What sugar values are appropriate?
In the general population, ie, in nondiabetic sugar levels in blood it is considered normal when, in a situation of fasting, after eight hours without eating, are less than 110 mg / dL.
In people with diabetes, it is considered that sugar control is suitable when blood glucose levels are below 130 mg / dL before meals and 180 mg / dL two hours after I started eating do. However, these control objectives are not widespread and should be individualized according to the circumstances of each person; is different from the control objective in a 80 year old in a person 45 years. In older people less strict glucose control is recommended, by the presence of other complications that could worsen, while in the younger population should attempt to achieve virtually the normalization of glycemia, if possible.
What progress there has been in recent years in this disease?
Progress has been fundamentally therapeutic, since much has deepened knowledge of the factors involved in the development of type 2 diabetes, also called adult-onset diabetes.
In this sense they have appeared drug mechanisms of action different from the classical with being obtained highly satisfactory results, therefore greater effectiveness in controlling blood glucose, and the presence of less severe side effects and, mainly because some of them have shown to have protective effects on the cardiovascular complications of diabetes.
Notably in these groups of drugs to inhibitors of the enzyme DPP4 (alogliptin, Linaglitptina, sitagliptin and vildagliptin), inhibitors cotransporter sodium / renal glucose (canagliflozin, Dapagliflozin and Empagliflozina) and finally the receptor analogs GLP -1 (albiglutide, Dulaglutida, exenatide, liraglutide and LIXISENATIDE). The first two groups of drugs are orally administered while the latter are injected daily or weekly manner.
In addition, in recent years they have developed insulins easier handling, comfortable and profile more physiological action, that is, more like the normal production of insulin by the pancreas. It has significantly improved insulin treatment, unjustly considered as the "black beast" in the treatment of diabetes. The ability to inject insulin only once a day and reducing the number of hypos or hypoglycemia, are just one example of the advantages of this new type of insulins.
In more common in children and young people, in which the only treatment to date is the insulin type 1 diabetes, the research has been directed mainly towards the production of insulin-producing cells from stem cells (with poor initial results) and the development of smart infusion systems insulin, by combining insulin pumps and sensors highly technical interstitial glucose. In this sense they can be considered very satisfactory progress. High technology is finally serving the diabetes.
What is the trend in recent years incidence of diabetes?
The incidence of diabetes, ie the number of new cases is increasing exponentially. According to the latest data released by the International Diabetes Federation (IDF) it estimates that at present 415 million people with diabetes exist throughout the world and in 2040 the number will rise to 642 million (one in ten people). The most shocking is that only half of people with diabetes know it is, the other half unknown.
This increase is very evident in type 2 diabetes or adult. However, it calls attention to the increasing incidence of type 1 diabetes is experiencing in the past two decades.
In the case of type 2 diabetes there is a clear and direct relationship between this increase and the obesity epidemic worldwide suffer. However, the reasons for which they are increasing cases of type 1 diabetes is unknown, although being investigated.
What have diabetes link with the development of other diseases?
It is well known that diabetes, mainly when it is not well controlled, therefore inadequate treatment and its lack of diagnosis, determines complications in all organs.
Classically it is known that diabetes is the leading cause of blindness and amputations not caused by trauma to the lower extremities. In addition, chronic renal failure (which determines the need for dialysis and kidney transplantation), is another common complication. Nor should we forget the lesser known complications to appearance, but with a high impact health, such as periodontal and neurological.
However, the main concern is cardiovascular complications such as myocardial infarction, which are four times more common among people with diabetes and constitute the leading cause of death.
In recent years, attention is undergoing the relationship being observed between Alzheimer's disease and diabetes. In the near future we will get more information about it.
Can it be prevented with some sort of measures?
Type 1 diabetes is not possible to prevent it , given its mechanism of appearance by type immune processes virtually impossible to predict. However, type 2 diabetes is preventable in most cases. The shape? Maintain a healthy weight and physical activity regularly, ie, lead a healthy life.
What influence has the power?
It could not clearly establish the relationship of any specific food and the onset of diabetes. That is, eating patterns do not increase the probability of being diabetic, as long as the appropriate weight is maintained by combining a healthy diet and physical exercise.
However, it should be noted that excessive consumption of sugary drinks determines a significant increase in the incidence of obesity and hence diabetes, mainly among the younger population.
However, once diabetes is diagnosed by a specialist in endocrinology , nutrition is one of the mainstays of treatment thereof. There are no "special rules" in the nutritional approach to people with diabetes (mainly type 2) and the advice is to keep the principles of a healthy and balanced diet in the proportion of its components.
In the case of pregnancy, what should you do?
Pregnancy is a physiological situation that increases the risk of diabetes, which is usually transient, but can adversely affect fetal development. Gestational Diabetes is called.
The key lies in proper planning of pregnancy. To avoid developing gestational diabetes is essential to start pregnancy with a healthy weight, especially if there is a history of diabetes in the family.
Moreover, diabetic woman can get pregnant without problem, whenever present adequate control of their blood glucose levels and pregnancy is planned with your doctor long enough to make a complete evaluation and appropriate modifications in treatment.
In most hospitals are units of Diabetes and Pregnancy, they allow to handle this situation in a proper way and without complications.
Is it a hereditary disease?
Although you can believe otherwise, diabetes with greater genetic load is type 2 diabetes or adult. There is a high probability of developing it if some of the first-degree relatives already have it. It is good to know this end, allowing an impact on prevention from an early age, trying to avoid the occurrence of obesity.
However, type 1 diabetes, need other internal and environmental factors (not well known), apart from genetic, for its development.
Edited by Roser Berner Ubasos.