The diabetesa chronic and complex disease, faces an uninspiring outlook, since by 2040 it could become one of the main causes of death globally, according to data from the Hospital Clinic Barcelona. However, the present offers signs of hope. Advances in science and technology, together with an increasingly informed society, are driving improvements in the quality of life of millions of people who live with this disease. This approach recognizes that diabetes cannot be addressed exclusively from endocrinology, since social, emotional, cultural and economic factors also play a key role.
Understanding diabetes means recognizing that it is not a single disease, but that there are several types —type 1the type 2 and the gestational—, each one with specific causes, symptoms and treatments. Type 1 diabetes is defined by the complete absence of insulin; type 2, the most common, is associated with overweight, sedentary lifestyle and unhealthy habits; while the gestational one develops during pregnancy. Despite the increase in its incidence, this reality has motivated a profound change in the way of understanding and treating the disease.
In daily clinical practice, diabetes goes beyond measuring glucose or adjusting insulin doses. It is necessary to address the diversity of people, their lifestyle, their emotional state and possible long-term complications.
“In daily clinical practice, diabetes goes beyond measuring glucose or adjusting insulin doses. It is necessary to address the diversity of people, their lifestyle, their emotional state and possible long-term complications,” explains Jesús Blanco, endocrinologist at the Hospital Clínic of Barcelona. “Applying the same strategy to all patients no longer makes sense. Not all of them require the same pace of control or the same therapeutic tools,” he points out.
Technology has become a key ally for an individualized approach to diabetes management. Tools like continuous glucose monitoring, mobile monitoring apps, and hybrid insulin infusion systems are revolutionizing your treatment. Telemonitoring allows data on blood glucose, nutrition and exercise to be shared quickly between patients and health professionals, facilitating the detection of imbalances, the rapid adjustment of treatments and, ultimately, a better quality of life.
Applying the same strategy to all patients no longer makes sense. Not all require the same pace of control or the same therapeutic tools.
Although technology is key, prevention and early diagnosis remain fundamental in the management of the disease. In the case of type 2 diabetes, the risk of cardiovascular complications increases with age and poor metabolic control. Recent research by Hospital Clínic, IDIBAPS and IDIAPJGol has revealed that women are more susceptible to cerebrovascular complications, which highlights the need to incorporate a gender perspective in medical care. On the other hand, factors such as hypertensionthe obesity and the socioeconomic environment have a decisive impact on the evolution of the disease, underlining the importance of offering clear and accessible information to make informed decisions.
Diabetes not only affects metabolic control, but is also related to other pathologies, compromising essential organs such as the eyes. Joan Giralt, ophthalmologist at Hospital Clínic Barcelona, warns that diabetic retinopathya complication that can lead to blindness, is usually silent until the damage is significant. Therefore, periodic reviews are essential. This close monitoring highlights the importance of therapeutic education, a process that allows people with diabetes to acquire the knowledge and skills necessary to manage their disease autonomously and responsibly.
There are teenagers who do not accept their diabetes and often arrive to you in a very serious condition.
The emotional implications of diabetes cannot be ignored. The disease is present 24 hours a day, influencing diet, rest, physical activity and mood. This becomes especially complicated in adolescence: “There are teenagers who do not accept their diabetes and often arrive to you in a very serious condition.”says Giralt. In these difficult stages, family support, solidarity between patients and the guidance of experienced professionals can be key to promoting a more responsible attitude.
The definitive cure is not yet close, but research is advancing steadily. Cellular therapies, pancreatic islet transplants and drugs that could stop complications and even modify the progression of the disease are being explored. Each advance is integrated into a healthcare ecosystem that involves specialists in endocrinology, ophthalmology, nursing, primary care medicine, nutrition, psychology, among others.
We must understand diabetes in an integrated way. The goal is not only to reduce blood sugar, but also to improve quality of life, reduce complications, and promote patient autonomy.
“We must understand diabetes in an integrated way. The objective is not only to reduce blood sugar, but also to improve quality of life, reduce complications and promote patient autonomy,” says Dr. Marga Giménez, who leads a pioneering team in the use of real-time data to adjusting care for patients with type 1 diabetes at the Hospital Clínic Barcelona.
The contemporary view of diabetes, therefore, is the result of a balance of efforts. Beyond the endocrinological field, its management requires a multidisciplinary approach, the support of technological tools, personalized care plans and person-centered care.
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