24.11.2020

Diabetes: the patient is also responsible for their health

It is well known that diabetes, along with cancer, lung disease and cardiovascular diseases attributed to non-communicable epidemics. And diabetes some experts call “the plague of the 21st century.” Typical patients with type 2 diabetes, risk factors and control methods, edition News.Medicine talked with the Professor, doctor of medical Sciences, academician of the Russian Academy of Sciences Marina Vladimirovna Shestakova.

What are the statistics of diabetes in Russia and in the world?

According to statistics, the number of diabetes patients on the planet every 15 years is doubled. In Russia there is a similar trend. In our country since 1996 we are a register in which is entered information about each patient with diabetes. According to collected data, we now Russia is home to about 4.5 million patients with diabetes of which 4 million patients with type 2 diabetes. Is diabetes occurred in adults due to lifestyle features – hypercaloric nutrition and a sedentary lifestyle. All this contributes to the development of excess body weight, obesity and consequently, diabetes. 80% of obese patients must have diabetes.

Unlike type 1 diabetes, which comes suddenly and spontaneously, while type 2 diabetes know exactly why it occurs. If overweight and obesity were not, there would be no diabetes.

And how many patients not included in the register?

Despite the fact that the patient charts are filled now 90%, of course there are patients for which information in the register is not paid. In addition, there are people who don’t go to the doctor, they just do not know they are ill, or know about their diagnosis, but are treated in private clinics, or even doing self-treatment.

Presumably such patients in the country and another 4.5 million, this means that the number of patients with type 2 diabetes in Russia is two times more than entered in the register – about 9 million.

As usual there is a diagnosis of diabetes?

Type 2 diabetes is usually diagnosed in the later stages of the disease. Acute symptoms as type 1 diabetes, when a person begins to disturb thirst, diabetes, weight loss, have this form of diabetes is not. Therefore, the onset and a slight increase in sugar patients often do not notice, but thirst, polyuria, boils, severe fatigue and demotiviruet weakness appear in the later stages.

That’s why all those people over 45 who pass the screening must submit to a blood sugar fasting. Unfortunately, we as professionals understand that such analyses may not always catch already developed diabetes, it would be more correct to check blood sugar and fasting and 2 hours after a meal. It is, however, not always possible.

A generally accepted standard, which is approved and recommended by the world health organization that enables you to diagnose diabetes, regardless of the meal, is the determination of glycated hemoglobin. He’s talking about fluctuations in blood sugar over the past three months.

This analysis, incidentally, is included in the clinical examination – it is administered once the level of fasting blood sugar is elevated. In addition, they can hand it on their own in the commercial laboratories.

After receiving the results of such analysis can reveal or diabetes , or prediabetes. During the next stages of the examination the doctors will monitor, does prediabetes in diabetes – these patients usually medicines are not assigned, but are given recommendations about lifestyle changes.

Who is at risk of developing type 2 diabetes ?

A typical patient with diabetes – people over the age of 45, he usually 55-60. Now, however, type 2 diabetes younger and may be detected even in children and adolescents.

The body mass index of the patient is usually above 27 kg/m2. People with risk of diabetes, usually do not do sports in General lead a sedentary lifestyle, almost never walks, their food is very rich in calories.

At increased risk well as those whose close relatives suffer from type 2 diabetes – the hereditary factor can be traced quite clearly. Women who have had gestational diabetes (diabetes that developed during pregnancy), is also at risk. After the baby is born, the diabetes usually disappears without a trace, but after 5-10 years the disease can return in the form of type 2 diabetes. Another risk factor is the birth of large fetus, the baby weighing more than 4 kg. This is an indirect indication that the woman suffered gestational diabetes.

Is there a type 2 diabetes in apparently thin enough people?

Diabetes is associated with excess fat. The fat that can be deposited in different places, for example in subcutaneous fat (hips, buttocks). The fat cosmetically not always pleasant, but metabolically in terms of diabetes, he is not very dangerous.

It’s the internal fat, which is deposited in the internal organs (omentum, liver, kidney, pancreas, heart shells, the walls of blood vessels) is the most dangerous in terms of development of type 2 diabetes. As a rule increases the abdomen. This is also called abdominal obesity (from the English word “abdomen” the abdomen). Externally, this type of obesity can be, at first, not even very noticeable. Therefore, even relatively slim people can be in the high risk group. To overcome this type of obesity, you need to arm yourself with measuring tape and measure the waist circumference (FROM) and the circumference of the hips (ABOUT). If obesity is a, the ratio will be FROM ABOUT greater than 1.

Does the diagnosis of the patient’s life?

Now the life of patients with diabetes is easier than 10-15 years ago. New drugs that have minimum side effects, new technologies that help people with diabetes manage the disease. One of these technologies – non-contact scanner and the FreeStyle Libre sensor. People with diabetes need to constantly check the level of glucose in the blood, a new device allows you to do it without punctures fingers. It is not just the children but also for adults. Thanks to new technology eliminates the need to constantly puncture to determine blood sugar levels, which certainly improves the quality of life of patients with diabetes.

Our research shows that people know a lot about healthy lifestyles and risk factors of developing diabetes, but practically does their knowledge is not used.

So even after diagnosis the lives of many of them, unfortunately, almost does not change. After the doctor explains everything and gives recommendations about nutrition and physical activity, the first time people try to change their way of life. Soon, as a rule, the motivation fades, the person simply ceases to monitor the performance and maintain a healthy lifestyle – it all comes back to previous levels.

In fact, actively engage with your health, carefully observing the rules of an active lifestyle , abstaining from overeating, it is even possible to achieve stable compensation of diabetes and to reduce the doses of medications or even achieve remission of diabetes when it is possible to completely cancel drug therapy – this occurs in 10-15% of very motivated patients, observing a proper diet and exercise routine. Thus, success in the treatment of diabetes depends not only on the doctor, but is largely dependent on the patient, which also needs to take responsibility for their health.

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