Diabetes presents worldwide differences that affect the risk of suffering from this disease, infradiagnosis and the evolution of some of its complications.These inequalities are caused, on many occasions, for educational, economic and sociocultural reasons.

Therefore, the 2017 Campaign of World Diabetes Day has promoted the importance of affordable and equitable access to essential medicines and technologies, self -control education and information required by all women at risk or living with diabetes so that they canGet optimal results in your illness, and reinforce your ability to prevent type 2 diabetes.

Among the factors that mark gender differences, for example, a diet and poor nutrition, physical inactivity and a delay when looking for health care.

In this 2017 edition the motto of World Day has been ‘Women and Diabetes: our right to a healthy future’.Sonia Gaztambide, president of the foundation of the Spanish Society of Diabetes (FSED), has commented that “gender roles and power dynamics influence vulnerability to diabetes, affect access to health services and behavior in the behavior in theWomen's health search, and amplify the impact of diabetes on women. ”

“Women are more vulnerable to this disease because they are more exposed to risk factors, such as less healthy nutrition and lower physical activity, especially in developing countries;In addition, because of socio -economic inequalities, women seek medical attention more late and, even, in certain countries, they have less access to medical services, ”he added.

Perhaps in Spain gender differences are not so evident, but in other countries serious deficiencies are produced regarding gestational diabetes screening in all pregnant women, the recommendations to perform a regular physical activity and even, in some cultures, women womenThey are prohibited from exercising in public spaces.In this sense, María Ángeles Martínez de Salinas, head of the Endocrinology Section of the San Pedro Hospital (Logroño), analyzes the peculiarities that occur in Spain: “These differences are much lower, but certain inequalities in health persist, especially, to disadvantaged socioeconomic situations, which occur more frequently in the female population.It is shown that this circumstance entails a greater risk factor of developing diabetes, worse control of the disease and lower adhesion to treatment. ”

The president of the FSED emphasizes that “education is not done equally in all autonomies, in the same way that access to reactive strips necessary for control is not the same in all autonomous communities;And there is also no equity in access to continuous monitoring systems. ”

"feeding guardians"

Martínez de Salinas considers that "women, worldwide, can play a fundamental role in diabetes prevention", since they play the role of "feeding guardians at home.""Knowledge should be offered to transmit that ability to prevent or delay type 2 diabetes, and help in the adoption of healthy lifestyles that improve their health and that of their families."

Regarding self -care, this specialist comments that "many women are key in the health care of others, but sometimes it is difficult for them to take care of themselves."It is necessary to train women about adequate diet, regular exercise and the correct taking of medication for optimal disease control.Likewise, healthy behaviors must be promoted before and during pregnancy, andAdvise gestation planning with optimal metabolic control.

self -control and treatment of treatment

The World Health Organization (WHO) considers diabetes a pandemic, which, if not properly controlled, produces very serious complications such as cardiovascular diseases, kidney disorders or diabetic retinopathy with loss of vision.In fact, diabetes is considered one of the main causes of death in Spain due to the important risk of developing cardiovascular disease.A patient with diabetes has a risk to five times greater of suffering a cardiac pathology.

In this sense, Sonia Gaztambide, president of the FSED, clarifies that "type 2 diabetes is in itself a cardiovascular risk factor" and that "hyperglycemia and insulinor resistance of diabetes have a direct effect and produce arteriosclerosis, soas alterations in blood coagulation and vascular endothelium with the consequent cardiovascular complications. ”

Also Ana Mateo, manager of the Diabetes Foundation, talks about the control of risk factors, because "there are diabetes 365 days a year and 24 hours a day" and adds "in a few pathologies the success of the treatment depends so muchof self -control by those who suffer from it as in diabetes.Both the patient and their relatives must have, among others, knowledge about the measurement and control of the blood glucose level, the administration of insulin or other drugs, the prevention and treatment of episodes of hypoglycemia and the necessary habits to avoidThe overweight.Therefore, diabetes formation is key. ”

socioeconomic inequalities

The International Diabetes Federation blames to certain socio-economic conditions the fact that girls and women with diabetes face barriers in access to cost-effective prevention, early detection, diagnosis, treatment and attention, especially in developing countries.Socio -economic inequalities expose women to the main risk factors of diabetes, such as poor diet or nutrition, physical inactivity, tobacco consumption and harmful use of alcohol.

Two out of five women with diabetes are of reproductive age, which represents more than 60 million women worldwide.Women with diabetes have more difficulty conceiving and can have bad results in pregnancy.Without prenatal planning, type 1 and 2 diabetes can cause a greater risk of maternal-infant mortality and morbidity.

It is also highlighted that approximately 1 in 7 births are affected by gestational diabetes (DMG), a serious threat and unattended for maternal-infant health.Many women with DMG experience complications related to pregnancy, such as high blood pressure, great weight and childbirth complications.A prominent number of these women will also develop type 2 diabetes later, leading to more health complications and expenses.Half of women with a history of gestational diabetes can develop type 2 diabetes between 5 and 10 years after childbirth.

Another characteristic of diabetes in women is that it has a greater risk of cardiovascular disease with respect to the male."It is speculated that there may be differences in the way that hormones and inflammation act to develop cardiovascular disease, in addition to management of less aggressive cardiovascular risk factors in women in certain countries," says María Ángeles Martínez de Salinas.

