Diabetes, the harm of sugar

 

Diabetes is the fourth-biggest cause of death in developed countries, with the World Health Organization (WHO) estimating that it will affect over 360 million people globally by 2030. Despite this, many people are uninformed of the disease's symptoms and implications.

What is diabetes?

Diabetes is a global chronic disease that is on the rise. In France, 5.2 percent of the population, or 3.5 million individuals, had diabetes, with 600,000 people living with the disease without realizing it (source: French Diabetes Federation). One out of every five men aged 70 to 85 and one out of every seven women aged 75 to 85 are affected.

We can learn to live better with diabetes and lower the risk of complications, even if we can't cure it.

Diabetes is characterized by the presence of excess sugar in the blood, glucose. When the blood glucose level exceeds 1.26 g fast twice (or at any time of the day if the glucose is greater than 2 gr/)l, in the presence of the above symptoms. Diabetes. The body of people with diabetes cannot properly regulate this excess blood sugar.

Type 1 diabetes and type 2 diabetes are the two most common types of diabetes. Type 1 diabetes is most commonly diagnosed in children, however, it can also be found in adults as young as 35 years old. Between 5% and 10% of diabetics are affected. When the pancreas does not produce enough insulin, a hormone that regulates blood sugar levels, this type develops. Increased thirst and hunger, increased urination (diabetic urine), weariness, weight loss despite a reduced appetite, and muscle loss are among symptoms of diabetes.

Type 2 diabetes affects more than nine out of ten people. It primarily affects sedentary and overweight adults over the age of 40, although it is also affecting younger and younger people. It affects more males than women, and the risk rises with a large waist circumference (due to the accumulation of fat in the abdomen). The body's cells are unable to use insulin adequately when it is created. The cells have a form of resistance that prevents glucose from being absorbed, resulting in an excess of glucose in the blood.

This type of diabetes can go unnoticed for a long time, and it can cause the same symptoms as type 1 diabetes, but in a milder form.

Late diagnosis might result in significant consequences, such as blindness or amputation. Diabetes doubles or triples the risk of heart attacks and strokes. It's also one of the most common reasons for kidney failure. As a result, detecting diabetes is critical.

What are the treatments for diabetes?

Insulin therapy, insulin injections that allow the patient to regulate his level, or insulin pumps are the most common treatments for type 1 diabetes (see next paragraph). The diabetic youngster can have a normal diet, just like his siblings, but it must be well-balanced and varied. Insulin doses are always adjusted to account for dietary and physical activity. It's worth noting that stress affects blood sugar levels (it increases in stressful situations).

The first line of defense against type 2 diabetes is to eat a diet that is low in fat and high in fiber, such as fruits and vegetables. Complete starches, pulses, and alcohol should be consumed in moderation due to their high sugar content.

If the glucose level has not decreased after 6 months, anti-diabetic medications can be provided, with a variety of pharmacological families to choose from. It could be metformin (a member of the biguanide family that improves insulin sensitivity); if not enough, it's taken alone or in combination with another medication. Sulfonamides and glinides, for example, can boost insulin synthesis. Another type of drug is incretins, which are GLP-1 analogs (see paragraph below). Other medications (alpha-glucosidase inhibitors) reduce sugar absorption, but they are rarely used.

SGLT2 or glifozines, which enhance urine elimination, have been approved since April 2020 and have a favorable effect on blood glucose, weight, blood pressure, and renal function. DPP4 inhibitors are also of interest since they generate less hypoglycemia.

Finally, with type 2 diabetes, insulin injections are sometimes required. Physical activity is strongly encouraged and is part of the treatment plan.

It's important to remember that "hyperglycemic strokes" are dangerous to the arteries of the heart (diabetics have a fifteenfold increased risk of heart disease), kidneys (10% of dialysis patients are untreated diabetics), legs (8,000 amputations are performed each year due to untreated diabetes), and eyes (diabetes is the leading cause of blindness in adults). Because type 2 diabetes is identified later, problems are generally delayed, whereas type 1 diabetes is detected earlier and complications are more common at the time of diagnosis.

Diabetics don't feel sick as long as there aren't any complications, therefore they have a hard time accepting the essential follow-up and therapy. Follow-up is tough even when the disease is advanced.

Insulin pumps

Type 1 diabetics, whose pancreas no longer produces insulin, benefit from the easier-to-use insulin pumps. They enable the required amount of insulin to be injected as needed throughout the day and night. It provides a small continuous dose (known as basal flow) as well as increased doses at meals and snacks (bolus).

