How is the process after the diagnosis of diabetes? What are some of the main challenges that must be faced? These are some of the questions that patients ask themselves from the moment the health professional says, "you have a disease called diabetes".
Diabetes mellitus (DM) is a chronic condition that is triggered when the body loses the ability to produce enough insulin or to use it effectively. Given this, the body does not process glucose properly, so it is circulating in the blood, causing hyperglycemia (high blood sugar). Over time, hyperglycemia tends to damage body tissues, which in the future can cause various complications - acute or chronic.
When the doctor tells the patient that he has diabetes - be it type 1, type 2 or gestational - it begins what could be called a “new life” for that person who, from now on, must follow a series of instructions to maintain his health and preserve their well-being in the short, medium and long term.
Depending not only on the type of diabetes, but also on each person and their particular life circumstances (socioeconomic context, psychological and emotional state, and regular activities, among others), each patient must adhere to a plan or treatment permanently - which can be modified as long as the health professional considers it appropriate.
How is DM diagnosed?
According to the National Institute of Digestive and Kidney Diseases (NIDDK), while the symptoms of type 1 diabetes can appear quickly, in a matter of weeks, in type 2 diabetes they can progress very slowly and even, be so light that they don't even get to be noticed over several years.
Some of the main symptoms of diabetes are: increased thirst (polydipsia), frequent and abundant urination (polyuria) and increased appetite (polyphagia); fatigue and blurred vision; numbness and tingling in the hands and feet; ulcers that do not heal or take a long time to do so; and weight loss for no apparent reason, among others.
When several of the mentioned symptoms appear, it is important to determine through medical examinations if, in fact, it is diabetes. According to the Latin American Diabetes Association (ALAD), any of the following criteria can be used to make the diagnosis of diabetes mellitus:
- Symptoms of diabetes, plus a casual blood glucose - at any time of the day not related to the time elapsed since the last meal - measured in venous plasma that is equal to or greater than 200 mg / dl.
- Fasting blood glucose - a period without caloric intake of at least eight hours - measured in venous plasma that is equal to or greater than 126 mg / dl.
- Blood glucose measured in venous plasma equal to or greater than 200 mg / dl, two hours after a 75 g glucose load during an oral glucose tolerance test (PTOG).
- An HbA1c (glycosylated hemoglobin) greater than or equal to 6.5%, using a methodology traceable to the NGSP standard (National Glycohemoglobin Standardization Program).
What follows diagnosis?
And to achieve this goal, it is necessary to maintain a positive attitude towards life and sufficient self-control to meet as much as possible all the goals set in the health field under the supervision of your treating doctor. Life after diagnosis includes frequent visits to the doctor (controls that should be done regularly every three months, in general), eventual medical emergencies and even occasional hospitalizations - which can be significantly reduced or avoided with proper management of the disease.
As in any encounter with the unknown or not experienced, it is very useful and beneficial for the patient to surround himself with his family and with people who help him strengthen his spirit and accompany him in the process of adaptation to his "new life", In which you should follow, among other recommendations: a healthy or balanced diet, perform regular or moderate physical exercise, use insulin or take the medications indicated for the treatment of diabetes, perform self-monitoring of sugar levels at home with the glucometer and avoid or manage stress in the best possible way.
General recommendations - How to accept the diagnosis? ---- ›(See second entry of Diabetes: life after diagnosis)
ReferencesALAD Magazine [PDF]. ALAD Guidelines on the Diagnosis, Control and Treatment of Type 2 Diabetes Mellitus with Evidence-Based Medicine Edition 2019 [published in 2019; accessed April 27, 2020]. Available at: http://revistaalad.com/guias/5600AX191_guias_alad_2019.pdf
National Institute of Diabetes and Digestive and Kidney Diseases [website]. Symptoms and causes of diabetes [published in November 2016; accessed April 27, 2020]. Available at: https://www.niddk.nih.gov/health-information/informacion-de-la-salud/diabetes/informacion-general/sintomas-causas