Diabetes: One of the Fastest Growing Diseases
What do we mean when we talk about diabetes? First of all, we have to learn that the disease is divided into two forms: type 1 diabetes, with no insulin secretion, and type 2 diabetes, resulting in reduced sensitivity to insulin by the liver, muscle and adipose tissue and / or reduced pancreatic insulin secretion.
In this article we focus on type 2 diabetes as it is the most common disease between the two. The scientific community identifies type 2 diabetes as a defect of insulin secretion, which can progressively worsen over time and which is established on a pre-existing insulin resistance condition. Type 2 diabetes is a widespread disease throughout the world and its prevalence is constantly growing, so much so that by 2030 more than 400 million patients are expected in the world. This disease is typical of the mature age and of all diabetes patients, 90% of the cases are of type 2 diabetes, while only 10% are type 1 diabetes.
Thus type 2 diabetes is characterized by two elements:
- Insulin secretion deficiency: not enough insulin is produced to meet the body’s needs
- Insulin resistance: the insulin produced does not act satisfactorily
The result, in both cases, is the consequent increase in blood glucose levels (hyperglycemia).
What are the main causes of diabetes?
The cause of diabetes 2 is still unknown, but it recognizes polygenic and multifactorial origins, so much so that it is not considered a single disease but a set of different syndromes. The risk of developing the disease increases with age and generally occurs in adulthood, after 30-40 years, with the presence of obesity and lack of physical activity, but can be also diagnosed in children and teenagers.
Therefore the underlying causes of the onset of the disease are generally to be found in 2 main factors:
- the hereditary factor: Through in-depth studies it has been shown that there is a hereditary transmission factor. Consider that about 40% of type 2 diabetics have first-degree relatives, parents or siblings with the same disease.
- the environmental factor: by environmental factor we mean all those elements that do not concern genetics and are due to the person’s habits. Among the environmental causes we find weight gain and obesity, unhealthy diet, sedentary lifestyle.
Some risk factors that make some people more prone to developing type 2 diabetes should not be underestimated.
The main risk factors are:
- Obesity (BMI greater than or equal to 30 kg / m2 for DM2)
- Hypertension (PAS greater than or equal to 140 mmHg and PAD greater than or equal to 90mmHg)
- HDL cholesterol (less than or equal to 35 mg / dl)
- Triglycerides (greater than or equal to 250 mg / dl)
Another risk factor to consider is gestational diabetes. Gestational diabetes means an increase in glucose levels that occurs or is detected for the first time in the period of pregnancy. This condition occurs in 8% in pregnant women. Although it is a temporary condition, if it is not diagnosed and adequately treated, it can lead to serious consequences, both for the mother and the child. Generally, gestational diabetes tends to disappear at the end of pregnancy, however, women who suffer from it have a higher risk of developing type 2 diabetes in later life.
Diabetes care during pregnancy is basically through a diet aimed at ensuring the right caloric intake necessary for the growth of the fetus, preparing the maternal organism for delivery and breastfeeding, as well as for avoiding episodes of hypoglycemia or hyperglycemia for the mother’s body. It cannot however disregard the practice of physical activity.
What are the symptoms of type 2 diabetes?
It is very important to understand what the symptoms of the disease are. In general, the person with type 2 diabetes is a person of the second or third age, with a weight higher than the ideal one, often with relatives of first grade diabetics.
Symptoms are generally not as obvious as in type 1 diabetes, so they are easily ignored and the discovery of diabetes can occur quite randomly, for example during a check-up.
The diagnosis of this form of diabetes, therefore, can also be very late (months or years) and, for this reason, it is easy to find at the time of diagnosis the presence of complications in an advanced state and a greater difficulty in prevention. Type 2 diabetes generally remains silent for many years as hyperglycemia develops gradually and, at least initially, is not as severe as to cause the typical symptoms of diabetes, which are:
- feeling tired,
- frequent need to urinate even at night,
- unusual thirst,
- sudden and unexplained weight loss,
- blurred vision and slow healing of wounds
- gestational diabetes
The most serious complications derived from diabetes can cause damage to the patient, even those that are important at neurological, renal, ocular and cardio-cerebrovascular levels.
