The integral approach, the individualization of the treatment, the improvement of the adhesion and the education of the patient are the main challenges in diabetes that have identified the more than 450 expert doctors gathered these days in Madrid.
In type 2 diabetes (DM2) therapeutic adhesion is crucial.But only between 30 percent and 50 percent of patients who take oral antidiabetics and only 25 percent of the insunity meet the treatment.And the worst compliments are young people, who will also have a greater risk of developing cardiovascular complication.
This has been shown by the specialists gathered in Diabento, a symposium organized by Esteve where more than 450 doctors from all over Spain have analyzed the current and future challenges of the DM2 from a multidisciplinary perspective.
The lack of adhesion is one of the main causes of bad metabolic control and is associated with greater morbidity and cardiovascular mortality in DM2.
"Those who control their illness are young patients. We must pay greater attention to diabetics between 40 and 50 years old, because they will have DM2 for more years and this will result in a higher risk and a more early appearance of chronic derived complicationsof diabetes, especially cardiovascular type, "according to Edelmiro Menéndez, president of the Spanish Diabetes Society and Diabento Scientific Coordinator.
Patient's education in the control of their illness is fundamental.The treatment in DM2 is for a lifetime and, in addition to adhesion to pharmacological therapy, lifestyles modification is essential.It must be integral, taking into account all cardiovascular, and individualized risk factors, according to the characteristics and medical history of each patient.
Early debut due to childhood obesity
The latest epidemiological studies show that prevalence is growing: in the world there are almost 400 million diabetics and forecasts are almost 600 million in 2035. This is an increase of almost 50 percent in 20 years.
In addition, "for ten or fifteen years we are seeing that the DM2 appears every time at earlier ages, over the 30s, something that did not occur before," according to Menéndez.
The important increase in the prevalence of DM2, especially among young people, is directly related to the increase in obesity and overweight."There is a pathogenic relationship between obesity and the development of insulin resistance that conditions the appearance of type 2 diabetes. And what we have to do is prevent."
Currently, Spain is the European Union country with the highest childhood obesity index.In addition, "80 percent of patients with DM2 are obese and the rest is overweight. Less than 10 percent have a normal weight," said the expert.
diabetes and cardiovascular risk
The poorly controlled DM2 is a risk factor of cardiovascular complications.In fact, the main cause of death in these patients is cardiovascular disease (ECV), responsible for 86 percent of deaths and 75 percent hospitalizations.In turn, DM2 is, in itself, a risk factor for appearance, development and poor prognosis of ischemic heart disease and heart failure.
