The premature death rate due to diabetes increased by 5% between 2000 and 2016, and in 2019 it was a direct cause of about 1.5 million deaths, and therefore it is called the “sickness of the century.”
World Diabetes Day came to recognize the urgent need to pursue multilateral efforts to encourage and improve human health, and to provide access to health care treatment and education.
The theme of this year’s World Diabetes Day is access to diabetes care. 100 years after the discovery of insulin, millions of people with diabetes around the world are still unable to get the care they need. People with diabetes need ongoing care and support to manage the condition. health and avoid complications, says the United Nations.
The centenary of the discovery of insulin presents a unique opportunity to make a meaningful difference to the more than 460 million people living with diabetes and the millions more at risk.
How do we get diabetes?
Dr. Ahmed Nizar, founder of the Ahmed Charitable Medical Project in Syria, said in an interview with “Sky News Arabia”: “We must first address the mechanism by which the body deals with sugar, or what is scientifically known as glucose, after the end of the digestion process and the entry of glucose into the bloodstream. To distribute it to the cells of the body, the action of the hormones insulin and glucagon, which is responsible for controlling glucose levels in the blood and maintaining its correct values, begins.
He continues: “Where in the pancreas there are cells called beta cells, which are very sensitive to high blood sugar levels, as they secrete the hormone insulin responsible for the entry of glucose into the cells of the body, and into the liver, where it is stored, and there are also cells in the pancreas called alpha cells responsible. About the secretion of the hormone glucagon, which is responsible for releasing glucose stored in the liver in the event of low blood sugar.
He continued: “Beta cells are damaged, and the amount of insulin secreted decreases, which paves the way for the occurrence of diabetes, as Nizar explains, who adds:” If the condition is accompanied by the presence of insulin resistance, a large consumption of sugary substances is associated with obesity and a decrease in daily activity, which makes the amount of insulin The secretion is insufficient to control blood sugar, with the presence of the previous workers, the amount of insulin secreted becomes very little and insufficient to control blood sugar, which eventually ends in diabetes.”
How is this disease diagnosed?
The Syrian doctor answers: “Diabetes has distinct symptoms, and symptoms may vary according to the type of diabetes, and sometimes the patient may not even feel any symptoms at the beginning of the infection or may feel some or all of them together, which are: thirst, constant hunger, frequent urination, and decreased Weight, general weakness, blurred vision, slow wound healing, frequent infections.
When one or several symptoms from the previous combined are observed, special blood tests must be performed to diagnose or deny the infection, which are several blood tests, including: Checking the level of sugar in the blood after fasting for a period of not less than 8 hours, where it is known that the correct level of sugar should be lower From 108 mg / dl, if the fasting blood sugar level is higher than 125 mg / dl in two successive examinations, this is evidence of infection and requires an expansion in blood, urinary and hormonal analyzes to determine the type of diabetes and choose the appropriate treatment for the patient, by the supervising doctor , as Dr. Nizar explains.
What are the types of diabetes?
There are 3 main types of diabetes: Type 1 diabetes, insulin dependent – Juvenile diabetes, which is believed to be an autoimmune disease in which the immune system attacks and destroys beta cells, resulting in the production of very little or no insulin.
It is also believed that genetics and the environment also play a role in its infection, as Nizar adds, “Type 1 diabetes begins to develop in children and young adults, but it may appear at any age, and the patient needs to use insulin for life.”
As for type II diabetes: non-insulin dependent, which is the most prevalent type, occupying between 90 and 95% of all patients with diabetes, and this type is usually associated with advanced age, obesity, physical inactivity, and medical and family history, as seen by the doctor.
Nizar says: “Most patients with type 2 diabetes suffer from weight gain before contracting the disease, and although the pancreas produces a sufficient amount of insulin, the body is not able to use insulin effectively and benefit from it, which is called insulin resistance, and unfortunately, the production of insulin may decrease. After several years, the patient is considered to have type 1 diabetes and needs insulin treatment as well.
And he continues: “As for the third type, it is gestational diabetes, which occurs when a woman develops diabetes during pregnancy, and is common among obese pregnant women and those who suffer from a previous family history of diabetes, or have previously given birth to a child weighing more than 4 kilograms.”
He added: “Most women do not show symptoms of gestational diabetes, so the glucose level is checked between the 24th and 28th weeks of pregnancy, and the infection is not considered chronic, but the sugar level returns to normal after childbirth and in a few cases it may develop into type 2 diabetes, if Presence of predisposing factors for infection and neglect of treatment.
Causes of diabetes
Regarding the factors and causes of diabetes, Dr. Nizar says: “They mainly include the following: “obesity and lack of physical activity.”
