Type 2 diabetes, a disease ‘from head to foot’

Type 2 diabetes is a disease that suffers more than 350 million people worldwide and that is fundamentally characterized by insufficient production or inappropriate use of insulin, that is, the hormone responsible for the cells to capture the glucose of the glucose ofBlood to produce energy.

The result is an excess of glucose in the circulatory torrent, which ends up causing damage to multiple body organisms.In fact, and as the specialists participating in the XXVII National Congress of the Spanish Society of Diabetes (SED) held last week in Bilbao (Vizcaya), diabetes is the paradigm of systemic diseases - that affects, which affectsOrgans of the whole body - and, therefore, requires a multidisciplinary and integral approach with the participation of professionals of all specialties - among others, cardiologists, nephrologists, ophthalmologists, neurologists and dentists.

As Edelmiro Menéndez, president of the Spanish Diabetes Society (SED) explains, “it is well known that diabetes is correlated with an increase in the risk of developing cardiovascular and atherosclerotic disease, which accelerates its evolution, which worsens its prognosis and multiplyThe early mortality rate of cardiovascular origin.And also, the usual worsening of renal function in the person with diabetes is also assumed and the possible loss of vision is accepted as a regular consequence of this disease ».

But diabetes complications do not end here.And it is that the negative effects of the disease occur ‘from head to foot’.Or what is the same, throughout the organism.This is the case, among other consequences, of an increase in the risk of Alzheimer's disease, of the amputations of the lower extremities or, even, of periodontitis - the conspful ‘gum disease’ or ‘piorrea’.

throughout the organism

In the words of Edelmiro Menéndez, «even today there is a great social ignorance on the effects that diabetes have on bone fragility, in the risk of the appearance of neurodegenerative diseases, in the development or aggravation of the health of gums orin the development of foot ulcers that end in amputations ».

Thus, the prevalence of diabetes is much higher in patients with depression - until two times greater - or with schizophrenia - four times higher.And as regards dementia, insulin deficit and lower hormone sensitivity at the brain level can contribute to the pathophysiological process of Alzheimer's disease.And since neurons have greater difficulty to use glucose, their ability to produce energy is remarkably diminished and, consequently, their survival is lower.

More;Diabetes is also associated with the accumulation of Tau protein in neurons, one of the characteristic damage of Alzheimer's.The result is that patients with diabetes are twice as risk of developing this type of dementia.So much so that, as Félix Bermejo-Paraja, neurologist at the University Hospital 12 of Madrid, "refers to" preventing diabetes decreases the incidence of neurodegenerative diseases, such as Alzheimer's Alzheimer's. "

and ‘at his feet’

Diabetes corresponds to the first cause of lower limb amputations in the whole world.The reason, the name 'diabetic foot', that is, the infection, ulceration or destruction of the deep tissues that, related to neurological alterations and peripheral vascular disease in the lower extremities, can suffer patients in which diabetes is notcorrectly treated.

The diabetic foot and associated amputations cause in five more yearsdeaths that colon or mamapillary cancer sail
However, as Pilar Vela Orus points out, vascular surgeon of the Cruces University Hospital in Bilbao, “it is surprising that enough attention is not paid and, even, the patient does not see it as a threat.All this despite the fact that the diabetic foot and the amputations that it usually entails causes in five years more deaths than colon cancer or breast cancer ».

Therefore, and in addition to better training and coordination between health professionals, patients awareness of this complication should be required.And in this context, it is possible to highlight three simple measures with which the impact of the diabetic foot would be significantly reduced.As Pilar Vela Orus reports, «you have to be careful in the use of antibiotics to deal with diabetic feet, since there is a certain over -pass.It is also essential that the wound be cleaned with extreme care and rigor, examining the lesion daily, before using any dressing to cover the ulcer of the foot.And finally, a vascular exploration must be performed, that is, find if the patient has pulses or not ».

And this risk of diabetic foot is similar for all patients?No;There is a type of people with diabetes that have an increased risk of developing the disease, especially “elderly patients - the specialist indicates - and with many comorbidities: those known as‘ fragile ’patients.In these cases, the diabetic foot is only the tip of the iceberg, a disorder that hides a much broader and more complex pathology, associated with high morbidity and mortality.

oral health

But as already indicated, diabetes exerts a negative effect on all areas of the body.Thus it is understood that, for example, it also threatens the mouth and that its control is committed by poor oral health and, particularly, by poor periodontal health.Not surprisingly, not only the bad control of diabetes involves a triplicate risk of suffering periodontitis, but the ‘gum disease’ can initiate or increase insulin resistance in a similar way to how obesity does.

Taking care of the gums we will take better care of diabetesdavid herrera
In fact, gum problems can help detect the presence of diabetes.So it is that, as David Herrera, president of the Spanish Periodontics Society (SEPA),that we are helping to prevent its appearance.And also, that the dental clinic is an ideal place to identify the risk of non -known diabetes, as well as to perform all preventive tasks, early diagnosis and treatment required by a person with diabetes ».

In short, diabetes approach requires better collaboration between dentists and diabetologists.As Edelmiro Menéndez concludes «Dentists could play an important role in the detection of diabetes in those not diagnosed.And in addition, they could also help detect people with diabetes with a bad control manifested in gingival complications.On the other hand, diabetologists must pay attention to oral alterations as a manifestation of non -controlled hyperglycemia to send these patients to dentists and receive adequate care ».