Diabetes complications are largely preventable, one of the first strategies in that regard is linked to education: knowing the disease and overcoming fears are key steps.With this objective, Dr. Juliana Mociulsky, head of the Area of Endocrinology and Diabetes of the Dr. Cormillot Nutrition and Health Clinic, spoke with the press and gave answers to the usual concerns related to diabetes.
Type 1 diabetes -----------------------------------
Type 1 diabetes occurs in increasingly young people and children, so parents are the ones who usually load a lot with concern.The incidence of type 1 diabetes in children under five are increasing.
Concern: The idea that the child will have to use insulin for life for parents is very traumatic, because insulin brings a historical message of poor evolution of the disease.
Answer: It should be understood that insulin is a wonderful resource for a disease that has a replacement of what is missing.
Concern: Parents are usually afraid of hypoglycemia, especially night hypoglycemia, in children.That is, the child is asleep, that he has a hypoglycemia and not realize.
Answer: Given this scenario, diabetological education is very important in terms of: insulin application schedules -which requires an organization by family -food and physical activity.
Another thing that is very useful is to seek help in associations for people with diabetes.In Argentina we have to take care, which is very helpful for parents who have children with type 1 diabetes.
Regarding food, the coordination between what is eaten and the insulin that is applied is essential.Two keys of food must be taken into account: distribution and composition.The food in people with type 1 diabetes has to be, preferably, distributed throughout the day in six meals.In addition, it is necessary to lower the amount of carbohydrates in the diet, without eliminating them, and increase the fibers.
On the other hand, recreational physical activity in children with type 1 diabetes helps regulate blood glucose and have a lifestyle as close as possible.
Concern: Not to completely control diabetes and suffer relapses.
Answer: Chronic disease involves having relapses at some point.This is normal to happen and what is important is how to get out of relapse and, eventually, learn from error.The expectation is not that the control of diabetes is perfect over the years but to be as close as possible to the goal of glycosylated hemoglobin, which will depend on each patient, but ranging between 6.5 and 7,5.
Type 2 diabetes -----------------------------------
Type 2 diabetes is the most frequent.80% of those affected by the disease suffer from this type of diabetes, which is associated with obesity and lifestyle.For this reason, the most important weapon against type 2 diabetes is prevention.
Concern: Do I have a risk of diabetes?
Answer: The population considered risk is made up of: people over 40;those that have a family history of this disease;Women who have had a son with weight greater than four kilos or diabetes of pregnancy;People who have associated diseases (such as coronary heart disease or high cholesterol, which can imply that this person is at risk of metabolic syndrome and, therefore, diabetes);People with obesity and sedentary.This population should be carried out, at least once a year, a laboratory study that includes blood glucose.
Concern: I amPart of the population at risk of diabetes.Can I prevent disease?
Answer: Yes. The most important thing is to maintain adequate body weight, which is the one that is guided with the doctor;Stay active and perform medical controls.
Concern: I have type 2 diabetes and more than 30 years will I suffer problems in my sex life?
Answer: is something that can happen.However, the prevention of chronic complications will depend on metabolic control.That is, a diagnosis of diabetes diagnosis but that achieves good control of their glycemia can prevent this type of chronic complications.
Concern: I have type 2 diabetes, will I be able to have children?Will I transmit the disease to my son?
Answer: Yes, but it is necessary to make a planned pregnancy.This means reaching pregnancy with a glycosylated hemoglobin less than 7% and adequate body weight (or, at least, lose some weight to be able to get pregnant), control that there is no urinary infection and that the pressure is under control.In addition, you have to lower salt consumption and adjust the treatment, which will be safe with insulin.
Concern: I don't have diabetes, do I run the risk of suffering it if I pregnant?
Answer: women who are at risk of gestational diabetes are those who suffer obesity, or who have a family history of diabetes, or who have had another son who weighed more than four kilos (although he did not have diabetes in thatpregnancy).
Concern: I am more than 50 years old and type 2 diabetes Am I prone to disability for a cardiovascular event or a stroke (stroke)?
Answer: To reduce the risk of cardiovascular events or stroke it is necessary to control, in addition to diabetes, the variables linked to associated diseases.For example, you have to focus on cholesterol control and blood pressure.It is essential to ensure that all these variables are controlled, basically with detection and medication.
Concern: Are you going to amputate my foot or will I be blind for having type 2 diabetes?
Answer: Education is very important in this regard.There are those who believe that by the mere fact of suffering diabetes they have "diabetic foot."However, diabetic foot is called to the foot when it hurts.
It has been clearly demonstrated that glycemic control allows to prevent microvascular complications, such as diabetic foot, retinopathy or nephropathy.
Concern: I suffer diabetes and lately I feel depressed.Is it something passenger?
Answer: There are two key questions that we can ask professionals who attend to diabetic patients to detect depression: In the last month, have you felt little interest or feel less pleasure in doing your things?And did you feel depressed, low or tired in the last month?These two questions serve for rapid detection.
There is a high percentage of depression associated with diabetes and is more frequent in women.It is estimated that the approximate prevalence of depression in the general population is 16% and, in people with diabetes, is between 29% and 40%.
Depression alters the control of diabetes in different ways: one of them is that the depressed patient does not go to the doctor or lack of consultations.Another is that it does not take the medication, or that it does not meet the food plan, that it does not want to do physical activity, that blood glucose is not measured and that the feet are not taken care of.
If a patient is depressed, he cannot do anything based on his care, therefore, any intervention that is tried will fail.That is why it is important to detect and treat it.
In the treatment of depression there are psychotherapeutic measures, the group approach also helps, but many times themedication.
By Agustina Sucri - Diario La Prensa
