Tuesday, February 7, 2023

Diagnostic testing for prediabetes: key given the high prevalence in Puerto Rico

It is important for the expert to know how to recognize it and change habits to deal with it.

Patient commitment is key, cautions Dr. Monica Santiago. Photo: Journal of Medicine and Public Health.

According to organizations like WHO and PAHO, diabetes It is considered the third cause of death in the world. For its part, data from the Centers for Disease Control and Prevention ensures that more than 37 million people in the United States have diabetesAnd worst of all, about 95% of them don’t know they have it. diabetes Type 2, so they don’t get professional help or treatment.

We chatted our show: With health expert, Dr. Monica Santiago, an endocrinologist by profession, she explained to us about prediabetes and the importance behind it diabetesloss the treatment And the specific differences of this pathology growing in Puerto Rico.

symptoms of diabetes

To begin with, it is important to clarify what is so special about diabetes Type 1 and Type 2. In earlier we discussed that the patient needs insulin because there is a malfunction in the pancreas. Type 2 is acquired over the years and is caused by poor diet, but unlike the previous one, the pancreas continues to function, except there is resistance to insulin and the body stores or produces high levels of sugar. Besides, there is also diabetes Pregnancy, which sometimes occurs in pregnant women.

Prediabetes occurs when the body has problems with insulin, which is a hormone that helps glucose enter cells and turn them into energy, which will then be consumed. From here, two problems arise: insulin resistance or that the body cannot produce it.

In turn, it may complications Will be more affected: cardiovascular system, and nervous system (cerebrovascular accidents). The said effects are kidney disease, retinopathy (eye damage which may include loss of vision) and it is also possible that the patient may have to have one of his limbs amputated.

How is prediabetes diagnosed?

With that in mind, it’s as its name indicates: prediabetes usually occurs before diabetes, To diagnose it, a series of tests are done that determine diabetes Like, looking at the symptoms of the patient. Dr. Santiago explains that there are two basic steps to diagnose whether there is a presence diabetes And in what degree is it.

  • Fasting plasma glucose (FPG) test: which measures blood sugar at a point in time. Test results are given in mg/dL (milligrams per deciliter): a normal level is 99 or less, prediabetes is 100 to 125, diabetes Type 2 is 126 and up.

  • A1c test: which measures your average blood sugar level over the past 3 months. The results are given as a percentage; The higher the percentage, the higher your blood sugar level (normal is less than 5.7%, prediabetes is between 5.7 and 6.4%, diabetes Type 2 is above 6.5%).

Inquiry: test and opinion

To start, the patient undergoes a fasting test, which means they have not eaten for at least an eight-hour period: “The labs are done randomly and in the event that they have a fasting sugar of 102 are found, or it’s glycosylated at 5.9, and that sugar is between 100 and 125, that’s prediabetes,” Santiago explains.

However, when the doctor refers to the glycated hemoglobin score, she clarifies that it depends on a high and low range: “It is also prediabetes when defined as having a glycated hemoglobin between 5.7 and 6.5; because there is more than 6. 6 is already diagnosed diabetesand fasting sugar over 126 is already diagnosed diabetes“, Understand.

In addition to these labs, an oral glucose tolerance test (OGTT) is performed, where the patient is given 75 grams of glucose and tested two hours later: “Between 140 and 190 is considered prediabetes, if it is is more than 200, its diagnosis diabetes“, says the endocrinologist.

As can be seen, the distinction made by diagnosis is barely a point between prediabetes and diabetes. diabetesBased on labs and exam enrollment. However, it should be emphasized that the patient may present symptoms According to various experts, even before prediabetes.

Are people who enter this stage of prediabetes going to develop diabetes?

This is a question that many patients often ask themselves when specialists assure them that they are presenting with prediabetes. Faced with this scenario, Dr. Santiago explains that it’s not necessary: ​​”I always tell patients that prediabetes is the little yellow light at the traffic light, we can stay there, go to the green light, which is no longer diabetesor we can go to that little red light that’s already done diabetes“, experts say.

Throughout his experience, Dr. Santiago comments that he has seen all kinds of cases in which patients’ commitment to manage their condition comes to the fore: “I have patients who are very compliant and have had prediabetes for many years. persist; but I have others who continue to consume what they should not eat and the lifestyle is not the best, so they become diabetic already,” he says.

It is important to understand that in the early stages, prediabetes can be treated and the risks of its progression can be reduced. diabetes, Changes in eating habits, physical activities are necessary for prevention.

Signs and symptoms

symptoms are important to identify prediabetes or diabetes, But there are patients who are completely unaware of this. Keep in mind that according to the World Health Organization, one in three people has prediabetes, and it is more common in: people who are overweight, over the age of 45, those with a family history, sedentary, those with high blood pressure and high cholesterol problems. with, in the case of certain metabolic syndrome and women, if you have diabetes Gestational or polycystic ovary syndrome.

“Many studies say that already when the patient is prediabetic, he may present symptoms of complications from diabetes, there are complications Macrovascular and Microvascular. In fact, when I was on the medical science campus, I did research on patients who came in with neuropathy and often they had a sugar tolerance test and were prediabetic; that is, the patient already presents complicationssays Santiago.

It is important that people understand this because care and keeping sugar levels stable so that they do not occur is important. complications,

Does a Prediabetic Patient Have a Place for Drug Treatment?

The endocrinologist confirms that this issue has its own dilemmas, there are two approaches regarding the treatment of prediabetic patients and some professionals treat patients at this stage, others do not. “Personally I treat them, and depending on: if the patient is obese, a smoker, or has other risk factors, if he has fasting (GPA) for example whether he is prediabetic , and two hours (PTOG) he develops prediabetes, I treat it,” he says.

in the meantime the treatmentThese vary according to each patient and the tables of indications and symptoms He shows Similarly, blood sugar levels: “According to the latest guidelines issued by the American Society of Endocrinologists, an algorithm has been established and treatment will depend; because the patient tells me ‘But doc, am I already going to start insulin if I have just been diagnosed with the condition?’, and not all the time, it depends on the glycosity values ​​that the patient has. Glycosity of 7% is not the same, versus over 10%”, explain .

Endocrinologists conclude that the patient’s commitment and awareness of the fact that it cannot be neglected and that prediabetes is diagnosed is important, it deserves attention. It is necessary for the patient to make changes in his lifestyle, in his diet and thus he will be able to prevent complications,

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Nation World News Desk
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