Comprehensive” and “correct” understanding of diabetes from experts

08/05/2023

Diabetes mellitus is a chronic metabolic disorder characterized by increased blood glucose levels above normal levels, caused by defects in insulin secretion. Diabetes causes a number of dangerous complications and is the leading cause of cardiovascular disease, kidney failure, blindness and amputation.

Overview of Diabetes

According to the statistical report of the Global Burden of Disease Collaborative Network (GBD) in 2019 across 204 countries and territories, Diabetes is a of the three leading causes of death in the world.

Data from the International Diabetes Federation (IDF) in 2021 also shows that the number of people with diabetes worldwide at the age of 20 – 79 years accounts for 1/10, and in 6 children born, 1 child is affected by this disease from the stage of fetal development.

Meanwhile, according to the results of an investigation by the Ministry of Health of Vietnam in 2021, there are currently nearly 5 million people suffering from this disease, of which more than 55% of patients have complications such as cardiovascular complications (34%), kidney complications (24%), eye and neurological complications (39.5%).

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1204-1222.Erratum in: Lancet. 2020 Nov 14;396(10262):1562.

Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee . IDF DIABETES ATLAS [Internet]. 10th edition. Brussels: International Diabetes Federation; 2021.

Bộ Y Tế, Kết quả điều tra tình trạng đái tháo đường tại Việt Nam. 2021

In 2021, 5 million people suffering from diabetes in Vietnam (Photo: Freepik)

In 2021, 5 million people suffering from diabetes in Vietnam (Photo: Freepik)

Also according to the Vietnamese Ministry of Health, 70% of cases of type 2 diabetes have preventive treatment plans and slow down the disease’s appearance by following a healthy scientific lifestyle with reasonable nutrition and exercise. However, only 31.1% of people with diabetes have been diagnosed, of which only 28.9% of people with diabetes are managed at medical facilities4. Therefore, the management, screening and raising awareness of diabetes in the community is receiving attention and concern from the government and health organizations in the situation of an increasing number of diabetes patients.

So, what is diabetes? According to the definition given by the World Health Organization in 2002: “Diabetes mellitus is a chronic disease caused by lack of insulin production by the pancreas or ineffective insulin action due to acquired and/or genetic causes with consequences of raised blood glucose. Hyperglycaemia damages many systems in the body, especially blood vessels and nerves”

Diabetes causes many dangerous complications if not detected and treated promptly (Photo: Freepik)

Diabetes causes many dangerous complications if not detected and treated promptly (Photo: Freepik)

Currently, there is no treatment to help diabetic patients completely cure diabetes, however, early detection and diagnosis of the disease enable options for patients to manage the condition and prevent unexpected complications.

Types of diabetes and criteria for diagnosing diabetes

According to the American Diabetes Association (ADA), diabetes is classified into 4 types as follows :

– Type 1 diabetes: The body has an absolute lack of insulin due to the destruction of pancreatic beta cells.

– Type 2 diabetes: The body gradually loses the ability to secrete insulin due to the gradually decreasing function of pancreatic beta cells, progressing on the basis of previous insulin resistance.

– Pregnancy diabetes: The medical condition of diabetes is detected and diagnosed in the second or third trimester of pregnancy, and the pregnant woman has not previously had any type of diabetes..

– Diabetes due to other causes: For example, monogenic diabetes syndromes (such as neonatal diabetes and young-onset diabetes), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), pituitary, thyroid, and adrenal and drug- or chemical-induced diabetes (such as glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation).

American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S17-S38.

Diabetes causes many dangerous complications if not detected and treated promptly (Photo: Freepik)

Diabetes causes many dangerous complications if not detected and treated promptly (Photo: Freepik)

The following are some groups at high risk of prediabetes and type 2 diabetes:

– The overweight and obese (BMI index ≥ 23 kg/m2)

– Having a first-degree relative (parents, siblings, biological children) has diabetes – History of atherosclerosis

– Hypertension (Blood pressure ≥ 140/90 mmHg, or being treated for hypertension)

– People with lipid metabolism disorders (HDL cholesterol < 35 mg/dL (0.9mmol/L) and/or triglycerides >250mg/dL (2,8mmol/L))

– Women with polycystic ovary syndrome

– People with little physical activity

– Women who have been diagnosed with gestational diabetes

– People aged 45 and over

– Other clinical conditions related to insulin resistance

During testing, people whose test results fall into 1 of the following 3 criteria will be diagnosed with pre-diabetes and need to be monitored regularly, as well as required to have more healthy lifestyle:

– Fasting blood sugar from 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L)

– Blood sugar after 2 hours of tolerance test with 75g of oral glucose from 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L)

– HbA1C index from 5.7–6.4% (39–47 mmol/mol)

Basic Diabetes treatment methods

In the treatment of diabetes, patients need to be assessed for basic health status, accompanying diseases, living habits, economic, social, psychological conditions, and life prognosis, thereby individualizing treatment goals. Below are some general diabetes treatment measures:

– Consulting on treatment compliance and weight control instructions

– Using oral medications and injections to lower blood sugar

– Control risk factors such as hypertension, dyslipidemia, and hemophilia

– Treatment and control of complications caused by diabetes

– Consulting on lifestyle change interventions including diet, physical activity and eliminating harmful habits. In particular, diet plays an important role in improving the health of people with diabetes. The main reason is that people with diabetes often encounter micronutrient deficiencies due to their daily diet. This causes the body to feel tired, numb to the limbs, and cause blood sugar to fluctuate erratically, increasing the risk of complications during the disease. At this time, patients can use specialized nutritional products for people with diabetes such as Glucare Gold to support blood sugar control while improving patient health.

Glucare Gold contains the Glucare sugar powder system (Isomalt, Maltitol, Palatinose) with slow absorption and Chromium imported from the United States to help balance blood sugar for diabetics every day. In particular, the product has been clinically proven to have a low glycemic index, making it safe for diabetics. Glucare Gold nutritional products contain 38 essential nutrients such as high quality Protein, Omega 3, Omega 6, Vitamins and minerals to help improve health every day. The product is suitable for diabetics, and people at risk of diabetes. With 2 cups morning and evening, Glucare Gold helps balance blood sugar, improving health every day for patients.

Lifestyle changes including diet, physical activity and eliminating harmful habits are one of the basic methods in treating Diabetes (Photo: Freepik)

Lifestyle changes including diet, physical activity and eliminating harmful habits are one of the basic methods in treating Diabetes (Photo: Freepik)

It’s essential for Diabetes treatment methods to be carried out according to the principles of: prioritizing lifestyle change interventions, minimizing the amount of medication used, regularly checking the effectiveness and compliance with old medications of the patient before new prescriptions, providing individualized regimens for patients regarding the patient’s ability to comply with treatment, cost and availability of treatment.

Thus, Diabetes is a disease that pose risk to different groups, it is dangerous and possibly results in complications. Therefore, it is necessary to diagnose the disease at an early stage to have timely treatment interventions to control the disease at an optimal level.

REFERENCES:

  1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1204-1222.Erratum in: Lancet. 2020 Nov 14;396(10262):1562.
  2. Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee . IDF DIABETES ATLAS [Internet]. 10th edition. Brussels: International Diabetes Federation; 2021.
  3. Bộ Y Tế, Kết quả điều tra tình trạng đái tháo đường tại Việt Nam. 2021
  4. Bộ Y Tế. Quyết định 5481/QĐ-BYT. 2020
  5. https://www.who.int/health-topics/diabetes#tab=tab_1
  6. American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S17-S38.
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