Warn that low glucose levels are "as dangerous" as hyperglycemia
Jano.es · July 20, 2012 14:14

The Hot Challenges in Diabetes Seminar, organized by the Boehringuer-Lilly Alliance, has addressed the main challenges of the disease, such as individualized therapy in the treatment of type 2 diabetes (DM2);Hypoglycemia as a cardiovascular risk factor or incredine therapy and its role in cardiovascular disease.

Dr. Pedro de Pablos, of the Department of Endocrinology and Diabetes of the Dr. Negrín Hospital (Las Palmas de Gran Canaria), has defended the need to individualize the treatment and adapt the tools available to the lifestyle and the particularities of each patient.A need that, according to Dr. de Pablos, has already been revealed in 1993, in the clinical guides for the management of the disease.

"Type 2 diabetes," added this specialist, "requires the active participation of the patient.He is the protagonist of the film, there must be a degree of commitment on his part and doctors have to facilitate adherence to treatment. ”Personalization, however, does not mean that the doctor does not play an important role in treatment.In Dr. De Pablos, "individualization does not mean therapeutic inertia, all people with diabetes should receive education about their illness, periodic medical assistance and the combination of adequate medicines in the precise time."

In the debate after the presentation, an individualized treatment model has been claimed."It cannot be pretended that the levels of blood glucose, glycosylated hemoglobin or body weight improve if it has a medical visit only every 6 months," said one of the attendees.

Hypoglycemia as a cardiovascular risk factor

Professor Antonio Ceriello, from the August Pi I Sunyer Medical Research Institute of Barcelona (IDIBAPS), has focused, on the other hand, in hypoglycemia as an independent factor of cardiovascular risk, a research trend that relates the decreases in blood glucose with blood cells witha greater probability of suffering atherosclerosis."In my student, I was taught the negative effects of hyperglycemia, but now I know that low glucose levels are also dangerous," says Ceriello.

In this sense, Dr. Francisco Javier Ampudia-Blasco, endocrinologist and deputy doctor of the University Clinical Hospital of Valencia, said that “in a vulnerable heart, such as a patient with DM2, hypoglycemia can be really dangerous.If we add to this that some hypoglycemia are silent, that is, the patient does not recognize the symptoms, we are facing a situation of enormous risk. ”

Prof. Ceriello has also related hypoglycemia with the "death syndrome in bed" that usually occurs in young adults with type 1 diabetes, and has warned that it is important to pay attention to the way the patient recovers from the decreases from the decreasesof glucose."If you go from hypoglycemia to hyperglycemia, the cardiovascular damage that occurs is more serious than if it is followed by a Normaglycemia."

Origin Study

Continuing with cardiovascular disease, another of the main points of interest of the seminar has been the effect of incredine therapy on the function of the heart and blood vessels.In this regard, Dr. Ampudia-Blasco stressed that “there are more and more data that supports that this type of therapies can have an important role in the decrease in endothelial function.It has also been seen how the contractility and perfusion of the blood vessels improve at the heart level improve. ”

Finally, Dr. Juan José Gorgojo, of the Endocrinology and Nutrition Unit of the Alcorcón Foundation University(Madrid), has reviewed the main current issues presented at the Congress of the American Association of Diabetes (ADA).Among them, the study originated that, in the words of Dr. Ampudia-Blasco, “it has been positive because it has shown that the insulin Glargina does not increase the incidence of cancers although, on the other hand, the results show that the early use of this insulinIt is not better than standard treatment in the prevention of cardiovascular events. ”