Monitoring glucose levels 4 to 6 times a day is still critical, but the continuous glucose measurement system has been one of the most significant advancements in recent years. Glucose sensors allow you to monitor your blood glucose levels in real-time, see how much they fluctuate, and take action before hypoglycemia develops. Based on an algorithm that estimates the dose of administration, this device resulted in "closed-loop" insulin therapy. For the time being, this technology is only available to patients with imbalanced diabetes and a glycated hemoglobin level of more than 8%.

For approximately 25,000 people, the insulin pump improves their quality of life. However, 70,000 people could benefit.

Incretins: an effective treatment

Around 2007, a new class of medications called incretins was introduced. They are gastrointestinal hormones that increase insulin synthesis indirectly. There are various classes available. Some even have the benefit of helping persons with type 2 diabetes and severe dietary difficulties lose weight. For diabetologists, this is an intriguing tool. "If the tablets don't work, we'll try GLP-1 analogs, which are injected once a month or even daily, says diabetologist Dr. Huet. If it fails, insulin will be taken, initially once a day with a pill medication."

Screening and Living with Diabetes

Screening is necessary. It is straightforward and reliable: all that is required is a blood test that checks fasting blood glucose (blood sugar level) twice.

People over 40 who have diabetic parents, high blood pressure, high cholesterol, or high triglycerides, and are hence overweight, should be examined for diabetes. Women who have given birth to children weighing more than 4 kg also need to be tested.

Type 2 diabetes is now affecting younger and younger people as a result of the obesity "epidemic." Diabetologists would like to see tests developed for children and teenagers.

It's worth remembering that the rate of overweight youngsters has risen from 3% forty years ago to over 16% in 2016. Boys aged 6 to 17 make up 16 percent of the population, while girls make up 18 percent.

In terms of genetic determinants, we know that having a type 2 diabetic parent increases the risk of offspring by 30%, compared to only 6% in the general population. If both parents have diabetes, the risk increases to 50%, and the condition emerges sooner, between 30 and 40 years. When it comes to identical twins, if one is diabetes, the other is at 90% risk.

The days for many diabetics are punctuated by fingertip checks to check their blood glucose levels. For these patients, the burden is often great. There are now non-stinging ways to measure blood sugar, such as the latest glucose sensors. Glycated hemoglobin measurement is also part of surveillance and provides an estimate of blood glucose levels over two or three months; it is estimated to be 6% at the start of the disease and 6.5 percent to 7% as the disease develops. Every three months, glycated hemoglobin should be tested.

Diabetes: talking about it to accept the disease

Medical appointments, injections, and dietary restrictions... Diabetes affects people's life and can be stressful. An association in Marseille gives diabetes patients speaking groups to help them learn how to live with their ailment.

It's not easy to learn to cope with diabetes. Patients must adjust their eating habits as well as cope with the new fears that treatment can bring. Participants form friendships and, most importantly, feel understood by expressing their sickness. Because stress can harm blood glucose, psychological assistance is critical for the most nervous.

You don't need a needle to check your blood sugar if you have diabetes.

Diabetes treatments have improved over time, notably in terms of technological advancements. New technologies may make life easier for type 1 diabetics, who must inject 3 to 5 times each day to monitor their blood glucose levels. It's the sugar in your blood.

Boxes allow diabetologists to obtain vital data by continuously documenting the evolution of blood glucose, allowing them to follow their patients' diabetic balance. The advantage of patient size is that they no longer need to prick their fingertips to check their blood glucose levels. The box continuously records data via a sensor, and patients experience far less hypoglycemia.

However, there is a significant disadvantage because the sensors are frequently in short supply...

Another innovative feature is a mini-pump that distributes insulin and is implanted in the patient's body, such as the arm. The patient must enter his blood glucose level as well as the dose of insulin to be injected into a remote control before the machine takes over.

Constant blood glucose control thanks to the housing, exact insulin dose diffusion thanks to the pump... All of these advancements make life easier for patients. These two devices are only reimbursed to type 1 and type 2 diabetics who inject at least three times each day.

Type 2 diabetes prevention is a big concern.

Type 2 diabetes can be avoided by leading a healthy lifestyle. The World Health Organization recommends the following relatively easy steps to take:

-achieve or maintain a healthy weight (BMI less than 25 kg/m2)

-get at least 30 minutes of moderate-intensity exercise per day -eat a well-balanced and diverse diet free of sugar and saturated fat

-Discontinue smoking

source:https://www.allodocteurs.fr/maladies-diabete-diabete-les-degats-du-sucre-975.html