
The diagnosis of diabetes is made through an analysis performed in the laboratory, measuring blood glucose. Diagnostic criteria are the detection of values of:
Fasting blood glucose was higher than 126 mg/dl in two different determinations.
Random blood glucose higher than 200 mg/dl accompanied by typical symptoms such as excessive thirst and frequent urination.
Values above 200 mg/dl, after an oral glucose overload (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 blood glucose, which is a prediabetic state.
Another diagnostic criterion is a glycosylated hemoglobin value greater than 6.5%. This protein estimates the average glycemia of the last 2-3 months.
Can diabetes be cured?
It is a chronic disease that can not be cured, for the time being, although there is an effective treatment that allows people to lead a practically normal life.
How is diabetes treated?
Although we will talk more extensively about treatment at another time, it is based on the balance of three factors: diet, drugs (either oral antidiabetic drugs or insulin) and regular physical exercise (especially in people with DM2). A person with diabetes should coordinate these three elements at all times so that glucose levels remain within normal values most of the time. To this end, capillary blood glucose should be measured with some frequency by means of a drop of blood from the finger. Diabetes education will enable this learning process so that people with diabetes can take an active part in making daily treatment decisions.
Diabetes can cause long-term complications due to vascular damage that can affect the eyes, kidneys, heart, brain, and feet, although these can be avoided with proper glycemic control.
Types of diabetes
The most frequent forms are DM 1 and DM2.
Gestational diabetes is a pregnancy-induced form of diabetes, which occurs in 3-10% of pregnancies. When the baby is born, diabetes may continue or be “cured”.
Diabetes is secondary to medications (corticosteroids, immunosuppressants,…). Diabetes is 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 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 the insulin-producing cells of the pancreas, usually by an autoimmune mechanism. Our immune system (which is what we know as defense) is designed to protect us from external aggression, but in this case, it becomes an aggressor and attacks our body, producing the inactivation of the beta cells of the pancreas. This results in an absolute insulin deficit, which is why it is ALWAYS essential to treat with insulin from the beginning.
Type 1 diabetes usually presents abruptly, with a marked increase in thirst (polydipsia) and urine output (polyuria), fatigue and weight loss (even after eating much more than usual).
Usually, type 1 diabetes occurs in isolation, but sometimes there is a family history.
So far, no treatments have been developed to prevent type 1 diabetes, although there is a lot of research in this field that will hopefully give results soon.
TYPE 2 DIABETES MELLITUS:
This is the most common form of diabetes, between 90-95% of all cases.
It is much more common to start in adulthood, hence the popular name of diabetes of the elderly, although it can start at any age. It is more frequent at older ages, and especially in obese people. In our environment, out of every 100 people, 8 have diabetes, although it is estimated that another 6% are unaware that they have the disease.
Type 2 diabetes mellitus (DM2) is due to the inability of the body to produce or adequately use its own insulin.
Type 2 diabetes usually results in generally less obvious symptoms than type 1 diabetes and often does not cause any discomfort and goes unnoticed for a long time. For this reason, many people find out about it by chance through routine tests performed for another reason (company check-ups, controls for another disease,…) If glucose values are very high, they may notice the typical symptoms.
Treatment may vary depending on the stage at which the disease has been diagnosed and its evolution. It will always be necessary to follow a healthy eating plan, which helps to control body weight, along with regular physical activity. It may be necessary to add medication (oral antidiabetics or pills) and sometimes, over the years, they may also require insulin.
It is frequent that other people in the same family also suffer from diabetes.
It is often associated with other cardiovascular risk factors, such as hypertension or lipid disorders (elevated cholesterol).
Unlike DM1, people at high risk for DM2 can prevent and/or delay the onset of DM2 by maintaining a healthy body weight and engaging in 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, nutrition and exercise are the basis of treatment, although oral antidiabetics and/or insulin may be needed later. Diabetics should learn everything they need to know about diabetes so that they can enjoy a long and healthy life thanks to the comprehensive treatment of their disease.