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 20 to 79, or 10.5% of the population. world of this age group. The data comes from the Diabetes Atlas 2021, published 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 the condition, and the estimate is that by 2045 , the disease will affect 23.2 million Brazilian adults.
Pensioner Walquiria Lopes, 64, had the first sign she might have the disease during a routine test at the office where she worked. After a month of medical follow-up and daily measurement of capillary blood sugar, 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 due to kidney stones. I wasn’t eating a lot of sweets anymore, but I was eating a lot of carbs, and I didn’t know that could also cause the disease,” Walquiria recalls. The retiree stresses the importance of the exams and says that it was with the finger prick 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 having periodic check-ups, taking medication and going to the doctor regularly.” She stresses that the examination is important because if the diabetes is discovered early, the person can start treatment. With proper treatment, life is perfectly normal, he says.
There are four types of diabetes, says endocrinologist and president of the ABC Diabetes Association, Marcio Krakauer. “Type 1 is caused by an autoimmune disease, in which the body stops producing insulin at this time (or hours and days before), and symptoms are excessive, such as hunger, intense thirst , weight loss, blurred vision, urinary and genital infections, body aches”.
In this type, when insulin is replaced, the person recovers quickly. Type 2 diabetes is a disease that combines hereditary and weight gain and which 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 in reality the glucose is no longer normal. Diagnosis is made by fingertip glucose counts, either the glycated hemoglobin test or the glycemic curve test. This is the beginning of the story of diabetes”, and then people have to be treated to prevent them from becoming diabetic, underlines the doctor.
Gestational diabetes is the one that appears because of pregnancy. “In general, these are obese women, who have a history of parents with type 2 diabetes and who, when they are between the 26th and 28th week of pregnancy, due to pregnancy hormones, can present with blood sugar high, diabetes. These women need to be treated because there can be many complications for the mother and the 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 for a change in lifestyle: in the foreground, eating healthy, nutritionally adequate. Those who are overweight should lose weight, those who are underweight should gain or maintain their weight.
He adds that it’s important to reduce simple carbohydrates and favor whole carbohydrates, ingesting them in small amounts and breaking up foods throughout the day. The dish should be composed in a healthy way: half vegetables, greens, salads, a quarter whole carbohydrates and a quarter proteins, which can be vegetable or animal.
People with type 1 diabetes should replace insulin, as it does not produce the hormone, and maintain healthy lifestyle habits. Insulin, a hormone produced by the pancreas, is responsible for transporting glucose from the blood to the cells.
Gestational diabetes, depending on the situation, can only be treated with a healthy diet. “If necessary, gestational diabetes can be treated with insulin. For now, no oral medication is used. Although some studies release metformin, currently 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, follow-up and education are necessary. “You have to do a fingertip test or use continuous glucose measurement to make a decision, both to see the effect of food, the effect of the emotional part, blood sugar, the effect exercise, medication, insulin. Follow-up is very important.”
Krakauer explains that when diabetes is well compensated, with parameters close to normal, the risk 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 first cause of blindness in the world – in the heart and in peripheral arterial disease.
There may also be neurological problems, warns the doctor. “We call this diabetic neuropathy, which greatly increases the risk of loss of sensation in the feet. These people can have infections and undergo amputations, as well as kidney disease due to diabetes which leads to hemodialysis or a kidney transplant. And several other problems, such as fat in the liver, lung disease, worse response to infections, like, for example, covid-19.
The doctor explains that people with diabetes react badly to the disease because high blood sugar lowers immunity to infections. “When the disease is controlled and well compensated for a long time, this does not happen.”
The formula healthy diet 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, plenty of exercise, drinking plenty of water, getting enough sleep, and reducing stress when possible.”
Krakauer points out that ultra-processed foods also accelerate the incidence of the disease. “Ultra-processed foods are foods high in white flour, sugars and fats that 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 and have 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 reduce the risk of contracting the disease, says the doctor. “Do not smoke under any circumstances, reduce alcoholic beverages, for those who drink in excess, lead a healthy life, as much as possible. Sometimes drugs that can reduce the risk of diabetes by about 30% may be indicated.