Diabetes is a problem that afflicts many Costa Ricans and to understand more about this issue, we have to define both terms since it is necessary to know that our body needs certain levels of glucose in the blood, so prediabetes is a condition where the body begins with problems regulating blood sugar, it can occur in anyone regardless age, gender, socioeconomic status and even country, prediabetes is a small warning in which glucose rises gradually and if not detected in time it could lead to diabetes. Approximately 5% to 10% of people with prediabetes, without making changes to treat it, will develop diabetes.
Now, diabetes is a disease that is caused by the accumulation or excessive levels of glucose / sugar in the blood, which not only cause acute effects, but also chronic complications that can affect vision, circulation, kidneys and heart.
For practical purposes, the difference between one and the other is the numbers, so it is very important to know that the same problem that leads to prediabetes if not treated could progress to diabetes, due to having a high level of glucose in the blood.
How many types are there?
We recognize that there are two main types of diabetes, type 1 and type 2. Type 1 diabetes generally occurs very aggressively, since the cells of the pancreas responsible for producing insulin are destroyed and stop producing it, so the person must use insulin from the beginning and for the rest of his life.
Type 2 diabetes is related to insulin resistance, where the body must work in a forced way, in order to maintain an average sugar level; that is, the pancreas begins with a large production that it cannot maintain in the long term. The above means that, when we have obesity or more fat in the abdomen as fat in our liver, our body demands a greater load of insulin that it is no longer possible to produce.
Main risk factors for developing diabetes?
The main risk factors have to do with our lifestyle and family history, that is, if our parents or close relatives had this condition. Obesity and overweight represent an important risk factor, especially if fat is concentrated in the abdomen since there the fatty tissue produces more inflammation and substances that affect metabolism, the fact of not doing physical activity, sedentary lifestyle; or have other conditions such as high blood pressure, cholesterol or triglyceride problems, fatty liver, polycystic ovaries or gestational diabetes, to name a few.
Is there a “formula” in terms of habits, lifestyle and diet, to prevent this condition?
Preventing type 2 diabetes helps us avoid significant wear and tear on our health. That is why a first step is to take care of the diet, you must have a balanced diet, taking care of the amount of flour and carbohydrates, it is very common that in the same dish 4 to 6 types of carbohydrates are served, such as rice, beans, a potato hash, an omelette, ripe banana, breaded fish, a snail salad, a fresh fruit; You must learn to balance all these foods to help your body.
If we choose a healthy diet and stay active, and make it our lifestyle, it is possible to prevent the development of type 2 diabetes for up to 30 years, added to this, several studies have confirmed that there is a decrease in mortality from heart disease and blood vessel complications, we can achieve all this by modifying these two elements in our lives.
How is the panorama of the region, regarding diabetes and also, in the specific case, in Costa Rica?
In Costa Rica and the region, the numbers continue to advance. Every time a survey of cardiovascular risk factors is done, the numbers that are reflected are increasingly alarming, diabetes is a silent pandemic.
Data from the International Diabetes Federation project that by 2030, more than 578 million adults in the world will be diagnosed with this disease. In the case of Costa Rica, according to the Costa Rican Social Security Fund (CCSS), 14.8% of the population over 20 years of age suffers from diabetes.
Is there the % of people in the country who do not know they have diabetes and it is not treated in time?
It is said that of this 15%, 2% do not know they have diabetes. For a person who does not visit the Dr. on a regular basis, what are some of the warning signs that they have prediabetes?
Signs: obesity, sedentary lifestyle, family history. There are marks that can be made on the skin, they are known as acanthosis nigricans, that is a dark lesion, it looks like dirt and is usually located on the neck, groin, armpits, under the breasts; in short, in those places where there are folds.
The other are what is popularly known as vein heads, they are injuries that, if they are in a large quantity in the neck, can indicate that there is insulin resistance and prediabetes.
Do you know of any website where people, in this case Costa Ricans, can find out the % risk of suffering from it?
Sure, currently we can use many tools that the internet provides us; However, the main recommendation is to go to the doctor; In case of not being able to do it, there are different risk calculators, for example there is the site www.prediabetes.la, where you can know the risk of presenting this condition from a simple questionnaire that analyzes the risk factors and helps us to identify the presence of this disease in time, which leads us to treat it and avoid the risk of progressing to diabetes.
Doctors seek to slow down the progression of diabetes, so we ask to go to a general check-up, where we can carry out blood tests such as the ‘glycosylated hemoglobin’ or glucose load test. In addition, an evaluation of body composition is extremely useful, where we not only see our weight in kilograms, but we can also know how much it is fat, muscle or water. With these measurement strategies we find out where the localized fat is, because if a lot is in the abdomen it is a risk factor for diabetes and we can carry out a better help strategy.
Has this condition grown during the pandemic (the last two years)?
Although prediabetes and diabetes are a silent pandemic, the current confinement has promoted an increase in the levels of obesity and overweight that are risk factors for progressing towards these diseases, so we could say that yes, the lifestyle in This pandemic has given way to a growth in these diseases.
By staying at home, locked up, for many hours with the use of screens, all this influences leaving a healthy lifestyle, and the risk of conditions such as obesity is greater, so it is important that people stay active and look for options that promote healthy habits
What are the main oral treatments for diabetes and how do they work in the body?
The main recommendation is to maintain a constant check-up and visits to the doctor, in addition to adopting a healthy lifestyle, exercise, good nutrition, and consume water. In addition to this, it has been shown that the early initiation of drug treatment can favor the reduction of complications derived from diabetes or prediabetes.
Within medications, the basis in the control of diabetes is usually the use of metformin, a safe drug with the experience of being with us for many years. It is important that you have an extended-release presentation, as this helps the tolerance to treatment is optimal and can be used as long as necessary for people with prediabetes or diabetes. Along with the above, healthy habits allow the patient to have a correct control of their glycemic indices, which favors adherence, allowing them an improvement in their quality of life and in their health in general.
The current pandemic gives us the opportunity to understand more about the implications of personal health, in addition to the fact that the use of telemedicine has been accelerated so that patients are cared for without neglecting their treatments.