The reasons also include, according to the Syrian doctor, “the food pattern where most of us today depend on fast and ready foods rich in fats and carbohydrates that raise blood sugar significantly, age when more than 45 years old, genetics and family history of disease, uncontrolled high blood pressure, hypercholesterolemia and triglycerides.” glycerides.
As for treatment, Nizar adds: “The treatment varies depending on the type of diabetes, the patient’s condition, his response to treatment and his commitment to changing his lifestyle. The treatment of type 1 diabetes is based mainly on insulin injections and monitoring and recording of glucose values on a daily and frequent basis, and blood glucose is measured either by The home device, to measure glucose concentration by a drop of blood from a finger, or by advanced electronic devices under the skin to measure glucose concentration in the body consecutively and throughout the day.
It explains the mechanisms of insulin therapy that depend on the type of insulin injected, where long-term insulin treatment provides a daily injection that provides the body with the basic amount of insulin, which helps the patient to accept treatment due to the lack of need for injections several times, while treatment by short-term insulin is taken directly After meals to balance blood sugar.
Regarding the treatment of type 2 diabetes, he says: “It varies from one person to another, according to laboratory tests and blood glucose values. The treatment includes two main parts, lifestyle change and drug treatment with oral hypoglycemic agents.”
It includes lifestyle changes, healthy nutrition, weight reduction, exercise, stopping smoking, and controlling cholesterol and blood lipids, with the aim of reducing insulin resistance, always according to Dr. Nizar.
As for drug therapy, it includes many drug groups, the most important of which are: Metformin: It is considered a first line of treatment, especially for obese people, as it works to regulate blood sugar levels. It is also known to be used in polycystic ovary syndrome to reduce the accompanying insulin resistance.
Sulfonylurea: It increases the secretion of insulin from beta cells, and one of the known and common side effects of these drugs is excessive weight gain and a sharp drop in the concentration of glucose in the blood.
Thiazolidinediones: This group improves insulin resistance in the body and may stimulate its secretion.
Meglitinides: They also stimulate insulin secretion from beta cells.
Alpha-glucosidase inhibitors: These medications work by slowing the absorption of sugar in the digestive system.
Dipeptidyl peptidase-4 inhibitors: These drugs help regulate the level of glucose in the blood, and we may have to use insulin instead of oral treatment if the condition develops and it is difficult to control blood sugar.
The treatment of gestational diabetes depends mainly on modifying the lifestyle and diet, and continuously monitoring the level of sugar in the blood. In some cases, treatment may require the use of insulin to protect the fetus and the mother, as Nizar explains.
Complications in case of neglect
And if diabetes treatment is neglected, this carries a great risk, ranging from minor complications to serious and life-threatening.
Nizar says: Complications are divided into a group that appears in the short term and others in the long term, and the most prominent of these complications are: eye problems such as retinopathy and this disease that affects some individuals with diabetes, and it is likely to cause some problems in the eyesight that may end in blindness, It can be avoided with a routine examination of the eye, as well as a diabetic foot, and it can end in amputation of the foot if it is not treated properly, so a doctor is required to consult a doctor when he notices any new lesion in the foot, in addition to strokes and heart attacks where high blood sugar leads to injury to blood vessels and damage it.”
Among the complications also are: “Kidney problems, the most important of which are kidney disease and failure, as diabetes may lead to kidney damage in the long run, which leads to difficulty in getting rid of fluids and waste, and this is called diabetic nephropathy, in addition to that, high blood pressure and cholesterol. triglycerides, and low “good” cholesterol.
Acute complications
As for acute complications, they are those that can occur at any time during diabetes, and may sometimes lead to chronic complications or death in the absence of prompt intervention, such as severe hypoglycemia or severe rise, according to Nizar.
Regarding the complications of gestational diabetes, he says: “The majority of women give birth to healthy babies, but if the blood sugar of a pregnant woman is not controlled and not monitored and treated as it should, the newborn may suffer from overgrowth, hypoglycemia or jaundice, and in rare cases it may end the death of the child.
Regarding ways to prevent diabetes, he answers: “Unfortunately, it cannot be prevented in the case of the first type, but a healthy lifestyle contributes to the prevention of the second and gestational type, and is based on healthy nutrition, increasing physical activity, maintaining an appropriate weight, and an indicator healthy body mass.
The doctor may decide to use some oral antidiabetics, to reduce the risk of developing type 2 diabetes when there is a high risk of infection, and alarming blood glucose values approaching 125 mg / dl of metformin, concludes Dr. Ahmed Nizar.
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