In Mexico, 13 percent of diabetes patients use insulin as a blood glucose control method.However, administering it to a lesser or greater amount than the required implies a risk that the patient suffers blood glucose increase (hyperglycemia) or low (hypoglycemia), which has repercussions at various levels in the body.
When the glucose rises, the possibility of a heart attack grows, and on the contrary, if the low sugar is a risk factor of dementia, hence the importance of administering insulin and its exact dose for the patient.This is indicated by Valentín Sánchez Pedraza, interim head of the Endocrinology Service of the General Hospital of Mexico.
According to the expert, more than half of the patients care about the risk of hypoglycemia and one in four presents this problem at least once a month.Because of the same cause, up to 20 percent of those mentioned, arrives soon or leaves the school or work, a condition that can be extended for two to three days.
In mild cases of hypoglycemia, the affected person has sweating, tachycardia, irritability, hunger or anguish, symptoms that can improve taking a natural juice.But if the complication occurs while the patient sleeps, he does not notice and may suffer convulsive crises and even reach myocardium infarction when the problem is recurring.
“Of the hypoglycemia, approximately 50 percent are nocturnal and in them there are electrocardiographic changes, such as arrhythmias and in some cases the heart rate occurs very slow (bradycardia), which increases the risk of sudden death.
“In addition, it is estimated that, on average, patients with insulinized type 2 diabetes have 23 mild hypoglycemia episodes per year.However, half of them do not report their doctor about it, ”he warns, the endocrinologist.
While the international scientific community points out that insulin is the most appropriate treatment for diabetes, which corresponds to each patient?
Dr. Sánchez Pedraza clarifies that there are various types, including the basal whose objective is to maintain glucose under fasting control, as the calls make the human insulins and their analogs.There are also prandial insulins that fulfill the goal that glucose does not rise after eating, of which you exist of the rapid type, those of prolonged effect, their analogs.There are also those that combine both types, basal and prandial.
“Determine what is indicated for the patient will depend on their characteristics, for example, on their age, if it has renal damage, if you have who is administered or use a device for it, the lifestyle and even the economic aspect, betweenOther factors.
“For doctors it is a complex issue, and even 76 percent recognize that it could recommend insulin to more patients if there were not the risk of hypoglycemia, that is, the sugar indicator is below 70 milligrams per deciliter (mg/dl) of blood.Ideally, in a lower range it is between 70 and 99 mg/dl, ”he emphasizes, the endocrinologist of the General Hospital of Mexico.
Finally, the specialist orders the patient with diabetes to create a communication bond with his treating doctor on the effects of prescribed insulins and even carelessness in the administration and their ways to do so, because it will depend on the results in the results in the results in theglucose controls.
