Diabetes, what is it?

Diabetes is a chronic condition caused by the pancreas failing to synthesize the required amount of insulin, producing low-quality insulin, or being unable to use it effectively. ​Insulin, a hormone produced by the pancreas, primarily maintains proper blood glucose levels. It facilitates glucose entry into the body and its transport into cells, where it transforms into energy for muscle and tissue function. Additionally, it helps store glucose in cells until needed.

People with diabetes have excess blood glucose (hyperglycemia) because it is not distributed properly. Noemí González, secretary of the Spanish Diabetes Society (SED) and an endocrinologist at La Paz Hospital in Madrid, explains that elevated glucose can harm "the entire body, especially the heart, kidneys, and arteries, increasing the risk of kidney problems, heart attacks, vision loss, and lower limb amputations."

Types of Diabetes

Type 1 Diabetes: Generally appears in children but can also begin in adolescents and adults. It often occurs suddenly, regardless of family history. It results from the destruction of insulin-producing beta cells in the pancreas by autoantibodies, meaning the body attacks its cells as if they were foreign.

Type 2 Diabetes: Common in adults, especially older people, and is ten times more prevalent than Type 1. It involves reduced insulin action, where even high insulin levels cannot function effectively. According to González, "Type 2 has a mixed component: less insulin in the pancreas and poor insulin functionality in tissues (insulin resistance)."

Gestational Diabetes: During pregnancy, insulin levels increase to boost energy reserves. If this increase doesn't occur, gestational diabetes can develop, typically disappearing after childbirth. However, affected women face a higher risk of developing Type 2 diabetes later in life.

Symptoms

Potential symptoms of high glucose levels include: - Excessive thirst (polydipsia). - Intense hunger (polyphagia). - Frequent urination, even at night (polyuria). - Weight loss despite eating well. - Fatigue. - Blurred vision. - Tingling or numbness in hands and feet. - Recurrent fungal skin infections.

Diabetic Foot

A common issue for diabetes patients is diabetic foot, resulting from sensitivity changes (peripheral neuropathy) and arterial circulation problems (peripheral arthropathy). The risk of developing this increases with disease progression, with an amputation incidence of about 4 per 1,000 patients annually. It is estimated that 15% of diabetics will experience diabetic foot lesions during their lifetime.

Warning Signs of Diabetic Foot

Initial symptoms include redness, increased foot temperature, persistent calluses, and ulcers that may deepen, leading to osteomyelitis or advanced gangrene. Proper monitoring and control can prevent these issues.

Basic Care for Diabetic Foot

Strict diabetes control and managing risk factors significantly reduce complications. Diabetic patients should have regular foot exams by healthcare providers and follow proper hygiene and care practices, such as: - Avoid cutting nails too short. - Avoid walking barefoot. - Check water temperature before soaking feet. - Use moisturizing creams.

Prevention

Currently, Type 1 diabetes cannot be prevented despite ongoing research. However, Type 2 diabetes, the most common form, is preventable. Preventing obesity through active lifestyles, avoiding junk food and sugary drinks, can reduce Type 2 diabetes risk by 80%.

Treatments

Diabetes treatment is based on three pillars: diet, exercise, and medication. The goal is to maintain normal blood glucose levels to minimize complications.

Insulin is the only treatment for Type 1 diabetes: Administered via injection using insulin pens or continuous infusion systems. Patients must frequently monitor glucose levels using glucometers or interstitial glucose sensors, some of which are now subsidized in certain regions.

Type 2 diabetes offers a broader range of treatments: Unlike Type 1, insulin is not always necessary. A healthy lifestyle and weight loss can normalize glucose levels.