A reference in diabetes, obesity and thyroid pathology, Dr. Martín Vaquero is medical director of the D-medical center in Madrid and of the medical magazine Espacio Diabetes. On World Diabetes Day, she explains what this pathology consists of and the advances in its treatment.
Diabetes…. that silent disease that corrodes the blood vessels and ends, most of the time, in a vascular disease (angina, heart attack, thrombosis, retinal, renal or nerve vessels).
Glycemia…. that “sugar” in the blood that acts as gasoline for our cells… If the energy supply is difficult to obtain, all the blood vessels are altered:
a) the large ones, and then the coronary, carotid and leg vessels are affected, which can lead to infarction, angina pectoris, stroke and peripheral thrombosis b) the small vessels of the eye (retinopathy), kidney (nephropathy), and the vessels of the peripheral nerves (neuropathy), among others.
Diagnosis of diabetes
Half of the people with type 2 diabetes are unaware of their disease. It is well known that in type 2 diabetes “slightly” elevated blood glucose hardly produces any symptoms in patients, which means that it is often diagnosed late and by chance. When the diagnosis is made, the patient’s disbelief is total: “That’s not possible! I don’t feel sick at all! That’s not like me! But if such a diagnosis is made, it would be better to contact the specialist and follow his advice from the very first moment in order to control oneself properly.
At the beginning of the disease this control is very simple and the evolution of the process will stop or evolve very slowly, thus keeping future vascular complications “at bay”. If you look the other way and do not believe it, the disease will present itself to you sooner or later in the form of one of its complications.
Treatment of diabetes
Until a few years ago, endocrinologists fought type 2 diabetes with weapons such as diet, physical exercise and medications that produced other problems such as weight gain and hypoglycemia. But in the last decade new drugs have appeared in the clinic that are changing the prognosis of the disease and are leading to better metabolic control, weight loss and less cardiovascular risk for patients.
These are glucosurics and drugs with incretin action. Disadvantages? There are always those: they are more expensive upfront drugs than the usual treatments, they are not free of complications that have to be taken into account when prescribing them, and one of them has to be injected subcutaneously. And, of course, they do not prevent you from having to make lifestyle changes because diet and exercise, as well as measuring your blood sugars, remains the mainstay of treatment in type 2 diabetes.