Diabetes: Many People Talk About It And Even Suffer From It But They Don’t Know These Facts

“Diabetes is a disease caused by the accumulation of excessive levels of glucose (sugar) in the blood, which not only cause acute effects, but also chronic complications that can affect vision, circulation, kidneys, and heart,” explains Víctor Román, a doctor specializing in internal medicine and endocrinology.

Most of the food we eat is converted into sugar, also known as glucose, which is released into the blood. The pancreas produces a hormone called insulin, which acts like a key to open the doors of the cells so that glucose can enter and be used for energy.

When a person has diabetes, the body does not produce enough insulin or cannot use it properly, so a lot of sugar remains in the bloodstream, and, over time, this can cause serious health problems.

There are two types of diabetes: Type 1, in which the pancreas becomes ill and is critically damaged, so it stops producing insulin. The patient’s blood sugar levels rise and they must be treated as soon as possible because there is a risk of death.

In type 2 diabetes, the pancreas does produce insulin, even in excessive quantities, but it does not work properly, so a lot of insulin remains in circulation and levels begin to rise when measured. “This is why the term prediabetes was coined, which is a risk category in which a diabetes diagnosis can be made early and prevented,” says Román.

This type of diabetes was previously common only in adults, however, in recent years cases have already occurred in childhood.

Risk factors

According to Raúl Velasco, a pediatric endocrinologist and president of the Association of Endocrinology, Metabolism and Nutrition of Guatemala, the risk factors for suffering from diabetes during childhood are: having a family history of Type 1 Diabetes, being a carrier of genes associated with this type of diabetes and age, since there are two peaks of higher incidence: between 4 and 6 years, and between 10 and 14.

While adults are more likely to have diabetes if a close relative (parents or siblings) has also been diagnosed with the disease, those who are overweight, have poor eating habits, do not practice enough physical activity, or have had gestational diabetes – diabetes during pregnancy.

In both childhood and adulthood, the patient may not present any symptoms. However, when they do, it is common to feel very thirsty during the day, go to the bathroom to urinate many times, lose weight without exercising or eating healthy, or have vision problems.

These are indicators that your blood sugar is elevated, perhaps in the 300 to 500 range, when the normal fasting level is less than 100.

Treatments and care

Every November 14th, Diabetes Day is celebrated to give this disease the importance it deserves. This 2021, the theme of World Diabetes Day is access to care for this disease. Although Type 1 Diabetes cannot be cured, some treatments prevent its progression, and care can prevent it.

Diabetes medications are divided into oral and injectable. There are different methods of action, for example, when there is excess sugar in the urine, the goal of the medication is to help the kidneys eliminate the sugar, while other drugs help the pancreas function better.

Metformin is one of the most well-known and widely used drugs in Guatemala. It helps the liver produce less sugar and has an effect on the liver and intestines, and through other hormones, it helps the pancreas function better. It is also used to prevent diabetes.

Drugs called DPP4 cause more hormones to be produced that stimulate the pancreas to produce insulin. Some hormones cause this organ to produce insulin just when we eat. Meanwhile, sulfonylurea drugs cause more insulin to be produced, but this is not always recommended because it can tire the pancreas.

Insulin is the most powerful treatment because it has a direct effect on cells. “The treatment for type 1 diabetics is insulin, which must imitate the normal secretion of this hormone with the different types that exist commercially,” says Velasco.

Adult diabetic patients are generally overweight, so the medication used is also focused on weight loss or at least does not stimulate weight gain.

“The idea is to lower blood sugar, but also to make the medicine favor the goal of losing weight. We are trying to make simpler medicines, with fewer pills or fewer injections for the patient. Insulin injections with weekly effects are already being used so that the person can better achieve their goals,” says Román.

Beyond medicine, specialists say it is vital for patients to be physically active, for example, taking 10,000 steps a day or doing some other type of exercise, and to take care of their diet, that is, avoiding sugar and animal fats. This way, they will be successful in achieving their goal of good control, which is trying to keep their glucose levels below 100 when fasting.

Glucose monitoring is also required using glycosylated hemoglobin A1C, a medical test that indicates in numerical values ​​how the glucose was three months ago. Depending on these results, the type of treatment is chosen, to have blood sugar at values ​​of 6.5 in the next evaluation, or less than 7 if good habits are not strictly maintained.

When diagnosed during childhood, regular evaluations should be done with a multidisciplinary group consisting of a pediatric endocrinologist, nutritionist, psychologist, pediatric nephrologist, ophthalmologist, pediatric neurologist, and a diabetes educator, Velasco explains.