Diabetes is a chronic disease that occurs because the pancreas does not synthesize the amount of insulin that the human body needs, produces it of inferior quality, or is not able to use it effectively.
The insuline is an hormon produced for the pancreas. Its main function is the maintenance of adequate blood glucose values. It allows glucose to enter the body and be transported into the cells, where it is transformed into energy for muscles and tissues to function. In addition, it helps cells store glucose until its use is necessary.
In people with diabetes there is excess glucose in the blood (hyperglycemia) since it is not distributed properly. Specialists warn that, if patients do not follow the appropriate treatment, the tissues may end up damaged and very serious complications may occur in the body.
Diabetes type 1:
The most common ages at which it appears are childhood, adolescence and the first years of adult life. It usually occurs suddenly and often regardless of whether there is a family history.
The causes of type 1 diabetes are mainly the progressive destruction of the cells of the pancreas, which produce insulin. This has to be administered artificially from the beginning of the disease. Its particular symptoms are an increased need to drink and an increase in the amount of urine, a feeling of tiredness and weight loss despite an increased desire to eat.
Type 2 diabetes:
It generally arises at older ages and is about ten times more frequent than the previous one. As a rule, type 2 diabetes is also diagnosed or has been suffered by other people in the family.
It originates due to poor insulin production, along with insufficient use of this substance by the cells. Depending on which defect of the two predominates, the patient will have to be treated with antidiabetic pills or insulin (or a combination of both). In these cases, the patient does not usually present any type of discomfort or specific symptoms, so it can go unnoticed by the affected person for a long time.
Gestational diabetes:
It is considered occasional diabetes that can be controlled just like other types of diabetes. During pregnancy, insulin increases to increase energy reserves. Sometimes, this increase does not occur and can cause diabetes during pregnancy. It also has no symptoms and detection is almost always carried out after the routine analysis that all pregnant women undergo after 24 weeks of gestation. What does greatly increases the risk of developing diabetes after a few years.
Diagnosis:
The diagnosis of diabetes occurs when the patient has abnormally high blood glucose values. This analysis is usually monitored and measured during a routine annual examination or in a clinical examination performed before starting a new job or playing a sport.
Tests may also be done to determine the possible cause of symptoms such as increased thirst, urination, hunger, or whether there are characteristic risk factors, such as a family history of diabetes, obesity, frequent infections, or any other complications associated with diabetes. .
As Rebeca Reyes, coordinator of the SEEN Diabetes Mellitus Working Group, points out, the diagnosis of diabetes is made through a blood test. “The current diagnostic criteria, according to the American Diabetes Society in its 2015 recommendations, are as follows:
-Glycosylated hemoglobin greater than or equal to 6.5 percent.
-Basal fasting blood glucose greater than or equal to 126 mg/dl or blood glucose 2 hours after an oral glucose tolerance test with 75 g of glucose greater than or equal to 200 mg/dl.
All of them must be repeated twice, except when there are unequivocal signs of diabetes, in which case a random blood glucose level of ≥ 200 mg/dl is sufficient,” he specifies.
Evidence:
To measure the concentration of glucose in the blood, a blood sample is obtained from the patient, who must be fasting for at least 8 hours before the test.
It is normal for there to be some degree of elevation in blood glucose values after eating, but even then, the values should not be very high. In people over 65 years of age it is better to perform the test on an empty stomach since the elderly have a greater increase in blood glucose concentrations after eating.
There is another type of blood test, called an oral glucose tolerance test, that is done in certain cases, such as when a pregnant woman is suspected of having gestational diabetes.
In this test, a fasting blood sample is obtained to measure the glucose value and the patient is given a special solution to drink, which contains a standard amount of glucose. During the next two or three hours, several blood samples are obtained.
Treatment:
The treatment of diabetes mellitus is based on three pillars: diet, physical exercise and medication. It aims to maintain blood glucose levels within normality to minimize the risk of complications associated with the disease. In many patients with type 2 diabetes, medication would not be necessary if excess weight was controlled and a regular physical exercise program was carried out. However, insulin replacement therapy or oral hypoglycemic drugs are often necessary.
-Oral hypoglycemic drugs: They are prescribed to people with type 2 diabetes who cannot lower blood glucose through diet and physical activity, but they are not effective in people with type 1 diabetes.
-Treatment with insulin: In patients with type 1 diabetes, exogenous administration of insulin is necessary since the pancreas is incapable of producing this hormone. It is also required in type 2 diabetes if diet, exercise and oral medication fail to control blood glucose levels. Insulin is administered through injections into the fat under the skin of the arm, since if it were taken orally it would be destroyed in the digestive system before entering the bloodstream. Insulin needs vary depending on the food you eat and the physical activity you do. People who follow a stable diet and regular physical activity vary their insulin doses little. However, any change in the usual diet or participation in sports requires modifications to the insulin regimens. Insulin can be injected through different devices:
-Traditional syringes: They are single-use, graduated in international units (from 0 to 40).
-Insulin injection pens: These are pen-shaped devices that have a cartridge inside that contains insulin. The cartridge is changed when the insulin runs out, but the pen continues to be used.
-Pre-filled syringes: These are devices similar to pens, but previously loaded with insulin. Once the insulin runs out, the entire syringe is thrown away. The blood glucose level depends on the area of the body where insulin is injected. It is advisable to insert it into the abdomen, arms or thighs. It penetrates more quickly if injected into the abdomen. It is recommended to always inject in the same area, although moving the injection point about two centimeters from one time to the next. Avoid injections into skin folds, the midline of the abdomen, and the groin and navel area.