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Every 5 seconds someone in the world develops diabetes, every 10 seconds someone dies because of it. Americans are starting to be more restrictive about blood sugar standards. They also change the approach to treating diabetes.
Despite advances in treatment, diabetes ranks fifth on the world’s list of causes of death. Why is this happening? Professor Krzysztof Strojek, a national consultant in the field of diabetes, explains that diabetes is not a question of high blood glucose levels, but a problem of its consequences. High glucose concentration causes changes in blood vessels and, consequently, damage to internal organs. Patients with diabetes are at risk of disability caused by damage to eyesight, kidneys, amputations, heart attack, stroke and, consequently, premature mortality. Many of them could be alive if they had been properly treated. Meanwhile, half of the patients do not even know that they are ill because initially they do not feel any ailments and do not seek help from a doctor. The professor emphasizes that the earlier the treatment is started, the lower the risk of complications.
Fighting with elevated sugar
The American Diabetes Association has changed the approach to treating diabetes. Until now, people with slightly elevated sugar were advised to change their diet and follow-up. Currently, such a flexible approach is being abandoned across the ocean. It used to be believed that special care and intensive treatment must be provided to patients who are ill for many years, who already have complications and require many medications. Today it is known that even a slightly elevated sugar in a previously healthy patient must be brought into line with the applicable standards. – It is very important to treat it intensively at the time of diagnosis, because the treatment of diabetes, including initial diabetes, determines whether the patient will have a heart attack and die after 15 years – says prof. Outfit. In addition, the risk of other diabetic complications is also reduced, the most dangerous of which are blindness, kidney damage leading to the need for dialysis treatment or kidney transplantation, and foot ulcers that can lead to necrosis and amputation..
Measurement of glycated hemoglobin
Americans adopted new ways to diagnose diabetes this year. In addition to the traditional measurement of fasting blood sugar after drinking a glucose solution, diabetes can also be diagnosed by measuring the value of glycosylated hemoglobin. The test involves taking blood from the patient’s finger. Diabetes is diagnosed when the test result is higher than 6,5%. Diagnosing diabetes based on the value of glycated hemoglobin is faster and less burdensome for the patient. He does not have to drink a whole glass of sweet juniper and wait for two hours for the test result. For some sick people, this is real torture. The result of the glycosylated hemoglobin test is immediately visible. The examination can be done in a doctor’s office. Unfortunately, this method is more expensive. In the US, such a test costs $ 10.
What is diabetes
The disease owes its sweet name to its basic symptom – too high blood glucose levels. The main cause of diabetes is the lack of, or a malfunction of, the hormone insulin produced in the pancreas. Insulin is responsible for the conversion of glucose consumed with food into energy needed for the work of every cell of the body, and thus for maintaining its proper concentration in the serum. Long-lasting high blood sugar levels destroy blood vessels, kidneys and eyes.
Treatment of diabetes mellitus
Therefore, treating diabetes is primarily based on maintaining an adequate blood sugar level by inhibiting glucose production or administering insulin. Patients may be given tablets that lower blood glucose levels. They limit the absorption of this sugar from the gastrointestinal tract, inhibit its production or accelerate burning. If this does not help, the diabetic is given insulin injections. – Medicines that we have at our disposal, when taken regularly, allow to bring the sugar level in patients to normal values - says prof. Outfit. The most important thing is that the patient should start therapy as early as possible. Modern medicine is based on the fact that treatment begins not when the disease is already causing ailments, that is “troubling” the patient, but when the test results are incorrect. Because we know that in a few years they will “result in” complications. Meanwhile, the complications of diabetes cannot be cured, only their further development can be stopped – emphasizes prof. Outfit.
Modern incretin drugs
A few years ago, new drugs that stimulated insulin production appeared on the market. They mimic the action of incretin hormones that stimulate the body to release insulin. These drugs do not cause an excessive reduction in blood sugar levels, which can happen with insulin or preparations of certain other groups. Hypoglycaemia or hypoglycaemia is manifested by weakness, impaired coordination of movements, coma and can lead to death. Incretin drugs only work when blood glucose levels are too high. In addition, some of them have a positive effect on the reduction of obesity – the nightmare of patients with diabetes. Professor Strojek explains that these are drugs intended for those patients in whom current therapies do not bring the desired results. Unfortunately, incretin drugs are not reimbursed in Poland. The cost of monthly therapy varies between PLN 300 and PLN 500. According to the Ministry of Health, they may be included in the reimbursement lists this year.
Text: Halina Pilonis