Living with diabetes

Anyone with diabetes must take care of their disease in a holistic manner. This phrase may sound like a cliché but it encapsulates the whole background of the diabetes problem. If you don’t do things right, the disease will – over time – unquestionably take its toll. And since with poorly controlled diabetes the awareness of the disease does not exist (except in advanced stages) it is very easy to minimize the problem and not want to see that you are diabetic and that you must take care of yourself. This is why the educational process is essential from the beginning. I always tell my patients: we have to draw a path to follow that you automate and integrate into your way of living, in terms of schedules, meals, drug dosages (not only insulin), exercise, behavior in the face of illness, vacations… in short: to know how to live with diabetes by following what is agreed 80% of the time.

If not, then the day to day comes and it is sometimes impossible to follow what has been agreed, but if one has well traced this path it will be easy to get back on track and control will be assured. Although many people get overwhelmed thinking that they are not able to learn everything that is required, then I speak of the driving license simile: the first day you get behind the wheel it seems impossible to pay attention at the same time to the road, to the rear-view mirrors, to your feet… and then you drive without thinking, automatically. This is how a person with diabetes has to process their disease: they must automatically learn to control themselves, and boy, do they succeed, even if perfection does not exist. And if they control themselves, complications and risks are minimized.

In spite of all this, the patient is usually worried about not being able to lead a normal life. Having to adjust to certain schedules, controlling what you eat, keeping an eye on blood glucose levels… are concerns that add to the uneasiness of losing their health. Therefore, education and the automated assimilation of a way of proceeding without causing your psyche to suffer is the smartest approach. The idea is that since you have diabetes, “take the bull by the horns”, learn to do things right and relax. Everything will be fine and you’ll chase away the specter of major complications.

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Diabetes, new technologies and advances

Nowadays, we must also consider the new technologies that facilitate glycemic control, improve quality of life and give you security. It is now unthinkable for young (and not so young) people to present themselves to their doctor with only a sheet of handwritten blood glucose control charts when all capillary blood glucose monitors have software from which a great deal of information on blood glucose levels can be quickly extracted: averages throughout the day, fluctuations, responses to meals or hypoglycemia, etc. These new glucometers, with bolus calculators, make it easier to adjust insulin doses without having to do it “at random”. There are also glucometers already linked to cell phones.

Other advances are, for example, insulin pumps, which are, for now, the most physiological way of administering insulin. Blood glucose sensors are another unquestionable advance. Telemedicine consultations (without the patient having to be present in front of the doctor) are easier if the person with diabetes uploads to his computer the blood glucose readings from his device, or the data from the insulin pump and/or the sensor, and his remote doctor has access to all this data… To put it bluntly, in the year 2013 it is no longer conceivable to have a diabetology consultation that does not work in this way. In my case, I have two patients, one in France and one in Germany, who only come to my office once a year (for Christmas), but every month or two months we connect to adjust the treatment and the doubts having in front of us all the blood glucose readings of the last weeks.