Can diabetes be cured | The point of self-control | Hospitalization | Physical activity | Inevitable complications
Can diabetes be cured?
This question is often asked by patients with type 1 diabetes, especially if it manifests itself in childhood. Unfortunately, there are no cases of cure for type one diabetes mellitus (T1DM) all over the world. T1DM is a genetically determined disease that in most cases develops as a result of spontaneous (random) gene mutations. This “breakdown” leads to the fact that the person’s own immune system ceases to perceive the beta cells of the pancreas, synthesizing the hormone insulin, as their own, which leads to the death of these cells and an absolute deficiency of insulin.
The clinical symptoms of T1DM appear when about 75% of the beta cells have already died. The rest will die in the next 2-3 years. Therefore, at the moment, insulin therapy is the only proven method of treatment that allows patients to live. Insulin therapy does not affect the process of autoimmune aggression: it replenishes only the insulin that is no longer sufficient for the body.
Insulin therapy is the only proven method of treatment that allows patients to live.
Good insulin medications, modern insulin delivery methods, and training in diabetes self-management have allowed our T1DM patients to study, work and live normally without diabetes complications for many decades.
What is the point of self-control in diabetes mellitus?
Self-management of diabetes mellitus is the competent management of your disease.
In order to protect himself from the complications of diabetes mellitus, the patient must strictly adhere to a rational diet, physical activity, and his own individual treatment regimen.
Patients need to independently monitor their blood glucose levels throughout the day using a glucometer. With type two DM, it is important to do a “glycemic profile” once a week, that is, to watch blood glucose on an empty stomach, before lunch, dinner and at night. These studies can be done on different days throughout the week. This is important for making changes in diet, physical activity, and medication.
A daily study of blood glucose, obtaining high values and the absence of any changes is not effective!
A daily study of blood glucose, obtaining high values and the absence of any changes (primarily in nutrition and physical activity, as well as in treatment) is not effective! This leads to the rapid progression of diabetes complications and disability.
The patient learns about individual target values, upper and lower permissible limits of blood glucose levels from an endocrinologist. At the School of Diabetes Mellitus, patients will be taught how to adjust their diet, physical activity, and medication.
Each patient should know their target blood glucose levels.
For ease of reference: the HbA1c target number corresponds to the desired fasting blood glucose level, before meals and at night.
After a meal, blood glucose may be 1.5 to 3.0 mmol / L higher (the higher the target HbA1c level, the greater the difference between fasting and post-meal blood glucose). For example, if the target HbA1c level is less than 6.5%, then on an empty stomach, before meals and at night, it is recommended to adhere to blood glucose less than 6.5 mmol / L, and 2 hours after a meal — less than 8.0 mmol / L.
If the target HbA1c level is less than 7.5%, then the desired fasting blood glucose level, before meals and at night — less than 7.5 mmol / L, 2 hours after meals — less than 10.0 mmol / L.
Thanks to the knowledge gained at the School of Diabetes and competent self-control, the patient can manage his diabetes. If, despite all the measures, it is not possible to correct the blood glucose level, the patient is referred for a consultation with an endocrinologist.
When do you have to go to the hospital?
Currently, patients with type 2 diabetes are mainly examined and treated on an outpatient basis. The exception is acute conditions, accession, or exacerbation of concomitant diseases, such as pneumonia, appendicitis, pyelonephritis, and others.
If a patient with type 2 diabetes receives appropriate antihyperglycemic therapy, his well-being does not deteriorate with a single increase in blood glucose levels.
Symptoms such as severe thirst, profuse urination, the presence of acetone in the urine, sudden weight loss, dry skin and mucous membranes are grounds for hospitalization of the patient in the endocrinology department of a multidisciplinary hospital.
Also, a patient with diabetes mellitus can be referred for planned hospitalization to a hospital if:
- during long-term outpatient follow-up, it was not possible to find an effective treatment regimen for him;
- the patient has aggravated complication of diabetes mellitus and requires intensification of therapy, including insulin therapy;
- the patient does not comply with the indicated diet and treatment regimen, which inevitably leads to a deterioration in his condition.
Why do people with diabetes need physical activity?
Glucose is a universal fuel for all cells of the human body. Almost all cells in our body consume glucose only in the presence of insulin; There are only two types of cells that are able to use glucose without insulin — these are brain cells and working muscles. When we are actively involved in exercise, we give some to the muscles, we thereby open up “spare pathways for its burning” for glucose, which leads to a decrease in blood sugar.
Therefore, patients with diabetes should definitely take time out for physical activity every day. Aerobic (in the open air) physical exercise is recommended: brisk strides, swimming, yoga, gymnastics are suitable — only 30 minutes a day and at least 150 minutes. in a week! Considering that concomitant cardiovascular diseases and hypertension often develop with diabetes mellitus, it is worth consulting with an endocrinologist or cardiologist about the types of physical activity that are indicated for you.
Is it true that all diabetic patients sooner or later completely lose their sight, suffer from kidney failure, or have to endure amputation of the lower extremities?
No, this is not so, serious complications can be prevented! Type 2 diabetes mellitus is dangerous in that it is asymptomatic for a long time and manifests itself quite late. During this latent period, vascular complications can develop: nephropathy, diabetic foot, retinopathy, and others.
Why is this happening? With T2DM at the onset of the disease, there is a sufficient level of insulin in the body, but the cells are less sensitive to it, insulin resistance develops. And insulin is needed to deliver the glucose molecule through the pores to the cells. The glucose molecule is large enough; trying to pass through the pores of the vascular wall in conditions of insulin resistance, it is able to block the path of oxygen and nutrients to the cells. As a result, the cells die, and since pain receptors die along with them, the patient does not feel that something is wrong with his body for a long time. A striking example is trophic ulcers of the foot: they do not hurt, but they do not heal for a very long time, which leads to tissue suppuration.
Diabetes complications can only be prevented when blood glucose targets are met.
At the moment we have all the modern medicines for the treatment of diabetes mellitus, and this allows us to significantly extend the life of patients and preserve their quality of life. However, you need to understand that to a large extent diabetes is treated not so much with medications as with self-control and maintaining the correct active lifestyle.