Diabetes is a chronic condition, If one doesn’t intervene, glycaemia, which is to say, the concentration of sugar in the blood, tends to increase.
In type 1 diabetes, the person rapidly loses his/her capacity of producing insulin, a hormone necessary for life. He/she therefore must take in insulin from the outside every day, by way of several injections or in a continuous manner via a micro-infuser.
In type 2 diabetes, the capacity to produce insulin is not lost immediately. In a first stage, the organism reduces its capacity to use the insulin produced (insulino-resistance). The pancreas, which at first compensates this phenomenon by increasing the production of insulin, gradually loses its capacity for production.
The therapy of type 2 diabetes thus aims at:
reducing the insulino-resistance
slowing down the evolution of diabetes
These aims are first of all reached by improving one’s habits of life: reducing sedentariness, increasing physical exercise, reducing the quantity of calories in general and of animal fats in particular. To these, a pharmaceutical therapy can be added, carried out through daily intake for long periods or for life, of specific categories of pharmaceuticals.
The 'mark’ of diabetes is hyper-glycaemia, that is to say, an excessive concentration of sugars (glucose) in the blood. The therapy of all forms of diabetes aims at bringing back the glycemic values the closest possible to normal ones, at all times of the day. The person with diabetes can be put in the conditions of measuring his own glycaemia at any given moment with instruments that are easy to use.
Preventing type 2 diabetes is possible and, aiming for this target, the risk is drastically reduced of developing hypertension, hyper-cholesterolemia (high cholesterol level in the bloodstream), hyper-triglyceridemia (high triglyceride level in the bloodstream), and other factors of risk. How does one do so? By acting on one’s habits. It’s not about changing your life from one day to the next, but about rediscovering certain pleasures, and about pursuing other ones with less regularity.
One pleasure to rediscover is certainly that of life in open air and physical movement. The other pillar in diabetes prevention is a correct nutrition. Here, too, the main road to pursue does not consist in making particular renounces or sacrifices. It is necessary to gradually rediscover forgotten pleasures: a return to genuine foods, to homemade products, without resorting to packaged foods and of unknown origin; eating all types of foods in the right proportions: meat, fish, cheese, pasta, bread, vegetables, fruits.
The person with diabetes helped by his/her family members is the protagonist of every possible therapeutic intervention in all forms of diabetes. Treatment of diabetes cannot be entrusted to pharmaceuticals alone. The winning choices are those made every day, every hour by the person with diabetes.
Alone in his/her own day-by-day, the person with diabetes can, though, rely on many allies. Italy has long been at the forefront in the realm of diabetes therapy, thanks to the structure that it has made available to counter it, to the theoretical elaboration of the Scientific Associations that operate in the field, and to the ongoing endeavor of stimulation and proposition that the Associations carry on among persons with diabetes.
The diabetologic Team
The concept of a diabetologic Team is the response that Diabetes care has given to the health requisite of the person with diabetes. The team centers on the person with diabetes, who is its protagonist. This person displays different needs, to which different figures respond who, however, work as a team: the specialist Doctor (Diabetes specialist physician or Diabetes specialist Pediatrician), the general Medicine Doctor or family Pediatrician, the professional nurse. The team broadens if necessary, involving other specialized figures (Dietician, Cardiologist, Neurologist, Nephrologist…), and locally on the territory, concerning the Medical Home Care, the world of Volunteer workers, and Pharmacies.
The diagnostic paths
These figures move in accordance to shared and preset patterns. Over the course of his/her lifetime, the person with diabetes moves along a 'path' that includes both periodical evaluation ‘stages,’ and interventions requested by the person with diabetes. To coordinate these paths means to ensure the best assistance to the person, reducing at the same time the inappropriate recourses, the ‘duplicates’ or the ‘leaks’ that could occur if the route were random or ill-managed, or if it were to unfold among uncoordinated figures.
Self monitoring of blood glucose
Diabetes is very different from other conditions and chronic pathologies, due to several reasons:
it is symptom-less (especially in the case of type 2 diabetes)
it increases the risk of strokes or heart-attacks, but in the majority of cases, it does not have significant direct consequences
its therapy requires a substantial change of one’s habits, in particular, of those (sedentariness and excessive or unhealthy nutrition) which we are used to being valued in a positive manner
its therapy requires continuous attention and constant reflection on the relapses that almost every gesture of ours can have on glycaemia
A positive note is that diabetes is one of the few conditions the variable of which, glycaemia, can be measured easily and at any moment with specific instruments.
The therapy of diabetes requires, put in one word, ‘self-control,’ which only the person with diabetes (helped if need be by his/her family members) can truly put into practice day after day, by making the choices that are best for his/her health. In the therapy of diabetes, the person is the absolute protagonist.
The doctor, or better, the diabetologic team made up of the specialist, the professional nurses, the general medicine doctor, or the base pediatrician, as also the specific professional figures such as the dietician, the psychologist, and other specialists, play an important role in diagnosing, in defining, and in fine-tuning the pharmaceutical therapy, in educating the patient, in evaluating the results and the opportunities for improvement and, above all, in creating and maintaining motivation at a high level. But in the end, the role is that of a good coach, who can do much, but who during the game sits on the bench. The patient is the one who goes out on the field.