When we talk about chronic diseases, the thought immediately stops on one of the most common, diabetes, characterized by high blood glucose levels. Yes, the very sweet and irresistible sugars, the undisputed protagonists of the foods that have been increasingly loved and desired, but to be consumed sparingly: sweets.
When the quantity and function of the hormone insulin is altered, glucose begins to accumulate in the blood and here is diabetes, which is divided into different types.
What are the symptoms, consequences and causes of diabetes? These and other questions are answered by the Doctor Silvia Pasquini, Surgeon, Specialized in Endocrinology and Metabolic Diseaseswith whom we have explored the topic.
What is that
“The diabetes mellitus it is one of the most common chronic diseases in the world. In Italy alone, it affects more than 4 million individuals and it is estimated that at least 1.5 million people are affected by diabetes without knowing it.
The word comes from the Greek than dia and means “to go through, to flow” and refers to one of the main symptoms, that is the abundant amount of urine produced, while the adjective “mellitus” refers to “honey”, precisely for excess sugar that characterizes this disease.
Under normal conditions, our pancreas produces insulin to keep blood sugar (i.e. glucose, or blood sugar) under control. These sugars, if present in excessive quantities and for long periods, can cause problems damage to various organscausing the so-called “chronic complications” of diabetes, including:
- vision problems / blindness;
- kidney failure;
- diabetic foot;
- neuropathy (ed. or the dysfunction of one or more peripheral nerves that cause pain, weakness, alterations in sensitivity);
- stroke;
- heart attack.
Fasting blood glucose values measured on venous sampling greater than or equal to 126 mg / dL are indicative of diabetes mellitus ”, explains the doctor.
Types of diabetes
“There are different types of diabetes mellitus, the most frequent forms are:
Type 2 diabetes mellitus
And the most frequent form and often fits into a picture that is called “metabolic syndrome”, in which high blood pressure, hypercholesterolemia or hypertriglyceridemia, overweight / obesity coexist, with prevalence of abdominal fat. In this case the pancreas produces insulin, but this insulin does not work as it should, i.e. the cells of our body are resistant to its action (insulin resistance) and the result is hyperglycemia. This form of diabetes is quite “subtle” because it often does damage before becoming symptomatic.
Type 1 diabetes mellitus
It is rarer than type 2 (approximately 5-10% of the diabetic population) e it mostly affects young people; in this case the pancreas no longer produces insulin, which must therefore be administered from the outside, several times a day, trying to reproduce what the pancreas is no longer able to carry out independently.
Gestational diabetes mellitus
It is a type of diabetes that occurs during pregnancy, with a mechanism very similar to type 2 diabetes, namely insulin resistance: the diagnosis is made using a glucose load curve performed between the 16th and 18th week (if the woman is at high risk) or between the 24th week and the 28th. In most cases, after childbirth it resolveshowever, leaving a high risk of developing diabetes in the future.
prediabetes
There is also a high-risk condition, what was once called “prediabetes”, in which the blood sugar is in a halfway between normal and diabetes. In this case it is good to take the necessary precautions and follow specific precautions to prevent this condition from becoming diabetes.
Symptoms
“First of all, it should be noted that in most cases, especially in the initial stages (and this is undoubtedly true for type 2 diabetes) diabetes mellitus it is totally asymptomatic.
Where present, especially in the case of glycemic decompensation, the symptoms that should make us suspect diabetes are mainly:
- very thirsty;
- need to urinate often and in large quantities;
- uncontrolled increase in appetite;
- tiredness;
- weight loss (but only in some cases, usually in type 1 diabetes);
- blurred vision;
- increased frequency of infections, especially genital or fungal infections “, explains the expert.
In general, the diagnosis of diabetes arrives with the finding, on at least two occasions, of the presence of fasting blood glucose values (for at least 8 hours) ≥ 126 mg / dl or symptoms (such as those described above) associated with a random blood glucose value ≥ 200 mg / dl.
Cause
«They also correspond to different types of diabetes cause diverse. Type 2 diabetes is caused by insulin resistance, meaning insulin is produced by the pancreas but does not work. This disease depends on many factors, but (trying to simplify a much more complex pathogenesis) the most important are familiaritythat is, the “predisposition” to have it is inherited, and i environmental factorsas a lifestyle characterized by a sedentary lifestyle, incorrect diet (particular preference for simple sugars or excessive intake of carbohydrates and fatsnot balanced by an adequate amount of fiber), but also by risky behaviors such as excessive alcohol intake or cigarette smoking.
Type 1 diabetes, on the other hand, does not depend on lifestyle and nutrition, but it is one pathology on an autoimmune basis, that is the immune system, which is usually engaged in fighting against external agents, begins to attack the beta cells of the pancreas that produce insulin, creating a state of local inflammation, up to their destruction. The result is one absolute insulin deficiency.
The gestational diabetes has insulin resistance in common with type 2 diabetes: in pregnancy, insulin resistance is useful for providing more nourishment to the baby, but at a certain point, precisely due to a predisposition of the woman or a risk profile, this situation balance breaks, blood sugar rises too much, becoming harmful for the mother and the baby ».
What are the treatments
«Even the therapies are different according to the type of diabetes. For type 2 diabetes mellitus, the cornerstones of therapy, even before drugs, are precautions in terms of diet and lifestyle. That is, a balanced diet, free of simple sugars, with a preference for carbohydrates with a reduced glycemic index, taking care not to combine multiple sources of carbohydrates with the main meals (e.g. bread / pasta / potatoes must be interchanged), rich in fiber and low in fat.
The lifestyle should be as active as possible, with daily and regular exercise, preferably aerobic. Where the lifestyle is not sufficient, or the onset values are already particularly high, or complications are already present (for example cardiological), a pharmacological therapy, usually with oral medications. For type 1 diabetes the only therapy is insulin, which can be considered a life-saving drug for these patients, administered through 4 or more daily injections or through technological devices, the “insulin pumps”. Gestational diabetes is first treated with diet, but where this is not enough to ensure adequate control, insulin is used promptly, with a number ranging from 1 to 4 doses per day “, concludes the expert.
As we have seen, diabetes is a (very common) disease that can be caused by various factors, some related to our lifestyle, others to environmental and genetic factors. Although it is asymptomatic, in some cases we can have signs of its presence (as explained above). It remains the advice of regularly monitor blood sugar levels and to maintain a lifestyle that is as healthy as possible.