Even symptoms in women also delay their diagnosis, as this specialist points out, who says that “the prognosis of a cardiovascular event in women withDiabetes is worse, "also adds" women have more atypical or almost non -existent coronary disease symptoms and go to emergency services more late, complicating the fact that the tests for diagnosis are less precise than in men”

Diabeteslab: Training with recreational activities

On the occasion of World Diabetes Day, held on November 14, the Diabeteslab exhibition, aimed at patients, family and general public, was organized in the Circle of Fine Arts of Madrid.The Spanish Diabetes Federation (Fede) and the Diabetes Foundation, with the support of the Spanish Diabetes Society (SED) and the SED Foundation, promoted by Novo Nordisk and with the collaboration of Grupo Saed have participated in this initiative.

The objective of this exhibition has been that the visitor could learn, understand and know the prevention, approach and treatment of diabetes.To do this, different audiovisual and interactive recreational resources, workshops for children and adults, etc. have been available, etc.

videos and games

The exhibition was designed for patients and companions of all ages, true protagonists of this initiative.Among the elements arranged in this diabetes trip, a photographic and audiovisual schedule that reviews the history of diabetes from its first treatments to the present.In these videos, various professionals explain the scope of diabetes, the treatments and lifestyle of the person with this pathology.

Fede Societies and the Diabetes Foundation had a consultation and information space for all interested parties.

One of the biographical documentaries portrays the process that parents and a two -year -old child pass since they detect type 1 diabetes to the child until today.Another documentary reflects the experiences of seniors with type 2 diabetes.

In the children's area, children could express their sensations at an educational game table, with colored papers that later stuck on the wall, among many other activities.Through the drawing, the little ones expressed their feelings and fears in relation to this pathology.

Diabeteslab promoters have stressed that the incidence of this pathology continues to grow both in Spain and in most countries.If it is not controlled properly, it can produce serious complications.Therefore, the education and awareness of the population are key to the control of diabetes and risk reduction.

The presentation act has been chaired by Olga Insua, general director of Novo Nordisk Spain and president of the Diabetes Foundation, who has recognized that with this exhibition he has fulfilled “the dream of bringing diabetes closer to citizens to help them understand andKnow this chronic pathology. ”

“In Novo Nordisk we have been taking care of diabetes for almost a hundred years.Since I assumed the company's direction in Spain I was around this idea in my head.Our intention is that both people with diabetes and without diabetes and their families are the true protagonists.It is one of our challenges as a company, to promote citizen participation and involvement in diabetes prevention and care, as well as improve the quality of life of people who suffer from it. ”

Also, they have intervened in the presentation John Nielsen, ambassador of Denmark in Spain;Carmen Martínez, representative of Madrid Health of the City Council, as well as various spokesmen for scientific societies and associations of patients such as Andoni Lorenzo, president of the Fede;Anna Novials, president of thirst, and Sonia Gaztambide, president of the SED Foundation.

In his speech, Anna Novials hasRemember that "diabetes has a growing epidemiological, social, economic and health importance."“The knowledge of it is in an important phase of evolution and progress.And in this process the therapeutic education in diabetes has become an essential role, ”added the president of the thirst.

For his part, Andoni Lorenzo, president of the Spanish Diabetes Federation, has praised the initiative of the exhibition, which collects information about the pathology, the causes, testimonies of people with diabetes, the opinion of the experts, etc.“The exhibition is designed to facilitate understanding and expand knowledge about diabetes, while encouraging healthy life habits.And not many people, including patients, know the disease with depth. ”

The voice of patients

Another aspect that marks diabetes is the feeling of guilt that patients have, as has been proven in the meeting 'Once upon a time ... diabetes', organized on the occasion of the Diabeteslab exhibition and in which various relatives and patients have participated with patients withThis pathology.Eusebio Díez, patient with type 2 diabetes, has talked about the 'challenge walking through diabetes', and has talked about the worst phase: “At first you take a goodbye, because you are also obese and have cholesterol, but I have an environment that Ihelps overcome it. ”

The International Diabetes Federation indicates that stigmatization and discrimination facing people with diabetes are particularly pronounced in women and girls, especially in some developing countries, which entails a double burden of discrimination due to their state ofhealth and inequalities perpetrated in societies dominated by men."These inequalities can dissuade girls and women to seek a diagnosis and treatment and prevent positive health results," says Sonia Gaztambide.

In this same day, Francisco Tapias, patient with type 1 diabetes, has referred to the impressions he collects in his blog 'Diabetes is not my limit', where he addresses related issues from the diagnosis to the knowledge of the disease, and tries to demystifyConcepts to train the patient with confidence in the future.Of course, Tapias acknowledges that "diabetes changes your life.""With 17 years you have to make professional decisions and it conditions you, until you take the reins of your life and you realize that what you want can be done."

In general, patients and relatives ask for "more training" to better know diabetes, their causes, their risk factors, their treatment and, above all, the novelties that occur in the therapeutic and pharmacological field.For his part, Beatriz Vega, an amateur athlete, comments that sport helps him improve control: "I need less dose and get weight loss."Finally, Fran Carratala, professional cyclist of the Team Novo Nordisk team, has recommended to practice more sport, because "it facilitates coexistence with diabetes."