How to prevent diabetes
To prevent the onset of type 2 diabetes it is advisable to adopt a healthy lifestyle: it has been shown that the performance of moderate-intensity aerobic exercise lasting 20-30 minutes a day or 150 minutes a week, associated with loss of 10% of body weight, reduces the incidence of type 2 diabetes by 60%.
The diet is also important. With the fact that diabetes is linked to glycemia, sugars tend to be considered the major responables in nutrition. This is only partially true. Naturally a diet rich in sugars puts a heavy strain on the production of insulin and leads, over the years, to the development of insulin resistance. However, it must be considered that even a diet rich in saturated fatty acids such as animal fats increases the risk of developing diabetes, while the partial replacement of these with unsaturated fatty acids such as omega-3 reduces it.
Prevention of type 2 diabetes is very important for everyone, not just those at risk. In order to greatly reduce the chances of this disease arising, it is therefore essential to have a correct lifestyle from childhood by following a few simple rules:
- a balanced diet (eating less fat and more fruits and vegetables);
- weight control
- a life as sedentary as possible
- not smoking
- constant monitoring for those at risk
Diagnosis and treatment
A blood test is required to make the diagnosis of diabetes. For the diagnosis of diabetes, a value of fasting blood glucose> 126 mg / dl confirmed in at least two different days is sufficient, alternatively values greater than 6.5% of glycated hemoglobin confirmed by a second sample, or glycaemia> 200 mg / dl in the presence of symptoms.
Furthermore, there are clinical situations in which the blood sugar level does not exceed the levels established for the definition of diabetes, but which in any case do not constitute a normal condition.
In these cases we speak of altered fasting glycaemia (IFG) when the values of fasting glucose are between 100 and 125 mg / dl and of altered glucose tolerance (IGT) when the glycaemia two hours after the glucose load is included between 140 and 200 mg / dl.
These are situations known as “pre-diabetes”, which indicate a high risk of developing the diabetic disease even if they do not represent a disease situation. They are often associated with overweight, dyslipidemia and / or hypertension and are associated with an increased risk of cardiovascular events.
Diabetes is a complex disease, it is important for adequate treatment to access specialized centers where there is interaction between the various specialists (diabetologists, ophthalmologists, nephrologists, cardiologists) for the adequate control of risk factors and the screening of complications as well as care of the same, use of innovative therapies (incretins, new insulins, new drugs soon available on the market) associated with indispensable educational techniques (group educational therapy, physical activity, adequate diet therapy).
There are different treatments for type 2 diabetes. The spread of this type is largely related to the increase in obesity and a sedentary lifestyle, therefore a correct diet and a constant physical activity represent the cornerstone of the treatment of diabetes. However, only 10% of patients with type 2 diabetes maintain good control of the disease in the absence of pharmacological treatment over time, and in any case national and international guidelines recommend associating drug therapy (linked to lifestyle) with drug therapy. The drugs available for the treatment of type 2 diabetes are: Secretagogue drugs (sulfonylureas), Biguanides (metfromine), Thiazolidinediones, GLP-1 receptor agonists, DPP-4 inhibitor, Alpha-glucosidase inhibitors: reduce intestinal glucose absorption, Insulin.
It is important to consider that there is no valid drug therapy for all patients with diabetes, but for each of them there may be a personalized therapy in relation to the different characteristics.
In addition, the diabetic patient must avoid smoking, also check pharmacologically the blood pressure and blood fat values (LDL cholesterol and triglycerides).
What is the best diet for diabetics?
The diet must contain in the right proportions the essential nutritional principles for life: proteins, fats (minimum quantities are sufficient, among them those of vegetable origin are preferred), carbohydrates (sugar and sugary drinks, very energetic and with little power should be avoided). satiating), vitamins and minerals.
Proteins, especially those of animal origin (meat, fish, milk, eggs) are essential nutrients and should therefore never be eliminated from the diet or be introduced in insufficient quantities otherwise our body will burn those proteins to make up for this deficit reserve that we use to build muscles, fabrics, etc.
Among the characteristics of an effective and safe diet, an important place is the presence of an adequate quantity of vegetable fibers, which are present in many foods of vegetable origin. Soaking up with water, the fibers swell, exerting mechanical pressure on the walls of the stomach and intestines; they therefore possess a high satiating power.