Diabetes Mellitus
What is it?
Diabetes is a chronic disease in which there is an increase in blood sugar levels that the body is unable to bring back to normal.
This condition may depend on a reduced production of insulin, the hormone produced by the pancreas to use sugars and other components of food and transform them into energy, or on the body's reduced ability to use the insulin it produces.
High levels of glucose in the blood, if not corrected with appropriate therapy, can over time promote the appearance of chronic complications of the disease, such as damage to the kidneys, retina, peripheral nerves and cardiovascular system (heart and arteries).
It is possible to live with diabetes, but it is essential to know what makes glycemia rise or fall in order to keep it as close as possible to normal levels and avoid or delay the onset and progression of chronic complications that unfortunately worsen the quality of life.
Causes and risk factors
Diabetes is a common disease that affects 3-5% of the general population in Italy. In some countries of Northern Europe or North America, it may even affect 6-8% of the population. The worrying thing is that cases of diabetes are constantly increasing, probably due to the increase in obesity and sedentary populations. According to the World Health Organization, in the year 2030 there will be 360 million people with diabetes in the world, compared to 170 million in 2000. This is with major repercussions on the lives of patients and their families, and on the health systems that provide care for patients.
Anyone can be affected by diabetes, although the likelihood of developing this disease is greater if you have a first-degree relationship (parents, children, siblings) with a person with diabetes.
Which are the symptoms?
People with undiagnosed diabetes often have one or more of these symptoms:
- intense thirst with the need to drink frequently;
- need to urinate frequently or get up at night to urinate;
- weight loss;
- increased appetite;
- vision disturbances (difficulty focusing on objects, blurred vision);
- difficult healing of small wounds especially in the lower extremities;
- unusual sense of fatigue.
In some cases, there are no obvious symptoms because blood sugar rises slowly and gradually. This happens mostly in type 2 diabetes and means that a person can live for months or years without knowing he/she is diabetic and therefore without taking proper care.
How is it diagnosed?
Suggested exams
How is it treated?
All diabetic patients and their families should have a good knowledge of the different aspects of the disease. For this reason, information meetings offered by diabetes centers or patients' associations are important. It's very important for people with diabetes to be aware of their disease, to be familiar with the medications they may be taking to treat their diabetes and their main side effects, and to be prepared to deal with unforeseen events or special situations such as occasional illnesses, changes in meal times, travel, or planning a pregnancy.
A key aid to maintaining good blood sugar comes from the use of blood glucose meters. These are simple and reliable instruments that allow you to measure blood glucose on capillary blood obtained from the fingertip puncture, in total autonomy and at any time of day. The indication to perform blood glucose measurements and the frequency of measurements vary from case to case in relation to the type of diabetes, therapy and the degree of metabolic compensation.
In addition, people with type 1 or type 2 diabetes should modify their lifestyle to have a healthy diet and practice regular physical activity.
In general, it is recommended that diabetic patients should:
- follow a balanced and equilibrated diet;
- for overweight or obese people lose weight with the help of their doctor and dietician;
- do physical activity regularly because physical exercise improves the action of insulin and increases the consumption of glucose helping to lower blood glucose.
Pharmacological therapies
In patients with type 1 or type 2 diabetes, maintaining a good control of glycemia allows to prevent or delay the onset and slow the progression of chronic complications of diabetes, i.e. damage to the kidneys, retina, peripheral nerves or the cardiovascular system. For this reason it is necessary to carry out regularly:
- diabetes specialist check-ups (approximately every 3 months if on insulin therapy, 1 or 2 times a year if on oral hypoglycemic therapy or with only lifestyle modification, i.e. diet and exercise);
- blood and urine tests (approximately every 3-6 months for tests related to glycemic control, annually for tests related to cardiovascular risk factors or renal function);
- ophthalmic examinations for the evaluation of the ocular fund (once a year).
The frequency of visits will be established for each patient based on the type of diabetes and prescribed therapy (lifestyle modification, oral medications or insulin), the degree of metabolic control, the possible presence of complications or other concomitant diseases.
Regular check-ups allow to identify the complications of diabetes at a very early stage and, therefore, to start an adequate treatment when it is still possible to limit organ damage.
Suggested procedures
Where do we treat it?
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