Unlike what happens with other diseases, type 2 diabetes usually has no symptoms, it is silent. The reason is that these usually appear when glucose levels are high.

In the case of many diseases, it would be unthinkable for half of the patients to remain undiagnosed for years. However, this occurs with one of the most prevalent: type 2 diabetes.

The delay in its diagnosis and early treatment explain why it has become the fourth cause of premature death in the world among women and the eighth among men, according to the WHO. Ten percent of deaths between the ages of 35 and 64 are attributed to type 2 diabetes.

An early diagnosis and efficient follow-up when it has already been detected not only affect the life expectancy of patients, they also determine their quality of life.

And on the contrary, the worst-controlled patients have a higher number of hospitalizations due to health complications derived from diabetes than the rest of the population. They also suffer more readmissions and hospital stays are longer.

The conclusion of the International Diabetes Federation (IDF) is clear: “Without effective prevention and control programs, the impact will continue to increase in the world.”

The Diabetes Strategy, approved by the Interterritorial Council of the National Health System in 2006, already recognized that “the biggest problem is the rate of growth” of the disease.

To reduce it, two strategic lines were proposed: the promotion of healthy lifestyles, which would reduce the incidence of obesity, and early detection. However, the updates that have been made to the strategy have had to recognize that the plans have not yielded the desired results.

Physical inactivity and the deterioration of eating habits have increased the percentage of the population with obesity.

Physical inactivity and the deterioration of eating habits have increased the percentage of the population with obesity. In type 2 diabetes it has had an immediate effect: the prevalence has doubled since 2006, it has already become a public health priority.

One of the problems is that the complications associated with the disease are so varied that, even when there are symptoms, they may not be attributed to hyperglycemia.

The delay in diagnosis is sometimes of at least eight years. As it is a common disease and in most cases asymptomatic, screening becomes a fundamental tool.

The Diabetes Strategy recommends doing it every three years in the population over 45 years of age and every two years in risk groups, that is, in people who are overweight or obese, with high blood pressure, cholesterol or with a family history.

The indications are clear, but they are applied very unevenly and to a very small percentage of the population. Screening should be done systematically, as with other diseases.

This delay in diagnosis has important consequences. Often, when the disease is detected, the person already has serious health problems.

About 12% of the health budget goes to diabetes, and most of it is dedicated to treating the health complications it causes, not preventing it.

Prevention is insufficient and diagnosis late, but do things improve once the disease has been detected? The health system also presents important gaps in the exhaustive follow-up of patients, which must be carried out from the moment of diagnosis.

This control, together with adherence to treatment, is essential to minimize the risk of associated complications, so awareness campaigns should deepen training, aimed at both patients and their families.

The Diabetes Strategy points out the importance of addressing the disease from a global perspective, taking into account “therapeutic education, self-care and coordination between levels of care.”

The first one, primary care, is essential. Patient associations and scientific societies have long called for diabetes units in primary care composed of a doctor and a nursing professional specialized in the care required by patients and also focused on health education.

Specialists point out that, once the diagnosis is received, it is very important to apply weight reduction strategies that have proven to be the most successful in the long-term control of diabetes. The fundamental objective is that the person diagnosed knows the disease.

Unlike what happens with other diseases, type 2 diabetes usually has no symptoms, it is silent. The reason is that these usually appear when glucose levels are high.

That is why the precursor to the disease, prediabetes, is important. It is very common and, most importantly, it is reversible. Introducing changes in the lifestyle, improving someone’s diet and doing regular physical exercise can help people avoid the disease.

However, the concept is under review because some specialists understand that it is misleading, it does not convey the idea that this stage already carries significant health risks.

Many people with prediabetes have a high cardiovascular risk due to the risk factors they have, such as cholesterol, hypertension, and being overweight or obese.

At this point, an intensive treatment of these risk factors should be started. And the sooner it is done the better, because, although most can be modified, there are some that cannot. Chief among them is age.

 

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