National Diabetes Day, celebrated this Sunday (26), reinforces the importance of healthy habits to prevent the disease, which affects more than 537 million adults aged between 20 and 79 years, representing 10.5% of the world population in this age group. age. The data are from the Diabetes Atlas 2021, released by the International Diabetes Federation (IDF).
Brazil is the sixth country in terms of incidence of diabetes in the world and the first in Latin America — there are 15.7 million adults with this condition, and the estimate is that, by 2045, the disease will reach 23.2 million adults. Brazilians.
Retired Walquiria Lopes, 64, had the first sign that she might have the disease in a routine test at the office where she worked. After a month of medical follow-up and daily measurement of capillary blood glucose, she received the diagnosis: type 2 diabetes.
“I was very scared because they already wanted to give me insulin, because [o índice] it was too high. Then I started treatment with an endocrinologist. The discovery is very important, because I had no symptoms, diabetes is a silent disease. I was not thirsty, as I was already drinking water because of kidney stones. I no longer ate a lot of sweets, but I ate a lot of carbohydrates, and I didn’t know that this could also cause the disease”, recalls Walquiria. The pensioner highlights the importance of the exams and says that it was with the prick on her finger that she got the alert. Confirmation of the disease came later, with blood tests.
Walquiria learned to live with diabetes, managing the disease properly. “I still don’t have any symptoms, but I live with the disease by doing periodic exams, taking the medication and going to the doctor regularly.” She reinforces that the exam is important because, if diabetes is discovered early, the person can start treatment. With proper treatment, life is perfectly normal, she says.
types
There are four types of diabetes, explains the endocrinologist and president of the ABC Diabetes Association, Marcio Krakauer. “Type 1 is due to an autoimmune disease, in which the body stops producing insulin at that moment (or a few hours and days before), and the symptoms are excessive, such as hunger, intense thirst, weight loss, blurred vision, infections urinary and genital, body aches”.
In this type, when insulin is replaced, the individual gets well quickly. Type 2 diabetes is a disease that mixes hereditary with weight gain and appears very slowly in life. Usually, when a diagnosis is made because of such symptoms, they have been around for about five years or more, he adds. According to Krakauer, type 2 diabetes is completely asymptomatic or mildly symptomatic.
Pre-diabetes is a very early condition. “We give it that name, but actually the glucose is no longer normal. Diagnosis is made by fingertip glucose numbers, either the glycated hemoglobin test or the glycemic curve test. It’s the beginning of the history of diabetes”, and then people need to be treated to prevent them from getting diabetes, emphasizes the doctor.
Gestational diabetes is the one that appears because of pregnancy. “In general, they are obese women, who have a history of parents with type 2 diabetes and who, when they are between the 26th and 28th weeks of pregnancy, due to pregnancy hormones, can present high glucose, diabetes. These women should be treated because there can be many complications for both mother and baby,” notes Krakauer.
live with the disease
The risks of diabetes are many, but there are adequate ways to control the disease. “All [os tipos de diabetes] need a lifestyle change: foreground, eating healthy, nutritionally adequate. Those who are overweight should lose weight, those who are underweight gain or maintain the weight.
He adds that it is important to cut down on simple carbs and give preference to whole carbs, ingesting them in small amounts, and having the food fractionated throughout the day. The dish needs to be composed in a healthy way: half vegetables, greens, salads, a quarter of whole carbohydrates and a quarter of protein, which can be vegetable or animal.
Those who have type 1 diabetes need to replace insulin, as it does not produce the hormone, and maintain healthy lifestyle habits. Insulin, a hormone produced by the pancreas, is responsible for taking glucose from the blood into the cells.
Gestational diabetes, depending on the situation, can be treated only with healthy eating. “If necessary, gestational diabetes can be treated with insulin. For the time being, no oral medication is used. Although some studies release metformin, for now, insulin is only released during pregnancy. And physical activity too. In fact, physical activity is important for all types of diabetes and for all people.”
According to the doctor, to live with the disease, monitoring and education are necessary. “You have to do a fingertip test or use glucose measurement continuously for decision making, both to see the effect of food, the effect of the emotional part, of blood glucose, the effect of exercise, medication, insulin . Monitoring is very important.”
Krakauer explains that when diabetes is well compensated, with parameters close to normal, the chance of chronic complications is minimal. “But those who are [com o diabetes] poorly controlled and for a long time, they can have complications in the eyes – the disease is the biggest cause of blindness in the world –, in the heart and peripheral arterial diseases.”
There may also be neurological problems, warns the doctor. “We call it diabetes neuropathy, which greatly increases the chance of losing sensation in the feet. These individuals may have infections and undergo amputations, as well as kidney disease from diabetes that leads to hemodialysis or a kidney transplant. And several other issues, such as fat in the liver, lung diseases, worse response to infections, such as, for example, covid-19.”
The doctor explains that those who have diabetes respond poorly to the disease because high glucose lowers immunity to infections. “When the disease is controlled and well compensated for a long time, this does not happen.”
Prevention
Formula to prevent and control diabetes combines physical exercise and healthy eating – Archive / Brazil Agency
The formula healthy eating and physical exercise is the most effective way to prevent the disease, guides the specialist. “The mix is: healthy eating, weight loss for those who are overweight, lots of exercise, drinking lots of water, getting enough sleep and reducing stress when possible.”
Krakauer emphasizes that ultra-processed foods also accelerate the incidence of the disease. “Ultra-processed foods are foods with a high content of white flour, sugars and fats, which are harmful to the body. The individual who is prone to type 2 diabetes can, with the excess of ultra-processed foods, gain weight very quickly in the belly region and present excess fat in the liver and pancreas. [esteatose hepática ou pancreática]which is a huge risk factor for the onset of the disease.”
Staying away from cigarettes and alcohol is another way to lower the risk of getting the disease, says the doctor. “Do not smoke under any circumstances, reduce alcoholic beverages, for those who drink them in excess, lead a healthy life, as much as possible. Sometimes, medications that can reduce the risk of diabetes by around 30% may be indicated.”
Portal
Initiatives that provide quality information contribute to the proper management of the condition is a way to help those seeking knowledge. One of them is the portal Like youwhich brings together informative and educational content for patients and their families to learn and improve diabetes management.
Launched last week by Roche Diabetes Care, the portal aims to help people with diabetes to understand the appropriate measures and take better care of their health.
For the doctor, information is essential for changing the lifestyle of those who want to avoid diabetes and those who need to live with the disease. “It’s a lifestyle change. And you need knowledge, information, education to achieve transformation.”
